Alternatives to current treatments for bacterial and viral infection
Please discuss your findings and thoughts on this.
In the face of antibiotic and antiviral resistance increasing worldwide are there other approaches than antibiotics to address this approaching crisis such as immunotherapies that enhance immune responses in infected patients? The impact of antibiotics on the world, about eighty years ago, revolutionized the treatment of bacterial infections just as antiviral therapy changed the prognosis of HIV infection. Despite the World Health Assembly adopting a resolution, in 1998, encouraging member states to address the problem of antimicrobial resistance and to take action.1 Following this, in 2000, the World Health Organization presented a global strategy for the containment of antimicrobial resistance, calling for a multidisciplinary and coordinated approach.2,3 The resources needed to implement the strategy are not available.
Some of alternative strategies against infection include gene therapies that enhance the immune response to infection and bacteriophage antibiotics as antimicrobial defenses. Prokaryotic gene therapy has been suggested to combat multidrug resistant bacterial infection and was in use pre-antibiotic (pre1929).
A pathogen that tends to develop resistance such as Staphylococcus aureus is responsible for about 260000 nosocomial infections in the USA and causes between 60000 and 80000 deaths annually. Resistance to the newer Streptogamins, where resistance is related to the horizontal transmission of SatA (Synercid), has already been documented in streptogammin fed poultry. Apart from the obvious lifestyle choices and dietary requirements for a healthy immune response to pathogens (reduced stress factors, increased antioxidant function). Once infected, could biomedical approaches to boosting innate immune responses an alternative to antibiotics and antiviral drugs, a similar strategy to some cancer gene therapy approaches that consist of protective immune response stimulation.
Antibacterial therapy
Currently, an immunotherapeutic is in the early stages of development and would work by using antibodies, which neutralizes Clostridium difficile. Development of immunotherapeutic is being considered to treat patients with difficult to treat bacterial infections.
Antiviral and antitumor therapy
Immunotherapy has been used to treat cancer for some time and some researchers have reported antiviral effects when using percutaneous, intrahepatic IL-12 gene therapy for hepatocellular carcinoma [Sangro B et al., 2004]. An adenoviral vector delivered this IL-12 gene and when delivered directly to the site of the tumour there was little evidence of hypersensitivity and autoimmune reactions. Antiviral effects have been reported in patients treated with IL-12 gene therapy for liver tumors. One issue arising from enhanced immune response such as systemic IL-12 and IFN gamma therapy to treat viruses such as HCV can cause drug-induced hypersensitivity.
As our understanding expands about innate and adaptive immune responses and immunotherapy techniques develop, could this knowledge be directed to investigating new approaches to treating some microbial infectious diseases by pooling our knowledge and resources collaboratively?
There is great therapeutic potential in antimicrobial peptides, part of the innate immune system, whose action is confirmed in animal models and indicates that host defense peptides are crucial for both prevention and clearance of infection. However there is an argument that using these peptides may advance microbial resistance to natural innate defenses.
Prior to HIV treatments other than AZT, one of my patients develop Mycobacterium avium-intracellulare bacteraemia, a death sentence infection at the time. He should have died, but in addition to the usual antibacterials, I added DHEA. He survived on HIV monotherapy for another 10 years, and his HIV counts fell to zero.
I believe this and iron and Vitamin D all increased his innate immunity in various ways, but I have no proof of this.
That's really interesting, thanks John.
Supplementation does provide a lot of anecdotal evidence for protection against infection as well as some concrete statistical evidence.
2000mg of vitamin C and 30mg zinc seems to move respiratory viruses along quickly when the patient has a history of tonsillitis and chest infections without the supplements.
Vitamin and mineral status of a patient may be an important factor in infection outcomes and susceptibility to infection. Evaluating this status is usually extremely difficult as baseline status can vary so such much between individuals.
Have tried to soften the natural alternative: Ex neutralize through the bio-magnetic resonance.
'Homocysteine focused' pathways are all going to be relevant to how well the immune system and glutathione system and repair system and sleep systems will coordinate.
we used the biosurfactant purified from Lactobacillus for treetment some bacterial infection as alternative treetment
There are some really interesting aspects coming out of this discussion, some that I had not considered at all and I am appreciating the broad nature of your comments as we are usually so focussed. Perhaps this could lead to more lateral thinking in our approaches to the subject.
My own research has shown polymorphic differences in individuals that are associated with disease susceptibility and some indicate that certain alleles give increased expression of proteins that prove to be important in immune responses to infection or oxidative stress. Knowledge of this protein expression conferring improved outcomes to infection could be new areas to target for treatments (perhaps gene therapy).
I am very interested in epigenetic factors that exist due to a population’s environment. The homocystiene comment from John is interesting as it has a role in methylation of DNA and thus may be involved in epigenetic events. Imprinted genes that confer protection against disease or provide less protection may also be excellent targets for designing new therapies against human disease. I suppose an obvious example for this is in the antioxidant genes or proteins involved in the immune response. Aberrant DNA methylation patterns are used as potential biomarkers for cancer diagnosis and prognosis.
Prevention via vaccines and better infection control to reduce the overall burden of infectious disease
Smarter prescription of antibiotics e.g. near-patient point of care diagnostics that can distinguish between a bacteria and virus and also provide resistance profile rapidly (particularly important for the very ill, such as those with sepsis)
Improved surveillance in low and middle income countries to provide earlier identification of emerging resistance
I'm currently doing a research on using gen therapy to treat antibiotics resistance; however I hardly find any articles about it. Can you provide me some articles? I greatly appreciate your time and help.
Specific plasmids engineered by deleting antibiotic resistance genes can help restore antibiotic susceptibility in plasmid-mediated bacterial colonies in vitro. It is to be hoped these interference plasmids might help reverse antibacterial resistance in vivo as well.
By promoting and emphasizing good husbandry practices and discouraging over reliance of antimicrobial agents given continuously through feeds and water.
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