[HN Gopher] No antibiotics worked, so this woman turned to phage... ___________________________________________________________________ No antibiotics worked, so this woman turned to phage scientists Author : LinuxBender Score : 130 points Date : 2022-07-09 16:41 UTC (6 hours ago) (HTM) web link (edition.cnn.com) (TXT) w3m dump (edition.cnn.com) | chasil wrote: | It appears that commercial sources are already available. | | https://mybacteriophage.net/ | | Anyone with an aggressive bacteriological infection should be | aware of and consider phage therapy when beginning treatment. | | It is also important to pre-treat the selected phage in a | concentrated solution of the pathogen to allow time for | adaptation prior to injection. | uthinter wrote: | Georgia, the country. It has some of the best research and | treatment facilities when it comes to phage therapy. | gnicholas wrote: | > _But the long illness took its toll: Patterson was diagnosed | with diabetes and is now insulin dependent, with mild heart | damage, no feeling in the bottoms of his feet and gut damage that | affects his diet._ | | So if he had received the phage treatment sooner, would that have | lessened these effects? Or are they sure that these effects were | not caused by the phages themselves? Obviously it's better to be | alive, even with these effects, but if doctors were choosing | between several options for a future patient, they'd presumably | want to know the causal chain. | elcritch wrote: | Yes getting the treatment sooner would've prevented damage, | though how much would be harder to say. According to the | account, by the time of treatment the bacterium had caused | widespread damage and the patient had multiple organ failure | before the treatment. | | Phages are also highly adapted to attack bacteria and often | specific bacteria. It's highly unlikely to affect humans. | That's easy to show since dirt is loaded with bacterial phages. | | Additionally there was significant research in Soviet bloc on | the safety and efficacy of phage treatment. | | I'm hoping phage treatment becomes more common and better. The | rise of bacterial superbugs is one of the greatest threats to | modern life, as in we don't expect ourselves or loved ones to | die routinely from bacterial infections. However that's very | recent thing in human history. I'd readily wager that bacterial | diseases have killed far more people than viral infections. | They're the literal plague. | pieter_mj wrote: | There's also the success story of terror victim Karen | Northshield. She has had about 70 operations after the march 2016 | Brussels airport attack. | | In the beginning of her recovery, she survived life-threathening | bacterial infections with phage therapy. | Traubenfuchs wrote: | Why do we keep reading annoyingly insular case reports of people | with relatively common, but highly multi drug resistant bacteria | who get saved by phages, while at the same time being afraid of | the antibiotic apocalypse? | | What keeps us from having a register/bank of highly effective | phages to treat people with those boring old multi drug resistant | bacteria bacteria? | | Why do we keep saving and at the same time ruining peoples lifes | with fluoroquinolones, gentamicin and other dangerous antibiotics | instead of just giving them phages? | coryrc wrote: | > What keeps us from having a register/bank of highly effective | phages | | The FDA. The only freedom you have in the USA is to die. | | Oh, sure, you are allowed to do it entirely yourself and with | your own funds, but you can't share the burden with people. Yay | freedom. | jryb wrote: | It's super complicated - clinical trials of phage therapy have | been relatively unsuccessful for one thing, so there's that. | But additionally: - Bacteria adapt to phage | infections, just as they do to antibiotics - Many phages | are very host-specific, so a given cocktail might not even be | able to target the pathogenic bacteria in question. There are | phages with broader host spectra, but then they might be able | to target the rest of your microbiome, which can lead to other | health problems - Since phages have protein shells, human | antibodies will target them, and may prevent them from reaching | the infected tissue. You might also only be able to use a | particular phage once for this reason. | | I could go on, but suffice it to say, there are lots of | unknowns and lots of complexity. Still, I do have hope for the | technique in general, and our ability to understand phage- | bacteria interactions is only getting better now that | sequencing is super cheap. But I wouldn't bet my life on phage | therapy working if I needed it today - which is why it's | generally limited to compassionate use when antibiotics have | failed. | treeman79 wrote: | How on earth did she