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<ul class="summary-list"><li>A new study found hundreds of unique viruses called bacteriophage on toothbrushes and shower heads.</li><li>Phage target bacteria, not humans, and could be a useful tool against disease.</li></ul>The next big breakthrough in <a target="_blank" class="" href="https://www.businessinsider.com/disease-prevention-ideas-us-could-learn-from-uk-israel-canada-2022-12">disease-fighting innovation</a> could be no further away than your bathroom.A recent study found hundreds of viruses on samples from toothbrushes and shower heads, including many that have never been seen before, let alone examined.But this specific kind of viruses, known as bacteriophage, aren't concerning for human health because they target and infect bacteria, not us, according to Erica Hartmann, a professor of civil and environmental engineering at Northwestern University who led the study."It's still a big deal; it's just not scary. It's actually really exciting," Hartmann told Business Insider.Understanding how these infectious particles work could be a valuable step in protecting us from <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/conditions-symptoms/what-is-the-difference-between-bacteria-and-virus">harmful pathogens and bacteria</a>, including those that cause tuberculosis and other serious diseases."The more we know about what's in shower heads and what's on toothbrushes with regard to viruses and microbes, the more we can advance in understanding how we get sick and even devise new tools to fight those pathogens," Miryam Wahrman, a professor of Biology at William Paterson University of New Jersey who was not involved with the study, told Business Insider.<h2 id="cfd924b0-3be2-4e3b-8329-12a9c8ebdb95">Unexplored ecosystems are living on your household items</h2>Researchers from Northwestern University were inspired to investigate toothbrushes because of a previous study investigating whether <a target="_blank" class="" href="https://www.businessinsider.com/photos-show-droplets-aerosols-emerge-when-flush-toilet-2022-12">flushing the toilet could release aerosols</a> that might contaminate a toothbrush left out on the countertop.The good news is that the study, nicknamed "Operation Pottymouth," found no evidence of poop-related germs on toothbrushes."Overwhelmingly, we find that microbes on your toothbrush come from your mouth," Hartmann said.The research team decided to put all those used toothbrushes to good use and took a closer look at what's hanging out there.In a previous study, they also analyzed samples taken from <a target="_blank" class="" href="https://www.businessinsider.com/guides/home/how-to-clean-shower-head">shower heads</a> to offer even more insight into our bathrooms' microscopic occupants.The researchers weren't surprised to find that these household items were home to many germs because of their warm, moist environments.But they were blown away by how many different kinds of viruses were present. There was so much diversity that there was almost no overlap between the samples, meaning each toothbrush and shower head was host to its own unique microscopic world.The findings were published October 9 in <a target="_blank" class="" href="https://www.frontiersin.org/journals/microbiomes/articles/10.3389/frmbi.2024.1396560/full">Frontiers in Microbiomes</a>."I'd encourage people to look at things they see every day and think of these as places where we could be making exciting discoveries for new biotechnology," Hartmann said.<h2 id="a5e9a1f5-fb1b-4af8-9e10-a9a211c4ecf9">Phages could be the new frontier in disease-fighting biotech</h2>There's no reason to be grossed out by the tiny inhabitants sharing our homes."I don't think there's any need to change behavior or enhance cleaning. These are not viruses that are going to infect you, these are viruses that are potentially cool," Hartmann said.It's a common misconception to think of all germs and microorganisms as potential threats, but plenty of microbes are neutral, beneficial, and sometimes <a target="_blank" class="" href="https://www.businessinsider.com/foods-better-than-probiotics-for-gut-health-2023-8">necessary for human health</a>.Bacteria and viruses have sparked groundbreaking innovations in science, <a target="_blank" class="" href="https://www.businessinsider.com/longevity-stem-cell-biotech-reverse-aging-cellular-reprogamming-2024-9">biotechnology</a>, and healthcare that we benefit from every day, such as penicillin and DNA research."Microbes are everywhere all the time, and the vast majority of them won't make you sick," Hartmann said. "If we approach with wonder and curiosity instead of fear, we can work with microbes instead of against them."Phage are exciting because they specialize in attacking and replicating inside bacteria, including bacterial pathogens. These pathogens make us sick and can become resistant to our current protective strategies, like <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/treatments/how-long-does-it-take-for-antibiotics-to-work">antibiotics</a>."The enemy of our enemy is our friend. They are potentially a very helpful tool for us," Wahrman said.Researchers have known about the existence of phage for more than a century, but antibiotics have gotten most of our attention. Now that some pathogens have outsmarted antibiotics, phage are a wide-open frontier for innovation.In the future, phage might be a rich source of biotech innovations like <a target="_blank" class="" href="https://www.businessinsider.com/ampliphi-phage-therapy-treatment-bacterial-infections-2017-10">phage therapy,</a> in the same way pharmaceuticals have developed medicines from plants or animals. Rather than scouring remote reaches of the planet, these discoveries could come from digging deeper into what surrounds us every day."There are a lot of things waiting to be discovered just under our noses or on our toothbrushes," Hartmann said.

Your toothbrush is home to hundreds of new viruses. They could be the future of biotech.

