tv Steffanie Strathdee Thomas Patterson The Perfect Predator CSPAN April 18, 2019 1:17am-2:18am EDT
and they are kind of developing this in a fight against one another so one of the things that happensned is is the bacteria can become resistant and that was demonstrated and the navy was ready for this. they said we don't know how long it is going to take. going aer e they realized by looking at the bacterialwith a rea isolate thee it into the resistance. they developed a second-generation cocktail that was actually able to attack thet mutant bacteria, and they did w. this within a week and approved to them personalized therapy on demand is a reality, and as adey result of that, the new company called adaptivesult to therapeus
developed and that is kind ofph. disabilityy and branch. i should acknowledge we havege m stock in that company so i had to take advantage of that opportunity. [laughter] opptunity. what this resistance is can be overcome so the fact that resistance occurs if it's going to be a doomsday kind of d opportunity.therap >> would ever be more than just a last resort?e? >> we hope so because if it is shown to be efficacious than it could be an adjunct antibiotic or in antibiotics or in the >> we arere antibioticscs fully not refuse any more, it could replace in those cases. c.
>> i think there was another question in the back. >> there must be many types. how did you figure out what the sequence to use them in or how r many did you have to try before you cost them their?an estimat l >> 10 trillion on a planet in fact the doctor from san diegorn university has been the state unive to estimate the ecology, so when i realizedd when this, i was overwhelmed with how am i going to find those that will match his bacteria. luckily that wasn't my job, but i did need to find researchers h were studying those that would be going active against so i wek to google and found researchersa in the u.s. that were studying
this and that's who i contactedn they wereta total strangers. resource and i can literally say my husband is full of you know d is ful what.w [laughter]hey but they do basically is imagine a petri dish and incubated so you've got these at each one isl a bacterial colony. you can put a sample of sewage or pond water on the dish and an incubated and if there is one that is active against the bacterial isolate, it will comea
back looking like swiss cheese.t there will be a whole literallythe phage with y so even though you can't see it with your nak naked eye or knowf it's eating away the colony had been you can take that out andwo out are bacteria to it so that't what was done into this to be purified and that's where they came in at the 11th hour forwas. this massive quantity. some had to pick the exact righe to outwit the immune system into those kind s of ysttehming we se don't know how. we are still promoting research to be able to optimize therapy. >> it comes in and eats the bace bacteria. i i'm getting a pac-man image
here, but then you have a virus in your body.ur body what do you do then? do the >> so now you have a virus instead of bacteria. the good news is they only exist as long as there's bacteria then match to eat so once those areoe gone, then they are naturallyd excreted byy factbody and back to the liver and spleen which include they are naturally excreted. ..we don't realize that the gatekeepers are the phages and
there's fungi in arcata and other organisms as well. phages have been called the viral dark matter of microbiota. the american got project that is led by doctor rob knight who is a famous researcher in san diego. people pay him to test her poop. which is pretty amazing. he is testing their poop not just for bacteria but for the phages. he is come to appreciate the value that the phages half in the micro biome. maybe someday according, you could have phages products or probiotics that include phages that could groom your micro biome to keep the healthy bacteria and get rid of the nasty ones. but we don't know enough about our micro biomes to promote those products now. they do exist but it's likely those phages are not the right ones for you.
in this whole field is in its infancy. >> the phages given intravenously,. [inaudible] >> the question, the phages were given intravenously, was on a trip and how do we know how much to give him. there was a lot of unknowns. this is the part of the book that we focus in on this doctor who did his homework and consulted with an expert in the field. and he had to use phage therapy on humans and had an inkling on how to do this. there is no protocol in tom's case report is the first that reports on this. even in the former soviet union and poland they use phage therapy as their oral or through a nebulizer or through catheters in the abdome abdomen.
we first predators catheter so we could see, the worst place, the center, if he lives to the ministration of phages to the catheters then we will get the phages and administer them intravenously. if there is a hidden reservoir of bacteria that can come resistant don't have any other phages ready. and then he will die. so we got some estimates of how many phages would be appropriate intent to the nine. mille which is a billion phages. dose was the estimate. that was an educated guess to be honest. it was thought, if you under
dose the phages it is going to be worse because the phages could get eliminated by the human immune system and not get to the intended target. if you get too many phages we thought, then the phages will just be excreted because if they don't find enough bacteria. we obviously did something right but there is more questions than answers. we have treated all the other cases that we have been involved in intravenously as well. we go topically at first and we haven't had any side effects. we were going to worry that he was going to have a septic shock episode. that was the scariest moment of my life because i came up with it and i was putting forward and if i killed him, even though he was going to die anyway it was on my head and i had to tell his stepdaughters. that was like the monumental suffocating moment for me in agonizing detail. >> what would be the side effects or symptoms are there
short-term? >> what are the negative aspects of phage therapy. we have not seen any side effects of phage therapy at all any of the cases we are treated. there are theoretical negatives and so there's two lifecycles of phages. one is a living cycle which is basically the phages turned the cell into a phages manufacture plant and then it makes all the baby phages. then there's up to 300 phages that burst out of this check under bacterial cell. that's a stag phages rage that e want. the other cycle, the called temperate phages. when the phages enters the bacterial cell and integrate its genetic material into the dna of the bacterial cell and hit the snooze button as i say. we don't want that because we want the bacterial cell to die and we want to phages to