get approval? | | It took me a year of doctor shopping to get an approved treatment | for a common condition. | docdeek wrote: | Very interesting - thanks for sharing. I'm not a scientist and | the only time I've come across discussion of phages before was in | the Michael Crichton novel, Prey. | carapace wrote: | In a nutshell, it works but antibiotics work better (until they | don't, eh?), so phage therapy was largely eclipsed in the West. | However: | | > Isolated from Western advances in antibiotic production in | the 1940s, Russian scientists continued to develop already | successful phage therapy to treat the wounds of soldiers in | field hospitals. During World War II, the Soviet Union used | bacteriophages to treat many soldiers infected with various | bacterial diseases e.g. dysentery and gangrene.[28] Russian | researchers continued to develop and to refine their treatments | and to publish their research and results. However, due to the | scientific barriers of the Cold War, this knowledge was not | translated and did not proliferate across the world. | | https://en.wikipedia.org/wiki/Phage_therapy | | See also https://en.wikipedia.org/wiki/Marine_bacteriophage | (for fun, or maybe horror? The oceans are _grey goo_.) | neodypsis wrote: | That Wikipedia entry mentions that bacteria may develop | immunity from previous bacteriophage infection. | robocat wrote: | > However, due to the scientific barriers of the Cold War, | this knowledge was not translated and did not proliferate | across the world. | | I would hazard a guess that the reasons are other than | translation. Keen scientists learn enough of foreign | languages to read papers in their area of interest - reading | scientific language in a speciality area is much easier than | learning a language generally (I personally know scientists | that have self-taught themselves for Russian, German, French, | etcetera). | | "Many researchers agree that the development of phage therapy | has stalled because of 'concerns over intellectual property | protection' and 'lack of a predefined regulatory pathway' | (Kingwell, 2015)" https://academic.oup.com/phe/article/13/1/8 | 2/5741402?login=f... | | > across the world. | | Is that an American centric worldview? It makes little sense. | Maybe the USA and allies, but there is a lot more to the | world than that, and phages haven't been used. The reasons | for that are very unlikely to be due to what appears to be a | simplistic world view. | carapace wrote: | I gather phage therapy was seen in Western bloc nations as | akin to Lamarckian evolution, so even otherwise keen | scientists tended to dismiss it. And of course, antibiotics | work really well (until they don't.) | | I have no idea how widespread phage therapy was in the | Soviet bloc nations. | | The Cold War distorted a lot of things. | DonaldFisk wrote: | Bacteriophages are also in Arrowsmith by Sinclair Lewis, where | they were used to treat plague. | eranation wrote: | > First, Strathdee found an obscure treatment that offered a | glimmer of hope -- fighting superbugs with phages, viruses | created by nature to eat bacteria. | | > Then she convinced phage scientists around the country to hunt | and peck through molecular haystacks of sewage, bogs, ponds, the | bilge of boats and other prime breeding grounds for bacteria and | their viral opponents. The impossible goal: quickly find the few, | exquisitely unique phages capable of fighting a specific strain | of antibiotic-resistant bacteria literally eating her husband | alive. | | > Next, the US Food and Drug Administration had to greenlight | this unproven cocktail of hope, and scientists had to purify the | mixture so that it wouldn't be deadly. | | > Yet just three weeks later, Strathdee watched doctors | intravenously inject the mixture into her husband's body -- and | save his life | [deleted] | stareatgoats wrote: | What an amazing story, one which should give hope to the many | people that are battling superbugs as we speak. Her (Strathdee's) | Wikipedia page gives some more background, out of which this | stood out to me: | | "Although phage therapy had been used for one hundred years in | Eastern Europe, it was not licensed for clinical use in the | United States or most of Western Europe" [0] | | Which indicates (if not proves) that healthcare is one one of the | casualties of our polarized world. | | [0] | https://en.wikipedia.org/wiki/Steffanie_A._Strathdee#Role_in... | bsedlm wrote: | it's really terrible how the caring for one's health aspect of | the medicine industry has taken a secondary role, the really | important thing is corporate profit, patients are getting | treated, but not healed | | this is not to say the treatments are not effective, but I | think it's telling to consider that the reason treatments | remain effective is