Use of Antibiotics : Dangerous or Helpful Aids?

Introduction:

Although, broad spectrum drugs are effective against a wide range of bacteria they also drive antibiotic resistance. When physicians are unsure of the type of infection they are dealing with they use these 'last resort antibiotics'. (A) E.coli for example, which is a type of bacteria that lives in the intestines but, some types of E.coli such as E.coli 0157:H7 causes intestinal infections. Diarrhea, abdominal pain, and fever are just some of the symptoms. Sometimes these symptoms although rare can lead to bloody diarrhea, dehydration, and kidney failure. Intestinal infections are commonly caused by contaminated food or water. Most infections can be treated at home and usually resolve within a few days to a week. (D)

Then there is Klebsiella pneumoniae which is a type of gram negative bacteria that causes different types of healthcare-associated infections. (some examples include: pneumonia, bloodstream infections, wound/surgical site infections, and meningitis) The Klebsiella bacteria have developed antimicrobial resistance to a class of antibiotics known as carbapenems. Just like E.coli, Klebsiella is found in the intestines, but also in human feces. Patients who are recieving care in hospital/healthcare settings through devices such as ventilators, intravenous vein catheters, and those taking antibiotics are at highest risk of a Klebsiella infection. (E)

In recent reports there can be seen an overall rise in consumption of antibiotics through surgeries whereas the number of perscriptions are falling. Between the years of 2010 to 2014 blood stream infections from E.coli and Klebsiella pneumoniae have increased from 13.5% to 17.2%.  Between 2011-14, there was a 6.5% rise in total antibiotic consumption (defined as doses of antibiotics per 1,000 people per day).(A) 

Streptococcus Pneumoniae infections are just some of the small group of bacteria that have shown good results in cutting infections. Their infections have fallen by 23% between 2010 to 2014 which seem to be related to have increased pneumococcal vaccination rates. If one was to look at the molecular level, these forms of mutations can actually prevent an antibiotic from entering the bacterial cell at all. By changing the target molecules that do not bind to the antibiotic or enhancing the efficiency of efflux of mechanisms in the bacteria that allows it to pump a drug back out again. Specific genes can actively degrade antibiotics by limiting their effectiveness once they have entered the cell.

The World Health Organization (WHO) has reported on the global antibiotic resistance because of the serious concern that there could very soon be a very serious threat to public health which has been recently rapidly growing. Diseases that we have thought to be treatable or far from concern could very possibly be a scary new reality. Everyone could be affected by this not just individuals living in poverty or developing countries. Tuberculosis is an example of a disease that used to be of the past is considered fatal now.

Research:

In 2014, most antibiotics in England were prescribed in general practice (74%), followed by prescribing for hospital inpatients (11%), hospital outpatients (7%), patients seen in dental practices (5%) and patients in other community settings (3%). Antibiotic prescribing to hospital inpatients increased significantly by 11.7% and to hospital outpatients by 8.5% between 2011-14. With the exception of general dental practice, antibiotic prescribing increased across the NHS in 2014.

The rising resistance to antibiotics routinely used to prevent patients getting infections during and after surgery is disastrous. It will mean increased risk for operations such as caesareans, hip replacements and appendix removal, and also treatment for cancer patients, who are given antibiotics because chemotherapy drugs undermine their immune system, making them vulnerable to infections.

 

About 32 percent of patients believe that they should stop taking antibiotics when they feel better rather than completing the prescribed course by their physicians, meanwhile over 76 percent of patients think that resistance occurs when the body itself becomes resistant. However, scientific research shows that bacteria grow resistant to antibiotics not humans or animals.

When the PHE released a second annual report on antimicrobial resistance, it supported WHO's survey that revealed a widespread public misunderstanding of antibiotics. The results showed that 64 percent of individuals have the misconception that antibiotics can actually cure common cold and flue whereas antibiotics have no impact on viruses. Subsequently, it is clear to see how antimicrobial resistance is quickly becoming a major threat to delivery of healthcare across the globe. 

