More than one hundred years ago Paul Ehrlich,
postulated creating “magic bullets” for using chemotherapeutic agents to fight
against human diseases. During those years, maximum number of human deaths was
due to microbial diseases. Different kinds of synthetic drugs were discovered
and used over the years, the last ones being the “sulfonamides” before the
ground breaking discovery of penicillin was made by Alexander Fleming in 1928. The
era of “antibiotics” continued for a long time and is going strong up to the
present time even though antibiotic resistant microorganisms are fast
developing. The methicillin-resistant Staphylococcus
aureus has created fear in the hospital-setting causing diseases to the
patients, which in many cases become fatal. The development of multi-drug
resistant tuberculosis strains is another example which creates significant
worries among poor nations.
The present day medical research has moved from
treating microbial diseases to treating human diseases emanating from systemic
bodily defects such as diabetes, arthritis, cardiovascular diseases, kidney and
liver diseases, nerve related diseases such as Alzheimer’s and Parkinson’s
diseases, cancer and several others. To treat all these conditions mainly the
aim has been to develop technologies to produce substances that body produces
for its harmony such as proteins of diverse kinds including insulin, cytokines and
various other enzymes. The aim was to treat patients with “replacement
therapy”, providing the materials that body requires but cannot produce within
the body because of defects. The other approach was to scientifically
understand the concept of “ligand-receptor interaction” with reference to bodily
macrolides such as proteins, nucleic acids, carbohydrates, peptidoglycans etc.
and to treat most such conditions by attempting to modulate cellular
communication and inter-cellular modification of substances and also to reduce cellular
inflammation. In doing so, several recombinant proteins and monoclonal
antibodies started getting evolved and entering into the treatment regimen of
human medical armory. At the moment more than 150 such products are in use
globally. Another approach to treat bodily afflictions has been to “regenerate”
the defective tissues by utilizing “stem cells” with the idea that the
defective tissues would be “repaired”. This approach continues today at various
laboratories and several new methods and technologies are anticipated to emerge.
The present approach is mainly “autologous” in nature.
In the meantime, the disease producing microbes that
were contained by use of “antibiotics” have become stronger and resistant to
the known antibiotics to humankind. Resistant microbes have emerged in their
intense desire to survive in environments “soaked” in antibiotics. Interestingly,
the natural antibiotic molecules were isolated from some microbial sources.
Even though many such natural antibiotics had been “modified” by human
intervention, the essential chemical structure of those molecules was learnt by
human kind by studying the natural molecules. The survival instinct by which
the bacteria had evolved themselves to survive in an environment surrounded by “enemy
bacteria” was “stolen” and modified by the “enemy bacteria” and thus the “enemy
bacteria” recreated themselves as the resistant species. Development of antibiotic
resistance in nature is therefore essentially a phenomenon of “self-readjustment”
and “self-recreation” with an intense desire to survive. This natural law was
understood by human kind from early 70s and efforts continued to develop more
powerful antibiotics. However, this approach would be abandoned in course of
time and newer methods are to be evolved. In the light of such thinking, it was
discovered that a large number of viruses exist in nature that can “kill” the
bacteria. The natural reserve of such a pool was enormous. It was further observed
that the huge pool of viruses were continuously growing into their host-microbe
and were bursting open their hosts from within. This was done by producing
specific kinds of enzymes by the viruses that were capable of tearing off the peptidoglycan
cell walls of the bacteria. This is a natural phenomenon. Once this concept was
understood, several scientists started to investigate if such proteins could be
produced in large quantities to contain the target bacteria. On pursuing this
concept, recently a drug has been discovered which is known by the name CF-301
and is an enzyme that kills Staphylococcus aureus in mouse model. The
drug was discovered by M/s ContraFect Corporation, USA. It is
anticipated that many such drugs would be discovered using the approach of
identifying enzymes that can “dissolve” the peptideoglycan cell wall of bacteria
from within. Once such enzymes are discovered and structures identified, these
would certainly be produced in large quantities in fermentors using approprie genetically
modified microbes such as E.coli and yeast and would be used to contain the “resistant
bacteria”. The enzymes would “dissolve” the peptidoglycan cell wall of the
bacteria and would kill. However, such discovery approaches would not be easy.
Very sophisticated laboratories with highly talented scientists would have to
work in R&D institutions to undertake basic and applied research to come up
with new products for mankind. Only then the era of antibiotics will come to a
close.
Dear Sir,
ReplyDeleteThanks for sharing such a wonderful summarize infromation about ongoing acitivites in antimicrobial drug discovery, Effect, cause and future.
Vivekanand