Viruses and bacteria have a very long history. Because viruses can't reproduce without a host, they've been attacking bacteria for millions of years. Some of those bacteria eventually became <keyword id="645857" type="General" weightage="80" keywordseo="mitochondria" source="Orion">mitochondria</keyword>, synergistically adapting to life within eukaryotic cells (cells that have a nucleus containing chromosomes). Ultimately, mitochondria became the powerhouses within all human cells. Fast-forward to the rise of novel coronaviruses like SARS-CoV-2, and the global spread of COVID-19. Approximately five per cent of people infected with SARS-CoV-2 suffer respiratory failure (low blood oxygen) requiring hospitalization. In Canada, about 1.1 per cent of infected patients (almost 46,000 people) have died. This is the story of how a team, assembled during the pandemic, recognized the mechanism by which these viruses were causing lung injury and lowering oxygen levels in patients: It is a throwback to the primitive war between viruses and bacteria more specifically, between this novel virus and the evolutionary offspring of bacteria, our mitochondria. SARS-CoV-2 is the third novel coronavirus to cause human outbreaks in the 21st century, following SARS-CoV in 2003 and MERS-CoV in 2012. We need to better understand how coronaviruses cause lung injury to prepare for the next pandemic. How COVID-19 affects lungs People with severe COVID-19 pneumonia often arrive at the hospital with unusually low oxygen levels. They have two unusual features distinct from patients with other types of pneumonia: First, they suffer widespread injury to their lower airway (the alveoli, which is where oxygen is taken up). Second, they shunt blood to unventilated areas of the lung, which is called ventilation-perfusion mismatch. This means blood is going to parts of the lung where it won't get sufficiently oxygenated. Together, these abnormalities lower blood oxygen. However, the cause of these abnormalities was unknown. In 2020, our team of 20 researchers at three Canadian universities set about to unravel this mystery. We proposed that SARS-CoV-2 worsened COVID-19 pneumonia by targeting mitochondria in airway epithelial cells (the cells that line the airways) and pulmonary artery smooth muscle cells. We already knew that mitochondria are not just the powerhouse of the cell, but also its main consumers and sensors of oxygen. Mitochondria control the process of programmed cell death (called apoptosis), and they regulate the distribution of blood flow in the lung by a mechanism called hypoxic pulmonary vasoconstriction. This mechanism has an important function. It directs blood away from areas of pneumonia to better-ventilated lobes of the lung, which optimizes oxygen uptake. By damaging the mitochondria in the smooth muscle cells of the pulmonary artery, the virus allows blood flow to continue into areas of pneumonia, which also lowers oxygen levels. It appeared plausible that SARS-CoV-2 was damaging mitochondria. The results of this damage an increase in apoptosis in airway epithelial cells, and loss of hypoxic pulmonary vasoconstriction were making lung injury and hypoxemia (low blood oxygen) worse. Our discovery, published in <keyword id="15391817" type="General" weightage="50" keywordseo="redox-biology" source="Orion">Redox Biology</keyword>, explains how SARS-CoV-2, the coronavirus that causes COVID-19 pneumonia, reduces blood oxygen levels. We show that SARS-CoV-2 kills airway epithelial cells by damaging their mitochondria. This results in fluid accumulation in the lower airways, interfering with oxygen uptake. We also show that SARS-CoV-2 damages mitochondria in the pulmonary artery smooth muscle cells, which inhibits hypoxic pulmonary vasoconstriction and lowers oxygen levels. Attacking mitochondria Coronaviruses damage mitochondria in two ways: by regulating mitochondria-related gene expression, and by direct protein-protein interactions. When SARS-CoV-2 infects a cell, it hijacks the host's protein synthesis machinery to make new virus copies. However, these viral proteins also target host proteins, causing them to malfunction. We soon learned that many of the host cellular proteins targeted by SARS-CoV-2 were in the mitochondria. Viral proteins fragment the mitochondria, depriving cells of energy and interfering with their oxygen-sensing capability. The viral attack on mitochondria starts within hours of infection, turning on genes that break the mitochondria into pieces (called mitochondrial fission) and make their membranes leaky (an early step in apoptosis called mitochondrial depolarization). In our experiments, we didn't need to use a replicating virus to damage the mitochondria simply introducing single SARS-CoV-2 proteins was enough to cause these adverse effects. This mitochondrial damage also occurred with other coronaviruses that we studied. We are now developing drugs that may one day counteract COVID-19 by blocking mitochondrial fission and apoptosis, or by preserving hypoxic pulmonary vasoconstriction. Our drug discovery efforts have already enabled us to identify a promising mitochondrial fission inhibitor, called Drpitor1a. Our team's infectious diseases expert, <keyword id="15391818" type="General" weightage="50" keywordseo="gerald-evans" source="Orion">Gerald Evans</keyword>, notes that this discovery also has the potential to help us understand Long COVID. "The predominant features of that condition fatigue and neurologic dysfunction could be due to the lingering effects of mitochondrial damage caused by SARS-CoV-2 infection," he explains. The ongoing evolutionary battle This research also has an interesting evolutionary angle. Considering that mitochondria were once bacteria, before being adopted by cells back in the primordial soup, our findings reveal an Alien versus Predator scenario in which viruses are attacking "bacteria." Bacteria are regularly attacked by viruses, called