The Ebola epidemic in West Africa puts into perspective the global antibiotic resistance pandemic. In 2014, the Ebola virus accounted for over 11,000 fatalities making it officially the most devastating outbreak virus in history. A rough estimate of 700,000 lives have lead to death worldwide because of the antibiotic resistant bacteria. Unless drastic changes are made, this number of annual deaths is predicted to rise to 10 million by 2050 where numbers of bacteria which are already fully resistant to every clinical antibiotic available are growing.

Scientists from San Diego Institute of Oceaneography have collected samples of marine life from the ocean floor, 20,000 feet below the surface of the pacific ocean in the coast of California. Within the small clumps of sediment, they found micro-organisms that can one day give us an answer to one of the most urgent issues in modern healthcare.

Professor Otto Cars described resistance to antibiotics as “a silent tsunami, crumbling down the pillars upon which modern medicine is built.” Cars, who has spent decades campaigning for awareness on the topic, describes the problem as one of complacency. While antibiotic consumption has increased by 36% in the past decade, no new classes of these drugs have been discovered since the 1980s. In June, the World Health Organisation unveiled a global action plan to tackle antibiotic resistance. One of the stated aims is to have a whole new class of antibiotics in development by 2019.

Over the past 80 years, the main focal point of the search for new antibiotics has been soil microbes, and the variety of substances they produce to kill each other as part of their ongoing chemical warfare. But until recently, we haven’t been especially adept at keeping them alive in the lab for long enough to obtain their weapons for our own use.

Meanwhile, scientists in Germany as well as in the United States have developed a method that has led to the discovery of teixobactin. This substance is believed to have the potential of becoming the very first new antibiotic since 1987. It has the ability to destroy some of the most dangerous drug resistant bacteria (i.e MRSA). Teixobactin has a very low potential for developing a resistance but it is ineffective against the most difficult to treat family of all bacteria, the gram-negative bacteria. Gram negative bacteria develop resistance at an incredible rate due to their rapid DNA sharing. This has evolved in gram negative bacteria as an extra protective membrane and a sophisticated efflux.

Scientists have been shifting their focus to organisms who live thousands of feet beneath the ocean surface. These specific organisms have evolved their own ways of defending against microbes where most of them are still unknown. Anthracimycin is a compound that is produced by a bacterium living in the pacific ocean which has given scientists potential however finding such compounds is just a minor aspect of the challenge.

The number one problem is finding compounds that are not toxic or harmful to humans. It is well known that bacteria, humans as well as all living creatures have the same biochemical mechanisms essential to life. This is what antibiotics usually target. Killing a bacterium is to poke a hole in its membrane. However, discovering something that specifically pokes holes in bacteria and NOT human cells is another challenge.

Gibbons feels the WHO’s 2019 deadline is unrealistic. “There’s a lot of work from simple testing to safety testing, and then animal models involving mice or rabbits, before you even think about a clinical trial. And you have to prove that you can generate enough of the substance itself. So I doubt we’ll see any new classes of antibiotics until 2021 or 2022 at the very least.”

Others are instead looking at redesigning old, discarded antibiotics to increase their stability and effectiveness. Some were originally abandoned because they only worked on a small handful of bacteria, but now it’s thought that a range of more narrow spectrum treatments may be a better way to avoid driving resistance.Lee is currently researching spectinomycin, an antibiotic introduced in the 1960s to treat gonorrhoea, before being cast aside as it only worked in massive doses. He believes that a remodeled version has the potential to work well against a range of respiratory tract infections and sexually transmitted diseases.

“The drug has always been very safe, and fifty years on we now know its crystal structure,” he says. “So we can exploit that along with all the old knowledge from the pharmaceutical companies who tried to develop it in the 1980s, to improve its design and help it access the target bacteria more effectively.” Of course, some bacteria will eventually become resistant to spectinomycin and other old antibiotics, but Lee believes that it is possible to design these drugs so this comes at an evolutionary cost to the bacteria.

Tuberculosis:

Tuberculosis should be treatable within 6 month period once individuals are given a prescribed course of drugs including isoniazid and rifampicin antibiotics. However, there is a resistance to these medications as well as a wide range of pharmaceuticals used to treat the disease. Because of this recent obstacle, a multi drug resistant TB has emerged, "XDR-TB" and a total drug resistant TB officially confirmed in India. Many countries have run out of treatment options for their patients such as those in South Africa and have to choice but to discharge the patients from the hospitals without proper treatment. As of today, 92 countries are reported to being resistant to TB hitting the global scale mark with XDR-TB.

