OM85: could bacteria in a capsule protect us from coronavirus and other respiratory infections?


Peter Sly, The University of Queensland

Scientists around the world are continuing to test countless vaccines and drugs in the hope of finding effective ways to prevent and treat COVID-19.

Among the trials happening in Australia is one my team is about to begin, looking at something called OM85.

OM85 is not a conventional drug, but a combination of molecules extracted from the walls of bacteria that commonly cause respiratory infections.

It’s not available in Australia, but has been used widely in Europe and South America for 40-50 years, commonly under the brand name Broncho-Vaxom.

We’re now looking at its potential to prevent respiratory infections, including COVID-19. But how does it work?

Read more:
Where are we at with developing a vaccine for coronavirus?

First, a bit of background

Some of our organs, including the skin, airways and lungs, and gastrointestinal tract, are effectively “open” to the outside world. The cells that line these organs, called mucosal linings, host trillions of bacteria.

These bacteria, known as our “microbiota”, play essential roles in keeping us healthy. This is especially important in the gastrointestinal tract, where the microbiota “train” the immune system.

One of the ways they do this is by providing a continuous stream of signals that move through mucosal linings into the tissues below, where immune cells are found. Specialised immune cells responsible for detecting the invasion of infectious pathogens recognise and respond to these signals.

We now recognise these signals from the microbiota operate as “immune training” agents, helping to keep the front-line defences of the immune system in a state of high alert.

OM85 is made from molecules extracted from the walls of bacteria.

OM85 is an immune stimulant

OM85 appears to enhance some important aspects of this natural “immune training” process. One way it does this is by stimulating the maturation of regulatory T-cells (called Tregs) in the lymph glands in the upper intestine.

Once they have fully matured, these Tregs can migrate to other mucosal surfaces in the body to bolster local anti-inflammatory defences. This process is especially important in the lungs and airways to prevent respiratory infections.

Read more:
Explainer: what is the gut microbiota and how does it affect mind and body?

OM85 signals also leak into our circulation. There they are recognised by cells in the bone marrow, which control the production of other immune cell types.

This results in increased immune cells – both in number and function – that travel to front-line mucosal surfaces, including the airways, to further bolster our immune defences.

We strongly suspect OM85 also influences the makeup of the gastrointestinal microbiome itself, although we know very little about how this happens. This in turn helps to promote the survival of bacterial strains that stimulate the immune system.

What the evidence tells us

OM85 is a preventative, given to those at risk of more severe consequences from respiratory infections, rather than as a treatment of current infections.

Studies have shown OM85 reduces the risk of wheeze linked to infection in infants and schoolchildren.

It also reduces the incidence of
severe flare-ups of chronic obstructive pulmonary disease in adults.

A review of 35 placebo-controlled studies involving 4,060 children concluded that immune stimulants, including OM85, reduced respiratory infections by an average of 40% in susceptible children.

Read more:
A strong immune system helps ward off colds and flus, but it’s not the only factor

OM85 has a good safety profile. A small proportion of people may experience some gastro-intestinal upset, but in clinical trials, such as one we conducted in infants, side effects are rarely seen.

So why don’t we use it more widely?

No application has been made to bring OM85 to Australia. We are a small market not necessarily attractive to drug manufacturers.

In countries where OM85 is available, doctors can prescribe it but people can also buy it over the counter, in the same way they might a complementary medicine or health food supplement.

Research shows OM85 can reduce the risk of severe respiratory infections in children.

OM85 has attracted plenty of scepticism in its time, with some people regarding it as “snake oil”.

Scientists are sceptical when we don’t understand why something works, or at least where we don’t have a plausible explanation for how it works. The idea something swallowed but not absorbed could protect the lungs sounds fanciful, especially without solid explanations.

But as we start to understand more about the mechanisms that may explain how OM85 works in the body, and with the accumulating clinical evidence, we have good reason to be open to and further explore its potential.

What we’ll do in the trial

Health-care workers are susceptible to severe respiratory respiratory infections associated with other viruses, including influenza, that can cause them to miss work.

We plan to give 1,000 health-care workers OM85, half immediately and half delayed by three months.

To understand how OM85 works we will collect blood samples and test immune responses.

We will determine which virus caused the respiratory illnesses if illness occurs (COVID-19 or other), whether the immune response is different depending on the virus, and whether OM85 is equally effective against all respiratory viruses encountered.

The trial is due to start this month and first results should be available by November.

Read more:
The fascinating history of clinical trials

The Conversation

Peter Sly, Director, Children’s Health and Environment Program and World Health Organization Collaborating Centre for Children’s Health and Environment, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Theology Students in Indonesia to be Evicted from Campground

Government stops paying rent for site where students were driven more than a year ago.

