Southampton doctors in world-first trial of new nose drop to fight meningitis

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Doctors in Southampton are leading a world-first trial of a new nose drop containing a type of modified ‘friendly’ bacteria that could help prevent meningitis and other infections.

It was developed by Professor Robert Read, director of the NIHR Southampton Biomedical Research Centre and Dr Jay Laver, senior research fellow in the experimental human challenge group at the University of Southampton.

Together they have inserted a gene into a harmless form of bacteria to help it remain in the nose and cause an immune response, with the first person given the drop at the NIHR Southampton Clinical Research Facility last week.

It is hoped the enhanced ‘friendly’ bacteria, known as Neisseria lactamica (Nlac), will protect against its close cousin, Neisseria meningitidis (N.meningitidis), the strain responsible for causing a severe type of meningitis.

Around 10% of adults carry N.meningitidis in the back of their nose and throat with no signs or symptoms. However, in some people it can invade the bloodstream and cause life-threatening bacterial infections including meningitis and blood poisoning, known as septicaemia.

Meningitis occurs in people of all age groups but affects mainly infants, young children and the elderly. Meningococcal meningitis, which is a bacterial form of the disease and is responsible for 1,500 cases a year in the UK, can cause death in as little as four hours from the onset of symptoms.

In a previous study, Prof Read's team found inoculating adults with unmodified Nlac resulted in it settling harmlessly in the nose of a third of recipients and prevented them carrying N.meningitidis at the same time.

They hope genetically enhancing the bacteria with a ‘sticky’ surface protein from N.meningitidis will increase its ability to reside in the nose and generate a strong immune response that protects against the meningitis-causing bacteria.

“We have already shown that placing Nlac in the nose of healthy adults caused no harm to the volunteers - the bacteria settled and it caused an immune response which prevented the acquisition of harmful bacteria in a number of patients,” said Prof Read, who is an honorary consultant at University Hospital Southampton NHS Foundation Trust and professor of infectious diseases at the University of Southampton.

“By enhancing Nlac with a gene which we know helps bacteria stick to human body cells in larger numbers, we can increase the number of people who carry this friendly bacteria in their nose and thus block out N.meningitidis which can cause invasive meningococcal disease."

He added: "If successful, this would offer the potential to prevent the spread of infection or the ability to rapidly control an outbreak as meningococcal meningitis cannot develop in the absence of N.meningitidis.

“It would also mean we would then have a future therapy that we can adapt to combat other diseases caused by bacteria that breed in the nasal pathway such as pneumonia and ear disease.”

The study is being run in collaboration with Public Health England and funded by the Medical Research Council. For more information on taking part in the study, email uhs.recruitmentCRF@nhs.net or call 023 8120 3853.

Posted on Tuesday 27 November 2018