Gonorrhoea: 

Gonorrhoea is a sexually transmitted infection. It used to be easily treatable but once penicillin and tetracycline, however since the bacteria behind the disease developed high levels of resistance that now there is only one drug left to treat it. Even this antibiotic, ceftriaxone, is becoming less effective. With last-resort drugs losing their impact, this sexually transmitted infection (STI) could spread throughout the population.

Klebsiella:

Klebsiella is a common bacterium that is part of the group of bacteria with the 'apt' acronym of Eskape. that causes a range of conditions such as pneumonia, UTIs, septicaemia, meningitis, as well as diarrhea. Their ability to avoid the effects of antibiotics which are used against them. The 'apt' acronym stands for the names within the bacterial group members: Enterococcus faecium, Staphylococcus aureus; Klebsiella pneumoniae: Acinetobacter baumannii; Pseudomonas aeruginosa; and Enterobacter. Klebsiella are just some examples of this group. Although MRSA is a concern it is declining in hospitals. Eskape pathogens are causing more and more problems. As the WHO report highlighted, routine hospital visits or treatments could result in these previously treatable bacteria having fatal consequences.

Typhoid:

Typhoid is a somewhat rare disease for humans because of the routine vaccinations against typhoid are performed. There are a large amount of people affected by typhoid, around 21.5 million people per year.  Since people are always traveling to developing countries and travel to  areas with increased sources of infection has become more common. This has affected more than 5,000 American lives as they have become infected after ingesting contaminated foods or drinks.

Typhoid consists of a typhoid fever where the bacterium salmonella typhi although typically treated with antibiotics have been increasing their resistance to multiple antibiotics. Reduced susceptibility to fluoroquinolone class of drugs and the emerging of multi drug resistance has complicated the treatment of infections. (especially those from South Asia). There is good news as the vaccination for typhoid does in fact exist, however it is critical for people to be vaccinated before getting onto a plane. 

Syphillis and Diphtheria:

Although resistance to these diseases is yet to emerge, public awareness of them has reduced as a result of effective treatments. But in an era of resistance there is always the potential for them to return as a serious public health threat. Although rates of syphilis are low, they have been increasing in the UK since 1997. This STI is currently treated by a single injection with penicillin, but resistance to this antibiotic has developed in other diseases. Imagine the impact if it happened again. The fever and chills of diphtheria are mainly prevalent in the developing world, but with travelers contracting typhoid even though a vaccine is available, the same could happen with diphtheria.

CONCLUSION:

“The most common way this happens is through the acquisition of genes from other resistant bacteria,” says Gerry Wright, a chemical biologist at McMaster University in Ontario, Canada. “Bacteria are very promiscuous and the most shocking thing we’ve realised over the past 60 years is just how rapidly this gene sharing occurs. They often acquire these resistance genes in packages, giving them resistance to multiple antibiotics at the same time, and that’s a major problem in hospitals. Resistance also develops through chance mutations during DNA copying when bacteria reproduce. This is believed to be how bacteria became resistant to rifampin, a drug used to treat tuberculosis.”

Since antibiotics are harder for bacteria to develop a resistance against, mutated bacteria can bypass the drug however they do not live very long. So you could become infected but it won’t be as virulent and threatening. Developing a new product from scratch or even rewiring an old one comes with substantial costs and challenges, and so there are many scientists focusing exclusively on ways to make our existing antibiotics useful once more against resistant bacteria. One popular idea is combination therapy – combining multiple drugs together to form a cocktail mix which is both more potent and difficult to evade.

By continuing the discovery of specific genes essential for the life of the bacterium that interact with multiple other genes in the cell in a complex web-like fashion. By combining antibiotics with other molecules and using these combinations to target this web in various random fashions, perhaps we can unexpectedly improve antibiotic activity or overcome bacterial resistance in new ways. Such random screening required vast numbers of drug combinations to be tried and tested, a thankless needle-in-a-haystack task which would have taken years of labor in decades gone by. But with 21st century robotics technology, Wright and his colleague Eric Brown are able to screen thousands in a mere afternoon.

