CNS Infection from Corona Virus Via Nasal Mucosa over Sphenopalatine Ganglion? Can Intranasal Antibody Prophylaxis be utilized?

Nasal Application of Serum Antibodies May Slow Infection Rates and spread in victims.  Can patients self-administer SPG Blocks to decrease sympathetic overload and stress reactions while simultaneously delivering serum antibodies for Covid 19 protection?

The following article is reprinted from Sleep and Health Journal.

 

Covid 19 is caused by “Severe Acute Respiratory Syndrome Coronavirus 2” (SARS-CoV-2) which is an RNA virus. The Avian Flu (H5N3) was also an RNA Virus. An article in Arch Virol (abstract below) “Avian influenza virus intranasally inoculated infects the central nervous system of mice through the general visceral afferent nerve.” noted how the invasion into the central nervous system was created experimentally by intra-nasal inoculation of the virus.

SARS-CoV-2 creates a gastrointestinal symptoms in some patients compared to experimental mice in which “only the intranasal infection group mice showed depression and retention of gas in the digestive system”. The pathology in the experimental group showed “Pathological findings in the animals were bronchointerstitial pneumonia and non-suppurative encephalitis restricted to the brain stem”

The experimental mouse model found “Prior to the development of the CNS lesions, viral antigen was detected in vagal and trigeminal ganglia. These results suggest that the primarily replicated virus in the respiratory mucosa ascended to the CNS via sensory nerve routes, inducing lesions in the brain stem, and then spread trans-synaptically in the CNS.” Essentially, the virus and replicated virus spread via autonomic nerves (of sphenopalatine ganglion) which goes to hypothalamus and limbic system.

The question is whether it would be possible to decrease severity of symptoms from
CNS involvement of SARS-CoV–2 by utilizing an “Intranasal Antibody Prophylaxis” and simultaneously reduce the susceptibility to infection. The paper states “Mucosal delivery may be advantageous because it allows the antibody to neutralize the virus particles before they initiate infection and because it concentrates the antibody where viral replication takes place.”

Should we concentrate research on development of nasal antibody treatments for humans which will have lower risks and shorter development time than typical viral vaccines. The paper suggested that “Polyclonal human immunoglobulin from pooled plasma preparations can be used to provide broad protection against a number of different pathogens, while monoclonal antibodies or their fragments can be used to target specific viruses.” Pooled plasma might represent an solution for changes in the virus over time that create genetic variations which may need different vaccines over time. As the paper notes “Vaccine development has been hampered by antigenic variation among virus strains, lack of effective or long-lasting immune responses, and, in some cases, vaccine-induced immunopotentiation of disease.”
The concept of passive immunity is currently being looked at for Covid-19, with advocates stating that we can take serum from previously infected individual to create a specific antiviral response. This is a good idea for long-term but the use of these same imune globulins for decreasing infections through the nasal mucosa should be considered for a more immediate approach.
The paper also states “The effectiveness of antibody delivery to mucosal surfaces, including the respiratory tract, is under investigation. This strategy may be most useful for treatment of the upper airways, where secretory antibody is most important for protection against viral infection. “
There is a link below to the entire article below. I am proposing this approach may be ideal during the current pandemic and prophylactic effectiveness can be studies as we reopen the economy and return to normal life. It may help prevent a second surge in cases.
The use of attenuated nasal vaccines should also be considered for this current pandemic which have been used with other viruses across multiple species. There is little risk if the the vacine is attenuated or killed.
My good friend and Mentor Dr Norman Thomas BDS, PhD suggests that a nasal spray of antibodies could also cover “The palatine tonsils, nasopharyngeal tonsil (adenoid) and lingual tonsil constitute the major part of Waldeyer’s ring or nasal-associated lymphoid tissue (NALT), with the tubal tonsils and lateral pharyngeal bands as less prominent components. The lymphoid tissue of Waldeyer’s ring is located at the gateway of the respiratory and alimentary tract and belongs to the mucosa-associated lymphoid tissue (MALT). As tonsils are the first site of encounter with inhaled and ingested micro-organisms, they are considered the first line of defense against exogenous aggressors. The generation of B cells in the germinal centers of the tonsil is one of the most essential tonsillar functions. This manuscript aims to review the anatomy and current knowledge on the immunologic function of the Waldeyer’s ring.” (See Abstract below)

Another excellent question based on how virus probably enters CNS is whether Sphenopalatine Ganglion Blocks or neuromodulation decrease Central Nervous System symptoms of Covid 19.

Arch Virol. 2000;145(1):187-95.
Avian influenza virus intranasally inoculated infects the central nervous system of mice through the general visceral afferent nerve.
Shinya K1, Shimada A, Ito T, Otsuki K, Morita T, Tanaka H, Takada A, Kida H, Umemura T.
Abstract
To define the route of influenza virus invasion into the central nervous system (CNS), an avian influenza A (H5N3) virus was inoculated into mice intranasally or intravenously. Only the intranasal infection group mice showed depression and retention of gas in the digestive system. Pathological findings in the animals were bronchointerstitial pneumonia and non-suppurative encephalitis restricted to the brain stem. The nerve nucleus primarily affected was the nucleus of solitary tract. Prior to the development of the CNS lesions, viral antigen was detected in vagal and trigeminal ganglia. These results suggest that the primarily replicated virus in the respiratory mucosa ascended to the CNS via sensory nerve routes, inducing lesions in the brain stem, and then spread trans-synaptically in the CNS.

Intranasal Antibody Prophylaxis for Protection against Viral Disease
Richard Weltzin, Thomas P. Monath https://cmr.asm.org/content/12/3/383#sec-14

Acta Otorhinolaryngol Belg. 2000;54(3):237-41.
The Waldeyer’s ring.
Hellings P1, Jorissen M, Ceuppens JL.
Abstract
The palatine tonsils, nasopharyngeal tonsil (adenoid) and lingual tonsil constitute the major part of Waldeyer’s ring or nasal-associated lymphoid tissue (NALT), with the tubal tonsils and lateral pharyngeal bands as less prominent components. The lymphoid tissue of Waldeyer’s ring is located at the gateway of the respiratory and alimentary tract and belongs to the mucosa-associated lymphoid tissue (MALT). As tonsils are the first site of encounter with inhaled and ingested micro-organisms, they are considered the first line of defense against exogenous aggressors. The generation of B cells in the germinal centers of the tonsil is one of the most essential tonsillar functions. This manuscript aims to review the anatomy and current knowledge on the immunologic function of the Waldeyer’s ring.

Ira L Shapira DDS, D,ABDSM, D,AAIPM, FICCMO, MICCMO
Past Chair, Alliance of TMD Organizations
Diplomat, Academy of Integrative Pain Management
Diplomate, American Board of Dental Sleep Medicine
Diplomate, American Board Sleep and Breathing
Regent, Master & Fellow, International College of CranioMandibular Orthopedics

Board Eligible, American Academy of CranioFacial Pain

Dental Section Editor, Sleep & Health Journal
CranioFacial Pain Section Editor, CRANIO: Journal of Craniomandibular and Sleep Practice
Member, American Equilibration Society

Member, Academy of Applied Myofunctional Sciences

Member, Academy of Cosmetic Dentistry
Life Member, American Dental Association
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