Have you ever been prescribed a course of antibiotics to treat your bacterial infection, but neglected to complete the full course of medication? You may think that there will not be any serious repercussions, but in truth, there may be. If you were to stop your treatment early, there is a risk that the antibiotics may not have killed all the bacteria and that they will mutate and develop resistance to the antibiotic. Not only does this pose a danger to you, the individual, as the infection may recur and be more difficult to treat, but there is also an associated risk to the general population due to the infecting bacterium becoming more resistant to the specific antibiotic.
On September 9, 2016, Harvard Medical School released a video online titled ‘The Evolution of Bacteria on a “Mega-Plate” Petri Dish (Kishony Lab)”, wherein they carried out a lab experiment demonstrating how the bacterium E. coli adapts to increasingly higher doses of antibiotics. In less than two weeks, the researchers observed as the bacteria spread towards the highest drug concentration of the antibiotic trimethoprim at an alarmingly rapid rate. The bacteria produced mutant strains that were capable of surviving a dose of the antibiotic that was 1,000 times greater than the one that killed their progenitors. While this petri dish experiment does not perfectly imitate the conditions in the real world, it does provide insight to the adaptive and survival abilities of bacteria more accurately than traditional lab cultures. This study ultimately demonstrates the possible implications of people misusing and overdosing on antibiotics.
The implications of this example may not seem significant until it is applied to the real world. In the same month as the Harvard experiment above, a woman in her 70’s died from infection caused by carbapenem-resistant Enterobacteriaceae (CRE), a strain of bacteria that is now resistant to all existing antibiotics. But why haven’t we heard anything about it on the news? Last year, a Pew Charitable Trust report revealed that too few antibiotics are in development, and that a majority of antibiotics are being developed by small companies, rather than large pharmaceutical companies. Not only are these big pharmaceutical companies not stepping up to the plate, but there has been a complete lack of media coverage and awareness regarding these issues. This crisis of antimicrobial resistance has not been receiving the attention and coverage it deserves.
It is a lesser known fact that nowadays, antibiotics are not only used and abused by humans but also fed to livestock to keep the animals healthy, thus contaminating our environment and indirectly influencing us again. This puts us, as a global community at high risk of developing an accelerating resistance to many forms of harmful bacteria. As more and more antibiotics are exhausted, we are at a desperate need to discover more new antibiotics that the bacteria have never been exposed to before. Without time on our side, this is a concern that is quickly becoming a global crisis at an alarming rate.
However, not all hope is lost in this seeming futile battle against antibacterial resistance. Recently in November of 2016, professor Sean Brady, head of the Laboratory of Genetically Encoded Small Molecules at Rockefeller University, and his team discovered a new method of finding new antibiotics. They used computational methods to scan the genomes of many microbes for sequences that may produce useful antibiotics, and then synthesized these compounds in the lab. They produced two new antibiotics this way without having to culture any bacteria, which is a tricky process as not all bacteria can grow in labs, and often the genes that will code for antimicrobial resistance won’t be turned on. Brady says that he hopes his new method will inspire the scientific community to take advantage of new technologies to further digitally mine the genomes of many bacteria that have not been sequenced yet, to produce novel antibiotics efficiently.
But in essence, this does not solve the root problem of the antimicrobial resistance crisis, as resistance will still persist even as we continue to churn out new medicines. It’s a never-ending arms race, and we must continue to creatively max out all of our resources to discover novel ideas and approaches to counteract resistance. One thing to take home from all this, is that currently, antimicrobial resistance cannot be stopped, but can be slowed down - and that requires the global knowledge of the effects of antibiotics and its proper usage. In this fight, less is more, and controlling our intake of antibiotics is the first step in buying us more time in research and development.
For more readings:
WHO Antimicrobial Resistance Fact Sheet: http://www.who.int/mediacentre/factsheets/fs194/en/
Harvard Medical School Study: https://hms.harvard.edu/news/bugs-screen
Bacteria Resistant to All Antibiotics: http://www.forbes.com/sites/brucelee/2017/01/15/woman-dies-from-bacteria-resistant-to-all-antibiotics-why-dont-more-people-care/#37462a570329
Prof. Sean Brady of Rockefeller University: http://www.futuretimeline.net/blog/2016/11/20.htm#.WIpmtfkrKM8
Written by: Sherry Cui and Elenka Yu
Sherry and Elenka are currently in their first year of undergraduate studies at Western University and serve as UAEM Empowerment and Events’ representatives.
Our nation has been one of the drivers of innovation in the field of medicine and we are very fortunate to have so many research institutions, such as Western University, contributing to pushing the boundaries of knowledge. I know that many science students are involved in research or at least are thinking about pursuing an area of research. The question I want to ask in the context of Western is, what areas have we been focusing on? What areas have we been neglecting?
As researchers, we have the curiosity that drives us to further explore our passions but also the noble goal of benefiting our society and humanity. Have you heard of Chagas disease? Dengue fever? Lyme disease? These are diseases that devastate a huge proportion of the world’s population yet hasn’t been brought to the public awareness or the topic of discussion in academia. This is also the case for the rising problem of antimicrobial resistance illustrated in the previous blog posts. All of these observations of a lack of research in areas that have lower profitability illustrates a larger problem in our research and development system. In many ways, it is failing to address global health needs.
We see that this is important to address because universities play a role; one quarter to one third of new medicines originate in a university lab. “The social mission of academic institutions allows them to use public resources to serve and strengthen society. Our universities can, and should, be challenging this profit-driven system using their unique leverage to both propose and implement solutions to create a patient- centered R&D system.”- Rachel Kiddell-Monroe.
