Miami Herald - Saturday, October 6, 1984
Abby Cohn

Researchers cautioned that it was too early to tell whether the medication, called suramin, can be used to effectively treat victims of the deadly Acquired Immune Deficiency Syndrome.

But the results were encouraging enough to spur National Cancer Institute scientists in Bethesda, Md., to start testing the drug on two AIDS patients.

"People should have a reasonable idea of whether this drug seems promising or not in roughly a year," said Dr. Samuel Broder, associate director of the cancer institute's Clinical Oncology Program.

At San Francisco General Hospital, Dr. Paul Volberding said he would explore the possibility of testing suramin in a few San Francisco Bay Area patients in the next month or two.

"We'd want to see more data in the laboratory," said Volberding, whose clinic has treated 750 AIDS victims.

The government tests showed that suramin prevented human T-cell leukemia virus III -- a recently discovered virus believed to cause AIDS -- from replicating and attacking white blood cells, called helper T-cells.

T-cells are the body's weapons against invading infections. In AIDS patients, these cells are destroyed. Victims' immune systems shut down, and they become prey to a variety of tumors and other diseases that eventually prove fatal.

Writing in Friday's edition of the journal Science, Broder and a team of NCI researchers say that suramin had a "strikingly protective effect" on T-cells at concentrations that might be used safely in humans.

But a cautious Broder said that one of his chief concerns is that suramin could trigger dangerous side-effects. The drug has been known to damage kidneys and lead to shock and even coma.

He also noted that test-tube results often aren't duplicated in humans. And he cautioned AIDS patients against building false hopes about the discovery.

"Please don't call it a breakthrough," he said in a telephone interview. "It's a test-tube kind of observation. We have no idea whether it will have a clinical application or not."

Currently, there is no treatment for AIDS. Since 1981, 6,251 Americans -- mostly homosexuals, drug abusers and Haitian immigrants -- have reported contracting the disease, and 2,950 have died from it.

Broder said human tests will determine whether suramin reverses disease in AIDS patients and how much of the medication can be prescribed safely. Though starting with just two patients, he plans eventually to recruit a "handful."

Doctors are selecting patients with recently diagnosed cases of AIDS. They think the immune systems of victims with advanced cases of the disease are far too damaged to save.

When asked how scientists decided to test suramin's effects on AIDS, Broder responded, "It's called serendipity."

Suramin has been used for decades to treat sleeping sickness, a parasitic infection of the brain that causes lethargy and death. It also is prescribed for another parasitic disease called river blindness.

Five years ago, Broder said, a researcher found that suramin inhibited a unique group of viruses, called retroviruses, from growing.

Retroviruses reproduce in a flip-side pattern of the way normal cells grow: they use a genetic code made of a protein called ribonucleic acid (RNA) instead of the deoxyribonucleic acid (DNA) used by most cells.

AIDS is believed to be caused by such a retrovirus, HTLV-3. But because the disease was largely unknown in 1979, the report about suramin "languished in obscurity," Broder said.

Last April's discovery of HTLV-3 gave researchers a foothold to start testing possible drug treatments.

"Now that the virus that causes AIDS is in hand, we can look at drugs that inhibit it," Broder said.

But, he added, "it doesn't mean that the first one we found will work in a human being."

Local physicians responded to the finding with equal amounts of caution.

"A lot of things work well in the test tube, but when they have been tried in human tests, they don't work," said Dr. Dennis McShane, president of Bay Area Physicians for Human Rights, a group interested in gay and lesbian health issues.

For instance, two drugs, gamma interferon and interleukin-2, looked like promising candidates for treating AIDS patients based on laboratory tests. So far, both have proved disappointing in human experiments.

Volberding, director of San Francisco General's AIDS clinic, said suramin could follow a similar path.

AIDS patients, he said, "should realize these are preliminary reports but they do show research is going on at a rapid pace."
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