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Revision as of 15:30, 16 October 2018
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ACTORS AND PARTNERSHIPS
It’s impossible to use bacteriophages and to develop a detection device if we don’t know what are the needs and the constraints in hospitals and in medical analysis laboratory. So we need to discuss our project with physicians, specialists and even with the whole population. We also developed partnerships with local research laboratories and companies, to borrow equipment, recover bacteria and bacteriophages, and, most important, ask them for advice.
We discussed with a lot of people to develop our project, to better understand what is useful to implement, create and integrate into our project from their remarks.
GROUND FLOOR: We established partnerships with local companies like Biomérieux and local laboratories like TIMC in order to benefit from their advice/expertise and we had the opportunity to get some of their biological material. Our engineers and researcher partners gave us a lot of recommendations all along the summer and helped us to get an external point of view on our project.
FIRST FLOOR: We visited a medical analysis laboratory and we met the laboratory manager. We discussed with him about the detection system used in his laboratory and about the advantages and limits of our system, if it was used in this kind of laboratory.
SECOND FLOOR: We met with doctors and patients who talked with us about bacteriophages and antibiotic resistance. We discussed with them to know if our detection system could be used in hospitals and what modification we should make in order to improve it. You can have a look at them on the third floor (see our schematic below).
THIRD FLOOR: All the societies must be implicated in our project. But it is essential for us to be aware of what people know about phage therapy and antimicrobial resistance. It’s important to evaluate people's knowledge and then produce an appropriate outreach.
CLICK ON THE PEOPLE YOU WANT TO HEAR FROM ! Everybody has something interesting to share with you.
Learn how partnerships had influenced our project !
BIOMERIEUX
According to their advice we have:
- used a lysis buffer as an efficient positive control
- planned to add a cover to protect the contents of the tubes
- placed a ball bearing in the axis of the pipette
- understand that hybridization will happen even without mutations, rendering false positives. A possible idea to fix this problem is to do as for the resistance probe design on Staphylococcus aureus: it is necessary to find an enzyme that cuts at the place of the mutation (butt or cohesive) and a plasmid that is cut in the same place. In this case even if there is hybridization with the two ends cut it does not reform the plasmid, so it is not transformed if there is no mutation.
But the plasmid must be in very large excess to decrease the effect of competition and it is unlikely to find an enzyme that cuts at the level of mutation. This problem might be solved by using CrisPr-Cas9 system.
TIMC
Béatrice advised us to make dilutions of the positive control for the freeze-drying of bacteria rather than comparing with the frozen equivalent each time. She also advised us to compare the processing efficiency after freeze-drying with the conventional laboratory freezing method (number of colonies similar to a given dilution).
Les midis MINATECH
Cécile Breton's conference on phage therapy, antibiotic resistance, hyper-efficiency and specificity of phages led us to choose the subject of our project.
AVALUN
Avalun offered us SMD camera fluorescence detection and advised us to work with STmicroelectronics.
INTERVIEW WITH PIERRE-ALAIN FALCONNET
Medical Analysis Laboratory Manager
ORIADE NOVIALE
38240 MEYLAN
Medical Analysis Laboratory Manager
ORIADE NOVIALE
38240 MEYLAN
We presented our system to Pierre Alain Falconnet to see if it could work in the context of a medical analysis laboratory. The system seems totally adapted to the laboratory use. According to him, the operating principles are good. It is still necessary to make specificity and sensitivity tests and to know the processing time of a sample.
The most important is to have an accreditation (COFRAC, CEIVD) because without this, the analysis laboratories will probably not want to have the system.
If the use of phages is regulated by a standard P2 and not P3 or P4, he could even use the machine in his own laboratory.
He offered to help us by giving us test samples.
INTERVIEW WITH PR. MAX MAURIN
Dr. Max Maurin notes that in the last few years, he had to face new therapeutic dead-ends caused by the antibiotic resistance that did not exist before. The issue of antibiotic resistance is, in fact, a major issue that we should urgently address. Pseudomonas is a pathogen that he encounters quite often in his department. It is not too virulent but it has numerous resistance mechanisms. According to Dr. Maurin, phage therapy is a very interesting alternative even if it arises some ethical unsolved issues and can also cause a resistance of the bacteria toward phages. The use of bacteriophages in a medical establishment seems feasible because a few years ago, viruses were already used in the biological laboratory of hospitals.