As science students who are active in the research community, we believe that access to healthcare should be a right, not a privilege. It is important to consider the potential impacts of our research on society and global health. We need to take the initiative to ensure the fruits of our research are disseminated to people who need them most. Students also play a role in this global health issue and they will continue to play a role because they will make up the next generation of researchers, educators, and policy makers.
For more readings:
Written by: Emmy Sun
Emmy is currently in her third year of undergraduate studies at Western University and serves as UAEM Western's VP Innovation.
Dr. Chil-Yong Kang of Western University and his team of researchers have been making waves in the scientific community for their development of a prophylactic vaccine against HIV. More than 36 million people around the world are currently living with the virus, and almost as many have died from AIDS-related diseases since its discovery in 1983. Over the years, there have been countless efforts to produce a drug or vaccine against HIV but they have met with little success.
What sets Dr. Kang’s research apart from previous attempts is that his vaccine uses a deactivated whole HIV-1 virus to build the body’s natural immune system against it. Although vaccines against diseases such as polio and hepatitis A use a similar approach, it is controversial in the fight against HIV as the virus’s quick mutation rate makes it difficult to inactivate completely. To overcome this issue, Dr. Kang’s team genetically modified the HIV-1 virus using genes from honeybees and further used chemical treatment and gamma radiation to ensure the virus is entirely deactivated.
Phase I trials were completed in 2013 using 33 HIV-1 infected subjects. The results exceeded expectations – the vaccine produced no adverse effects in the subjects and even showed signs of increasing immunity against the virus. Phase II is to begin in 2017 and will further test this immune response.
SAV001 has been approved by the FDA for human testing, and the R&D costs for the vaccine are funded by the Bill and Melinda Gates Foundation and the government of Canada. Currently, Sumagen Canada, a subsidiary of Sumagen Co., Ltd. holds the Exclusive License for the development and subsequent commercialization of vaccine. If human trials produce desirable results, the company will look towards collaborating with pharmaceutical companies to sell the vaccine in countries around the world.
UAEM is a group that is focused on the importance of increasing access of vaccines and drugs to lower and middle income areas, especially in developing countries. Through Western’s Technology Transfer Office (TTO), Sumagen Canada has secured patents for SAV001 in 70 countries, including China and India. While this is great news, life-saving drug patents cannot be handled on a case-by-case basis, which highlights the importance of setting a framework such as the GALF that allows the university’s medicine and biotechnology innovations to be accessible to low- and middle- income areas around the globe.
For more information on the biochemistry behind the vaccine and to learn more about the R&D process, please visit the following websites:
In-depth information on SAV001: http://www.natap.org/2013/newsUpdates/092313_01.htm
Vaccine access and R&D: http://www.doctorswithoutborders.org/news-stories/special-report/giving-developing-countries-best-shot-overview-vaccine-access-and-rd
Role of universities in the access to drugs fight: http://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0030136&type=printable
More coverage on SAV001: http://mediarelations.uwo.ca/2016/12/01/western-virologist-hopes-test-vaccine-600-hiv-negative-subjects-next-fall/
Information on the Global Access Licensing Framework: http://uaem.org/our-work/global-access-licensing-framework/
Written by: Jasleen Dayed
Jasleen is currently in her first year of undergraduate studies at Western University and serves as one of UAEM Western's Report Card Leaders
CRISPR is a powerful gene-editing tool acclaimed to be the biggest breakthrough in biotech since well, the start of biotech. Unlike its gene-editing predecessors, it is able to essentially cut and paste sequences to targeted loci with relative ease by simply synthesizing the corresponding guide RNA. The discovery seems to show limitless possibilities with its implications for genome engineering, disease models and gene therapy.
Western has already made progress in affecting efficacy and possibly off-target effects in CRISPR/Cas9 as David Edgell and his team of researchers have published a paper last month in the Proceedings of the National Academy of Sciences (PNAS) on the addition of I-TevI to Cas9. Other progress in HIV immunity and muscular dystrophy have been made however no “CRISPR drug” exists yet.
With the promising future of CRISPR, control over the technology could be worth billions. Startups have already invested millions into developing CRISPR into cures including Editas Medicine and Intellia Therapeutics, associated to Feng Zhang of MIT-Harvard Broad institute and Jennifer Doudna of the University of California, Berkeley respectively. Zhang and Doudna are currently in a fierce and complex legal battle for patent rights on the commercialization of CRISPR. Until a decision is made, commercialization of CRISPR has come to a halt.
The legal case of CRISPR is just another example of problems within the current licensing system of medical technologies. As the future of one of the greatest discoveries of mankind hangs in the balance of a legal tug-o’-war, it is a reminder of the importance of UAEM’s mission to reform university patenting and licensing policy to enable access and innovation of essential medicines and technologies.
For more readings:
MIT Technology Review: https://www.technologyreview.com/s/532796/who-owns-the-biggest-biotech-discovery-of-the-century/
KQED Science: https://ww2.kqed.org/futureofyou/2016/12/08/billions-at-stake-uc-berkeley-gets-day-in-court-vs-harvardmit/
Bloomberg Businessweek: https://www.bloomberg.com/features/2016-how-crispr-will-change-the-world/
Written by: Soojie Hong
Soojie is currently in her third year of undergraduate studies at Western University and serves as UAEM Western's Finance Leader.