bacteriophages, that need a host to replicate in. The bacteria in turn fight back, using an ancient form of the immune system called the CRISPR-cas system, which chops up the viruses' genetic material. Humans have recently exploited this CRISPR-cas system for a Nobel Prize-winning gene editing discovery. The ongoing competition between bacteria and viruses is a very old one, and recall that our mitochondria were once bacteria. So perhaps it's not surprising at all that SARS-CoV-2 attacks our mitochondria as part of the COVID-19 syndrome. Pandemic pivot The original team members on this project are heart and lung researchers with expertise in mitochondrial biology. In early 2020 we pivoted to apply that in another field virology in an effort to make a small contribution to the COVID-19 puzzle. The diverse team we put together also brought expertise in mitochondrial biology, cardiopulmonary physiology, SARS-CoV-2, transcriptomics, synthetic chemistry, molecular imaging and infectious diseases. Our discovery owes a lot to our virology collaborators. Early in the pandemic, University of Toronto virologist Gary Levy offered us a mouse coronavirus (MHV-1) to work with, which we used to make a model of COVID-19 pneumonia. Che Colpitts, a virologist at Queen's University, helped us study the mitochondrial injury caused by another human beta coronavirus, HCoV-OC43. Finally, Arinjay Banerjee and his expert SARS-CoV-2 virology team at Vaccine and Infectious Disease Organization (VIDO) in Saskatoon performed key studies of human SARS-CoV-2 in airway epithelial cells. VIDO is one of the few Canadian centres equipped to handle the highly infectious SARS-CoV-2 virus. Our team's super-resolution microscopy expert, <keyword id="15391819" type="General" weightage="50" keywordseo="jeff-mewburn" source="Orion">Jeff Mewburn</keyword>, notes the specific challenges the team had to contend with." Having to follow numerous and extensive COVID-19 protocols, they were still able to exhibit incredible flexibility to retool and refocus our laboratory specifically on the study of coronavirus infection and its effects on cellular/mitochondrial functions, so very relevant to our global situation," he said. Our discovery will hopefully be translated into new medicines to counter future pandemics. SEE ALSO: <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/science/research/news/young-working-professionals-now-at-high-stroke-risk-study/articleshow/95163788.cms">Young working professionals now at high stroke risk: Study</a> <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/science/space/news/isro-carries-out-key-test-of-its-heaviest-rockets-engine/articleshow/95158967.cms">ISRO carries out key test of its heaviest rocket's engine</a>

Covid-19 damages lungs by continuing an ancient battle that began in the primordial soup

<div class="KonaFilter image-container display-table float_right"><div><div class="image on-image"><a href="http://en.wikipedia.org/wiki/Phage_therapy#/media/File:Phage.jpg">Dr Graham Beards / Wikipedia</a>An electron micrograph image shows phages attached to a bacterial cell.</div></div></div>Antibiotic resistance - the phenomenon in which bacteria stop responding to certain antibiotics - is a growing threat around the world.It's expected to <a href="http://www.businessinsider.com/superbugs-will-kill-10-million-a-year-by-2050-2015-1">kill 10 million people annually by 2050</a>. And it hasn't been easy to develop new drugs in order to stay ahead of the problem. Many major pharmaceutical companies have stopped developing new antibiotics, and the drugs that are still in development have <a href="http://www.businessinsider.com/woman-died-antibiotic-resistant-bug-why-2017-1">faced numerous stumbling blocks toward approval</a>.So some drugmakers are starting to turn to other solutions, <a href="https://www.nature.com/news/phage-therapy-gets-revitalized-1.15348">including</a> one that's actually had a fairly long history: phage therapy.The treatments are made of bacteria-killing viruses called bacteriophages, or phages for short. Discovered in the early 1900s, bacteriophages have the potential to treat people with bacterial infections. They're commonly used in parts of <a href="http://www.bterfoundation.org/phage">eastern Europe and the former Soviet Union</a> as another way to treat infections that could otherwise be treated by antibiotics. Because they are programmed to fight bacteria, phages don't pose much of a threat to human safety on a larger scale."There's huge potential there that regular antibiotics don't have," NYT columnist Carl Zimmer <a href="http://www.businessinsider.com/carl-zimmer-on-phage-therapy-and-superbugs-2015-10">told Business Insider in 2015</a>. "I think what we'd actually have to work on is how we approve medical treatments to make room for viruses that kill bacteria."A conversation about approval pathways is already underway, with a <a href="http://www.phagoburn.eu/">handful</a> <a href="http://www.pherecydes-pharma.com/">of</a> <a href="http://investor.ampliphibio.com/press-release/ampliphis-bacteriophage-manufacturing-facility-receives-cgmp-certification">companies</a> starting to get into the space. The trials, while still in early stages, could one day change the way we confront antibiotic resistance. <h2>A need for new options </h2>Dr. Paul Grint, CEO of one small company, AmpliPhi Biosciences, is trying to turn phage therapy into a tool that doctors might be able to one day use alongside antibiotics to treat serious infections. The company's working on phage-based treatments to treat Staphylococcus aureus, a bug implicated in sinus infections, and Pseudomonas aeruginosa, a bug connected to lung infections in people with cystic fibrosis. There are a number of reasons why these treatments are gaining some momentum now: for one, there's a big need for antibiotics. In September, the World Health Organization warned that the <a