Pathogenic Precision

WRITTEN BY

Steve Projan, Senior Vice President, R&D and Infectious Diseases & Vaccines iMED Head

Today, antimicrobial resistance from antibiotic misuse and overuse poses an imminent and urgent public health threat, making it more important than ever to develop new therapies to treat infections.  Fortunately, science may be on the precipice of transformation.

The timing couldn’t be more imperative. Nearly 100,000 patients in US hospitals die annually from bacterial infections; about 70,000 of these deaths are from drug-resistant bacteria, in large part because of the inappropriate overuse of broad-spectrum antibiotics.

What makes this scenario disturbing—beyond the loss of individual patient lives—is the dissemination of these drug-resistant infections into the larger community. This happens because broad-spectrum antibiotics cast a wide net, killing not only the intended pathogenic culprit, but also our collective microbial ecosystems. Further, bacteria have the ability to become resistant to the antibiotics. The challenge has been a broad-spectrum antibiotics concept that hasn’t changed for decades.

Pathogen-specific antibodies

So how is the scientific community working to tackle this crisis? Some answers will be presented this week at the 2017 Precision Medicine World Conference (PMWC), where I’ll be chairing a session about antimicrobial resistance and related Infectious Disease topics, along with several industry colleagues. The focus of our talks during this session includes the problem of antibiotics—specifically, broad-spectrum antibiotics—why they are risky, and what biotechnology is doing right now to ameliorate that threat.

In part, the convergence of rapid diagnostic testing and novel antibacterial monoclonal antibodies (mAbs) may make pathogen-specific therapeutics a reality. What this offers is the ability to first identify via diagnostics and then to deliver a mAb that precisely targets and destroys a particular invading pathogen; this decreases the use of broad-spectrum antibiotics and spares the microbiome.

At PMWC, I’ll be talking in more detail about our own investigational novel bispecific mAb—MEDI3902—and its role in taking on Pseudomonas aeruginosa (P. aeruginosa). The source of common bacterial infections among hospitalized patients and problematic in terms of morbidity and mortality.

From a public health threat perspective, the CDC notes that, “An estimated 51,000 healthcare-associated Pseudomonas aeruginosa infections occur in the United States each year. More than 6,000 (or 13%) of these are multidrug-resistant, with roughly 400 deaths per year attributed to these infections.”

Clinical studies suggest that monoclonal antibodies like MEDI3902 have the potential to disarm a bacterium’s pathogenic mechanism or clear bacteria from its host, ultimately reducing the use of antibiotics and without the threat of stimulating antibiotic drug resistance.

It’s true that antibiotics have been a major triumph for modern medicine, and they will remain useful. But, in this precision medicine era—including successes in therapeutic areas such as oncology and inflammatory conditions—the time and technology are now for novel and custom therapeutics that can successfully address antimicrobial resistance.

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