There can still be unexpected drawbacks as it is often hard to match the exposure of two drugs at the site of infection to see the desired effect.. Wright and Brown thought they’d struck gold with a combination of the antibiotic tetracycline with a drug called imodium, used to treat diarrhea. Imodium enhanced tetracycline’s ability to penetrate bacteria, but further testing showed this only worked in the gut, limiting its usefulness.  “The alternative is to have one drug that simultaneously hits several , often related bacterial targets making resistance harder to develop,” Lee says. “This is a serendipitous strategy applied by many currently successful antibacterial agents including fluoroquinolones and beta-lactam antibiotics. But from a de novo discovery angle this is technically much harder to do.”

As a result, some feel the right combinations of drugs have major advantages when it comes to developing viable products. Given that the individual drugs themselves are known to be safe, and can be produced in large quantities at a reasonable cost, the path from lab to clinic should, in theory, be much faster and less expensive. Wright believes combination therapy is the main way forward, just as combinations of antiviral drugs proved to be the way to control HIV. “With multiple molecules, bacteria often have to develop resistance to each one. And with three or even four molecules together, there’s less and less chance of this actually happening.”

Antibiotic resistance is a problem we can all help to reduce. Good hand hygiene when visiting people in hospital helps. Only taking antibiotics when prescribed by a doctor is crucial; as is always completing a full course if you do have to take them. In addition, doctors themselves should only be prescribing these medicines when patients truly need them. These may be small things, but if we all do them it will have an impact and maybe prevent a future where treatable diseases become fatal once more.

Links:

(A) http://www.theguardian.com/society/2015/nov/16/last-resort-antibiotics-growing-threat-healthcare-report

(B)http://www.theguardian.com/society/blog/2015/aug/21/antibiotic-resistance-the-race-to-stop-the-silent-tsunami-facing-modern-medicine

(C) http://www.theguardian.com/commentisfree/2014/may/09/6-diseases-becoming-resistant-to-antibiotics

(D) http://www.healthline.com/health/e-coli-infection#Overview1

(E)http://www.cdc.gov/HAI/organisms/klebsiella/klebsiella.html

*Please note! These are not my images! They were found on various sites. Please let me know if any are yours so that I can give you credit for them! Thanks so much & enjoy~

Robin Williams: Dementia with Lewy Bodies VS Alzheimer's

 "You are only given a little spark of madness. You must not lose it"~ R. Williams  

 

D is not a rare disease. It affects an estimated 1.4 million individuals and their families in the United States, but many doctors or other medical professionals still are not familiar with LBD. - See more at: http://www.lbda.org/learn_about_lbd#sthash.KJTg8Hv4.dpuf

D is not a rare disease. It affects an estimated 1.4 million individuals and their families in the United States, but many doctors or other medical professionals still are not familiar with LBD. - See more at: http://www.lbda.org/learn_about_lbd#sthash.KJTg8Hv4.dpuf

Many people did not know what Robin Williams, beloved actor and inspiration to all, was suffering quietly alone. He suffered from depression, paranoia,  Parkinson's Disease, as well as dementia. These symptoms describe dementia with Lewy Bodies (DLB). The symptoms fluctuate in their intensities in very unpredictable ways. DLB is the second most common cause of dementia in older individuals, where Alzheimer's is the first. (A)

 According to the LBDA (Lewy Body Dementia Association) there are 3 common symptoms: some will begin with movement disorder leading to Parkinson's Disease then later to dementia. (diagnosis: Parkinson's Disease Dementia), another group of individuals will have cognitive/memory disorder that could easily be mistaken for Alzheimer's Disease, but time will show more distinctive characteristics that leads to LBD. Next, is the smalls group of this disease who at first show neuropsychiatric symptoms (e.x: Hallucinations, behavioral problems, and have a hard time with more complex mental activities) (B)

• Some individuals will start out with a movement disorder leading to the diagnosis of Parkinson's disease and later develop dementia. This is diagnosed as Parkinson’s disease dementia.
• Another group of individuals will start out with a cognitive/memory disorder that may be mistaken for AD, but over time two or more distinctive features become apparent leading to the diagnosis of ‘dementia with Lewy bodies’ (DLB).
• Lastly, a small group will first present with neuropsychiatric symptoms, which can include hallucinations, behavioral problems, and difficulty with complex mental activities, also leading to an initial diagnosis of DLB.