to avoid defrauding customers (err. | patients), not becuase the intention is healing people. | kosyblysk666 wrote: | t_mann wrote: | Thanks for sharing. Multiresistant bacteria are high on my list | of slow-mo crashes happening before our eyes that no one seems to | be talking about (compared to eg climate change, which is also a | slow-mo catastrophe, but at least one that people are talking | about). And it's always puzzled me how little I hear about work | being done on phages, which pose an interesting approach to | tackle the problem (compared to eg quantum computing, where | commercialization potential seems to be a lot further out). | Loic wrote: | At least in France, a series of antibiotics are not allowed to | be used/sold outside of hospitals. This is to ensure that | hospitals have some _last resort_ antibiotics in hard cases. | But even with that, they have issues. | | In Germany, where I live at the moment, the risks and issues | are well known and talked about. I have seen a large reduction | of the prescription of antibiotics. The younger the MD, the | less antibiotics are given. | | But 80% (maybe even more) of the antibiotics are used by animal | farming... | belorn wrote: | It kind of worries me when people talk about reduction in | prescription of antibiotics. If we are talking about | primarily about false diagnoses and prescription of | antibiotics when there exist equal or better treatment plans, | then a reduction in antibiotics is good. The day when people | got antibiotics in order to treat a cold is hopefully over. | | The cases that worries me most is however debilitating | chronic illnesses (where antibiotics is used as a stop gap | until medical science find a cure), and illnesses which if | let untreated might turn into a debilitating chronic problem. | I hope they are keeping a close watch on the outcomes from | those younger MDs. | | Antibiotics in animal farming is obviously terrible. Animals | should not be allowed to be kept unless it is in an | environment that is safe and healthy for them. Antibiotics is | a tool used to fix how poor some large scale farmers treat | their animals. | gwerbret wrote: | > The cases that worries me most is however debilitating | chronic illnesses (where antibiotics is used as a stop gap | until medical science find a cure) | | Which debilitating, non-bacterial chronic illnesses are | treated with antibiotics as a stopgap measure? | Teever wrote: | not necessarily debilitating, but current treatments for | rosacea include a low dose prescription of antibiotics | like doxycycline, basically forever. | sterlind wrote: | acne is bacterial but chronic. it's standard practice for | dermatologists to prescribe long-term antibiotics for | severe acne, rather than turn to accutane. | NikolaNovak wrote: | Controversially but famously, "chronic Lyme disease" | involves course of multiple super strong antibiotics over | potentially years. Then things to try to save your organs | from antibiotics. Then pills to help you digest those. | Taking 50 pills on regular basis is apparently common | enough. | sterlind wrote: | iirc antibiotics in cows are _not_ principally used as | medicine. it 's because chronic antibiotic use makes cows | put on weight faster. I don't know the mechanism. | voisin wrote: | > But 80% (maybe even more) of the antibiotics are used by | animal farming... | | This is what needs to be talked about more. Like guns in the | US, or telecom oligopolies in Canada, it seems animal based | agriculture gets the "thoughts and prayers" treatment rather | than any substantive discussion about what harm it is causing | the planet, human health, and biological safety via | antibiotic resistance. | nradov wrote: | The FDA is actively working on this issue. | | https://www.fda.gov/animal-veterinary/safety- | health/antimicr... | Terry_Roll wrote: | It is. https://www.worldanimalprotection.org.uk/sites/defau | lt/files... | | 1ml of sea water will contain billions of phages, but its | pot luck if you get the right strain. | | Another thing not mentioned with antibiotics is man y are | penicillin based that when metabolised become penicillamine | which is used to treat copper toxicity or Wilson's disease, | ie it makes the liver dump copper out of the body. Copper | is needed to produce Interleukin-2, a naturally occurring | chemo drug, most effective when injected into tumours, but | having naturally high levels circulating can be helpful as | a prevention measure. | | Creatine when metabolised becomes creatinine which in | sufficient qty can kill gram positive and gram negative | bacteria. If you get 3rd degree burns, the muscles | catabolise to release creatine and then the creatinine | helps to keep bacteria at bay with the wounds. | | It probably also explains why the US military are | reportedly