Is the use of nano silver a legitimate application of on unlicensed treatment, or cynical exploitation of a mounting humanitarian crisis? Having studied and written about the biological impacts of nano silver for some years now, I must confess I was surprised by the Nigerian decision.
Silver as an antimicrobial
Silver has been used as an antimicrobial agent for thousands of years – the Romans used to use silverware to reduce food and drink-borne infection. More recently, nanoparticles of silver have been used in everything from food containers to socks in an attempt to imbue them with microbe-killing properties.
When used in the right way, the material certainly does exhibit antimicrobial properties. But there’s a massive jump from odor-resistant socks to curing Ebola patients.
An Open Letter on Ebola Treatment to Nigeria’s President
“There is, in fact, a well-established, non-toxic anti-microbial, without any known side effects, available at remarkably low cost which – • Requires no refrigeration • Is self-sterilizing. • Is readily available • Has a very long shelf life • Is not subject to degradation under temperature and humidity extremes. That nutrient substance is Nano Silver.”
Colloidal nano silver – nanometer-sized silver particles suspended in water – has been used by people to self-medicate innumerable conditions for around a century now. Although there is no clear evidence that it has beneficial health effect at low concentrations, it can cause the disease argyria at high concentrations.
Nano silver has been on the radar of researchers and regulators for over a decade now as a substance that may be more toxic than originally thought. As a result, there has been an intense global research effort into its human and ecological toxicity in recent years. Studies have shown that nanoscale silver particles can be harmful if released into the environment in large quantities, and may possibly cause harm in unexpected ways in the human body under specific circumstances. Yet there’s been little published on the use of nano silver as a treatment for infectious diseases.
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US Government Research on Nano Silver and Ebola
The source of Dr. Laibow’s optimism appears to be a 2009 presentation of research carried out by Janice Speshock and Saber Hussain at the US Air Force National Laboratory. A Powerpoint of this presentation has been declassified, and is currently doing the rounds on the internet.
The presentation reports on research into the effectiveness of silver nanoparticles in rendering hemorrhagic fever viruses like Ebola ineffective. The study was carried out using cell cultures, and a number of viruses and virus-like particles. It seemed to indicate that when the silver nanoparticles penetrated into cells along with the virus in sufficient quantities, they were effective at preventing the virus from being active once the cell had been exposed.
While it is impossible to interpret research findings from Powerpoint slides alone, the data do suggest that there are some unusual interactions between silver nanoparticles and Ebola-like viruses, although there are no data indicating whether similar interactions are also seen with other nanoparticles. More importantly, they do not indicate whether these same interactions would occur in an infected patient. They also do not indicate the quantity of silver nanoparticles someone wold need to take to render Ebola ineffective, or whether the necessary dose to have an effect would cause medical complications.
This presentation builds on previously published research by Speshock and Hussain that looked at Monkey Pox virus plaque formation inhibition by nano silver. Using cell cultures, the researchers found that nano silver and and silver ions were effective at reducing Monkey Pox Virus-induced plaques. However, they also concluded
“The present study demonstrates the feasibility of implementing the use, and characterizing the efficacy, of silver-based nanoparticles against [Monkey Pox Virus] infection in vitro. However, for nanoparticles to be used in therapeutic or prophylactic treatment regimens, it is critical to understand the in vivo toxicity and potential for long-term sequelae associated with exposure to these compounds.”
In 2010 Speshock and Hussain published research on the interaction of silver nanoparticles with Tacaribe virus. The research – published in the Journal of Nanobiotechnology – indicated that in cell cultures, the presence of silver nanoparticles increased the cell uptake of the virus, but also suppressed its activity once in cells. They concluded
“Due to the known toxicity of Ag- NPs [silver nanoparticles] in many human cell lines, and the short time limit of efficacy following infection, the Ag-NPs would likely make a more effective decontamination tool as opposed to an in vivo therapeutic agent. However, if the Ag-NPs do indeed facilitate the uptake of arenaviruses into the cell and inactivate the virus prior to cell entry, further studies should be performed to determine if Ag- NPs can prove to be an effective vaccine adjuvant.”
Speculative Studies and Clinical Use
These studies provide valuable insights into silve nanoparticle-virus interactions, and indicate that, with significantly more research, silver nanoparticles may have some role to play in preventing or managing infections. But the research does not support clinical applications at this stage. Even if there was proof that silver nanoparticles are effective in humans in suppressing viral activity (and there is not), there are critical questions over dose and delivery.
To be effective, there would need to be systemic uptake of nano silver within the body at doses that are sufficient to inhibit the Ebola virus, but low enough to prevent unacceptable harm. Currently, scientists have no ideas what an appropriate dose is.
Even if they did, it is not clear how the silver nanoparticles would be delivered. Taking the material orally – as would be expected of colloidal silver dietary supplements – is unlikely to be effective as silver nanoparticles dissolve in gastric juices. Nanoparticle uptake from the gut into the body is also very poor. Inhaling silver nanoparticles is likewise unlikely to lead to significant nano-silver distribution through the body. Which leaves direct injection of silver nanoparticles into the bloodstream – not an option to be undertaken lightly with an unproven and untested nanomaterial.
Given the commercial interests involved here and the paucity of evidence for nano-silver being in any way an appropriate treatment for Ebola, the wisdom of treating patients in Nigeria with the material has to be questioned on both medical and ethical grounds. There may be future treatments for infectious diseases that use nanoscale silver and other engineered nanomaterials. But this does not seem the time to be cynically jumping on the Ebola bandwagon to promote products that may offer false hope, but little else.
Update August 16, 7:05 AM EST: It seems that the Lagos State Government has resolved not to use nano silver in the treatment of Ebola, but rather resolved to use ZMAPP. Source: The Daily Post