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This virus therapy could help us survive the Superbug era



In November 2015, infectious disease epidemiologist Steffanie Strathdee and her husband, evolutionary psychologist Tom Patterson, spent Thanksgiving week exploring pyramids and pharaohs tombs in Egypt when Patterson came into contact with an unpleasant bout of food poisoning on board her cruise ship. However, as his condition rapidly deteriorated and he had to become an emergency physician, first to Germany and then to the medical center of UC San Diego, where both scientists worked as collaborators, blood and imaging tests showed why Patterson's body failed. A football-sized cyst in the abdomen was infected – swarming with one of the world's most dangerous antibiotic-resistant bacteria.

Thus The Perfect Predator begins the gripping true story of a scientist crusade to save her husband's life by reviving a centuries-old Soviet healing largely ignored by Western medicine. Part of the medical mystery, a part of the personal memoir, the couple's first book reports of Strathdee's desperate attempts to recruit researchers ready to recruit Patterson into phage therapy ̵

1; a cocktail of viruses that infest bacteria from septic shock and eventually into and out of coma.

Strathdee and Patterson spoke for an interview to talk about the experimental treatment that brought him back from the brink of death, and how it has led scientists and physicians in the US to take a closer look at phage therapy as a possible solution to the problem upcoming era of superbugs.

WIRED: Steffanie, before Tom became ill, had you ever heard of phage therapy?

SS: # I It came on PubMed [a free, public search engine for biomedical journal articles] late at night along with a number of other alternative therapies for superinfections. I knew from my college microbiology lessons that phages are viruses that attack bacteria, but I did not know they were ever developed for therapeutic purposes. And I thought, wow, they have been used in the former Soviet Union for decades and it was like, "Why are not they used here?"

WIRED: Well, why not her?

SS: There were a few things going on. Initially, the main bacteriophage discoverer, Felix d & # 39; Herell, was a difficult guy. He tended to tick people off. And because he was a "vagabond scholar" with no formal education, some of the people he worked with, including a few Nobel laureates in the West, really had something for him. The other part was that phage therapy was vigorously adopted by the former Soviet Union, the Republic of Georgia and Poland. It was discovered before the arrival of modern antibiotics and persisted thereafter, as access to penicillin was very poor at that time. Thus, Stalin and others adopted phage therapy as a pillar of the Soviet approach to health. And that's why the West really looked down. If you support phage therapy in the US, you were referred to as the Pinko Commie. In fact, it's a fascinating story about how geopolitical inclinations creep into science. The fact that this was considered a Soviet science has really shaped Western views on phage therapy for decades.

WIRED: How did you convince Tom's doctors that, given his turbulent history, this approach was worth a try? SS: You know, in our dealings with medicine, especially in the US, we have been taking risks because of legal disputes – the whole worry, if we try this experimental treatment and the patient dies, you will become us Sue. But in that case, we were lucky enough to be at UC San Diego, a teaching and research hospital where everyone knew that Tom would die if we did not do something drastic. Some people said he died within hours if we did not initiate phage therapy.

WIRED: They have completed work with researchers from Texas A & M University and the US Naval Medical Defense Order to obtain three different phages that are able to attack the Acinetobacter infection. Tom, when did you first find out that you were the subject of this great experiment?

TP: When I came out of coma, I was in a coma for over two months. I turned to Steff and said, "What did I miss?" And she said, "Well, Donald Trump is the presumptive candidate for the President of the United States. And we healed you with viruses from a sewer in Texas. "I thought, I must surely hallucinate again!

SS: We had to tell him again and again because he could not keep much information at this point. It all sounded so fantastic.

WIRED: What do you think now that you have had some time to think about your guinea pig experience?

TP: Steffanie and I met from our work as AIDS researchers, and in this world, viruses are always considered the villain. So it was a real transition to believe that viruses could do a good job. But now I can really appreciate it from an evolutionary point of view. I see this whole battle that took place in my body, similar to the Serengeti Plain. The bacteria are the herds of wildebeest, they expand too much and eat up all the grass because there are not enough predators. The predators in this case are the phages, so I think they are considered lions. Our employees had to go out and find the lions. You can not just take a snow leopard and drop it into that environment and expect it to eat gnus because it evolved to shoot something else.

SS: That's really cool. To our best estimate, Earth has 10 out of 31 phages – 10 million trillion trillion. And all have evolved to attack different bacteria. One day we may know enough about the phages to clean the microbiome, not only weed out antibiotic-resistant bacteria, but also other types of insects. Most experts say that we do not know enough about phagioma to reach this goal, but it is the future.

WIRED: In the meantime, however, you've been working on testing phage therapy for serious infections here in the US. What is the latest news?

SS: It moves very fast. After Tom's case was published in April 2017, we received funding to establish the first center in North America to better understand the role of phage therapy in the treatment of superbugs. It is at UC San Diego under the name IPATH (Innovative Phage Applications and Therapeutics) and we now have two clinical trials underway. One is for people with ventricular devices who tend to become infected with biofilm-forming bacteria that are difficult to penetrate for antibiotics. And the other is for patients with cystic fibrosis who develop resistance to the drugs that keep them alive by fighting against chronic pneumonia.

These are small studies, but they help in answering many of the questions we still have in the end of Tom's case. What happened to all the phages we injected him with? Where did you go? Did his immune system already have existing antibodies? What is the right dose? That sort of thing will help teach larger studies and mainstream phage therapy, not something the scientists in the university corridors have just whispered about.

TP: resources and had connections that many people do not have. This privilege enabled us to emerge from this nightmare relatively unscathed. We want to help ensure that the estimated 1.5 million people who die each year from superbug infections have more resources available as a result of our history.


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