href="http://www.who.int/mediacentre/news/releases/2017/running-out-antibiotics/en/">world is running out of antibiotics</a>. "There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery," WHO Director-General Dr. <a href="http://www.who.int/mediacentre/news/releases/2017/running-out-antibiotics/en/">Tedros Adhanom Ghebreyesus</a> said in a news release. For phages in particular, there have been a number of advancements that help make it more straightforward for phage therapy to go through the FDA approval process. Grint told Business Insider that includes being able to sequence the bugs, which would help determine that you're absolutely getting the right phages in treatment. AmpliPhi also has a way to manufacture the therapy that's up to <a href="http://investor.ampliphibio.com/press-release/ampliphis-bacteriophage-manufacturing-facility-receives-cgmp-certification">regulatory</a> standards set up by the <a href="https://www.fda.gov/drugs/developmentapprovalprocess/manufacturing/ucm169105.htm">FDA</a>. <h2>Using phage therapy in the US</h2>While phage therapy has been around for more than a century, Grint said there's still a lot of education that needs to happen to get doctors and researchers on board, especially in the US. In July, the FDA and National Institutes of Health hosted a workshop regarding bacteriophages, which Ampliphi and others participated in.There are also some researchers like a group at the University of California at San Diego that are researching phage therapy. In 2016, for example, researchers at UCSD <a href="https://health.ucsd.edu/news/releases/pages/2017-04-25-novel-phage-therapy-saves-patient-with-multidrug-resistant-bacterial-infection.aspx">used AmpliPhi's therapy to treat a professor</a> at the university who had a drug-resistant infection.Even so, the US is treading carefully into the world of phage therapy. For now, AmpliPhi is able to recruit patients under the FDA's "<a href="https://www.fda.gov/NewsEvents/PublicHealthFocus/ExpandedAccessCompassionateUse/default.htm">compassionate use</a>" pathway, making it mostly a case-by-case situation for now when other antibiotics have failed.The hope is to use that information, along with some <a href="http://www.ampliphibio.com/product-pipeline">phase 1 studies that are happening in Australia</a> to gear up for a <a href="http://investor.ampliphibio.com/press-release/featured/ampliphi-biosciences-announces-positive-feedback-fda-phase-2-development">phase 2 trial</a> in the US. The company's aiming to start that trial in the second half of 2018, meaning it still might be a while before we start using viruses to treat our bacterial infections. <div class="margin-top"> <h3>NOW WATCH: <a href="http://www.businessinsider.com/tried-22-day-revolution-beyonce-vegan-diet-weight-loss-2017-9">I went on Beyoncé's 22-day diet - and I lost 15 pounds</a></h3> <div> </div> </div>

Viruses discovered a century ago may be our best defense against a threat that could kill 10 million people a year by 2050

<div class="KonaFilter image-container display-table"><div><div class="image on-image"><a href="https://www.cdc.gov/media/dpk/2013/dpk-untreatable.html">CDC</a>A researcher tests bacteria's ability to growth in the presence of antibiotics.</div></div></div><ul><li>Novartis <a href="https://endpts.com/novartis-joins-the-big-pharma-exodus-out-of-antibiotics-dumping-research-cutting-140-and-out-licensing-programs/">in July</a> became the latest pharmaceutical company to shut down its antibiotics research projects. </li><li>The move comes as FDA commissioner Scott Gottlieb has expressed concern over the growing epidemic around antimicrobial resistance, which is when bacteria grow resistant to available medications.</li><li>New options to combat the resistant bacteria include antibiotic-combination therapy and bacteriophage therapy.</li></ul>Just two years after Novartis announced it would embrace the challenge of searching for cures for life-threatening infections known as superbugs, the drugmaker said last week it would exit antibacterial and antiviral research.Novartis' retreat follows a growing trend of big pharmaceutical companies - including AstraZeneca, Sanofi, and Allergan - that are exiting from this type of research because of a lack of profit.That leaves Merck, Roche, GlaxoSmithKline, and Pfizer as the remaining pharmaceutical companies with active antibiotic programs, according to <a href="https://www.nature.com/articles/nbt.4193">Nature Biotechnology</a>. Only 12 antibiotics have been approved since 2000.Ever since the invention of penicillin, antibiotic development has been a treadmill. Patients who took too little of too much antibiotics would evolutionarily select for stronger strains by killing off only the sensitive bacteria. Antibiotics were once a <a href="http://www.businessinsider.com/history-antibiotic-resistance-and-superbugs-2016-9?r=UK&amp;IR=T">lucrative business</a> before inventing new drugs to catch up with the evolution of resistant strains became exhausting.Dr. Jean Patel, <keyword id="41551" type="ENTERTAINMENT" weightage="100" keywordseo="science">science</keyword> team lead of antibiotic strategy and coordination unit at the CDC, said a fair number of active antibiotics used against bacteria actually come from small, startup-sized companies, that usually later get acquired by big pharma, which provides the infrastructure to complete clinical trials and market the drug. But with increasing numbers of big pharma firms backing out of antibiotic pursuits, it decreases the variety of new drugs that can be brought to market."The costs to develop a new antibiotic drug are no less expensive compared to development of drugs for other therapeutic areas, yet the commercial potential and return on investment for companies developing new antibiotics are significantly lower than drugs to treat chronic conditions such as diabetes or heart disease," said Gary Disbrow, deputy director of the Biomedical Advanced Research and Development Authority, which sits within the U.S. Department of Health and Human Services. The lack of research from big pharma companies is a problem. Each year in the US at least 2 million people become infected with antibiotic-resistant bacteria, according to Centers for Disease Control and Prevention, and 23,000 people die each year as a direct result of these infections.It's estimated that as many as 10 million people could die annually from superbugs by 2050 if nothing is done, according to a report commissioned by the UK.