JAKARTA, Indonesia, October 20 (CDN) — Approximately 700 students from Arastamar Evangelical Theological Seminary (SETIA) are facing eviction at the end of the month from a campground where Muslim protestors drove them last year.

Education will end for students who have been living in 11 large tents and studying in the open air at Bumi Perkemahan Cibubur (BUPERTA) campground, many of them for more than a year. Hundreds of protestors shouting “Allahu-Akbar [“God is greater]” and brandishing machetes forced the evacuation of staff and students from the SETIA campus in Kampung Pulo village on July 26-27, 2008.

Urged on by announcements from a mosque loudspeaker to “drive out the unwanted neighbor” following a misunderstanding between students and local residents, the protestors also had sharpened bamboo and acid and injured at least 20 students, some seriously.

The Jakarta provincial government has ceased paying the rental fee of the campsite in East Jakarta, a bill that now totals 2.7 billion rupiahs (US$280,000), which camp officials said will result in the eviction of the students and the end of their studies at the end of the month.

At the beginning of the month, camp officials cut off electricity and water; as a result, the students have had to go 1,500 meters to bathe and use the toilet in the Cibubur marketplace. Additionally, several of the student tents were taken down. In spite of the conditions, sources said, the students have maintained their enthusiasm and no one has quit the school.

SETIA officials said camp management rejected their request for an extension.

“The electricity and the water were cut off after the Cibubur campground managers rejected Arastamar’s request,” said Yusuf Lifire, SETIA administrator.

Other students at the seminary have taken temporary shelter in the other parts of greater Jakarta. Those living quarters, however, are so overcrowded that some of the students have become ill.

Umar Lubis, head of BUPERTA campground, said camp officials have provided the students great leeway and shown great tolerance in the year that rent has not been paid.

“We have provided water, electricity, and other facilities,” Lubis told Compass. “However, Jakarta Province has not paid us campground rental since October 2008. The government did pay 700 million rupiahs [US$75,000], but that only covered the rental fees through September 2008.”

Muhayat, area secretary of Jakarta Province who goes by a single name, told Compass that beginning in October 2008, the provincial government was no longer responsible for campsite rental for the SETIA students. The provincial government made this decision, he said, because the seminary refused to move to Jonggol, Bogor, West Java, about 50 kilometers (31 miles) from the old campus.

“We offered to move them to Jonggol, but Arastamar took a hard line and wanted to be in Jakarta,” Muhayat said.

The Rev. Matheus Mangentang, rector of SETIA, said that they refused to move to Jonggol because their school permit was for Jakarta.

“If we moved to Jonggol, we would have to get a new permit,” Mangentang told Compass. “We suspect that this would be an extremely difficult process.”

Illness Strikes

Many students are suffering from respiratory and other illnesses, and some have breast cancer. The sick are being cared for at the Christian University of Indonesia hospital.

One of the students living at the BUPERTA campground told Compass that many of the students had fever from mosquito bites.

“When it rains here, we sleep on water and mud,” said a 21-year-old student who identified herself only as Siska. Her statements were echoed by a Christian education major named Ahasyweros.

“We struggle daily in a place like this – especially after our request was turned down,” the student said. “We don’t know where we are going to go. We hope that the Jakarta provincial government will have the heart to help us.”

The staff and students were forced from their campus by a mob that claimed to be acting for the local citizens of Pulo Kampung, Makasar District, East Jakarta last year. Key among motives for the attack was that area Muslims felt “disturbed” by the presence of the Christian college. They wanted it to be moved to another area.

The approximately 1,300 seminary students were placed in three locations: 760 at the BUPERTA campground, 330 at the Kalimalang Transit Lodge, and 220 at the former office of the mayor of West Jakarta.

The fate of the students at all locations was similar; they were overcrowded and short on water, and overall facilities were substandard.

Jakarta Vice-Gov. Prijanto, who goes by a single name, had promised to find a solution. He had also stated that the government was ready to help and would pay for the students’ room and board, but this has not been the case.

Mangentang said he continues to hope for good will from the Jakarta government, which he said should return the school to its original site in Pulo Kampung. 

“Even if there is talk in the provincial government that the locals don’t accept us, we still want to go back,” he said. “After we are back, then we would be prepared to talk and negotiate about the future. Healthy discussions are not possible if we are not back in our own home. If we tried to talk now, while we are trampled upon and pressured, nothing healthy would result. It is better that we return to our own place so that we can talk at the same level.”

Report from Compass Direct News