Regardless of the initial symptom, over time all three presentations of LBD will develop very similar cognitive, physical, sleep and behavioral features. - See more at: http://www.lbda.org/content/10-things-you-should-know-about-lbd#sthash.O4YsoqVj.dpuf

 

LBD can have three common presentations:

• Some individuals will start out with a movement disorder leading to the diagnosis of Parkinson's disease and later develop dementia. This is diagnosed as Parkinson’s disease dementia.
• Another group of individuals will start out with a cognitive/memory disorder that may be mistaken for AD, but over time two or more distinctive features become apparent leading to the diagnosis of ‘dementia with Lewy bodies’ (DLB).
• Lastly, a small group will first present with neuropsychiatric symptoms, which can include hallucinations, behavioral problems, and difficulty with complex mental activities, also leading to an initial diagnosis of DLB.

Regardless of the initial symptom, over time all three presentations of LBD will develop very similar cognitive, physical, sleep and behavioral features. - See more at: http://www.lbda.org/content/10-things-you-should-know-about-lbd#sthash.O4YsoqVj.dpuf

"To live...To live would be an awfully great adventure." ~Williams as Peter Pan in Hook  

Individuals who suffer from Parkinson's disease have symptoms of shaking tremors, slow movements of their limbs, and shuffling style of walk. Lewy bodies were found in people with Parkinsons. Lewy bodies are microscopic clumps of protein (aka: alpha-synucein) where under specific conditions- still unknown to scientists and physicians- accumulate in the nerve cells of the brain. This accumulation involving the brainstem, midbrain structures, and substantia nigra accounts for the loss of Dopamine (a neurotransmitter) in the brain leading to Parkinson's Disease. Recent studies show that Lewy bodies do in fact affect other parts of the brain that can occur in autonomic and PNS producing symptoms of low blood pressure, constipation, and sweating. These symptoms are very commonly known as vegetative symptoms. (A)

The most common symptoms of LBD include impaired thinking, fluctuations in cognition(attention or awareness), visual hallucinations,sleep disorders, behavioral and mood symptoms i.e. depression, anxiety, agitation, delusions, paranoia), and changes in autonomic body functions (i.e blood pressure control, temp regulation, bladder and bowel function) (B)

Impaired thinking, such as loss of executive function (planning, processing information), memory, or the ability to understand visual information.

Fluctuations in cognition, attention or alertness;

Problems with movement including tremors, stiffness, slowness and difficulty walking

Visual hallucinations (seeing things that are not present)

Sleep disorders, such as acting out one’s dreams while asleep

Behavioral and mood symptoms, including depression, apathy, anxiety, agitation, delusions or paranoia

Changes in autonomic body functions, such as blood pressure control, temperature regulation, and bladder and bowel function.

- See more at: http://www.lbda.org/content/10-things-you-should-know-about-lbd#sthash.O4YsoqVj.dpuf

DLB diagnosed patients have lewy bodies within the cerebral cortex. The symptoms begin with mild, fluctuating disturbances in attention and wakefulness. The individual will appear vague, drowsy or confused as their interests decrease and inabilities to reason and carry out daily tasks. (Similar to Apathy but is mistaken for depression). R. Williams' visuo-perceptual function was also affected as he would get bruising from bumping into objects. He would also have very life like hallucinations which is common in 80% of cases. (A)

"No matter what people tell you... words and ideas CAN change the world"~ Williams in Dead Poets Society

 As the lewy body disease progresses, general cognitive impairment and dementia get worse although it occurs in a fluctuating pattern of intervals. The hallucinations that these individuals suffer from can be life threatening, confusing as well as frustrating as to why they are unable to recognize familiar faces or strangers. Some have hallucinations as a form of nightmares which develops in part as a specific sleep disorder. The initial diagnosis of Parkison's disease is dementia followed by symptoms of short term memory failure, alzheimer's diseass pathology in the brain, and the walking nightmares people like Williams suffered with on a daily basis. (A)

 

 "Please, don't worry so much, because in the end, none of us have very long on this earth"~ Williams in Jumanji

If DLB is so common, why did it take so long for physicians to recognize it in Williams? Unfortantely, lewy bodies are extremely difficult to see in the brain using conventional methods such as staining. 