<h2>The superbug supercrisis</h2>The public threat from antibiotic-resistant superbugs is growing. Doctors <a href="http://www.businessinsider.com/sti-mg-could-become-antibiotic-resistant-superbug-2018-7">recently warned that an emerging sexually transmitted infection</a> could become an antibiotic-resistant superbug and lead to pelvic inflammatory disease, and ultimately infertility in women. A woman <a href="http://www.businessinsider.com/woman-died-antibiotic-resistant-bug-why-2017-1">died in 2017</a> because she contracted a bug that resisted 26 different antibiotics - every antibiotic available in the US.Antibiotic-resistant strains were also <a href="https://www.ewg.org/research/superbugs/">reported</a> to be found in a huge portion of supermarket meats, which the World Health Organization says is a threat to food safety and security.Why is there a rise in superbugs?<a href="http://www.businessinsider.com/antibiotics-are-being-over-prescribed-2016-5">The overuse of prescription drugs</a> and antibiotics in both humans and agriculture is one culprit, as is rise of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631814/">antimicrobial chemicals</a> in household products. Climate change may also be <a href="https://www.popsci.com/antibiotic-resistant-bacteria-climate-change#page-4">contributing to</a> growing antibiotic resistance.Certain <a href="https://www.theguardian.com/society/2014/jun/01/why-antibiotics-making-us-ill-bacteria-martin-blaser">lifestyle</a> factors like constantly using hand sanitizer and other antiseptics may decrease the body's microbial diversity. With fewer good bacteria in the body as defense, humans are more likely to become susceptible to bad, resistant ones. And the antibiotics one person takes can affect everyone because it's not the person who becomes immune; it's the strain of bacteria.Antibiotic resistance appeared almost immediately after the advent of antibiotics. To companies, that didn't matter for a lot of years because there were always new antibiotics in the pipeline. But that slowed down and almost came to a stop starting about 15 years ago. Unlike almost every area of drug development, antibiotics will all eventually lose their effectiveness, because bacteria is good at evolving ways to defeat them. The US is trying to do its part to combat these superbugs.To encourage the costly development of new antibacterial drugs, FDA Commissioner Scott Gottlieb has mentioned the possibility of a reimbursement model for antibiotics that met certain criteria, primarily their ability to target dangerous, multi-drug resistant infections.Both the CDC and the National Institute of Allergy and Infectious Diseases have developed <a href="https://www.niaid.nih.gov/sites/default/files/arstrategicplan2014.pdf">strategic plans</a> and <a href="https://www.cdc.gov/drugresistance/solutions-initiative/index.html">solutions initiatives</a> to fight antimicrobial resistance.Congress increased CDC's funding to combat antibiotic resistance in 2018 to $168 million, a $5 million increase over last fiscal year, and tasked it with the effort to contain, protect and prevent superbug spread. But prevention is just one aspect of the crisis. The CDC also tries to monitor new drugs that become active to ensure they are not underused or overused."We try to hold on to new drugs that come into market and use them prudently so they can remain active for longer," said the CDC's Patel. "This antibiotic stewardship is good for public health but not good for drug companies trying to turn a profit on their initial investment."Patel said that because of this there's a need for novel types of therapeutics, and also for diagnostic companies that can detect resistance early on so that it can be contained and eradicated before it spreads.<h2>What's in the pipeline for antibiotics</h2>There are two ways researchers are hoping to tackle antibiotic resistance. While there's a hefty research force dedicated to product development of therapeutic treatments, there's also a good chunk of research dedicated to understanding the mechanisms of resistance, including how it happens and how it spreads.In early July, researchers at the European Molecular Biology Laboratory in Germany <a href="https://www.statnews.com/2018/07/04/combining-antibiotics-drug-resistance/">combined different antibiotics </a>to take out drug-resistant strains and found sweet spots where certain combinations worked perfectly without damaging healthy bacteria. The treatment is being tested out in mice.Researchers have even gone as far as to revive a 100-year-old, discontinued method to battle bacteria: <a href="http://time.com/5316516/phage-therapy-virus-san-diego/">bacteriophage therapy</a>."It's a back-to-the-future kind of remedy," said Steffanie Strathdee, chief of the division of global public health in the department of medicine at University of California at San Diego. "It's tapping into the body's own microbial arms race."Strathdee's husband contracted an infection while on vacation in 2015 and fell into a coma after the gut-superbug resisted multiple antibiotics. In a case study now made famous, Strathdee dug up buried research on so-called phages, which are viruses that infect bacteria, in search of a cure. After finding a phage that matched up with the resistant bacteria and injecting it into his bloodstream, Strathdee's husband woke up from the coma.Since then, phage therapy has