Story here: Can a foot cream really do battle with HIV? - CNET
Trials are only just starting, but it sounds as if this drug may actually do it. It addresses the one huge problem of HIV eradication - the “hiding” infected cells which keep going as if they were healthy.
Far far far too soon to say. It works in a culture - in a petrie dish or test tube in a lab. Unfortunately, that’s not where most HIV+ people keep their viruses.
Also, I’m not sure how a drug approved only for topical (i.e. skin) treatment is going to eradicate HIV infection throughout the body.
Lots of work ahead.
I’m always hopeful. It will remain to be seen what initial trials show.
Makes you wonder how they figure this out. Trial and error? Are they just trying literally everything? Or did somebody with a foot fungus accidentally get some of their Ciclopirox in their HIV culture?
I wonder this about other stuff too. Like that pill that grows your eyelashes. Were they specifically trying to do that, or were they trying to, like, cure cancer and it turns out this shit just happens to make your eyelashes grow?
Relevant Simpsons quote:
If I remember, Rogaine (minoxidil) was originally a blood pressure medication.
“HIV-ON! Apply directly to your T cells!”
I don’t know about this trial in particular, but there are lots of people out there who spend their days working their way through huge libraries of known chemicals, testing them for effects on their favorite disease or other biological process. It’s a pretty standard technique if you have lots of money.
Many drugs have later been found to have positive benefits for other diseases/ailments after put into use for the original purpose.
Take the lowly aspirin - good for pain and helping with flu symptoms, etc.
Now it is pretty much the go-to drug of choice if someone is having a heart attack, and taking one a day is often prescribed by doctors. (I have taken one a day for over 20 years!) Since then, it has been shown it might not only prevent heart attacks, but also might be helpful in stopping colon cancer and several other diseases.
Sure, there are other drugs that are later found to have very, very negative side effects.
The point is, I would not be surprised to find a relatively common drug might have some strong affect on a variety of illness (including HIV).
I think they should kidnap Magic Johnson and make him tell them everything. Whatever the cure is, he has it. The guy looks great for having HIV in the 90’s. He’s probably healthier than me!
It’s often from side effects reporting. The eyelash-growing medicine is actually a liquid, applied with a little brush to your lash lines. It’s the same stuff as an eyedrop used to keep eye pressure (glaucoma) under control, called bimatoprost (brand name Lumigan). Some patients prescribed the eyedrop reported fabulous eyelash growth while using it, so they tested it as something that could be applied directly to the lash lines. Its intended effect of lowering eye pressure is why they tell you to not get it into your eyes.
Another accident of side effect reporting: Viagra was intended to be a drug for a particular kind of high blood pressure, to relax the walls of arteries.
Possibly, someone found a patient whose viral load only dropped while on this medication and had a light bulb go off. Either that or they just examined the mechanism of action for various medications and thought this one was worth a try.
I skimmed the original paper, available here. From my quick read, the reasoning goes:
[ol]
[li]The lab studies basic science mechanisms of how protein translation machinery in a cell is hijacked by viruses.[/li][li]Previous work showed that HIV uses a protein called eIF5a, which is involved in protein translation in the host and a lot of related RNA biology.[/li][li]eIF5a requires certain specific modifications to become active.[/li][li]The enzymes that modify eIF5a are inhibited by ciclopirox.[/li][/ol]
Basically the whole journey starts with pouring through the literature for mechanistic clues – their intro alone references 55 papers covering decades of work from dozens of labs. Then there’s lots of failed experiments, very little sleep on the part of a lot of grad students, and eventually, with a lot of dedication and luck, finding a hypothesis that turns out to be correct.
My gut reaction is that ciclopirox might have substantial side effects if you dose it intravenously rather than topically. It is, after all, gumming up a fundamental piece of biochemistry. But maybe it could be added to the standard antiviral cocktails in a way that improves overall efficacy.
It’s a long way from “we’ve got a mechanism that works in a dish” to treating patients. And “long way” can be quantified in years, hundreds of millions of dollars, and 99% failure rates.