ArticleCommunications medicine2026
Aminoglycosides induce immune activation but is insufficient for systemic viral control: a double-blind randomized-controlled clinical trial.
Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
11 authors.
Funding
Abstract
backgroundMucosally-applied aminoglycosides have demonstrated host-directed antiviral activity in preclinical models through induction of interferon-stimulated genes (ISGs). However, it remains unknown if systemically administered aminoglycosides elicit comparable effects in humans.
methodsWe conducted a single-centre randomized, double-blind, placebo-controlled trial in Singapore in 32 healthy adults who were randomized 1:1 using sequentially sealed envelopes, to receive single-dose intravenous gentamicin 5 mg/kg or placebo. Participants were subsequently challenged with live-attenuated yellow fever 17D (YF17D) virus and followed for 30 days. The primary outcome was the proportion of participants with detectable YF17D RNAemia. Secondary outcomes included RNAemia levels, symptom rates, neutralizing antibody titers, and innate immune transcriptomic changes.
resultsWe found no significant differences between the gentamicin and placebo groups in detectable RNAemia (62.5% [n = 10/16] vs. 68.8% [n = 11/16], p > 0.99), mean RNAemia levels (3.93 log
conclusionsThis study represents, to our knowledge, the first in humans to evaluate the host-directed antiviral effects of systemic aminoglycosides. Our findings suggest that, whilst modest and insufficient to control systemic viral infection, the immunomodulatory effects of aminoglycosides warrant continued exploration as a potential preventive strategy against mucosal viral infections.
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