been used successfully to treat five other patients. After the discovery of the antibiotics in the 1920s, phages were relegated to the back burner. The trickiest part lies in finding the matching phage, characterizing it and purifying it so that it's safe for patient use.Phage therapy is an experimental treatment used by doctors at UC San Diego Health and the demand has been so high that they've opened a <a href="https://medschool.ucsd.edu/som/medicine/divisions/infectious-diseases/research/center-innovative-phage-applications-and-therapeutics/Pages/default.aspx">new center</a>. Since it's not yet approved in the US, patients need approval from the FDA for emergency use to access it.Strathdee and her team of scientists at UCSD have partnered with two startups, <a href="http://www.businessinsider.com/ampliphi-phage-therapy-treatment-bacterial-infections-2017-10">AmpliPhi Biosciences</a> and <a href="http://www.aphage.com/">Adaptive Phage Therapeutics</a>, to compile a phage library and create personalized phage cocktails for patients. They noticed that bacteria became resensitized and started responding to antibiotics after interacting with phages, said Strathdee.Understanding the science and makeup of bacteria can also help scientists devise new ways to destroy it. To stay ahead of the mutation, many scientists are <a href="http://science.sciencemag.org/content/360/6390/733.full">sequencing the genomes</a> of resistant microbes to track their evolution and spread.There are also external funds from <a href="https://carb-x.org/">CARB-X</a> and <a href="https://www.phe.gov/about/BARDA/Pages/default.aspx">BARDA</a> - a part of the Department of Health and Human Services - to encourage development of new therapeutic agents and encourage drugs to come to market.On the front end of drug development, there's a lot of work being done. Dr. John Farley, deputy director of the office of antimicrobial products at the Food and Drug Administration, says the agency teams up with small and midsize companies to study bacteria pathways and develop drugs.There has been government-wide response to seek funding to move drugs into clinical trials and advance them through the approval process. Programs like <a href="https://www.fda.gov/downloads/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/UCM595188.pdf">Generating Antibiotic Incentives Now</a> and <a href="http://www.pewtrusts.org/en/research-and-analysis/articles/2015/06/lpad-a-regulatory-pathway-to-develop-antibiotics-and-fight-drug-resistant-infections">LPAD</a> also aim to attract external investment for the back end of drug development. "I don't think anyone thinks the pipeline is as strong as it needs to be," said Farley. "There are economic challenges that still remain that's at the heart of all of this."In the <a href="http://www.pewtrusts.org/-/media/assets/2017/05/antibiotics-currently-in-clinical-development-03-2017.pdf">antibiotic clinical pipeline</a>, two new drug applications have been submitted to the FDA for clinical approval. In clinical development, there are 15 drugs in phase 1, 13 in phase 2, and 11 in phase 3, according to a report by PEW. But medical experts say the number of drugs in development aren't nearly enough to address superbugs."There's relatively little in the pipeline that actually tackles the most serious resistant organisms that are out there today," said Allan Coukell, senior director of drugs and medical devices at the Pew Charitable Trusts.<a href="http://www.businessinsider.com/intelligence/ai-in-us-healthcare?IR=T&amp;utm_source=businessinsider&amp;utm_medium=ctgr&amp;utm_term=ctgr_leadgen&amp;utm_content=dhealth_ctgr_leadgen&amp;utm_campaign=dhealth_ctgr_leadgen_ai_in_us_healthcare"></a></hr> <div class="margin-top"> <h3>NOW WATCH: <a href="http://www.businessinsider.com/why-penalty-kicks-unfair-to-goalies-world-cup-2018-7">Why penalty kicks are so unfair to goalies</a></h3> <div> </div> </div>

Pharmaceutical companies are backing away from a growing threat that could kill 10 million people a year by 2050

<div class="KonaFilter image-container display-table float_right"><div><div class="image on-image"><a href="http://en.wikipedia.org/wiki/Phage_therapy#/media/File:Phage.jpg">Dr Graham Beards / Wikipedia</a>An electron micrograph image shows phages attached to a bacterial cell.</div></div></div>We're on the verge of an apocalyptic scenario when it comes to antibiotic-resistant superbugs.Misuse of existing antibiotics has led to <a href="http://www.businessinsider.com/antibiotic-resistant-superbugs-are-causing-bacterial-infections-2014-12">bacterial resistance</a> that could pose a major threat to our public health system.Far off on the horizon, though, could be a way to fend off resistant bacteria with something unexpected: Viruses. Not just any viruses: bacteria-killing viruses called bacteriophages, or phages for short. Discovered in the early 1900s, bacteriophages have the potential to treat people with bacterial infections. Because they're programmed to fight bacteria, phages don't pose much of a threat to human safety on a larger scale.While phage therapy might still be a ways off, New York Times <a href="http://topics.nytimes.com/top/news/science/columns/matter/index.html">columnist</a> and <keyword id="41551" type="ENTERTAINMENT" weightage="100" keywordseo="science">science</keyword> writer Carl Zimmer told us that they could be the solution to our antibiotic-resistance problem."There's huge potential there that regular antibiotics don't have," said Zimmer. "I think what we'd actually have to work on is how we approve medical treatments to make room for viruses that kill bacteria."That's because the idea of fighting an enemy with another enemy, as Zimmer calls it in the most recent edition of his book,"<a href="http://www.amazon.com/gp/product/022629420X/ref=as_li_tl?ie=UTF8&amp;camp=211189&amp;creative=373489&amp;creativeASIN=022629420X&amp;link_code=as3&amp;tag=bivideo-20&amp;linkId=FBWNQCKUKBVKQNKT">A