"You will always have bad times, but they will wake you up to things you weren't paying attention to"~Williams 

Trials for DLB have been rare because there is a lack of compounds to test. A preoccupation with targeting Alzheimer's and a reluctance of regulatory bodies to recognize DLB are just some of the obstacles researchers face. Because of Robin William's, pharmacological trials for DLB, will increase public awareness. Families will now search for organizations that provide information, advice, advocacy, and support for research activity. DLB is the key to unlock the key to BOTH parkinson's and Alzheimer's disease. (A)

"Never say goodbye because goodbye means going away and going away means forgetting"~Peter Pan, Neverland

Links:
(A)http://www.iflscience.com/health-and-medicine/robin-williams-had-dementia-lewy-bodies-so-what-it-and-why-has-it-been-eclipsed
(B) http://www.lbda.org/learn_about_lbd

*These images are not mine they were found on various tumblr sites! If any are yours please let me know so that I can give you credit~ Thanks so much!

Wednesday Inspiration: How the worst moments in our lives make us who we are

Medicare vs. Medicaid

Medicare (What is it?): Administered by the US federal government, Medicare is a national social insurance program, that has been implemented since 1966. About 30 private insurance companies provide health insurance for Americans who are 65 and older. These individuals have worked and paid into the system since their first job. Medicare also provides health insurance for younger people who have disabilities, end stage renal disease, and amyotropic lateral sclerosis. Medicare covers about half of the health care charges of those who qualify and are enrolled in the Medicare program. The rest of the approved charges have to be paid in either with forms of out of pocket coverages. Such out of pocket coverages vary on a case by case bases depending on the amount of health care the patient needs. Long term, dental, hearing, and vision care are uncovered services of Medicare. 

Medicaid(What is it?) : The Health Insurance Association of America (HIAA) describes Medicaid as a 'government insurance program for people of all ages whose income and resources are insufficient to pay for health care.' It other words, it is a social health care program for families and individuals who have low income as well as limited resources. Medicaid is funded by both the state and federal government, and as of today it is the largest source of funding for medical and health-related services. The states-which manage the funding from the state and federal government- decide who is eligible for the program. These individuals must be US citizens or legal permanent residents. Adults, children, and individuals with certain disabilities are included in this criteria. (Poverty alone does not qualify individuals for Medicaid)

Links:

*These images do not belong to me! They were found on various tumblr sites! IF any are yours- please let me know so that I can give you credit for them! Thanks so much~

Layla Richards: Designer Cells Impact

Introduction: 

One year old Layla Richards suffering from an aggressive form of leukemia is the first to be treated with designer immune cells that were genetically engineered to wipe out her cancer. Given only months to live after the failure of conventional treatments, a miracle has occured. (A) Layla was treated in London by specialists at Great Ormond Street Hospital (aka: GOSH).  They were unsure whether the treatment would work, curing the disease, or delaying its progression but knew that only time would tell. However, there are still many concerns about this type of treatment for all children. Nevertheless, this is a huge leap for new gene engineering technology. (A) When Layla was born, within 3 months she developed fast heartbeat, did not drink her milk, and cried more than expected. Blood tests revealed she had acute lymphoblastic leukemia (aka: ALL) being the most aggressive form that doctors have ever seen.(A) A doctor who cared for Layla, Sujith Samarasinghe, stated that only ~25% of children survive such aggressive forms of leukemia. Next day, Layla was given chemotherapy and had a bone marrow transplant to replace her damaged blood cells. Despite all the conventional treatments, the disease returned.(A)

Research: 

