Treating Infectious Diseases in a Microbial World Report of Two Workshops on Novel Antimicrobial Therapeutics (2006) / Chapter Skim
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The need for new antimicrobial therapeutics is acute because of growing resistance to available antibiotics, the emergence of new infectious diseases like SARS and West Nile virus, and the risk of bioterrorist attacks using infectious agents that may not be immediately identifiable. From one point of view, these are all manifestations of a single problem -- human vulnerability to microbial disease -- and therefore subject to one solution -- a single drug that can protect against any infectious agent.
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There was widespread recognition, however, that the road from a brilliant idea to a clinically available treatment is long and full of pitfalls. Differing approaches to antibiotic use in different countries, declining investment in antimicrobials by large pharmaceutical companies, increasing costs of clinical trials, and complicated regulatory and legal environments, are just a few of the obstacles to bringing new compounds rapidly from the laboratory to the clinic.
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(Antimicrobial workshop recommendation A-6.2) · Generating slight chemical variations of compounds with promising activity frequently results in more effective drugs; new chemical synthesis approaches that allow the rapid synthesis of more varied structures could speed this process.
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· The human immune system is constantly interacting with the thousands of bacterial species comprising the natural microbiota; understanding how the natural microbiota communicates with the immune system and how the immune system singles out harmful microorganisms could lead to drugs that help the natural microbiota outcompete pathogens. (Immunomodulation workshop recommendations I-6.1, I-6.2, I-6.3 and Antimicrobial workshop recommendation A-3.2)
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Participants in the antimicrobial workshop explored the idea of developing antibiotics that would be selectively activated through interaction with the compounds used by the immune system to signal damage. Future discussions of infectious disease treatments that target the disease-causing agent and enhance the immune response at the same time could generate even more promising ideas.
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