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Respiratory syncytial virus, or RSV, is a prevalent respiratory ailment that presents significant dangers to specific demographics, including very young children and elderly individuals.(Image credit: TUMEGGY/SCIENCE PHOTO LIBRARY via Getty Images)Share this article 0Join the conversationFollow usAdd us as a preferred source on GoogleSubscribe to our newsletter
A low-cost, readily accessible pain reliever, commonly used for ailments such as arthritis, appears to substantially decrease RSV within the human respiratory system, according to preliminary laboratory findings.
Respiratory syncytial virus (RSV) is the primary cause of infant hospitalizations in the United States, with infants under six months old facing the greatest susceptibility to severe illness and mortality from RSV. It also constitutes a serious health threat to adults aged 65 and above.
Presently, vaccines have been authorized for expectant mothers and seniors, alongside antibody-based treatments for children designed to prevent RSV infection. However, no specific antiviral medication exists to treat the condition once an individual is infected.
In the recent investigation, documented on May 7 in the journal Virus Research, scientists discovered that the anti-inflammatory medication indomethacin impedes a crucial protein that RSV requires to infiltrate human cells and propagate. This discovery suggests that the drug could be beneficial in treating RSV infections, though experts cautioned that laboratory outcomes do not consistently predict real-world effectiveness.
“The behavior of something in a laboratory setting can sometimes differ drastically from its behavior in reality,” stated Dr. Amy Edwards, a pediatrician in the pediatric infectious diseases division at University Hospitals in Ohio, who was not involved in the research. “Investigations like this represent vital initial stages in discerning which therapeutic options might warrant consideration for future clinical trials, but they are insufficient to advocate for immediate implementation in clinical environments,” she informed Live Science via email.
Dr. Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau in New York, concurred that the findings are intriguing but will not alter patient care in the near future. “It is a very early-stage paper proposing something of potential significant interest, but it certainly is not something that will change even a small part of the practical management of patients with RSV tomorrow,” commented Glatt, who also did not participate in the study.
One drug, different effects
Prior laboratory and clinical investigations had demonstrated that indomethacin exhibits antiviral properties against several viruses, including herpesvirus, rotavirus, and the coronaviruses responsible for SARS and COVID-19. In a modest clinical trial, COVID-19 patients who were administered indomethacin experienced a quicker recovery compared to those receiving acetaminophen, with most symptoms resolving in half the time. Nevertheless, the drug has not yet received approval as an antiviral agent for any infections.
To evaluate indomethacin’s impact on RSV, researchers infected cells derived from the human larynx (voice box), bronchus (airway), and lungs with RSV and subsequently treated these cells with indomethacin at varying concentrations. The medication diminished the virus’s capacity to replicate in all cell types and at very low concentrations, without causing harm to the cells themselves.
The investigative team observed that indomethacin was effective only when administered after the virus had already penetrated the cells. Its administration prior to infection or during the brief phase of viral attachment to cells yielded no antiviral benefit.
The group also examined aspirin, which functions similarly to indomethacin as a pain reliever; both medications are classified as nonsteroidal anti-inflammatory drugs, or NSAIDs. Aspirin demonstrated no effect on RSV whatsoever, indicating that indomethacin’s antiviral action is distinct from its pain-relieving capabilities.
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Indomethacin is currently employed in premature infants to address patent ductus arteriosus (PDA), a cardiac condition where a blood vessel that typically closes post-birth fails to do so, according to Edwards. (In this specific application, indomethacin is administered intravenously.)
“It has a long history of relatively safe usage in infants,” Edwards noted.
For short-term administration, indomethacin is generally considered very safe, Glatt stated. However, at elevated dosages and with prolonged treatment courses, it can introduce risks of adverse effects, including renal complications and gastrointestinal bleeding.
Further research is necessary to ascertain whether indomethacin provides benefits to individuals affected by RSV. The researchers also emphasize the need for additional investigation to fully comprehend the precise mechanism by which the drug inhibits viral multiplication and dissemination.