Researchers from UCL showed that modified cells had an anti-cancer effect on mice with leukemia. They gave one vial of the cells to baby Layla through the approval and consent from emergency ethics committee and her parents. Once approved, she recieved 1mL infusion of genetically engineered immune cells taking the infusion a total of 10 minutes. The vial of cells came from donated T cells (which were kept frozen) or more commonly known as WBCs (have vital role in human immunity). However, before the infusion, the cells were given an added gene so that the cells target the leukemia cells. As suspected, the doctors predicted that if the infusion did in fact work, Layla would develop a rash (an indication that the cells were having an effect).  (A) Results: Two months passed, and Layla was still clear of leukemia which allowed doctors to give her a second bone marrow transplant to replace her entire blood and immune system. The treatment had wiped both out so this was necessary and vital part of the whole process. Thirty days later and she was healthy to go home. Doctors and researchers are now inspired to modify the therapy so that they can treat other blood disorders and the various types of cancers that exist. Clinical trials of the cells could be a huge step forward in treating both leukemi and other cancers. (A) 

Concluding Remarks: 

“Re-engineering a patient’s immune cells to target cancer has shown real promise in a small number of patients with leukaemia. This trial has adapted this treatment so that it’s easier to make, and now we need to see if this new approach is effective. Finding a way to make this work in other types of cancer is the next big challenge.(A)”

Links:

(A)http://www.theguardian.com/science/2015/nov/05/baby-girl-is-first-in-the-world-to-be-treated-with-designer-immune-cells

*These images do not belong to me! They were found on various tumblr sites! If any are yours- please let me know so that I can give you credit for them! Thanks so much~

Blood Vessel Bio Printer

Introduction:

Creating a synthetic network of blood vessels to support organs that scientists have created artificially from the heart, liver, and lungs has been one of researchers greatest challenge. Blood vessels incredibly important because they are vital to the body's circulatory system supplying organs with nutrients and remove wastes. Researchers are able to create artificial blood vessels within the lab using 3D printers, which can be used for transplants and to test for new drugs.  (B)

Research:

On October 25, 2015 the Revotek (Chinese Co.) released the world's very first 3D blood vessel bioprinter where two nozzles work alternatively so that the bioprinter can finish a 10cm blood vessel within 2 minutes. The core of the pinter, 'BioBrick', holds within it stem cells wher when the perfect conditions are met so that the stem cell can differentiate into the cells that the scientists need. BioBrick refers to stem cell producing system with a biomimetic function. The major difference in 3D blood vessel bioprinting (compared to regular 3D printings) is that the stem cells are kept active during the process.(A) Discovering methods to keep vascular cells and other active substances alive are just some of the goals.  Not only does this type of printing print one blood vessel but it is capable of printing livers, kidneys, as well as other organs in the human body. Although the release of the worlds very first 3D blood vessel bioprinter is a mjor breakthrough in scientific research holding an incredible amount of potential to help patients, there needs a long period of time before it can be applied to human medical care. (A)

Methods:

There are two ways in which researchers can use 3D printing. They can either print the actual cells or they can print a structure on which they can grow the cells (later dissolving). However, caution needs to be applied during these processes and methods because printing cells often times damages or kills them.  The substances that get dissolved-mentioned above- can be harmful to cells in our body. In Khademhosseini's tissue study, he and his team were able to print a template for cell growth that can later be pulled out before damaging cells. A network of tiny channels of agarose as the role of template for artificial blood vessels was embedded into the passages of the gel structure. Here mouse cells were grown to develop into bone. (B)

*agarose is a polymer made from seaweed which is often used for culturing cells*

Results:

The blood vessels can effectively transport fluids, support living cells, and allow the cells to mature. The cells were also able to rearrange themselves into a layer of cells on the templates. (B)

Concluding Remarks:

The reason as to why this is such a milestone in medical research is that,  there is a significant need for blood vessels as well as tissue donor transplant. Even if patients who need an organ transplant were lucky enough to receive one, there is a great chance that the patients immune system will reject the new body part

Links:
(A) http://www.ibtimes.co.uk/china-revotek-releases-worlds-first-3d-blood-vessel-bioprinter-1525757
(B)http://www.livescience.com/46067-3d-printed-blood-vessels.html

*These images do not belong to me! They were found on various tumblr sites! If any belong to you please let me know so that I can give you credit for them- Thanks so much ! 

