Ira Pastor, ideaXme exponential health ambassador and founder of Bioquark interviews Dr. Steffanie Strathdee, Associate Dean of Global Health Sciences and Harold Simon Professor in the Department of Medicine at the University of California San Diego School of Medicine.
Ira Pastor comments:
So here we are in 2019, and although we spend a lot of time on the show talking about chronic degenerative disease responsible for human suffering and death, we can’t lose sight of the fact that infectious diseases remain a leading cause of death worldwide, particularly in low income countries, especially in young children.
Three infectious diseases rank in the top ten causes of death worldwide by the World Health Organization. They are lower respiratory infections (3.0 million deaths), diarrheal diseases (1.4 million deaths), and tuberculosis (1.3 million deaths). HIV/AIDS, which was previously on the list, has dropped from the global list of the top ten causes of death (1.0 million deaths in 2016 compared with 1.5 million in 2000), but it is still a leading cause of death in low income countries. Another infectious disease, malaria, accounts for a top cause of death in low income countries.
Antibiotics
An antibiotic, by definition, is a type of antimicrobial substance specifically active against bacteria and is the most important type of antibacterial agent for fighting bacterial infections and is widely used in both treatment and prevention.
The modern era of antibiotics started with the discovery of penicillin by Sir Alexander Fleming in 1928 and since then, antibiotics have transformed modern medicine and saved millions of lives.
Antibiotics were first prescribed to treat serious infections in the 1940s successfully controlling bacterial infections during World War II.
However, shortly thereafter, penicillin resistance became a substantial clinical problem, so that by the 1950s, many of the advances of the prior decade were threatened. In response, new classes (Tetracyclines, Erythromycins, Amino-Glycosides) as well as new beta-lactam antibiotics (penicillin derivatives, cephalosporins, monobactams, carbapenems, etc). were discovered, developed, and deployed in the clinic.
Bacterial Resistance
Unfortunately, bacterial resistance has eventually developed to all antibiotics that have been developed, including methicillin. Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 1962 and Vancomycin (a true antibiotic of last resort) which was introduced into clinical practice in 1972 for the treatment of methicillin resistance. However, cases of vancomycin resistance popped up shortly thereafter in 1979.
And the tangential big problem to all this antibiotic resistance was that the antibiotic pipelines of pharma simultaneously began to dry up. As a result, here we are in 2019, many decades after the first patients were treated with antibiotics, bacterial infections have again become a major threat around the globe.
So the big question becomes, on a planet with an endless array of pathogenic bacteria that have survived billions of years in quite inhospitable circumstances, and which have in the course of only one century shrugged off everything within modern medicines antibiotic portfolio, where do we look for future solutions to this problem?
Bacteriophages
Well, some creative thought leaders believe that the answers exists in another tough groups of organisms that live on this planet. Namely, the bacteriophage (or phage for short), which is a type of virus that infects and replicates within bacteria. The term derives from “bacteria” and the Greek (phagein), “to devour”.
Bacteriophages are among the most common and diverse entities in the biosphere and it is estimated there are more than 1031 bacteriophages on the planet, more than every other organism on Earth, including bacteria, combined.
Interestingly, phages have been used for over 90 years as an alternative to antibiotics in the former Soviet Union and Central Europe as well as in France. They are seen as a possible therapy against multi-drug-resistant strains of many bacteria and have been shown to interfere with biofilm production and quorum sensing involved in pneumonia and cystic fibrosis.
Dr. Steffanie Strathdee
So today’s guest, who is going to take us further along this theme and to where the future is taking us, is Dr. Steffanie Strathdee, Associate Dean of Global Health Sciences and Harold Simon Professor in the Department of Medicine at the University of California San Diego School of Medicine.
She is also an Adjunct Professor at Johns Hopkins and Simon Fraser Universities and co-directs UCSD’s new center for Innovative Phage Applications and Therapeutics (IPATH), Global Health Institute and the International Core of UCSD’s Center for AIDS Research.
A PhD infectious disease epidemiologist, she has spent the last two decades focusing on HIV prevention in marginalized populations in developing countries and has published over 600 peer-reviewed publications and has recently begun working to move bacteriophage therapy into clinical trials at IPATH.
Currently, she leads a multidisciplinary team of research on HIV risk behaviors among drug users and sex workers on the Mexico-US border. In 2009, she and her team were awarded the Leadership Award in International Collaboration from the National Institute on Drug Abuse, who also granted her a MERIT award for her research in Tijuana. In total, she has been awarded more than 64 million USD in federal research grants as a principal investigator.
The Perfect Predator
She has recently co-authored a book The Perfect Predator: An Epidemiologist’s Journey to Save Her Husband from a Deadly Superbug, published in 2019 which discusses her experience proposing an experimental bacteriophage therapy that saves her husband from a life-threatening multidrug resistant bacterial infection.
Today we will hear from Dr. Strathdee:
About her background, how she got interested in science, in infectious disease and epidemiology, and eventually into this “bleeding edge” therapeutic area. The history and regulatory dynamics surrounding phage therapy. More about her husband’s case and bringing him back from the edge of death. About the immunomodulating properties of phage therapies, as well as future therapeutic widespread potential in the space.
Credits: Ira Pastor interview video, text, and audio.
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