multiply. so these phages, temperate phages can carry toxic genes. we don't want to uses phages for phage therapy so the phages are being screened out or through gene editing techniques that are newly developed and you can actually turn a temperate phages into an analytic stage. the first human case to be treated with the genetically modified phages will be reported within the next month or two and that is a direct result of tom's case. the administration was done intravenously, it works. that will bring the gene editing books to the phage therapy world and that means we can potentially improve upon nature. so it's very exciting times. yes, in the back? >> what was the timeframe from your fused google and figuring out to use the phages with
success to the treatment ? >> i'm glad you asked that question. it is actually one of the most miraculous part of the story. i sent my e-mail to phages researchers on february 2, 2016 and we administered the phages on march 15, 3 weeks later. almost exactly three years ago. i still get goosebumps on march 15 every year. so compare that to an antibiotic which would take ten to 15 years to develop, $80 million and become useless due to resistance. there is no comparison. that is why we think the phage therapy offers a real future. the other interesting thing, in tom's case and several others, we have seen synergy between the phages in the in about it. it is putting pressure on the bacteria at the same time and
although the bacteria do not have brains there not thinking, they have to make a decision, genetic decision how to mutate to protect themselves. and in these cases that we observed the actually mutated to become sensitive to the antibiotics. there is actually a phages research team at yale that is using phage therapy to re- sensitize bacteria to antibiotics. let's just assume worth your worst case scenario it fails in clinical trials. but the only purpose is to resurrect antibiotics that were not usable anymore because of resistance, that is still a game changer. that is making the pharmaceutical industry finally pay attention. up until now they haven't figured out how to make money off of it. with the gene editing and anabolic synergy is becoming an area of intense interest. [inaudible]
>> how long did it take until tom responded. we injected phages into his abdominal catheter in march 15, on march 17 we went intravenous with the navy phages which were more potent and on march 20 tom woke up, lifted his head off the pillow and kissed his daughter's hand. that was not the end, there were more ups and downs that i will not get into but he had another septic shock episode and it turned out it wasn't the phages it was another bacteria. and so, he recovered from that two days later and we restarted the phage therapy and from then on it was an upward trajectory. so it was very, very rapid turnaround and that is what blew everybody away. most of the people in the icu thought he was going to die. [inaudible] >> can any of this work with kids are questioning. >> phages have been studied for several decades in the western world where they -- stage
therapy was in the back room but they were used to pioneer cancer biology, genetic engineering. there have been attempts to use phages as vehicles to deliver cancer therapies and also vaccines and that research is underway. there is also another parallel effort to use some viruses of phages or other viruses as viral therapy, the most famous cases are with glioblastoma. so it is using the manner technology and precision medicine. it is kind of bringing together several fields at the same time. any other questions? >> what travel insurance do you recommend? [laughter] >> we got our travel insurance to the university of california
system. it is called united healthcare. i did call them and tell them that we had a good news story for them but i don't think they caught onto it yet but i think we should send them a copy of the book. maybe we should do commercials. [laughter] a question in the back question ago yes that's my colleague from twitter. >> personal i would like to thank you very much for sharing your story. it's incredible. i really enjoy reading your book, every page. it's a story of love in an incredible story. as we know overuse of antibodies in a misuse of an old country in a biotics is causing a problem
particularly in egypt, ukraine, india or china. i know your book is now being translated into chinese, in addition to chinese are there other languages that your book is translated i wish -- i hope where readers can learn from your book. >> thank you very much. he raised an important issue that we have not talked about. the global superbug crisis in one of the reasons we decided to write a book was that if i am blindsided as an infection disease doctor, the most people in the world probably are too. so it's her overuse of antibiotics not to much of people in hospitals but in livestock. so 70% of animatics that are used in the u.s. in developed countries are used to promote growth in chicken and cows and pigs. it is not actually to treat the
disease or prevent the disease. there been attempts to clampdown on this. europe is done a great job into the uk and leaders. but several countries in the u.s. is one of them, china and india, some south american countries are really problematic in this area. in november 2015 when tom felt sick the gene that confirms resistance to callisto. as a last resort in about it. it was discovered in china. it was reported with the top journal medical of the world. but, by the time the resistant gene was reported it was in 30 other countries. so here we are, were suffering
from a problem of an detection, un- diagnosis and untreatable. in those three different problems are facing us now that by the near 2051% every 23 seconds is going to die from superbug unless a drastic turnaround is taken. i hate to leave you with dire news but we all need to take efforts, if you're going to eat meat en antibiotic free meat. and to put pressure on our legislators to stop using antibiotics and right now there's an effort to stop using antibiotics and citrus because the federal government is allowing this to happen and there is no need for it. anyway, that is a spiel to hopefully if you read the book you will enjoy it but you will learn a few things. thank you very much. [applause]
>> if everyone will hold the phages for right now. [laughter] we will let them get on mike's and then we will be doing a signing and ask everybody as you get up to take her tears, full them and put them to the side so we have a nice aisle. thank you for coming out tonig tonight. >> now on c-span2 book tv, more television for serious readers. this week you're watching book tv so you can see what programs are available every weekend. nowhere else can you find nonfiction books on politics, national security, economics, health and medicine. enjoy book to be now and every weekend on c-span2. >> c-span's "washington journal" live every day with news and
policy issues that impact you coming up thursday morning, the american conservative editor will be with us to talk about the forthcoming release of the mueller report and the impact on 2020. and then your time health and science reporter andrew jacob will talk about his recent piece examining the cbc world and publicly identified hospitals that are battling contain the spread of dangerous pathogens. be sure to watch c-span's "washington journal" at seven eastern thursday morning. >> books about business and economics. we began with naomi friends talking about her book, collision. then market roles, business and economics on both tv and primetime starting at 8:00 p.m. eastern on c-span2. . . .