PROMPT: Imagine yourself as the head of a funding agency (like the National Institute of Health) in which your job is to look at proposals for research projects and decide what projects to award funding to. Based on your readings this term, discuss a research project (or projects) that you would be most excited about funding as they relate to learning more about microbial influences on human health. As part of your response, consider what are we likely to learn from the project and how that might be important in future healthcare decisions.
There will likely always be two sides to getting funding for research that come into play when an agency makes its choice. First, the more obvious one, what are the potential monetary profits from any conclusions of the study? Second, what are the potential benefits, how significant are those benefits (i.e. lifesaving/changing vs very mild improvement) and how many people could potentially benefit from funding this research? Sadly, many times the first consideration will end up overshadowing the second no matter how significant. If there is no profit to be made from the results of the study, or only a small number of people the research targets, it can hard to find the appropriate funding needed. In a perfect world, no quanta of money would be considered more important than any life, and thus thinking in nontraditional manners is crucial to develop the latest and greatest treatment.
We have gone over a multitude of relations and impacts microbes have on human health, with different concepts having a varying reach of impact. If I were to propose a study that I would find to be interesting and would still be potentially highly profitable, I would look at MDROs and the drug resistances epidemic we are facing. As more and more antibiotics are becoming ineffective in treating infections, were running out of options of treatment, potentially at the cost of numerous lives. Since bacteria replicate so quickly and with a high rate of mutation, almost any time a new antibiotic is created, it will become relatively ineffective in some manner of time. Current antibiotics target various stages of bacterial replication, relying on this to make further replication ineffective and in time the bacterial colonies die, and the infection is cured. However, if a mutation occurs in a way which the antibiotic can no longer bind to, or negatively impact the replication, resistance forms.
Modern antibiotics use chemicals, either organic (i.e. in penicillin) or synthesized, to kill the bacteria causing the infection. Interestingly, nature created its own antibiotic organism long before the first animals stepped foot on land. These, are bacteriophages, or virus which infect bacterial cells. (1) The use of bacteriophages to fight infections, known as ‘Phage Therapy’ is no modern concept. It was discovered AND USED in the 1920s and 1930s, years before penicillin or sulfa antibiotics were discovered, and were the only therapy available for a short period of time. Unfortunately, when penicillin was discovered, phage therapy was put on the back burner in western medicine, and to this day is only allowed in a few regions of the world. (2) Antibiotics offered a cheap, relatively harmless cure for the infection, and our limited medical knowledge in the early-mid 20th century it made a lot more sense to focus on killing the bacteria with cheap medication that could be manufactured easily on a large scale.
However, at the time we were unaware of the epidemic that was looming over our future. With Antibiotic resistance bacteria popping up more and more, and with increasingly tough resistance to even multiple different forms of antibiotics, it’s clear that we must look elsewhere to find future treatments. Further, antibiotics are not harm free, the increasing need for highly specialized antibiotics has caused an increased price and limitations in available amounts, and harsh side effects can often result from antibiotic us from killing more than just the targeted pathogenic bacteria. These are two of the areas where phage therapy can shine.
First, bacteriophages, like bacteria, replicate at an incredibly fast rate and are thus able to potentially counter resistance developed by pathogens through their own mutations. This means that counter resistance could develop as quickly as resistance forms in the first place. Second, since bacteriophages replicate quickly, producing them on a large scale could be relatively cheap and quick with the right equipment. Third, with the phages being viruses, they are incredibly tiny, multiple times smaller than even bacteria. That means that little space is needed to store the bacteriophages used in treatments. Finally, another promising aspect of phage therapy is the fact that bacteriophages can be incredibly specific in the cells they attack, not only being able to be limited to target a single species but even individual strains! (2)
I am not sure exactly why Phage Therapy died out after the introduction of antibiotics, rather than be used concurrently. However, we are reaching a point where our future options are limited. The number of drug-resistant organisms is increasing much quicker than newly designed antibiotics can be developed, tested and put into public use. This is a critical time in medicine, and we must look at all potential avenues to find the light at the end of the tunnel, and not place limitations on the tools we can use. I think this is one area of medicine that will bring about some incredible innovations in the near future.
Sources:
- Lin D, Koskella B, Lin H. 2017. Phage therapy: An alternative to antibiotics in the age of multi-drug resistance. World J Gastrointest Pharmacol Ther. 8(3):162.
- Wittebole X, De Roock S, Opal S. 2013. A historical overview of bacteriophage therapy as an alternative to antibiotics for the treatment of bacterial pathogens. Virulence. 5(1):226-235.
