FFor years, researchers have been working on vaccines that aim to prevent viral infections by strengthening immune defenses at the entry point for viruses into the body: the nose.
TO small studio recently published in PNAS presents a similar idea, although less technological. Coating the inside of the nose with the over-the-counter antibiotic ointment Neosporin appears to trigger an immune response that may help the body repel respiratory viruses such as those that cause COVID-19 and the flu, the study suggests.
The research raises the idea that Neosporin could serve as an “additional layer” of protection against respiratory diseases, in addition to existing tools like vaccines and masks, says study co-author Akiko Iwasaki, an immunobiologist at Yale School of Medicine and a of the The leading nasal vaccine in the United States.
The study is based on some of Iwasaki’s ideas. previous research—which has shown that similar antibiotics can trigger potentially protective immune changes in the body—but it’s still preliminary, he cautions. For the new study, her team had 12 people apply Neosporin inside their nostrils twice a day for a week, while another seven people used Vaseline for comparison. At various points during the study, researchers swabbed participants’ noses and ran PCR tests to see what was happening inside.
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They found that Neosporin, and specifically one of its active ingredients, the antibiotic neomycin sulfate, appears to stimulate receptors in the nose that are “tricked into thinking there is a viral infection” and, in turn, create “a barrier that resists any virus.” “. ”Iwasaki explains. In theory, he says, that means it could protect against a variety of different infections.
However, for now that is just a theory. For this study, Iwasaki’s team did not take the next step of testing whether that immune response actually prevents people from becoming infected when exposed to viruses, in part because it is ethically questionable to intentionally expose people to pathogens for research. (However, they did show that rodents whose noses were coated with neomycin were protected from the virus that causes COVID-19.)
On his website, the Neosporin manufacturer says that the product has not “been tested or formulated to prevent COVID-19 or any other virus,” and also notes that they do not recommend putting the product in the eyes, nose, or mouth.
Dr. James Crowe, who directs the Vanderbilt Vaccine Center and was not involved in the research, says the study is “intriguing,” but he would need to see more data in humans before getting excited. “I’m skeptical that it’s very effective in people,” Crowe says. “If it has a modest effect on the virus, is it enough to really benefit it clinically?”
It is somewhat contradictory to think that an antibiotic, which kills bacteria, can do anything to protect people from viruses. It is not that the antibiotic has a direct effect against viruses, explains Iwasaki. Instead, it appears that neomycin, when applied topically, causes changes in the body that help it fight viruses, essentially triggering a natural antiviral effect.
So should you rub Neosporin in your nose the next time a wave of COVID-19 hits? Not so fast, says Dr. Benjamin Bleier, who specializes in nasal disorders at Massachusetts Eye and Ear and has studied nasal immunity.
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Bleier, who was not involved in the new study, calls the research “very well done” but says there are questions that need to be answered before it reaches “clinical prime time.” First, could the body develop tolerance or resistance to neomycin if the antibiotic were used regularly in this way? (Antibiotic resistance is a growing concern, and overuse or inappropriate prescribing of antibiotics contributes to the problem.) Second, could the average person apply neomycin deeply and thoroughly enough to gain meaningful protection? And finally, could this approach damage the delicate inner part of the nose or have other side effects over time? (Even in the small study, one of the people who used intranasal Neosporin dropped out due to minor side effects, apparently related to an allergy to the drug.)
“It’s great science, but there’s still a long way to go before we can shove it under our noses,” agrees Dr. Sean Liu, an infectious disease physician at Mount Sinai Health System in New York, who was also not involved in the study. the study.
Iwasaki agrees that more research is needed. She says the next step is to try higher doses of neomycin, since Neosporin contains a fairly small amount that may not be enough to provide solid protection in humans. To gather more data, he says, researchers could track people living normal lives (except that some apply neomycin to their nose and others apply Vaseline) and see if one group gets sick less often than the other, although that would require a lot of time. of time and people.
Despite the difficulties, Liu says there are good reasons for more studies. Finding new uses for affordable and widely accessible medicines is good for public health, and any progress toward neutralizing viruses is welcome. If the approach is shown to work, it could also be useful to have a tool that is effective against a wide range of viruses and could potentially be combined with other drugs to strengthen its effectiveness, adds Crowe.
Additionally, Iwasaki says, additional disease prevention tools could help people who are especially vulnerable to respiratory illnesses (such as those who are immunocompromised) and need extra protection to feel safe. If more research shows promise, Iwasaki says, he could imagine neomycin serving as an additional disease-fighting tool when people are in particularly germ-filled places, like a crowded party or an airport.