Editing Ribavirin (section)

=== Experimental uses ===
Experimental data indicate that ribavirin may have useful activity against [[canine distemper]] and [[Poxviridae|poxviruses]].<ref name=Elia2008>{{cite journal | vauthors = Elia G, Belloli C, Cirone F, Lucente MS, Caruso M, Martella V, Decaro N, Buonavoglia C, Ormas P | title = In vitro efficacy of ribavirin against canine distemper virus | journal = Antiviral Research | volume = 77 | issue = 2 | pages = 108–113 | date = February 2008 | pmid = 17949825 | doi = 10.1016/j.antiviral.2007.09.004 }}</ref><ref>{{cite journal | vauthors = Baker RO, Bray M, Huggins JW | title = Potential antiviral therapeutics for smallpox, monkeypox and other orthopoxvirus infections | journal = Antiviral Research | volume = 57 | issue = 1–2 | pages = 13–23 | date = January 2003 | pmid = 12615299 | pmc = 9533837 | doi = 10.1016/S0166-3542(02)00196-1 }}</ref> Ribavirin has also been used as a treatment for [[herpes simplex virus]]. One small study found that ribavirin treatment reduced the severity of herpes outbreaks and promoted recovery, as compared with placebo treatment.<ref>{{cite journal | vauthors = Bierman SM, Kirkpatrick W, Fernandez H | title = Clinical efficacy of ribavirin in the treatment of genital herpes simplex virus infection | journal = Chemotherapy | volume = 27 | issue = 2 | pages = 139–145 | year = 1981 | pmid = 7009087 | doi = 10.1159/000237969 }}</ref> Another study found that ribavirin potentiated the antiviral effect of [[acyclovir]].<ref>{{cite journal | vauthors = Pancheva SN | title = Potentiating effect of ribavirin on the anti-herpes activity of acyclovir | journal = Antiviral Research | volume = 16 | issue = 2 | pages = 151–161 | date = September 1991 | pmid = 1665959 | doi = 10.1016/0166-3542(91)90021-I }}</ref>

Some interest has been seen in its possible use as a treatment for cancers with elevated eukaryotic translation initiation factor eIF4E, especially [[acute myeloid leukemia]] (AML) as well as in head and neck cancers.<ref>{{cite journal | vauthors = Kast RE | title = Ribavirin in cancer immunotherapies: controlling nitric oxide helps generate cytotoxic lymphocyte | journal = Cancer Biology & Therapy | volume = 1 | issue = 6 | pages = 626–630 | date = November–December 2002 | pmid = 12642684 | doi = 10.4161/cbt.310 | s2cid = 24010404 | doi-access = free }}</ref><ref name="Ribavirin as an anti-cancer therapy">{{cite journal | vauthors = Borden KL, Culjkovic-Kraljacic B | title = Ribavirin as an anti-cancer therapy: acute myeloid leukemia and beyond? | journal = Leukemia & Lymphoma | volume = 51 | issue = 10 | pages = 1805–1815 | date = October 2010 | pmid = 20629523 | pmc = 2950216 | doi = 10.3109/10428194.2010.496506 }}</ref><ref name="Phase I study of induction chemothe">{{cite journal | vauthors = Dunn LA, Fury MG, Sherman EJ, Ho AA, Katabi N, Haque SS, Pfister DG | title = Phase I study of induction chemotherapy with afatinib, ribavirin, and weekly carboplatin and paclitaxel for stage IVA/IVB human papillomavirus-associated oropharyngeal squamous cell cancer | journal = Head & Neck | volume = 40 | issue = 2 | pages = 233–241 | date = February 2018 | pmid = 28963790 | pmc = 6760238 | doi = 10.1002/hed.24938 }}</ref><ref name="Pharmacodynamic and therapeutic pil">{{cite journal | vauthors = Burman B, Drutman SB, Fury MG, Wong RJ, Katabi N, Ho AL, Pfister DG | title = Pharmacodynamic and therapeutic pilot studies of single-agent ribavirin in patients with human papillomavirus-related malignancies | journal = Oral Oncology | volume = 128 | pages = 105806 | date = May 2022 | pmid = 35339025 | pmc = 9788648 | doi = 10.1016/j.oraloncology.2022.105806 }}</ref> Ribavirin targeted eIF4E in AML patients in monotherapy and combination studies and this corresponded to objective clinical responses including complete remissions.<ref>{{cite journal | vauthors = Assouline S, Culjkovic B, Cocolakis E, Rousseau C, Beslu N, Amri A, Caplan S, Leber B, Roy DC, Miller WH, Borden KL | title = Molecular targeting of the oncogene eIF4E in acute myeloid leukemia (AML): a proof-of-principle clinical trial with ribavirin | journal = Blood | volume = 114 | issue = 2 | pages = 257–260 | date = July 2009 | pmid = 19433856 | doi = 10.1182/blood-2009-02-205153 | s2cid = 28957125 | doi-access = free }}</ref><ref name="Assouline_2015"/><ref name="Assouline_2023"/> Ribavirin resistance in AML patients arose leading to loss of eIF4E targeting and relapse. Resistance was caused by deactivation of ribavirin through its glucuronidation in AML cells or impaired drug entry/retention in the AML cells.<ref name="Zahreddine_2014"/> There may be additional forms of ribavirin resistance displayed by cancer cells. In HPV related oropharyngeal cancers, ribavirin reduced levels of phosphorylated form of eIF4E in some patients.<ref name="Pharmacodynamic and therapeutic pil"/> The best response here was stable disease but another head and neck study had more promising results.<ref name="Phase I study of induction chemothe"/>