Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, November 15, 1994 TAG: 9411150100
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: LISA APPLEGATE STAFF WRITER
DATELINE: LENGTH: Medium
Dr. Charles Schleupner, chief of medical services and a professor with the University of Virginia's Roanoke-Salem medical program, said the VA is one of four locations across the nation to test a new cream, called Foscarnet.
The cream, although not expected to cure cold sores, may help reduce the duration and severity of sores, particularly those types that have developed an immunity to other treatments, Schleupner said.
People with a history of cold sores, the ulcers that form on the lip and are caused by herpes simplex one, will be paid $100 to be exposed to ultraviolet light, a possible cold-sore trigger. Participants who form a cold sore will receive an additional $75 and a tube of either the Foscarnet cream or a placebo.
Doctors will then analyze whether the creme was effective in speeding recovery.
There are two types of the herpes simplex. Type one produces cold sores and type two cause genital herpes. About 90 percent of the type one virus forms on the lip, although there have been some occurrences of type one on the genitals.
"By analogy," Schleupner said, "if the cream works on cold sores, it could also be effective in treating genital herpes."
Almost 70 percent of people have naturally developed the antibody necessary to prevent herpes simplex one. But for those who do catch the virus - usually by being exposed to an infected person's saliva - it's a permanent menace in their lives.
Even after all visible signs of the tingling, burning blister have disappeared, the virus continues to live inside a major group of nerve cells just behind the face.
Doctors aren't exactly sure what triggers the return of a sore - stress, respiratory infections, exposure to sunlight or other possible traumas.
Whatever the reason, the virus reactivates, travels back down the nerve, right back onto the lip to form another sore.
Acyclovir (pronounced a-SIGH-clo-veer), a drug commonly prescribed to speed healing, is prescribed in both a pill and cream form. The cream is not particularly effective, Schleupner said, and the pill form can be extremely expensive. A five-day pill prescription can run $35 to $40.
Plus, because acyclovir is frequently prescribed, doctors are seeing strains of simplex one that are completely resistant to the drug.
Foscarnet, however, has appeared to be effective in treating even the resistant strains.
Doctors prescribe Foscarnet, or phosphonoformic acid, in an intravenous form to prevent blindness in AIDS patients. Doctors have noticed that cold sores, common to people who suffer from AIDS, heal with Foscarnet treatments.
Astra Inc., a Swedish pharmaceutical company that produces Foscarnet, hopes the cream form will be just as effective.
Schleupner will join colleagues at the University of California at Los Angeles, the University of Cincinnati and the University of Utah in recruiting 60 to 70 people each for the test.
Using a black, Plexiglas box containing two ultraviolet bulbs and an opening just large enough to fit a closed mouth, researchers will try to trigger a cold sore in volunteers. The half of the lip where previous sores have occurred will be exposed to the light; the other half will be covered with sunscreen. Exposure time will vary, depending on skin pigmentation, but volunteers are only exposed once.
As soon as they feel a tingle, volunteers should begin applying the cream.
"We're testing two things here. One, we'll see if lesions are prevented by the cream, and if not, whether it can speed the recovery once the sore develops," Schleupner said.
He said researchers won't know who received a placebo and who treated their sore with Foscarnet until after the study is finished and they begin analyzing results.
More information about the study can be obtained by calling study coordinators Mary Lou Barritt or Sara Reed at 982-2463, ext. 1461 or 1463.
by CNB