Engineered phages help teenager with antibiotic-resistant infection

https://www.statnews.com/2019/05/08/phage-therapy-how-genetically-engineered-viruses-may-have-prolonged-teens-life/

by spking • 7 years ago

85 30 7 years ago

perilunar4• 7 years ago

Amazing story, but the fact that the patient’s mother had to suggest phage therapy, and that the specialists didn't know much about it is pretty damning.

sterlind• 7 years ago

Phage therapy is a blind spot for Western medicine. It's a new category of drug, which means lots of work to get it through FDA or UK trials, and it's not a single molecule - it's a process. There's little point to taking a single combination of phages, packing them into a pill and ramming it through the clinical trials process - it'll be way too specific to be worth it.

Instead, the entire pipeline - keeping a library of bacteriophages, testing them for efficacy against samples, modifying them for increased virulence, screening for safety - needs to be approved, and run for each patient.

That's too experimental for the FDA, and the FDA is too rigid to allow approval for such pipelines (except in rare cases, like CAR-T immunotherapy.) Plus the UK has that anti-gene therapy law because of a disastrous adenovirus trial that killed six healthy volunteers.

The West is too risk-averse and conservative to make the big bureaucratic changes to allow this. Russia had no such hangups, which is why phage therapy flourished there.

ummonk• 7 years ago

Plus the UK has that anti-gene therapy law because of a disastrous adenovirus trial that killed six healthy volunteers.

Wait, what? Have a link for the uninformed?

roywiggins• 7 years ago

The West was lucky enough to invent penicillin which rather limited the appeal of phage research- you don't need phages if you haven't discovered antibiotic resistance, and once you've committed to using broad-spectrum antibiotics you'll just do what we did, which is switch between them.

It sounds like the USSR was just not very good at producing its own antibiotics, so phage therapy remained popular there, as it wasn't any less effective than their poor quality antibiotics, which ended up causing resistance there before they did in the West. If you've managed to spur resistance, and you have persistent supply problems with your antibiotics, pushing forward with phage research makes a lot of sense.

http://discovermagazine.com/2017/oct/the-cold-wars--modern-r...

perilunar4• 7 years ago

It's a new category of drug

Well that's the thing — it's not new. It dates back to the 1920s. I heard about it years ago, so for physicians in late 2017 to watch for months as a patient with antibiotic-resistant infections declines and then to "send her home with palliative care" — that is just appallingly negligent.

altfredd• 7 years ago

Phage therapy is a blind spot for Western medicine. It's a new category of drug

It is a branch of traditional medicine, approximately 100000 years old and counting.

"Western medicine" ignores phage therapy, because growing a bunch of mud in a bowl does not bring anyone 10000% cuts. Cultivating phages still requires labor and equipment, and can be quite profitable, just not 10000% profitable, — because pretty much anyone can do it.

wetpaws• 7 years ago

US is pretty arrogant when it comes to everything outside of their worldview

perlgeek• 7 years ago

I know of several cases where patients heard from friends or relatives about experimental or new treatments that were a perfect fit for their situation, but that specialists had never heard of.

It's worth the time and effort to research conditions that affect you (or your family) and actively seek non-standard treatments that your doctors don't know about. Don't blindly trust their expertise.

phront• 7 years ago

Realy great result but may it be a major step towards z apocalypse if something goes wrong?

_bxg1• 7 years ago

Playing the part of the optimist, I think we'll always be able to outsmart our ailments in the long run. It's startling to see an arms race start with antibiotics, because we've been winning in that arena with very little effort for over a century, but having to get creative again and being totally helpless against a coming apocalypse are two different things.

iso1337• 7 years ago

Able to? Yes.

Willing to? Not as much.

Just consider the following: 1) it’s been so long since people have first hand witness of the horrors of smallpox, polio, etc. So long that anti-vax is alive and well in affluent, educated enclaves. 2) antibiotics are not profitable. Achaogen tried but the business case just wasn’t there. https://www.bloomberg.com/news/articles/2019-05-03/antibioti...

So I agree with your last statement that we at not totally helpless, but I do think (as with global climate change or deferred maintenance on levees) there has to be an immediate and pressing need for people to put their money and actions in the right place.

adrianN2• 7 years ago

It's not that hard actually. We just have to cycle through the various antibiotic components with a sufficiently long cycle time (so that any resistances have time to disappear from the gene pool) and stop overusing antibiotics, especially for livestock.

yegle• 7 years ago

A short video on Phage from Motherboard: https://youtu.be/aVTOr7Nq2SM

dang• 7 years ago

Also https://www.bbc.co.uk/news/health-48199915, via https://news.ycombinator.com/item?id=19867303.

Insanity3• 7 years ago

They wrote "helped prolong the patients life" in some paragraphs. That kept making me think that in the end the patient did die because of the infection but it just took longer.

However, it appears that the patient is still alive today. That's quite the achievement and opens up interesting ways of beating antibiotic resistance.

Interestingly and semi-related, one of my friends is resistant to antibiotics. Apperantly in her country of origin you can get them pretty much like normal medicine in the pharmacy. People use antibiotics for almost everything, and she did not know about the possibility of developing resistance against it. It was not even 'discovered' until she moved here (Western Europe).

Hopefully more countries will raise awareness around this issue. Because of my bubble I thought everyone would be pretty much aware of it, but as with many things, that was just my bubble :)

jdietrich2• 7 years ago

They wrote "helped prolong the patients life" in some paragraphs. That kept making me think that in the end the patient did die because of the infection but it just took longer.

The patient is alive and well, but her underlying illness (cystic fibrosis) is life-limiting; most CF patients die before the age of fifty and this treatment won't significantly change that life expectancy.

Insanity3• 7 years ago

Ah that explains :) Thanks!

DiseasedBadger• 7 years ago

Are you sure you didn't mean

"Ah that explains :("

perilunar4• 7 years ago

one of my friends is resistant to antibiotics

That's a bit weird. People don't become resistant to antibiotics; the bacteria do.

sena• 7 years ago

Also a nice informative video on bacteriophage from Kurzgesagt: https://www.youtube.com/watch?v=YI3tsmFsrOg

Amygaz• 7 years ago

And then the endogenous CRISPR system will take care of making bacteria resistant to the engineered phages, because that’s what it naturally does, and we will be in another arm race.

Eventually, mentalities around antibiotic used will have to changes: we have to use antibiotics only when necessary; we need to stop trusting that people will take their antibiotics properly and completely; we need to start using so-called “last-resort” antibiotics a lot sooner in the process.

m463• 7 years ago

I've wondered if phages would ever come into the spotlight ever since I read this article about 15 years ago:

"How Ravenous Soviet Viruses Will Save the World"

https://www.wired.com/2003/10/phages

Engineered phages help teenager with antibiotic-resistant infection

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