Inside the gym at Charlie Norwood VA Medical Center in Augusta, USA, Alphonso Evans is rolling his wheelchair into a weightlifting machine:
"I'm not too worried about the risk of death from heart attack or diabetes because I'm exercising very often. I know what I have to do to fight these diseases: you go on watching what I am eating and the time I spend on practicing. "
"But I can't do anything to fight infection. How do I fight the bacteria that are right in my body that I can't see until it's too late? ".
Evans is a 67-year-old patient, completely paralyzed from the chest down and can only use part of his hand. Like many patients with other spinal injuries, he is very susceptible to infections, especially bladder infections.
About two years ago, Evan actually had to go to Charlie Norwood VA medical center because of the symptoms of the disease. But after the doctors examined him, it turned out to be worse.
Evan also had bone infections and pneumonia. Finally he was taken to the intensive care unit. "It scared me. ", Evans said, "Although I'm not a shy person. "
Alphonso Evans – a patient with hemiplegia who is facing an antibiotic-resistant infection
Bladder infections, like many other infections, are becoming increasingly resistant to antibiotics.
"We are approaching a point, where there are organisms that are resistant to all the known antibiotics."Dr. Michael Priebe, head of the spinal cord injury department at Charlie Norwood VA medical center said.
"What scared me, it was right from the start armed race hey, it has brought them to the point where they can't keep up with the enemy – here are drug-resistant bacteria. The viruses occupy the upper hand and we have nothing to resist them. "
So Dr. Priebe invited Evans to join a pilot study, helping him develop another way to fight the virus. This is a new antibiotic created by genetically modified viruses using the CRISPR tool.
"What CRISPR can do is something we couldn't do before. And that's the precise selection of genes in the virus to target bacteria."Dr. Priebe said.
"If we succeed, this will revolutionize the treatment of infection. This may be a game-changing factor, taking us out of the arms race with drug-resistant bacteria, and allowing us to use a completely different mechanism to fight infectious bacteria. for us".
Human race with antibiotic resistant bacteria. The viruses occupy the upper hand and we have nothing to resist them.
The approach, developed by Locus Bioscatics – a biotechnology company in Morrisville, North Carolina, USA – involves viruses called phages.
Phages are natural enemies of bacteria. They can infect and kill bacteria by reproducing in large numbers within the bacteria, until the bacterial cell membrane cannot contain the virus and explodes literally.
Scientists at Locus have created a drug consisting of three genetically modified phages with CRISPR. It is the result of a process of studying the immune system of bacteria.
"What we have learned, is how to reprogram the immune system so that the bacteria will be attacked by themselves. ", Paul Garofolo, the company's CEO explained.
"We developed viruses with CRISPR structures, essentially acting like a tiny Pac-Man. They invade the target bacteria cells, then bite the target bacteria's DNA. Editing genes helps a phage become a much stronger bacteria hunter ".
Locus is one of several companies trying to use CRISPR to solve health problems. Their goal is to find gene codes that can help phage target precisely the bad bacteria in the body, and leave the bacteria good.
"I think it's really interesting.", Steffanie Strathdee, a phage body researcher from the University of California San Diego. "Using antibiotics today is the treatment of infection by a thorough method. That means antibiotics not only kill the bacteria that we want to destroy, but also kill the friendly bacteria inside our microorganisms. "
This microbial system consists of trillions of beneficial bacteria that reside in the human body.
"A viable approach is to nourish this microflora – by wiping out unhealthy bacteria and promoting the bacteria in the growing microbiota"Strathdee, the author of the book"The perfect enemy", talking about phage methods that saved her husband's life when an infection was resistant to all existing antibiotics.
Other scientists also agree that the strategy of using the natural enemies of bacteria, which are exactly phage, is very promising – especially for the threat that the virus is currently causing.
"I think it's an attractive approach. It is a really smart approach ", Graham Hatfull, professor of biological sciences at the University of Pittsburgh, a phage specialist. He was one of the first scientists to use genetically modified phages to try to treat infections caused by antibiotic-resistant viruses.
But Hatfull is still worried, because according to him, phage studies are still at an early stage. We do not fully understand the virus is the natural enemy of bacteria.
"In some cases, using genetically modified phages will be like trying to run before you can walk. It is hard to improve something without knowing the mechanism of what you are trying to improve"Hatfull said.
And there's always the risk that this method can be counterproductive. "The main concern now is that you can inadvertently turn a harmless bacterium into dangerous species"Hatfull said.
Dr. Priebe also acknowledges that therapies can potentially infect dangerous complications. That's why his initial tests were primarily aimed at ensuring genetically modified phages with CRISPR are safe.
Dr. Michael Priebe, head of spinal cord injury at Charlie Norwood VA medical center
"We have to do everything slowly"Dr. Priebe said."We don't know how things will grow ".
At the end of the year, he and his colleagues plan to begin transferring mixtures of genetically engineered microbial drugs with CRISPR to people like Evans twice a day for seven days at six centers. Medical centers throughout the United States.
The study will treat about 30 patients. Twenty of them will receive a mixture of genetically modified phages, and the remaining 10 will only be treated with placebo.
Later, the researchers will monitor these patients and conduct extensive tests in their blood and urine to see if the method is safe, and how it affects the level of bacteria. E.coli in their urinary tract.
If tested successfully, Locus Bioscatics plans to expand further studies to see how their phage therapy can help many patients with antibiotic-resistant infections.
To prepare for this long-term study, Dr. Priebe plans to recruit about 200 paralyzed patients, including Evans, to study the process of E. coli growth and in their urinary tract. .
Phage can infect the surface of a bacterium
Evans said that he was willing to volunteer for Dr. Priebe's research: "I think it's a great idea.".
Evans has served in the military for 25 years, fighting in Vietnam, South Korea and Germany. "It is ironic"Evans said."Twenty-five years in the army, I have never been injured. Not once. "
Yet an accident that happened just two days after he was demobilized caused Evans to be paralyzed half-hearted, thus struggling with numerous medical problems, including urinary tract infections.
When antibiotics were no longer working, Evans could now only put his hope into bacteriological studies like Dr. Priebe's.
"The fact that this research is giving us hope", he told.