Topical Treatment of Respiratory Infections including Covid

[in work and incomplete, only summary somewhat complete]

Summary Topical Treatment

Infections on the surface of the upper and lower respiratory tract can be treated topically. For upper respiratory tract infections this is already common as it is common for other locations such as the skin. Advantages of topical treatments are 1. that the medications reach the pathogens directly and 2.relaxed tolerability constraints compared to systemic medications. Topical treatments of the lower respiratory tract can be by inhalation of the medications or other methods such as washings.

Topical treatment is adequate to treat respiratory-tract-surface virus infections. Respiratory-tract-surface viruses (RTS viruses) denote here viruses with the following tropism:

Infection of differentiated epithelial cells at the air-liquid interface.
Release of the virions mainly on the apical cell side to the outer surface and the virions spread through the lining fluids.

Betacoronaviruses including SARS-1/2 or RSV are examples of RTS viruses.

Topical treatment is promising against RTS virus infections since:

To target the virions is often easier from the outside i.e. through the respiratory tract than from the inside e.g. via the blood. Since RTSV virions are not easily reached from the blood makes them difficult to target for systemic medications and the blood based immune system.
RTS viruses are usually enveloped and have fusion proteins to fuse with membranes. The fusion ability requires spring loaded energy which makes them unstable.
Without metabolism, virions can neither react to environment changes nor repair any damage.

Topical medications against SARS-like are especially promising since:

Coronavirus virions are especially delicate due to their large RNA genome and their powerful but unstable spikes.
Inside cells (i.e. in the metabolic phase) coronaviruses are hard to target both for systemic medications and the immune system since they shield their core metabolism in membrane vehicles.

Summed up with topical treatment the removal of infectious virions seems possible. The reduced viral load should enable the immune system to clear the infection better & faster and lessen the inflammation induced.

An example of a topical treatment is to modulate the temperature and humidity.

Introduction

[in work] On todays earth nearly all lifeforms life in an interplay with countless other lifeforms. Microbiota often live on epithelial tissues of multicellular lifeforms, the hosts. Mostly there is a balance and interplay between the host immune system and the microbiata. If the host immune is not prepared to keep the microbiota in check (e.g. because of injuries or new microbiata) a disease of the host can be caused. Topical medication to prevent or treat such diseases are common for many locations:

If the protective function of the skin is not intact in case of a wound, it is common practice to reduce the microbiate at the location by washing or disinfecting.
In the intestine topical medications are common too e.g. nystatin.
To reduce bacteria in the mouth teeth bruthing is common. It takes away the nutrients from harmful bacteria and some toothpastes also contain antimicrobial substances.
Traditional medicines to treat upper respiratory tract infections also act topical: e.g. steam inhalation, warm tee or honey. Also there are countless brands of tablets to treat upper respiratory tract infections.

The treat lower respiratory tract infections topicals medications are less common and also more difficult:

The lower respiratory tract is less easy to reach.
The lower respiratory is less separated from the blood:
- Systemic medications have better effects.
- Lower respiratory tract infections are more likely to become systemic.

Nevertheless topical medication for the lower respiratory tract can be beneficial since higher concentrations and even different medicines can be used. Different topical treatment options and possible benefits and risks are discussed.

Mode of Action to treat Virus Infections

[in work]

Topical Medications

Temperature and Humidity Modulation

At high temperatures, in condensation situations and on temperature changes virions decays faster. Such situations can be induced in the lungs and should reduce the viral load. Described on the page Local Temperature and Humidity Modulation