Planet of Viruses</a>," doesn't quite sit well with the US government, especially when antibiotics are still a valid option for most infections.One of the main arguments against phage therapy is that phages can only attack one species of bacteria, which is much different from an antibiotic that can fend off many different bacterial infections at once. A possible way to counter that, however, would be to combine a variety of phages in a single treatment.Some human trials with phage therapy have been <a href="http://www.nature.com/news/phage-therapy-gets-revitalized-1.15348">underway in Europe</a> in burn victims with E. coli, a bacteria associated with food poisoning and Pseudomonas aeruginosa, which can cause inflammation and sepsis and <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0078543">in birds with Campylobacteriosis</a>, a bacterial infection that's spread through food to humans. In "A Planet of Viruses," Zimmer details some of the other phage therapy trials in history, including one that took place in the country Georgia in 1963, where virologists showed that kids who were treated with phages were 3.8 times less likely to get dysentery than those receiving a placebo treatment.Phages infect bacteria by <a href="http://www.nature.com/nrmicro/journal/v8/n5/full/nrmicro2315.html">attaching themselves</a> to their surface. But once we introduce phage therapy for a specific bacterial infection, <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278648/">some have worried</a>, the bacteria could grow resistant to it. Resistant bacteria block phage receptors, confusing them and rendering them unable to latch on. However, studies suggest it takes a <a href="http://www.phagetherapycenter.com/pii/PatientServlet?command=static_phagetherapy&amp;language=0">much longer time</a> for bacteria to become resistant to a certain phage than to an antibiotic.Phages have some other limitations, though. For one thing, they're built to affect only certain bacteria. That limits the amount of bacterial infections that would resond to phage therapy. And not all phages are so great for the body: <a href="http://www.ncbi.nlm.nih.gov/pubmed/16423684">some carry toxins</a> that can do more harm than good. Plus, there are <a href="http://download.springer.com/static/pdf/598/art%253A10.1023%252FA%253A1016716606135.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1023%2FA%3A1016716606135&amp;token2=exp=1444873551~acl=%2Fstatic%2Fpdf%2F598%2Fart%25253A10.1023%25252FA%25253A1016716606135.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1023%252FA%253A1016716606135*~hmac=df33f2615931a5860bbfdd5a821a0e3079abbf1d1a8947c7b340ff0f2943e5a9">not a ton of long-term studies</a> that look at the potential long-term effects of phage therapy.Phage therapy, while promising, is still many years away. In the meantime, the best way to cut down on antibiotic resistance is to stop using it where it's not necessary, said Zimmer, such as in farms and in combination with inaccurate diagnoses at the doctor's office. After all, an antibiotic isn't going to do you much good if you have a viral infection like the common cold or the flu.

This could be our best defense against the antibiotic apocalpyse

<div class="KonaFilter image-container display-table"><div><div class="image on-image"><a href="https://www.cdc.gov/media/dpk/2013/dpk-untreatable.html">CDC</a>A researcher holds up a device used to test bacteria's ability to growth in the presence of antibiotics.</div></div></div><ul class="summary-list"><li>In an age where innovative technologies like gene and <a href="https://www.businessinsider.com/fda-approves-novartis-kymriah-large-b-cell-lymphoma-cancer-treatment-2018-5">cell therapy</a> are transforming how we think about medical treatments, some CEOs are wondering what's being left on the table. </li><li>Business Insider spoke to three companies developing new uses for old drugs, and they told us now might be a good time to rethink what we consider <a href="https://www.businessinsider.com/biotech-bluebird-bio-suggests-installment-plan-for-gene-therapy-lentiglobin-2019-1">innovation</a>. </li><li>Simply changing how drugs are dosed or delivered could open up the doors to more uses for existing medications in tough-to-treat conditions like female sexual arousal dysfunction or antibiotic-resistant infections. </li></ul>The key to tackling hard-to-treat diseases could have less to do with flashy new technologies than with finding new uses for old drugs.A range of smaller drugmakers are exploring the back catalogs of big pharma companies to discover old drugs that could be used in new ways, they told Business Insider. They're seeking treatments for conditions including a rare lung disease, antibiotic-resistant infections, and female sexual arousal disorder. Along the way, they're seeking to redefine what we think of as medical innovation."I came from an environment where 'sexy' was new, better, innovative," said Noreen Roth Henig, chief medical officer a <a href="https://breath-therapeutics.com/">Breath Therapeutics</a>. Before joining Breath, she worked in top roles at ProQR Therapeutics and at biotech giant Gilead Sciences.Breath is developing a treatment for bronchiolitis obliterans syndrome, sometimes called "<a href="https://www.thisisinsider.com/what-is-popcorn-lung-is-it-caused-by-vaping-2018-11">popcorn lung,</a>" in which the airways of the lungs get blocked, making it hard to breath. It often happens in lung transplant cases, and most recently became an issue in the early 2000s when a group of people working in a microwave popcorn factory were affected because of artificial butter flavoring in the air.The treatment involves reformulating an older immunosuppresant drug called cyclosporine- typically used to keep your immune system from rejecting an organ transplant - so that it can be inhaled into the lungs."Innovation isn't a brand new chemical entity necessarily," Henig said. "Innovation can be in delivering a drug in a way that's going to allow it to be more effective."Read more:<a href="https://www.businessinsider.com/massachusetts-payment-plan-novartis-avexis-5-million-gene-therapy-2019-1"> A revolutionary drug that could treat a rare and devastating disease is prohibitively expensive. But one state has a plan to pay for its potential $5 million price tag.