> The researchers then checked snot from hospitalized patients. Of 187 samples, all but one were colonized by either S. aureus or S. lugdunensis
> S. lugdunensis, was killing S. aureus. Its weapon of choice? A small compound dubbed lugdunin
> The German researchers who performed the study have filed a patent for lugdunin
Are we really allowing people to patent naturally occurring biological compounds these days? Shouldn't the patent be for specific treatments derived from their findings on lugdunin, not the compound itself?
You have to choose a system. If we don't want naturally-occurring compounds patented, but we want them researched for potential drug use, we need more public funding. Otherwise, we have to offer researchers and drug manufacturers an incentive to take risks with exploring these compounds.
Barring lugdunin from being patented while providing no public funding would incentivise this group to withhold publication until they thought they'd found every commercially-reasonably derivation.
The US spends yearly US$26.4 billion of collected taxes on medical research. If as you say, we got to choose a system, patents of naturally-occurring compounds or state funded research, does that mean that the state can by issuing this patent save $26.4 billion and put that money somewhere else?
Its not a "choose a system" kind of deal. It never has been. It always been state funded research + investment supported by patents + university funds + non-profit funds + additional government funded incentives. The question we should ask is if this specific incentive is needed together with all the other incentives in order to create a end user product that will saves lives sometime in the future.
At least if they'd kept their findings secret, researchers could independently be researching the same thing.
Now independent researchers won't want to touch lugdunin because they'll need to license the patent, however they won't know whether licensing the patent is worthwhile until they do their research. This will prevent further research, not encourage it.
As someone who used to work in drug development, I disagree.
Patents don't prevent compounds from being explored in research. If this is anything like other discoveries, companies will start looking at lugdunin very closely.
What is it's mechanism of action? Can the structure be optimized? What else could it be used for?
Other antibiotics have been patented and that didn't stop companies from doing the research and tweaking the structure to make it even better.
From this image of the structure (http://cen.acs.org/content/dam/cen/94/31/09431-notw4-Lugduni...) it looks very much like some kind of small pore. That's a total guess, of course, but a cyclic peptide with alternating chirality looks reasonable, although a little small at only 7 residues.
Worse, other commercial researches will be wasting their time with busywork to find a non-patented analog which they can claim for themselves, instead of working on new things.
Why is finding a non-patented analog a bad thing? A lot of our medical discoveries are incremental advancements brought about work on analogs.
Maybe a company will find a new mechanism of action when they look at analogs? Maybe a less toxic version? Maybe the lead compound fails but the backups work?
That's not actually a bad thing. The first signs of resistance occur on average 1~2 years after introduction of a novel abx; the search for variants helps to extend the usable life of a new family of antibiotics.
Are you sure about that? I would think that the patent wouldn't apply to non-commercial investigations or research. That is you would be free to synthesize or extract this chemical in a laboratory environment. However, if you wished to manufacture the drug for commercial purposes then you would need to license the patent.
Well, potential researchers will also have to weigh the possibility that they spend all of the time and effort to research other possibilities for it only to find out that after all of the licensing fees, etc they won't even be able to break even on the fruits of their research.
It carries too high of a risk for financially-minded people (looking for a return on investment) to throw money at it.
You're right that it won't apply for non-commercial investigations. But how are you funding the investigation? It's typically funded by the proceeds generated from the research. Research is always hit and miss as to profitability, more miss than hit. Factor in potentially unknown licensing arrangements, even if you do have a "hit", and suddenly your research doesn't look like such a good idea.
> It's typically funded by the proceeds generated from the research.
That's only true in the case of commercial R&D. For non-commercial (academic) research, the funding is normally through a grant mechanism (not company supported). Academic research is almost never concerned with the licensing/patent issues aside from "can I run my experiment". It is common for academic labs to use drugs that are still "in the pipeline" for experiments.
Indeed. It is all about incentives. And in the end, pharmaceutical companies have the incentive to keep people sick so they can keep selling drugs, while the public has the incentive to keep people healthy. So it is actually a no-brainer.
The website[1] of the lead author, Andreas Peschel, lists funding at the bottom. Almost all projects are funded by the DFG. The DFG is an institution that funds research and is itself funded by taxpayer money.
So yes, this research has been paid for by the German public. However, it is common for universities to apply for patents. Revenue from patent licensing is then usually shared between the university and the researchers.
I don't see any reason why the researchers couldn't have placed their discovery in the public domain, just as Tim Berners-Lee did with his ideas.
Unfortunately many universities (and hence researchers) are under pressure to commercialise their IP, based on the assumption that such behaviour is beneficial to the economy.
1. Get a patent, find a commercial partner and investors who will give you a ton of money to develop it in the hopes of getting a return.
2. Make it public domain, remove any financial incentive to develop it, then try and convince whoever to give you hundreds of millions of dollars to develop it without any hope of financial return?
Those are not the only options. Free and open source innovations can create enormous economic opportunities - witness Linux, the Web, etc etc. Even now, unpatented medicines are widely commercially available and making some people a lot of money.
It sounds like drug discovery ought to be taxpayer-funded, then, as a project that is in the public interest but difficult to monetize without jeopardizing the public interest.