Cystic Fibrosis: 2020 Gene Therapy

Cystic Fibrosis (aka: Muco-viscidosis) is a genetic disorder that affects the lungs as well as the pancreas, liver, kidneys, and the intestines. Individuals with CF have difficulty breathing, cough up mucus as a result of frequent lung infections, sinus infections, poor growth, fatty stool, clubbing of fingers and toes, and infertility in males. (There are many other symptoms) (B) The degrees in which people with CF have the symptoms listed above varies on a case by case basis. This chronic disease is inherited as an autosomal recessive way where there are mutations in both copies of a gene for the CF transmembrane conductance regulator protein. (CFTR) Those who have a single copy are carriers of the disease and are normal functioning/looking individuals. As of today, there is no cure for CF and lung infections are treated with antibiotics that can be received intravenously, inhaled, or by the mouth. (B) 

Introduction: 

In 1989, scientists failed to find a cure for cystic fibrosis although the faulty gene that causes CF was located. But with the use of experimental gene therapy (a technique where copies of normal genes are inserted into the cells DNA to counter the effects of the faulty gene) is giving hope for individuals suffering from CF. (C) Cystic Fibrosis (being the most common life-threatening inherited disease especially in the UK, shorting lives of many) was an early and clear target for scientists to further investigate gene therapy when the mutated gene that causes it.The results of a year-long trial showed only a small and variable improvement in the lung capacity of those children and adults who took part, but scientists now believe they have proved gene therapy is possible in treating cystic fibrosis. (A) After years of attempting to develop gene therapy for CF, recent research shows that a treatment for CF might be available within the next 5 years. Although results of first trial were ‘modest and variable’, second bigger trial aims to combine gene therapy with other treatments for longer term benefits. With more work, researchers say that they will be able to at least help stabilize these patients. (A) 

Research: 

The Royal Bromptom and Harefield NHS Foundation Tust and the NHS Lothian came together in 2001 to develop a gene therapy which was supported by the Cystic Fibrosis Trust. They were able to develop a technique where patients could breathe in molecules of DNA where a normal copy of the defective gene could travel to the cells of the lung. A trial of a total of 136 patients (ages 12 and older) showed results of better lung functioning in those who were given the gene therapy. This was the first demonstration that repeated gene therapy to improve lung function. Eric Alton (coordinator of UK Cystic Fibrosis Gene Therapy Consortium) stated that, “The effects were modest and variable. This is not yet ready for clinical use for those reasons. (A)” At Western General Hospital and the Royal Bromptom half of their patients were treated with gene therapy and the other half were give saline. Those with the best results were those who suffered from the worst lung function. The mucus obstructs the smaller airways so that most of the doses end up in the larger airways instead. Those with milder lung troubles would have to receive a larger dose to get the same results. (A) Unfortunately, the scientists were unable to make permanent changes to the faulty gene. According to the trial published in the 'Journal of Lancet Respiratory Medicine' patients were dosed only once a month and soon realized that increasing the dosages showed a direct correlation to improved results. In larger trials the goal will be to combine gene therapy with other treatments. (A) A new trial may be able to give patients benefits that last much longer through the injection of a specially engineered virus rather than injecting them in fat globules (aka: the method physicians use today in treating CF) This form of treatment was not considered much because repeated dosages treatment through a virus would cause the immune system to reject it. If the next trial shows a bigger benefit, said Alton, it would be feasible to have a treatment to improve lung function available for patients by the end of the decade. The aim would be to prevent damage to the lungs occurring. (A) “The lungs must be one of the worst possible organs to go for,” said Alton. “They are so extremely well-defended. With bone marrow you can take it out, do the gene transfer in controlled conditions in the laboratory and put it back in the patient. That is the low-hanging fruit. We have gone for the high-hanging fruit but I’m not at all sorry we have.(A)” 

Concluding Remarks:

Since gene therapy is still such an experimental process where there are very few treatments discovered through this technique which only apply to very rare diseases, there needs to be continuous investments, innovative approaches to genetic research, and creating advancements for diseases such as CF which cuts many young people's lives. There is no doubt that this study with experimental gene therapy is inspiring scientists and physicians world wide to explore more of this technique to target other genetic conditions as well as cancer.

Links:
(A)http://www.theguardian.com/science/2015/jul/03/gene-therapy-cystic-fibrosis-2020-scientists
(B) wiki/CF
(C)http://www.aljazeera.com/programmes/thecure/2015/08/gene-therapy-cystic-fibrosis-150817115228509.html

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