the only one's to use copper sulphate to debride | battlefield wounds. Even the WHO dont recommend using it! | Copper sulphate will dissolve skin though. | | Vitamin D also increases creatinine, and because creatinine | is used for estimated glomular filtration rate kidney | tests, high levels of creatinine can make you appear to | have various stages of kidney disease. Medical lab tests | (human and veterinary) can not tell if you are | supplementing so dont get an inaccurate diagnosis. | jryb wrote: | There are plenty of people/companies working on phage | therapies, and there are clinical trials happening now [1]. In | some eastern European countries you can buy phage solutions | over the counter. It just doesn't get much press - though I'd | speculate that's because phage therapy clinical trials have | been pretty lackluster so far. | | 1: | https://clinicaltrials.gov/ct2/results?cond=&term=phage+ther... | Archelaos wrote: | Research in the field of phage therapy has traditionally been | strong in the Soviet Union since the 1920s and in other Eastern | Bloc countries such as the GDR after WW2. In recent years, the | area has gained renewed attention in Germany. There exists | currently an extensive programme of basic research on phages | funded by the German Research Foundation (DFG). The project Web- | site is located at: https://spp2330.de/ | jamal-kumar wrote: | Shout out to the country of Georgia for being the stronghold of | this since the 1920s [1] | | [1] https://eptc.ge/ | blacksmith_tb wrote: | They've registered an even better domain name I see: | https://pha.ge/ | bijant wrote: | Broad Spectrum Antibiotics were superior to Phage Therapy when | they were first introduced, as they didn't necessitate time | intensive cultivation of the pathogen prior to administration. | The high selectivity of Bacteriophages was their main | disadvantage. Today, with all the knowledge about the | importance of a healty gut Biome, the potential risk to "good | bacteria" has to be weighed before administration of | antibiotics is considered. Fast diagnostic tests, like the use | of PCR to detect Covid-19, turn Phage Therapies greatest | Drawback, its selectivity, into its greatest advantage. | PaulKeeble wrote: | There are two really interesting parts of Russian medicine which | the West hasn't really pursued which it should. Phages is one and | they really are an incredible solution to antibiotic immune | bacteria, the issue is always finding the right one, there are so | many different phages and bank of all of them would be enormous, | 10s probably 100s of thousands. | | The second is auto vaccines and Lysates which present dead | bacteria to the body so it can create an appropriate immune | response. They are used in Russia for things like Urinary tract | Infections which in the West are often untreatable with | antibiotics but they do seem to work. Get the immune system to | recognise the baddy and work out how to kill it and then in the | harder to reach places it can be effective. Works fairly well for | Chronic infections but the issue is identifying the bacteria | precisely to match and existing mix or collecting the bacteria | and cultivating and killing it mechanically or with heat so it | can be injected back into the patient safely in other places in | the body. | | Both techniques were outrun by antibiotics in the beginning, | antibiotics are a lot easier to administer as you don't have to | identify the pathogen precisely and its easy to make in bulk. But | both these more natural solutions are a lot harder for bacteria | to become immune to and have undergone the evolutionary process | alongside us and them. I think both are worth serious efforts and | development. | chasil wrote: | Ideally, the bacteria can't become immune. | | The virus evolves and adapts with the bacteria, modifying its | receptors and modes of action as the host survivors mutate, | which is beyond the capability of a chemical antibiotic. | | This is why it is so important to pre-treat the phage in a | concentrated solution of the target pathogen prior to injection | into a patient, which allows the virus to maximize infectivity. | elcritch wrote: | It seems that'd help make semi "broad spectrum" possible as | well. | | Manufacture a serum loaded with hundreds or thousands of | phages known to target superbugs and let them decimate the | bacteria. Choose the survivors. If you could automate the | last step it could be something any old doctors office could | do. | chasil wrote: | It is important to carefully match the phage with the | target pathogen. A mismatched phage will not be effective. | | This tool can't be used like antibiotics. It requires | expertise in classification. | anewpersonality wrote: | Why don't we use machine learning to find phages? | saiya-jin wrote: | That