I think that even private-sector-developed drugs rely on publicly-funded research.
Worst is when American companies charge U.S. customers higher prices than overseas consumers for drugs that were developed using USA-taxpayer-funded research.
They charge everyone as much as they can get away with, its still the same old supply and demand. The issue is that say France/Egypt/India can provide an organize front when dealing with pharmaceutical companies so they get better deals.
Ever seen the video with Ron Paul being asked a question with what should happen to a person who has no insurance but needs immediate medical care and the audience shouted "Let him die!". There's your answer.
>we need more public funding. Otherwise, we have to offer researchers and drug manufacturers an incentive...
I'll take researchers for $1,000, Alex.
Not a knock to drug manufacturers who are simply acting as they should under the current profit-driven system, but I think we'd be far better off if more of this existential-level stuff (like health) were government functions, or at least government sponsored and not-for-profit.
So, let's support a federation of researchers who have direct incentive for discovery. Then, let's make those discoveries public domain.
That's not a valid counter argument. He's using an analogy to produce a practical counter-example where private funded research is producing better / cheaper solutions (presumably, I'm uninformed on the subject). I think a more valid counter-argument would be arguing SpaceX isn't better, or that the domains share no similarities.
>*a more valid counter-argument would be arguing that SpaceX isn't better or that the domains share no similarities
Not quite. Arguing that Space X is no better would be following a red herring and arguing that there are no similarities is too high a standard. A valid counterargument merely needs to show that they are sufficiently different in some important way.
And, my (admittedly pithy) counterargument ran exactly along those lines.
Meanwhile, the main difference between the domains had already been pointed out in my original comment, and I even provided an example of a relevant domain.
So, you've gotten it exactly backwards: the burden is on my respondent to demonstrate why SpaceX is a relevant analogy/counterargument.
There was a prior HN discussion around who owns what IP when public funding is involved. It was an interesting discussion for those who are interested:
https://news.ycombinator.com/item?id=9268349
Most antibiotics are naturally occurring biological compounds (besides things like sulfonamides). Given how little upside there tends to be for developing new antibiotics vs. the public good that new ones can bring for treating resistant bugs, this is one of the very few areas where I'm firmly in favor of allowing patent protection.
Well if it is patented and the terms are very lenient, because it's owned by the government, then that's the best of both worlds since it prevents some other company from patenting it and charging heaps and then it gets put into the public domain in 20 years (or whatever the term is).
Could they be patenting it to prevent others from doing so?
They'll probably make some money out of it, to fund more research, but hopefully any deal with pharmaceutical companies should have some pricing clause to make this widely affordable to public health services.
Under the Supreme Court's decision in Myriad (which held you can't patent naturally-occurring gene sequences by themselves), you probably can't patent a naturally-occurring biological compound.
This is the first thing I think of when I read this too. I am worried this will train bacteria to be resistant to natural immune defense mechanism of human... : (
It could happen, but we already have 30% of people with MRSA colonized in their noses. If we develop a new antibiotic that saves thousands or millions of lives, but the MRSA colonization number climbs to, say, 60%, will that be a net gain? I think so, since in general having MRSA colonized is not problematic, and that number is climbing anyway.
Interesting read. What I don't understand is why other body hair is not mentioned, and if that has the same effect. If not, what makes a beard different?
Now we need a globally agreed system of anti-biotic triage - you can have anti-biotics, but only administered in hospital, signed off by two doctors and with these life threatening conditions.
It's possible to find middle ground, and I think comprehensive IT systems for all doctors with real-time forbidden drugs lists and epidemia tracking would make this much easier.
It's even possible to divide hospitals into "different drug is forbidden here", and when someone has MRSA - put him in a hospital where the drugs that doesn't work on him - are banned anyway. And use "last ditch" drugs only in these hospitals.
And of course the main thing is to stop abusing antibiotics for agriculture.
I am advocating a more restrictive and considered prescription regieme - specifically only allowing hospitals to prescribe is an example not a policy decision
That's said I am under convinced it would overwhelm hospitals. Hospitals seem overwhelmed to me because A&E is a faster and more efficient way "into" the system than community based care or other approaches.
The common case is elderly care - almost no funding for in home nursing help, hard to get through the process, and elderly struggle on until a manageable chronic complaint turns acute, leading to ambulance, A&E admittance and a struggle for scare beds in wards. Whereas the hospital probably could have been avoided through treatment at home / locally.
Until we pay for community systems we won't relive the pressure on hospitals. And this out centre of excellence will just be fire fighting.
(Excuse the sudden rant - not sure where that came from :-)
Antibiotic use in humans has rarely been a problem, it's the way that "restricted" antibiotics are used on lifestock freely and in large quantities that keeps screwing us over.
Sometimes you have national organisations that provide advice about antibiotics, and you have doctors wanting to follow that advice, and you have patients who want to follow that advice, but a stupid rule by eg childcare means that everyone caves and prescribes antibiotics when they're not needed.
> Acute infective conjunctivitis is common among preschool children. Public Health England (PHE) recommends that children with conjunctivitis do not need to be excluded from child care, but childcare providers are required to determine their own sickness policies and prior research suggests that children are often excluded until they are treated or have recovered. How the content of these policies impacts on prescribing decisions has not been quantified.
