25 Jul 2023
By Dr. Ross Walker
The World Health Organisation has estimated that by the year 2050, multi-resistant strains of bacteria could claim around 10 million lives per year, globally. This is a cause of concern for health and medical organisations around the world and a breakthrough in this area would be widely received and appreciated by the medical profession and the public. However, it is not all doom and gloom, as there has been some exciting work coming out of the Wistar Institute in Pennsylvania as they develop new treatments that not only appear to kill resistant infections but also enhance the natural immunity of the host. The group at Wistar has launched a new generation of antimicrobials known as dual acting immuno-antibiotics (DAIAs).
Current antibiotics predominantly kill bacteria by either damaging the nucleus, synthesising proteins, or breaking down the cell membrane. As the function of every living organism is to survive, bacteria have developed mechanisms to survive by preventing antibiotics affecting any of these processes and therefore inactivating the antibiotics.
The research out of Wistar has found a metabolic pathway that is present in bacteria but not in humans. This pathway, known as MEP, is responsible for a production of chemicals known as isoprenoids, which are essential for cell survival. A particular enzyme known as IspH is vital for the production of these chemicals. Through extensive research, an inhibitor of this enzyme was discovered that was shown to be harmless to humans but toxic to bacteria. The IspH inhibitor out-performed current antibiotics, including resistant bacteria, with the added benefit of stimulating the immune system improving the body’s ability to eliminate pathogenic bacteria.
Although this work has only been performed in the laboratory, the next step is human trials to demonstrate efficacy and lack of toxicity. Although these treatments are still probably 5–10 years away, it will probably be around the same time that the multi-resistant bacteria start to become a very prominent and concerning aspect of human health, even more so than it is at present.
This study highlights the vital importance of ongoing research in all areas of medicine, other than just focusing on the pandemic which dominated the attention of the entire world over several years.
Unless we can conquer this increasing scourge of antibiotic resistance, in around a decade, we will enter the post antibiotic era which, in my view, is a much scarier thought than what we faced during the recent pandemic.
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