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Immuno-antibiotics: A New Frontier in the Fight Against Antimicrobial Resistance

January 25, 2021

Have you ever taken antibiotics for a sore throat and ended the treatment as soon as the symptoms disappeared and without finishing the course of medicine? This is a common mistake many of us have made and just one example of the many antibiotic misuses and over-uses that have led to the development and spread of antimicrobial resistance (AMR), one of the greatest threats to human health of our time. And one of the most under-reported.

Almost a century after the discovery of penicillin, an estimated 700,000 people die each year due to antibiotic-resistant infections such as tuberculosis and malaria, a number that could reach 10 million by 2050.

Because of the widespread use of antibiotics in agriculture and intensive farming to promote growth and prevent disease, more resistant bacteria are transferred to people and escape into the environment.

Without effective antibiotics, routine medical procedures could become risky, common bacterial diseases that used to be easily treatable are turning into serious threats, and others we considered long gone are coming back from the past.

Just imagine life in the pre-antibiotic era where a simple infection from a cut could kill you.

Not to mention the economic burden to patients and the health care system. In 2006, hospital-acquired sepsis and pneumonia cost the U.S. health care system more than $8 billion. If the AMR crisis is not solved by 2050, the estimated cost to the global economy will run into $100 trillion.

In the last two decades, only a few new antibiotics have been approved for clinical use and resistant bacteria have already emerged against these new drugs. The number of new molecules in the pipeline has been on the rise since 2014, but to stop resistant bacteria in their tracks we need creative, out-of-the-box solutions that are less likely to be circumvented.

The lab of Dr. Farokh Dotiwala at The Wistar Institute Vaccine & Immunotherapy Center recently reported a landmark discovery that could lead to the development of a new class of antibiotics, built on the idea that if we attack bacteria on multiple fronts, they are less likely to find a way out and become resistant.

Nature, one of the highest impact scientific journals, published the study and then highlighted it with a commentary in Nature News & Views, a scientific forum that discusses influential and broad-interest studies, as a highly promising proof of concept for an innovative strategy for tackling the emergence of drug resistance.

World Health Organization leaders “tweeted” about the importance of immuno-antibiotics to their more than million followers.

Dotiwala and his team reasoned that vaccines are much less likely to give rise to resistance because they work by enlisting the body’s immune response rather than just directly killing the pathogens (like traditional antibiotics do). So, they researched an antibacterial strategy that could also harness an immune response.

The new compounds, named immuno-antibiotics, kill bacteria by blocking a metabolic pathway that is essential for them to grow and survive. Though at the same time, these drugs potently activate a subset of T cells involved in immune responses to a wide variety of viral and bacterial infections, adding a second line of attack.

When tested on patient-derived, drug-resistant bacteria and in preclinical models of infection, immuno-antibiotics outperformed the current best-in-class antibiotics.

Creating a synergy between the direct killing of antibiotics and the natural power of the immune system, immuno-antibiotics have the potential to represent a milestone in the fight against AMR.