[FRIAM] ivermectin, nope

[David Eric Smith]

> On Aug 16, 2021, at 3:08 AM, Steve Smith <sasmyth at swcp.com> wrote:
> I understand Hydroxychloroquine to have been used widely in developing (equatorial) countries as an antiviral (in particular Malaria) \
> 
Not antiviral, Steve.  Plasmodium isn’t even a bacterium; it is a protozoan.  One of us, gooble gobble.  

Don’t mean to be a pedant.  But to the extent that we think things work for reasons, major domain distinctions are likely affect what we think deserves time to follow up.

I have a colleague who gave a talk at SFI once (on metastasis in cancers), in which as a supporting tangent to an argument about difficulty, he commented that he had had fungal toenail infection since teenage, when as an athlete he had developed it from locker room showers in England, and in the subsequent decades been unable to get rid of it.  His next sentence: “And that’s a different _kingdom_!”  But the least different from us you can get without going to the animals, and that was enough to drastically lower the interventions available for it.  His point: imagine how much harder it is to get rid of a cancer cell line that is your own personal genome, mostly.  (Be your own, personal, genome.)

Also, on Nick’s question about parasites.  I haven’t read the studies showing antiviral activity of ivermectin in vitro (I am not as good a person as REC, by a lot, but we knew that), but from what I have read, I gather that they drowned the virus in ivermectin, presumably in whatever cell culture they were growing it in.  But I would be amazed if any of those studies deliberately included cell parasites in the medium, so that ivermectin’s knocking them out would affect the ability of some unrelated virus to replicate in cells that perhaps that parasite doesn’t even touch.

Again, of course, in the world where, as Masha Gessen says of the cynical society under autocracies, “Anything is possible and nothing is true”, the fact that ivermectin is claimed to be antiviral at drowning doses in vitro with no parasites, and then by coincidence the same drug is claimed to be antiviral at doses many orders of magnitude smaller in people in countries where you have a lot less ability to referee study methods if you don’t live there, but where there could be different parasites, makes this connection completely comme il faut  

We know that at some sufficiently strong concentration, ethanol, and I assume either vinegar or baking-soda solution, will also be antiviral against almost anything.  (Whether vinegar or baking soda will depend on whether capsule denaturation is acid-catalyzed or base-catalyzed, but probably it will be one or the other.)  But of course, we know why you can’t get to those concentrations in a live animal.  That just isn’t interesting, because there isn’t anything singular about it.  The obscure drugs are singular, particularly if they are “anti parasitical”, given the above comment about how delicate a matter it can be to clear something that is phylogenetically not so far from you.

Btw, the use of “parasite” in pharmacology again makes the hair on the back of my neck stand up.  What _kind_ of parasite?  Protists and predatory lenders?  Bacteria and fungi?  Tapeworms?  I feel like, for any of these drugs that do actually have some efficacy, there is probably a more specific word for what they cover that could be used, and would aid in guessing-games about their likely off-label scope.  When efficacy is real, and against classes of things that really don’t have much in common, that becomes even more interesting.  

Eric



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