would explain why urinotherapy may work. Expose your | immune system to pathogens that are in place unreachable to it, | to mount response (multiply antigens that work on them) and | voila. Just that whole idea is rather hard to swallow... | adventured wrote: | You might notice something very peculiar about this story. Here | are the pieces: | | > What she accomplished next could easily be called miraculous | [bullshit] | | > Buoyed by her newfound knowledge, Strathdee began reaching out | to scientists who worked with phages: "I wrote cold emails to | total strangers, begging them for help," she said at Life Itself. | | > she convinced phage scientists around the country to hunt and | peck through molecular haystacks | | > One stranger who quickly answered was Texas A&M University | biochemist Ryland Young. He's been working with phages for nearly | 45 years. Young, a professor of biochemistry and biophysics who | runs the lab at the university's Center for Phage Technology. "We | just dropped everything. No exaggeration, people were literally | working 24/7" ... [that's what happens when I need help, | university departments drop what they're doing to assist] | | > Next, the US Food and Drug Administration had to greenlight | this unproven cocktail of hope [in a week] | | > But the woman who answered the phone at the FDA said, " 'No | problem.' ... " [like magic] | | > And then she tells me she has friends in the Navy [who doesn't] | | > Yet just three weeks later, Strathdee watched doctors | intravenously inject the mixture into her husband's body | | > Legal staff at Texas A&M expressed concern about future | lawsuits ... But Stephanie literally had speed dial numbers for | the chancellor and all the people involved in human | experimentation at UC San Diego. After she calls them, they | basically called their counterparts at A&M, and suddenly they all | began to work together [suddenly it happened, a miracle] | | Ready for it? | | > Strathdee was the associate dean of global health sciences at | the University of California, San Diego | | It wasn't a miracle. It was extreme privilege. She had elite | access and got extraordinarily special treatment and response at | every step. The phage aspect is very interesting, I've been | reading about phages on HN for over a decade probably (and in | that time there has seemingly been relatively little progress in | their usage in the West). The rest of the story is rather | disgusting in how it's portrayed in the article vs what's | actually going on (connections, status, privileged treatment). Oh | but it was like a miracle - no, no it wasn't. | DennisP wrote: | I hope your point is that access to this shouldn't be | restricted to such privileged people. The legal and regulatory | barriers could be lifted, and if that happened then companies | could be started to provide the therapy. | anewpersonality wrote: | I got this from the article too. This couple was incredibly | connected. | | But.. they lived and worked in a field for 40 odd years, why | the hell couldn't they take advantage of it? This isn't like | Dad getting his frat bro son a job at Goldman. | ratdragon wrote: | https://en.wikipedia.org/wiki/Halicin - a recently (2019) | discovered ATB with "an unusual mechanism of action" has been | found to be effective against Acinetobacter Baumanii in mice. | Found using deep-learning. | yibg wrote: | Great story and glad about the positive outcome. But also | highlights the benefits of being well connected. Doubtful a | couple in a similar situation that were not a professor and | associate dean at a well known university could've obtained the | same outcome. | derbOac wrote: | Yes, I had the same reaction. Altogether it's inspiring and I'm | happy to see novel treatments like it when antibacterial | therapies are desperately needed. At the same time seeing these | inequities in the system was disturbing to me. | | It's not only the special privileges the couple enjoyed -- how | they received the treatment and another did not -- it's also | how generating some sort of enthusiasm about a research area | can require this kind of private string pulling. If one of | those researchers had submitted a research grant on phage | therapy would it have been approved? | | I liked the article and am not meaning this as a criticism of | it, the couple, the people involved, or the therapy. It's just | revealing of structural problems in academics, health care, and | society. | hdjjhhvvhga wrote: | Interesting topic aside, thank you so much for linking to the | lite version. | triyambakam wrote: | I didn't even realize it was CNN | mirekrusin wrote: | Whoever came up with lite version at CNN should get standing | ovation. ___________________________________________________________________ (page generated 2022-07-09 23:01 UTC)