</a>The approach could potentially help finds solutions for problems like antibiotic resistance, too, according to the companies. None of them are working on it, though.Infections that are difficult or impossible to treat with antibiotics, often called superbugs, are expected to <a href="https://www.businessinsider.com/superbugs-will-kill-10-million-a-year-by-2050-2015-1">kill 10 million people annually by 2050</a>. Getting new drugs approved is a lengthy process that <a href="https://www.businessinsider.com/woman-died-antibiotic-resistant-bug-why-2017-1">often faces setbacks</a>. Companies have <a href="https://www.businessinsider.com/major-pharmaceutical-companies-dropping-antibiotic-projects-superbugs-2018-7">started to get creative,</a> turning to combinations of drugs and even a century-old idea that viruses called <a href="http://time.com/5316516/phage-therapy-virus-san-diego/">bacteriophage</a>, which attack bacteria, could hold the key to combatting resistance. In the end, it's all about getting to a solution that does its job for the patients who need it, not as much the new technology that enables that. "Innovation is a drug for a patient," said Michael Henderson, chief business officer of QED Therapeutics.QED picked up <a href="https://www.prnewswire.com/news-releases/bridgebio-pharma-licenses-late-stage-oncology-drug-infigratinib-to-tackle-fgfr-driven-maladies-establishes-new-subsidiary-qed-therapeutics-with-65-million-in-initial-financing-300589961.html">from Novartis</a> a cancer drug, infigratinib, which Novartis had decided to ditch after making it through a mid-stage trial in bile duct cancer patients. Now, QED is developing it to treat certain forms of cancer including bile duct cancer as well as a common form of dwarfism, where it's studying the use of the drug at a lower dose than when it's used to treat cancer. <h2>Where new uses for old drugs come from: a 'MacGyver moment'</h2>Often, the new ways to use existing drugs come from doctors who get creative to help their patients. "Sometimes that's where good ideas start, is just talking to the doctors, 'What is your best MacGyver moment,'" Henig said. Because her company is focused on lung conditions, those ideas may also come from looking at possible medicines that don't work as a pill and figuring out how to re-engineer them to work better in a different way, say, with a nebulizer, a machine that circulates a medication as a mist so that it can get into the lungs."There's a nice toolbox of opportunity to take medicines that may have challenging chemistry in their current form and move it over to redesign as well as engineer the delivery device at the same time," Henig said. <a href="http://newsletter.businessinsider.com/join/4np/health-insider&amp;hash=f4e91136c13f3c40c496d77bc7347502">Subscribe to Dispensed</a>, our weekly newsletter on pharma, biotech, and healthcare.Sabrina Martucci Johnson, the CEO of <a href="https://www.darebioscience.com/">Daré Bioscience</a>, a company focused on women's reproductive health, asks herself four questions to figure out whether Daré should explore a new approach with an existing drug:<ul><li>Is there a company willing to partner with Daré to pull it off?</li><li>Is there a persistent need for the new treatment? </li><li>Does it have a package? That is, is there a rationale to pursue developing the drug for a particular case and has the drug been successful in other areas? For example, Daré's working on reformulating sildenafil, the active ingredient in the erectile dysfunction drug Viagra. As <a href="https://www.darebioscience.com/pipeline">a cream</a> instead of a pill, the hope is to use it to treat female sexual arousal disorder. </li><li>Is there a way to make it personal so that it works for women? That could mean reformulating a drug so it's delivered via a vaginal ring or in another localized way. </li></ul>Then, of course, Daré will have to do the work to show if it's possible. <ul class="read-more-links"><li>Read more:</li><li><a href="https://www.businessinsider.com/the-challenge-of-merging-takeda-and-shire-cultures-2019-1" data-read-more-link="" data-e2e-name="read-more-link">A 237-year-old Japanese drug company just combined with a rival halfway around the world. Here's how they're confronting the challenge of merging 2 cultures.</a></li><li><a href="https://www.businessinsider.com/gsk-and-pfizer-spinning-out-their-consumer-health-business-2019-1" data-read-more-link="" data-e2e-name="read-more-link">A top executive at GSK reveals why it's prepared to ditch the brands that helped turn it into a $95 billion powerhouse</a></li><li><a href="https://www.businessinsider.com/biotech-bluebird-bio-suggests-installment-plan-for-gene-therapy-lentiglobin-2019-1" data-read-more-link="" data-e2e-name="read-more-link">A biotech is proposing a plan to pay for its pricey rare-disease treatment the same way you'd buy a TV or dishwasher. Here's the inside story.</a></li><li><a href="https://www.businessinsider.com/anti-aging-longevity-startups-face-fda-obstacle-2019-1" data-read-more-link="" data-e2e-name="read-more-link">Investors bet nearly $1 billion on startups that want to defeat aging, but there's a key challenge ahead</a></li></ul> <div class="margin-top"> <h3>NOW WATCH: <a href="https://www.businessinsider.com/what-if-earth-had-two-moons-tides-sea-level-collision-2019-1">A city in China wants to launch an artificial moon into orbit by 2020 - here's what would happen if Earth really did have two moons</a></h3> <div> </div> </div>

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