Dr. Thomas J. Braciale and Dr. Amber Cardani from the U.Va. School of Medicine may have found a way to prevent a fatal form of pneumonia using common allergy and asthma medications.
According to Cardani, influenza infections typically only affect the upper airways such as the throat and nasal passages. However in more serious cases, the virus infects alveolar epithelial cells in the lungs. The infection of these cells characterizes pneumonia — or inflammation of the lungs — and is potentially fatal as alveolar epithelial cells are necessary for oxygen and carbon dioxide exchange.
Cardani said the main issue with influenza pneumonia is its difficulty to treat. Once the pathogen infects the alveoli, the immune system responds by eliminating the infected cells. However, if a large area of the alveoli is infected, then the entire alveoli may be attacked by the immune system and general lung function begins to decline.
Braciale said that while other forms of pneumonia are transmitted via bacterial infection and can be treated with antibiotics, influenza pneumonia has very few available treatment options. Up to 40 percent of patients with influenza pneumonia may die from the infection.
“So it’s rare to get influenza pneumonia, but if you get it, it’s very serious because it can be fatal and life-threatening — because of your inability to respire, your inability to get oxygen into those terminal airways,” Braciale said.
Previous studies suggested that medicines used for allergies and asthma may prevent infection of alveolar cells. The researchers initially used mice to study the pathways involved in the development of severe influenza.
While treating the mice with allergy and asthma medications such as Singulair and Accolate, they found that the mice did not develop influenza pneumonia. Braciale said these results were unexpected.
“It was — first of all — a big surprise that these drugs might possibly be useful, and then an even bigger surprise that … When given to the mice [the drugs] actually protected them,” Braciale said.
However, the application of such drugs in humans to prevent influenza pneumonia has yet to be tested. Before a clinical trial can be conducted, more data must be collected.
In an attempt to duplicate the results of the mice experiment, researchers are using data mining. They are examining data from the last 10 years to determine whether people treated with these types of medications have reduced rates of infection. In addition, they are treating test tubes of human cells with allergy and asthma medications.
According to Cardani, the ultimate objective is for asthma medications to be used as a preventive measure for influenza pneumonia.
“The hope is that these drugs — that are already FDA-approved for asthma — could be given preventively to patients with pre-existing conditions that [predispose] them to viral pneumonia, or during some pandemic seasons,” Cardani said in an email to The Cavalier Daily.
Braciale adds that the applications of these drugs may go beyond prophylactic, or preventative, usage.
“The other way — in principle — that you might use [asthma medications] is if somebody comes down with the flu and it looks like it’s going to be a little complicated,” Braciale said. “In other words, [the infection] isn’t clearing up as quickly as [we] would like and maybe it’s getting hard for them to breathe — we could give them these medicines instead as a treatment early in the infection.”
While more research is necessary before asthma and allergy drugs can be used to prevent and treat influenza pneumonia in humans, Braciale is hopeful for future applications of results.
“These medicines which are out there and otherwise don’t have any side effects at all could be a useful aid to prevent people from getting serious flu pneumonia,” Braciale said. “But in the meantime, please take your flu shot.”
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