Expert Meeting and Review

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Expert Meeting and Review

Introduction

I have been working in the Microbiology laboratory for more than 25 years and I have witnessed the shifts and the trends in the antibiotics resistant patterns over the years. During these years I have participated in many antibiotics stewardship intervention programs to slow down those resistant trends as part of collaborative efforts between the laboratory and the physicians, infection control and pharmacy team. The new antibiotic discovery that can effectively treat the superbug was one of my potential aspirations. Fortunately, I was able to conduct a 20-minute interview meeting with Dr. Robert H Cichewicz as the subject matter expert in the new line of antibiotics discovery research.

Robert H Cichewicz, Ph.D., is a professor in the Department of Chemistry and Biochemistry at the University of Oklahoma. He holds an undergraduate degree in Biology and Anthropology from Grand Valley State University and M.S. degree in Pharmaceutical Sciences from the University of Louisiana. He also poses a Ph.D. from Michigan State University and completed his postdoctoral studies at the University of California, Santa Cruz.

Dr. Cichewicz’s current research interests focus on translating natural products into therapeutic leads to combat cancer, infectious diseases, and other unmet medical needs. Naturally, Gram-positive bacteria use anionic teichoic acid to chelate metals; however his team was able to block that process with cationic polymers that displace metal ions from the teichoic acid sites, (Foxley, et al., 2016). The multi-drug resistant organisms will always remain a difficult challenge to the public health; therefore researching for an effective intervention to treat the multi-drug resistant bacteria is one of my main research areas of interest. I am truly thrilled by Dr. Cichewicz’s research as it opened a new pathway for me as a doctoral student in public health. In addition, these research studies will build a new hope for public health practitioners to compact the life-threatening superbugs.

Interview summary

It was my honor to meet with Dr. Cichewicz in his office located at the University of Oklahoma in the department of Institute for Natural Products Applications and Research Technologies (INPART). I started the interview by thanking Professor Cichewicz for taking his time to meet and allow me to be part of this prestigious experience.

Firstly When I asked Dr. Cichewicz to share with me briefly about his work in the new antibiotics discovery, he stated that their research lab is focusing on natural products for drug discovery by building resources that can be used for all drug applications. He indicated that the need for new antibiotics has been certainly one of those topics much on everyone’s mind as it is a pertinent issue globally. Dr. Cichewicz emphasized that what they are trying to do is build a new resource that could aid in finding new antibiotics and new compounds that would improve the applications of current antibiotics.

Then I asked Dr. Cichewicz about the scope of their new antibiotics research and if they are focusing on certain groups of multi-drug resistant organisms such as gram positive, gram negative or fungal. On this, he was very opportunistic as a laboratory, as the new opportunities come up knowing that their library of natural products is applicable towards these opportunities. He indicated they have done projects looking into new antibiotics molecules, projects for biofuel inhibitors, and projects looking for receptors that enhance the antibiotics activity.

When I suggested to Dr. Cichewicz that we do not have a truly broad-spectrum antibiotic that works for every infection and that it is a lot of work to develop that universal super antibiotic, yet we need it. He outlined that it originates from the natural products side and he implied that humanity has not yet tapped into the natural resources. He said there are still molecules that nature has developed for defensive purposes or offensive purposes, and that we need to be smart in how we search and look for them and these could be a game changer.

I then said to Dr. Cichewicz that I understood it is a lot of work to develop an effective new antibiotic but it is worth the efforts and the resources. However, when I asked him about the future directions in this research area, he replied the future direction is to look for a clean drug that is capable to sustain affectivity taking in considerations all the possible smart mechanisms that those organisms are developing over time. He, therefore, underlined that they are going to have to dig deep into the world of nature for them to discover that new super molecule.

On Dr. Cichewicz’s thoughts on the molecular direction to go after the genetic components of the organisms, he alleged that they can find inhibitors that are going to work in that area but the problem with those organisms is that they are going to be more susceptible to having resistance develop much more quickly and this is the problem with single target meaning single solution.

I asked Dr. Cichewicz if there are any advocacy trends that support his efforts in the search and discovery of new antibiotic since it is a huge challenge and require a lot of resources and efforts. He ascertained that there are advocacy groups that are promoting their research since the word about their work is already spreading. He added that more people are aware that we are in a crisis, but stopped short of mentioning if there are any advocacy groups beyond that.

On the question, whether there are any advocacies from the public health agencies to promote researches for new antibiotics and to help in protecting the new drugs, the doctor clarified that he has seen trends that a lot of calls from the NIH has dealt with more surveillance and detection of antibiotics resistance. He acknowledged that he has seen an interest especially from the NIH in trying to build resources in other areas and he hoped they become successful. Then I inquired about the main challenge facing researchers like him in acquiring an effective new antibiotic, and he talked about the complexity of the bacterial structure and how they have come up with many tricks to evade and survive under the harsh conditions.

When I asked about the current fights in this research area, Dr. Cichewicz thought that people are not scared enough and that is a challenge. He said if there were more people more people who are really talking about the fatality impact of organisms such as the MRSA then it would have been different. He stated that we need people who are more fearful of what bacteria can do and are willing to put more resources and more focus. There is the need to get the younger generation scientists along quicker so that we all realize the importance of time-saving and doing effective research.

On matters to do with legislation about his researches, Dr. Cichewicz replied by emphasizing that he does not bank on the political systems for his work. He said that politicians do not believe in these kinds of research, therefore, he would only plan his time wisely and dedicate his time without depending on what happens in the political sphere. He acknowledged that while guns are a big problem causing fatalities, diseases are also killing many people. The politicians are focused on gun control than MRSA and the need for new antibiotics.

My last question to Dr. Cichewicz was regarding his article and the impact of his OU team discovery on the healthcare system and specifically the public health. He explained that currently, the application for this synergy mechanism is awaiting FDA approval. However, if one of it is approved for clinical use, then it will greatly impact the healthcare system and the public health as it will restore the efficacy in terms of costs.

Conclusively, both Dr. Cichewicz and I agreed that a lot of proactive work is yet to be done by the health system to slow down the multi-drug resistant bacteria endemic spread. Effective policies have to be put in place to ensure there are guidelines for monitoring the usage of antibiotics, specifically the last resorts antibiotics. Also, currently there is no effective policy to mandate MRSA surveillances to ensure accurate data available to quantify the severity and the impacts of the MRSA spread.

References

Foxley, M.A., Friedline, A.W., Jensen, J.M., Nimmo, S.L., Scull, E.M., King, J.R.,…Rice, Charles V. R. (2016). Efficacy of Ampicillin against Methicillin-Resistant Staphylococcus aureus Restored Through Synergy with Branched Poly(ethylenimine). J Antibiot (Tokyo), 65(12), 871-878. doi:10.1038/ja.2016.44.

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