Forgotten Cure
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How did having a state health system influence the treatment of infectious disease in 1940s-50s Russia?
The state health care system created by the USSR during wartime created many issues in the treatment of infectious disease. The conditions created by World War II spurred many outbreaks of bacterial infections. Then, non-traditional medicine became more popularized and this sparked an increased interest in phage therapy because it was viewed as natural or non-traditional. The government was communist at this time and thus people were distrusting of the government as a general rule. The government had interfered with antibiotic development and inserted itself into personal healthcare, so trust of the government wasn’t common. Antibiotic use in Russia was difficult to obtain at first, but then it turned to being available on shelves without prescriptions and this contributed to the growing number of antibiotic resistant bacterial strains and thus increased use of phage therapy.
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The Hirszfeld Institute is also intertwined with Russian history. A tragic quote is given on page 66 by Hirszfeld about the death of his daughter. Even so, the outcome of these 2 centers has been very different. Discuss why you think this is so.
Both the Hirszfeld Institute and the Eliava Institute came about because of oppressive regimes in eastern Europe and both had to overcome differing ideologies in regards to phage therapy. The Hirszfeld Institute found more success in its longevity because the Eliava Institute had only a short period of popularity and scientific discovery. Unfortunately, in order for institutes such as these to exist and experiment, they need funding and support. The geographical locations of the two made this immensely difficult when compared to similar places in countries like the United States; the Eliava Institute is located in Georgia, which is small and fell under Soviet rule in the days the institute was established. Thus, the Phage Therapy Center, located in Poland, has found more success than the Eliava institute because being rooted in Poland gives it more connection to the western world and thus more opportunity to receive funding from more developed countries and the donors that reside in them.
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Research in the USA often differs from other countries because of regulations by the FDA and private investments. Describe the experimental design that Merril used to determine how to select for phages that were not removed by the liver and spleen.
Review the Merril, Carlton, and Adhya PNAS paper, focusing on interpreting their figures.
Mice were injected with phage and a bacteria and the blood was tested after several hours and the phages that survived were isolated and propagated in order to increase the number of them. This was repeated 8 times until the remaining phages were able to survive for 18 hours within the mouse. The figures in the paper reflect the strength of the symptoms associated with the bacterial infection relative to the dose and type of phage used to treat the mouse. Mice treated with only antibiotic had reduced symptom presence, but mice treated with phage had the least symptoms.
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The most convincing argument for using phage is tied to the increasing problem of antibiotic resistance. Even so, many still consider phage therapy an alternative therapy. Chapter 8 describes several start-up companies:
Phage Therapy, Phage Biotics, GangaGen, Exponential Biotherapies. Research these companies and discuss the potential for phage therapy in modern Western medicine. What experiments need to be done?
First of all, many of the phage therapy studies mentioned in the book were completed in European countries and did not follow typical protocol for studies to be completely accepted, such as using double-blind experiments. Experiments proving again the effectiveness of combining phage therapy with antibiotics but following guidelines for research that will make it more widely accepted in western medicine. Because the currently published studies were not conducted in such a manner, there is doubt from western doctors and thus doubt in the usage of phages to treat bacterial infections.