A Novel Way to Fight Drug-Resistant Bacteria | Hacker News Reader

A Novel Way to Fight Drug-Resistant Bacteria

blogs.scientificamerican.com

109 pointsLinuxBender23 comments

I love this. Previously there was a story about using viruses in order to combat drug resistant bacteria[0]. The more tools we have to kill them off, the better. It's only tangentially related but my feeling is that we've barely scraped what's possible with viral, bacterial and protein engineering though. I can't wait until we start treating them much like we treat transistors and circuits. The building blocks are even nearly the same size at this point.

[0]https://mashable.com/2018/03/11/bacteriophage-viruses-from-p...

Came here to write about this. Phage therapy[0] is an extremely interesting topic and there are a number of startups working in this direction. It's funny, but in Eastern Europe (Georgia, Russia, Poland, etc.) phage therapy is used broadly for many years, whereas US is just catching up.

[0] https://en.wikipedia.org/wiki/Phage_therapy

People (in the west) have been writing about phage therapy and how revolutionary it will be for 20 years now. It still hasn't arrived.

Phage therapy requires determining which bacteria is causing the disease, then having phages on-hand suitable for that specific bacteria (or some system to culture them). Using the "wrong" phages is useless and there are hundreds of thousands (or even millions) of strains.

Bacteria also evolve phage resistance and phages themselves evolve to target other harmless bacteria in cases where their targets are eradicated.

Phage therapy will probably end up being one component of a multi-prong strategy but it is hardly a replacement for antibiotics.

> Phage therapy requires determining which bacteria is causing the disease

That's exactly what they do in Eastern Europe. They work with each patient individually. Here is a good read [0].

> A few weeks later, the Georgian doctors called Rose with good news: They would be able to design a concoction of phages to treat Rachel’s infections. After convincing Rachel’s doctor to write a prescription for the viruses (so they could cross the U.S. border), Rose paid the Georgian clinic $800 for a three-month supply. She was surprised that phages were so inexpensive; in contrast, her insurance company was forking over roughly $14,000 a month for Rachel’s antibiotics.

[0] https://www.buzzfeed.com/azeenghorayshi/mail-order-viruses-a...

> A few weeks later

A huge number of infections would lead to death within a few weeks. Critical ones within days or hours.

I'm not saying we shouldn't explore phage therapy. I'm saying it isn't the magic bullet supporters have been promising for 20 years. It isn't like western medicine is ignoring phages, there are just a lot of issues to work out.

I work in this area after curing my husband of a life-threatening superbug with IV phage therapy. That case has re-invigorated phage therapy in the West and there are several clinical trials that will start in 2019. Even if phage therapy isn't shown efficacious on its own, there is growing evidence of synergy between phage and antibiotics that itself is a game-changer. My husband and I wrote a book about our story which covers the strange history of phage therapy: ThePerfectPredator.com

I believe that subtle differences, called polymorphisms, in the DNA of host factor genes could explain why some individuals are more susceptible to pathogens than others.

Or not so subtle ones, like having cystic fibrosis.

an alternative approach called host-directed therapy (HDT), a suite of treatments whose goal is to enhance the host's own immune response rather than relying exclusively on antibacterial drugs.

I've been doing this for close to 18 years. Zahidul Alam is welcome to shoot me an email if he wants to talk about this stuff some time.

Some promising examples of HD include commonly used drugs for non-infectious diseases—verapamil and metformin, for example which modulate inflammation and increase host antimicrobial response to pathogens; cytokines, a group of proteins that include interleukins, that induce host pro-inflammatory cell signaling to kill pathogens; and nutritional products such as Vitamin D3, which augments the host’s cellular defenses.

A nutshell version of what I know:

Excess acidity promotes inflammation and that promotes the creation of biofilms. I've seen research indicating that if you reduce acidity, you can break up biofilm. Biofilm is a major factor in antibiotic resistance.

Second: Forget recommendations to take Vitamin D or Vitamin C or Zinc to treat a cold or whatever. Find out what nutrients you are short on and improve your nutritional status.

Third: Glycoproteins are structures composed of proteins and carbs. These play an important role in immune function. I found that getting the right carbs made a huge difference, probably because it's a building block for glycoproteins.

Fourth: Fasting. The gut is home to 70 to 80 percent of the immune cells in our bodies. My belief is that the food we eat is the single biggest source of income and, this digestion is the single biggest challenge to the immune system. Giving the immune system a day off can allow it to redirect resources elsewhere in the body.

It's shocking to me that half of the soap for sale at the grocery store is antibacterial. This should be illegal.

Note that in the US at least it no longer contains antibiotics like Triclosan[1]. Plenty of less-likely-to-create-resistance compounds are commonly used now, like acetic or lactic acid.

1: https://www.npr.org/sections/health-shots/2016/09/02/4923947...

Many things are antibacterial and work fine on your skin, but not in your body. Drinking hydrogen peroxide for example would be at best pointless and at worst harmful.

I think GP isn't trying to say that antibacterial soap should be illegal because it's harmful to humans, but that it should be illegal because it creates resistant bacteria.

If it’s not medically useful, I don’t see the benifit of avoidance.

Bleach is a highly effective antibacterial substance, it’s also toxic but that’s not a major problem for floors. Hell, bacteria have had billions of years to adapt to sunlight, it still kills them fairly quickly.

It is likely antibacterial by helping you wash off the bacteria better or having chemicals which kill indiscriminately by destroying membranes etc. These aren’t the same as antibiotics, which bacteria can develop resistance for.

The human body is truly incredible, and the immune system in particular. Each of us has a custom designed garbage collection system tailored for our bodies. I predict the next big leaps in medicine will come from empowering and leveraging that system to fight everything from infection to cancer.

The body's immune system can attack the body itself though. Cautious approach is needed.

Agreed, autoimmune diseases are obviously something to be wary of. Not similar to wildfire management, I think we're being foolish if we don't leverage the forces that have powered a natural ecosystem for millennia, instead of trying to replace them.

Can anyone complete the last sentence in this paragraph, I'm very intrigued what its actually attempting to refer to

> HDT also aims to balance host reactivity at the site of infection by reducing or preventing an excessive inflammatory response, which can damage internal organs and can even kill. This is achieved through cellular therapy, in which a specific population of bone marrow cells is injected in a host’s body, reducing and preventing tissue.

Preventing tissue what??

I assumed preventing tissue inflammation

damage.

This is essentially the basis of Ayurveda - boosting the host immune system to attack the disease instead of using a foreign agent to attack the disease

This approach is encouraging. I would also like to see more research with the opposite of antibiotics: probiotics. Which doesn't need to mean yogurt. I'm talking about something similar to the approach recently used with mosquitoes where infertile males were bred and released, hugely reducing the population. That type of thinking.

Tricky though, given that bacteria reproduce asexually[1]. However it might be possible to use horizontal gene transfer to do something similar.

1: https://en.wikipedia.org/wiki/Bacteria#Growth_and_reproducti...

There's at least a couple of studies [1][2] showing benefits of using a probiotic cleaner containing B. subtilis, B. pumilus and B. megaterium made by Belgian company Chrisal [3] over just using bleach for surfaces in a hospital setting. I first read about this in the book "I Contain Multitudes" which is about the microbiome.

From [1]: "This concept has been designated as biocontrol when the application is antagonistic towards a certain pathogen [26], and has already successfully been applied to the abatement of Legionella in water systems [27]."

[1] https://journals.plos.org/plosone/article?id=10.1371/journal... [2] https://journals.plos.org/plosone/article?id=10.1371/journal... [3] https://www.chrisal.com/about.php

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