Reply to “Statins may decrease the Fatality Rate of MERS Infection”

Totura, Allison L.; Baric, Ralph S.

Immunomodulatory drugs have great appeal as potential antiviral medications, due to the promise of broad-spectrum therapeutics that may be suitable against a number of different pathogens or maladies, depending on the downstream inflammatory gene expression profile. However, while there is a great need for treatment options for highly pathogenic coronaviruses that are already known to be safe in humans, we must temper our hope for these drugs against the potential of these immunomodulatory agents to cause more severe disease or increased transmission in MERS patients. Reliance on data from cell culture experiments is not likely to yield helpful assessments of drug efficacy against highly pathogenic coronaviruses, as ribavirin and interferon are both highly effective against coronavirus infection in vitro but not in human patients (5, 6) . The recent development of small-animal models of MERS-CoV infection offers a viable platform to test larger numbers of antiviral therapeutics and will be of critical importance in the development of medical countermeasure strategies against MERS or other emergent highly pathogenic coronaviruses (14, 15) . As we now know, the ongoing MERS-CoV outbreak in the Middle East has the potential to spread elsewhere, indicating that there is a critical need for basic research on highly pathogenic coronaviruses and that applied studies on potential therapeutic options could make significant contributions to global public health.