The Resistance

The resistance is growing fast, and I am not referring to the good guys in ‘The Terminator’. We have all taken antibiotics at one time or another, which are vital for fighting against bacterial infections to keep us healthy. However, disease-causing bacteria are now becoming increasingly resistant to antibiotics and the development of new antibiotics is at an all time low, which in combination could lead to a post-antibiotic era, which would be bad news all round.

A NHS appeal as part of the
 European Antibiotic Awareness Day

So why has this resistance come about? Antibiotics have been widely used for the past 60 years, commonly used to treat various ailments and diseases, as well as being used in the meat industry to promote the growth of animals to make us bigger, juicier steaks. Furthermore, more people are taking antibiotics in an effort to feel better when in fact the course is non-essential. People suffering with colds or flu often request antibiotics, which is pointless as antibiotics fight bacterial infections, not viruses. Even worse are those who stop taking antibiotics before the course is over. Taking half a pack exposes the bacteria to the poison in a non-lethal dose, allowing resistance to prosper. In combination, these actions are leading to dangerously 

increased antibiotic resistance.

The implications of this resistance are pretty severe. Antibiotics are vital for the treatment of otherwise life threatening bacterial diseases, and without effective antibiotics currently treatable infections could become lethal. We've all heard of MRSA, which stands for Methicillin-resistant Staphylococcus aureus. Although when said aloud Staphylococcus aureus may sound like a dinosaur, this is in fact one of the most resistant species of bacteria, having overcome every antibiotic developed over the past 50 years. With the emergence of MRSA in hospitals, the scientists brought out the big guns, in the form of Vancomycin. This antibiotic has been known as ‘the drug of last resort’, generally being able to stop any bacteria in its path. However, strains of Vancomycin resistant S. aureus (VRSA) have now been identified. 

So how do bacteria actually become resistant? Well, there are various mechanisms of resistance; some bacteria have evolved pumps to get rid of any incoming antibiotics, others block antibiotics from entering their cell in the first place and others make enzymes which can inactivate the antibiotics. Bacteria can also pass on their genes for resistance, allowing different bacterial species to exchange their resistance to certain antibiotics with others quickly and efficiently. So basically these single-celled little critters are standing up for themselves, and telling their mates how to do the same.

The development of new antibiotics has declined significantly in recent decades because pharmaceutical companies want to maximise profits. Sending scientists to unscathed environments for years, only to discover few and far between compounds, does not bring in the big bucks. Considering the threat of antibiotic inefficiency to humanity, it is hard to understand this lack of research and funding. But of course, Mr Pharmaceutical-Company would rather spend his money on popular drugs which bring in higher revenue. After all, money makes the world go round.

So what of the future? The careless use of antibiotics, as well as negligent infection control has caused this extensive antibiotic resistance on a world wide scale. By identifying novel antibiotics, reducing human consumption, eradicating antibiotic use in the animal industry and increasing hygiene and infection control, the resistance could be significantly reduced and the problem could pretty much be solved. This isn’t impossible; just look at the recent remarkable declines in MRSA infections in England. So it's not all doom and gloom, but be aware. These little buggers are standing up for themselves and it's time for us to man-up.

References
Crossley, K.B., Archer, G., Jefferson, K., Fowler, V. (2010). Staphylococci in Human Disease. John Wiley and Sons.
Dandekar, T., Dandekar, G. (2010). Pharmacogenomic strategies against microbial resistance: from bright to bleak to innovative.
Pharmacogenetics, Vol. 11, No. 9, pp. 1139-1196
French, G.L. (2010). The continuing crisis in antibiotic resistance. The international Journal of Antimicrobial Agents.
Godsland, J., Osmond, R., Pini, P. (2008). Darwin’s Gifts: The Lancet. Elsevier Ltd.

Read All About It!

The subject of this blog is a ruthless collection of diseases. One in three of us will be diagnosed with this during our lifetimes and one in four will die as a result.  Newspapers frequently report on the latest discoveries of causes and cures of this collective disease, the poisons and remedies found in our everyday lives. I am of course talking about cancer. I know the picture to the right is a give away, unless you were distracted by the ever-cheerful face of Andy Murray, but I'm not holding my breath on that one. 

Cancer is the uncontrolled proliferation of abnormal cells in the body, which can assemble to form a tumour and disrupt the functioning of tissues and subsequently organs. Cancer cells can metastasise (spread) from the tissues they originated in to other organs, where they colonize to form secondary tumours. Metastasis is responsible for 90% of cancer deaths and is subsequently a major issue in the battle against cancer. With over 200 different types of cancer, each having different causes, symptoms and treatments, scientists and health professionals have got a huge battle on their hands.

So that’s the basics, and let’s be honest, it’s not too cheery. But it’s not all doom and gloom. Cancer survival rates have doubled in the UK over the past forty years, and it’s thanks to scientific research funded by charities such as Cancer Research UK. Cancer Research UK funds the work of more than 4,000 scientists, doctors and nurses, and the research is coming thick and fast. For example, one of the latest publications in the scientific journal 'Nature' shows that scientists from the USA have used an experimental drug to inhibit the development of acute myeloid leukemia (AML) in mice.

Mis-formed white blood cells
of an AML patient

So what is AML? AML is cancer of the myeloid lineage of blood cells. AML occurs when the bone marrow makes too many white blood cells, which are consequently mis-formed and function incorrectly. The white blood cells then overcrowd the bone marrow, taking space that should be occupied by other types of important blood cells. The bone marrow is essential for fighting infections, which AML patients are subsequently more susceptible to.

The recent research by Zuber et al. revolves around the protein ‘Brd4’, identified to be involved in the development of AML. Scientists subsequently tested an experimental drug which inhibited the Brd4 protein from functioning and found it to inhibit AML in both cell and mice studies. The drug had anti-leukemia activity and showed minimal toxicity to non-cancerous cells, and is now being developed for therapeutic use. Although this will take an expected two years to enter clinical trials, it is a significant step in the treatment of AML. This recent report also brings news of the potential of this drug to contribute to the treatment of other types of cancer. 

There are frequent developments, such as the above, in the understanding and treatment of cancer. However, I personally believe that the media can take science out of context, an issue I feel very strongly about. ‘A glass of red wine stops cancer’, ‘a glass of red wine causes cancer’; with such headlines it seems that scientists don’t know what they’re talking about. Finding, for example, that a component of wine can inhibit a certain type of cancer in a certain model of set conditions can frequently lead to the headline ‘Wine Stops Cancer’. This is simply not the case and findings from initial research such as this shouldn’t be taken so literally as to change our daily behaviour. Scientific papers have the bare facts. Newspapers have the catchy headlines. 

I know which I prefer.

References

Zuber, J. et al. RNAi screen identifies Brd4 as a therapeutic target in acute myeloid leukaemia. Nature doi:10.1038/nature10334

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001569/

Appelbaum FM. The acute leukemias. In Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 194.

http://info.cancerresearchuk.org/cancerandresearch/