Overall, Dr. Maurin thinks that our system is very interesting and answers well the given problem. However, some biological risks have to be taken into account such as the dissemination of the system components. If these aspects are well evaluated and handled, the system is very promising. Yet, Dr. Morin thinks that it will be very difficult to play on the sensitivity and the specificity of our system to compete with today’s methods in molecular biology. Among all the different specificities of our system, it is mostly the bacteriophages selection that caught his attention the most.
At last, Dr. Morin thinks that physicians do not have enough ethical formations and are not aware enough of new bioethical laws.
INTERVIEW WITH PR. OLIVIER EPAULARD
Each day, Pr. Olivier Epaulard is confronted with patients suffering from diseases caused by resistant bacteria. According to him, a misuse of antibiotics is the cause of 90% of the resistances and one antibiotic treatment out of two is wrongly prescribed. The number of antibiotic resistances does not cease to grow, like the number of immunosuppressed patients. Therefore, antibiotic resistance is a major issue of our century. Pseudomonas is also a pathogen that he encounters quite often in his department. Pr. Epaulard cannot make up his mind on the subject of phage therapy because he does not understand why it is not more developed. The positive aspect of this alternative is that bacteriophages destroy all bacteria - even the inactive ones -, something that antibiotics cannot do. According to him, the use of bacteriophages inside his department would not cause any issue.
Pr. Epaulard thinks that the project is very interesting. He is not overly passionate about the identification aspect but rather by the therapy aspect of the project. The diagnostic tools he uses have already very good specificity and sensitivity. It is going to be hard to compete with them. He verified many aspects of the biology in the system and was pleased with our answers.
Pr. Epaulard thinks that one can learn about bioethics through practice. Therefore, there is no need for more theoretical courses on ethics in a physician formation.
INTERVIEW WITH H.G, PATIENT TREATED WITH PHAGE THERAPY
After getting infected feet wounds, H.G was treated with antibiotics but the infection was not cured. No antibiotic worked and the infection spread. The only way to treat this patient was to amputate the two legs. H.G had heard about phage therapy and contacted a doctor specialized on the subject. He chose to try phage therapy to cure his wounds. Bacteriophages were applied for a year on the wounds and he is now almost cured.
On the pictures, you can see the state of his left foot before and after the phage therapy.
WARNING: this includes images some readers may find disturbing (OPEN WOUNDS)
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Necrotic wound (black tissues)before phage treatment | Healing wound (pink tissues) after phage treatment |
Learn how partnerships had influenced our project !
"Science without conscience is only ruin of the soul" said F. Rabelais. Therefore, what consciousness are we talking about ? That of the scientist alone, that of his peers, or even the collective consciousness of a society, of the whole of humanity? For a long time, science thought itself capable of inventing, evaluating and understanding the stakes of its discoveries by its protagonists alone, but it is clear that this vision no longer has any relevance today. We have entered a new era, that of post-modernity; it is characterized by a questioning of science and its basic axioms, but also, a doubt as to the ability of its actors to consider all the dimensions of their discipline, as well as their legitimacy to choose in the name of the community. The stakes of science and technology are unprecedented, these two disciplines are at the heart of our lives and our future. Thus, they must be thought of and questioned, that in view of their potential consequences. The technique, but also the science that gives it body must be the concern of all. It is thus that democratization, in the sense of a participation of the whole society in what it counts of diversity of opinions, opinions and considerations must be necessary. The social community that can benefit or suffer the effects of scientific production is the very one that must decide on the acceptance or rejection of this production.
At first, our research consisted in finding at the heart of writings, reports and circulating information, the elements able to legitimize and support our approach and our questions. In this sense, we have formulated two writings that have tried to update and bring together the relevant elements for our reflection. The first was to take stock and summarize the problem of antimicrobial resistance. Then, in a second writing, it is the bacteriophages / phagotherapy that have been the focus of a similar methodology. From these two axes: antimicrobial resistance, then bacteriophage / phagotherapy, we synthesized a third writing that aimed to show how our machine could meet the challenges of antimicrobial resistance through the use of bacteriophages. As a result, we had a machine that could respond to existing needs and problems, only as we explained with the history of science, we could not stop at that. Our project had to fit into the heart of society, not only in terms of theoretical issues, but also among the representations and requests of people who would have to be confronted with our machine, as patients or doctors.
In this sense, the Human Pratices symbolize and incarnate this much needed dialogue between science, its projects, its issues and civil and democratic society. This is why, within our project, its articulation and its development, it is essential for us to integrate this same democratic and informative approach. This is the very meaning of our different actions. These are not only passive approaches to registration of opinions, but a multitude of real consideration of the fears, remarks and problems expressed, all of which will become part of the final development of the IGEM project.
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