Sir,
Ebola viral disease is an important infection and present global health concern. This viral infection can result in severe hemorrhagic complication.Citation1 The main basic pathogenesis is proved to be due to surge of cytokine in acute illness.Citation1 The problem of vascular endothelium can be seen and this can lead to multiple organ failure.Citation2 Focusing on nephropathology, the acute renal failure is common. Renal replacement therapy is usually needed.Citation3 In additional to fluid balancing therapy, there are some new alternative therapeutic methods for Ebola viral disease. The use of statin for immunomodulation has been recently proposed.Citation4,Citation5 It is mentioned that additional statin therapy might decrease the risk for practitioners in aggressive vascular access for fluid balancing treatment for the cases with Ebola viral disease.Citation4,Citation5 However, it is still questionable whether statin can be useful for management of Ebola patients with renal problem. Based on the proposed concept,Citation4,Citation5 to control immunopathology might be useful. Baskerville et al. noted that the renal pathology in Ebola was mainly due to thrombotic event due to host immune response and the direct viral invasion was rarely observed.Citation2 Nevertheless, there are still some left concerns. First, whether the immunomodulation due to statin can be sufficient to counteract the immunopathogenesis at renal endothelia is a big question. Although the observation in Sierra Leone shows a dramatical improvement in patients, after receiving statin, it cannot imply that this is due to statin since there is no comparative group. In addition, the recent report showed that short-term statin use contributed nothing to endothelial support.Citation6 Conclusively, it seems that using statin is useless for management of renal problem in Ebola viral disease.
Viroj Wiwanitkit
Hainan Medical University, Haikou, China Faculty of Medicine, University of Niš, Niš, Serbia Joseph Ayo Babalola University, Ikeji-Arakeji, Nigeria Dr DY Patil Medical University, Pune, India Surin Rajabhat University, Surin, Thailand
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
References
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- Baskerville A, Fisher-Hoch SP, Neild GH, Dowsett AB. Ultrastructural pathology of experimental Ebola haemorrhagic fever virus infection. J Pathol. 1985;147:199–209.
- Faubel S, Franch H, Vijayan A, et al. Preparing for renal replacement therapy in patients with the Ebola virus disease. Blood Purif. 2014;38:276–285.
- Fedson DS, Rordam OM. Treating Ebola patients: A ‘bottom up’ approach using generic statins and angiotensin receptor blockers. Int J Infect Dis. 2015;36:80–84.
- Fedson DS, Jacobson JR, Rordam OM, Opal SM. Treating the host response to ebola virus disease with generic statins and angiotensin receptor blockers. MBio. 2015 23;6:e00716.
- Wouters CW, Wever KE, Bronckers I, et al. Short-term statin treatment does not prevent ischemia and reperfusion-induced endothelial dysfunction in humans. J Cardiovasc Pharmacol. 2012;59:22–28.