[...]
> Acute infective conjunctivitis (AIC) is a common condition in preschool children.1 It is usually mild and self-limiting, often with no requirement for treatment or a doctor’s appointment.2 Evidence suggests, however, that parents and guardians are advised by childcare providers (CPs) to take their children with conjunctivitis to their GP for assessment.3–5 Furthermore, some CPs will not permit affected children to return to child care until antibiotics have been prescribed,3,4,6,7 thus parents are obtaining antibiotics to get their child readmitted. A situation in which antibiotics are prescribed for non-clinical reasons is difficult to justify and requires further investigation.
> Although most cases (50–75%) of AIC are bacterial in origin,8 the aetiology is difficult to determine clinically and only 36% of doctors are confident in differentiating between viral and bacterial conjunctivitis.9,10 In bacterial conjunctivitis, there may be some clinical benefit obtained from topical antibiotics;11 however, this benefit is perhaps not seen in children and topical chloramphenicol shortens the duration of symptoms by only 0.3 days.2 Despite this, most clinicians usually prescribe antibiotics for AIC.10
An interesting point would be that if S. aureus becomes resistant to lugdunin (a matter of a few years maybe), S. lugdunensis might evolve naturally to find a new antibiotic.
So a similar study in a few years might lead to a new antibiotic molecule targetting the mutated S. aureus.
I was just thinking something similar - maybe the future for bacterium-specific treatments isn't to try and find a new antibiotic, but rather to pit different nasty bacteria against each other in an endless in-vitro cage match, then analyze the winner to learn their tricks?
> The researchers then checked snot from hospitalized patients. Of 187 samples, all but one were colonized by either S. aureus or S. lugdunensis, but not both. The researchers think where one species grows, the other can’t.
How does S. aureus prevent S. lugdunesis from invading?
This is totally misguided. If this develops into a widely used antibiotic it will eventually provoke immunity in its MRSA targets. These same targets will then have free rein in our noses. Not a good deal.
30% of people already have MRSA in their noses. I'm not sure there's a realistic doom and gloom scenario here since if you've got MRSA in your nose, you don't have the lugdunin-producing bacteria anyway.
This does nothing to solve the real problem. The issue isn't (or wasn't) that we couldn't cure MRSA at all, it was a gradual evolution. In the 1960's we had 5 working drugs that would kill essentially any bacteria.
And then we had 4. We discovered new ones, at one point I believe up to 7. But resistance made it go down pretty much by one per decade, but each next one ended faster. And then it hit zero, in 2012 I believe.
Now we may (maybe) be back up to one. Big whoop. Not going to last.
The problem is that evolution is out-researching us, the problem is that we're losing the war, not any particular battle. Antibiotics used to last 3-5 decades. Now we're down to years. While we do find new antibiotics on a regular basis, the problem is the speed of adaptation. The problem is that science is losing/has lost the "battle with darkness" as it was called 700 years ago. We are now in the situation that there are people dying because they entered hospitals for unrelated reasons (where they were exposed to these bacteria).
The problem is that we need to let millions of people die of curable diseases constantly or risk a Spanish flu like incident that can be reasonably expected to kill somewhere between 500 million and a billion humans today.
>Biggest use of antibiotics today is in food production(agriculture etc.), not in hospitals. And it's also completely unregulated.
Completely false - antibiotic (and all drug) use in animals is absolutely regulated in nearly all countries, including the US [1,2,3]. Said regulations may not be what you'd like, but to claim they don't exist is silly.
True, but it must go down or we will never have functional antibiotics.
It seems to be possible, in Italy they use 50 times more antibiotics per pig than here in Sweden, due to the stricter regulation. Denmark is doing good but still uses twice as much as in Sweden.
This is due to our regulations, and it costs more to keep the pigs healthy, but due to EU:s strict trade rules, there are no way we can protect our farmers from the cheaper meat.
And somehow Italian ham is considered to be of higher quality...
AFAIK bacteria aren't developing a way to get resistant faster; the problem is antibiotics over-use (and misuse). Also, if an antibiotic for which resistance was developed doesn't get used for a long enough time, the bacteria lose the resistance.
The bottom line is that we need to use newly developed antibiotics more carefully, continue researching new ones, and no Spanish flu like incident will happen (even without considering that the Spanish flu was a virus, not a bacterium).
We are basically applying selective breeding in order to create the bacteria that will wipe the humanity out, and we are doing a very good job at that..
You realize people died from bacterial infections before antibiotics, right? Bacterial resistance to antibiotics doesn't make the bacteria more likely to kill us than before.
> The researchers then checked snot from hospitalized patients. Of 187 samples, all but one were colonized by either S. aureus or S. lugdunensis
> S. lugdunensis, was killing S. aureus. Its weapon of choice? A small compound dubbed lugdunin
> The German researchers who performed the study have filed a patent for lugdunin
Are we really allowing people to patent naturally occurring biological compounds these days? Shouldn't the patent be for specific treatments derived from their findings on lugdunin, not the compound itself?