28 karma · joined December 7, 2021
One major issue with chemical antibiotics (proteins or small molecule) is evolution. Antibiotic resistance is largely the product of the wide and incomplete treatment of bacterial infections, and the resulting emergence of resistant strains. Another issue, shy of evolution of genome modification, is simple gene / transcriptional regulation, and up-/down-regulating surface proteins and sugars that can render such proteins ineffective. It's not as simple as binding a protein target.
Consider that resistance to a novel antibiotic has been observed after a year or two on the market, and it doesn't make sense for a pharma company to invest in bringing one to market.
One interesting avenue is using bacteriophage to treat infections directly. The phage evolve with the bacteria and have a much higher chance of remaining effective. Treating with an antibiotic, or multiple phage, using different mechanisms, decreases the chance of evolving resistance. Phage have been used in eastern European countries for ~ a century, but were dropped in western countries in favor of small molecule antibiotics. There are several clinical trials to bring them back to market.
To bring it back to the article, interestingly phage don't seem to be mentioned, even though they are the most abundance organism on the planet. Surely something has figured out how to eat them...
You can see a breakout at the bottom of this poster [1] from Grail (developing a methylation based liquid biopsy) showing sensitivity per-cancer and per-stage.
Sensitivity increases as stage increases, as expected, and cancers like Leukemia are well detected. IIRC, the stage classifications vary across different tissue types as to when the cancer breaks through the basement membrane - would be compelling if sensitivity of the assay rises in accordance.
[1] https://grail.com/wp-content/uploads/2020/12/ASCO_2019_CCGA2...
This rekindles discussions back in school about chimeras... in order for the organs to be immunocompatible, the donor needs to be partially human. What % is too human to harvest for organs?
I suppose it's still too soon to answer such questions, but apparently, 0% acceptable.