How a long-forgotten virus could help us solve the antibiotics crisis
-
0:01 - 0:02Take a moment
-
0:02 - 0:04and think about a virus.
-
0:05 - 0:07What comes to your mind?
-
0:07 - 0:08An illness?
-
0:08 - 0:09A fear?
-
0:09 - 0:11Probably something really unpleasant.
-
0:11 - 0:14And yet, viruses are not all the same.
-
0:14 - 0:17It's true, some of them cause
devastating disease. -
0:18 - 0:22But others can do the exact opposite --
they can cure disease. -
0:22 - 0:24These viruses are called "phages."
-
0:24 - 0:27Now, the first time I heard
about phages was back in 2013. -
0:27 - 0:30My father-in-law, who's a surgeon,
-
0:30 - 0:32was telling me about a woman
he was treating. -
0:32 - 0:35The woman had a knee injury,
required multiple surgeries, -
0:35 - 0:37and over the course of these,
-
0:37 - 0:40developed a chronic
bacterial infection in her leg. -
0:40 - 0:41Unfortunately for her,
-
0:41 - 0:44the bacteria causing the infection
also did not respond -
0:44 - 0:46to any antibiotic that was available.
-
0:47 - 0:50So at this point, typically, the only
option left is to amputate the leg -
0:50 - 0:53to stop the infection
from spreading further. -
0:53 - 0:57Now, my father-in-law was desperate
for a different kind of solution, -
0:57 - 1:01and he applied for an experimental,
last-resort treatment using phages. -
1:02 - 1:04And guess what? It worked.
-
1:04 - 1:08Within three weeks of applying the phages,
the chronic infection had healed up, -
1:08 - 1:10where before, no antibiotic was working.
-
1:11 - 1:15I was fascinated by this weird conception:
-
1:16 - 1:18viruses curing an infection.
-
1:19 - 1:22To this day, I am fascinated
by the medical potential of phages. -
1:22 - 1:26And I actually quit my job last year
to build a company in this space. -
1:27 - 1:28Now, what is a phage?
-
1:29 - 1:33The image that you see here was taken
by an electron microscope. -
1:33 - 1:37And that means what we see on the screen
is in reality extremely tiny. -
1:37 - 1:41The grainy thing in the middle
with the head, the long body -
1:41 - 1:42and a number of feet --
-
1:43 - 1:45this is the image of a prototypical phage.
-
1:45 - 1:46It's kind of cute.
-
1:46 - 1:48(Laughter)
-
1:49 - 1:51Now, take a look at your hand.
-
1:52 - 1:56In our team, we've estimated
that you have more than 10 billion phages -
1:56 - 1:58on each of your hands.
-
1:58 - 2:00What are they doing there?
-
2:00 - 2:01(Laughter)
-
2:01 - 2:04Well, viruses are good at infecting cells.
-
2:04 - 2:06And phages are great
at infecting bacteria. -
2:06 - 2:08And your hand, just like
so much of our body, -
2:08 - 2:11is a hotbed of bacterial activity,
-
2:11 - 2:14making it an ideal
hunting ground for phages. -
2:14 - 2:17Because after all, phages hunt bacteria.
-
2:18 - 2:21It's also important to know that phages
are extremely selective hunters. -
2:22 - 2:26Typically, a phage will only infect
a single bacterial species. -
2:27 - 2:30So in this rendering here,
the phage that you see -
2:30 - 2:33hunts for a bacterium
called Staphylococcus aureus, -
2:33 - 2:36which is known as MRSA
in its drug-resistant form. -
2:36 - 2:38It causes skin or wound infections.
-
2:39 - 2:42The way the phage hunts is with its feet.
-
2:42 - 2:45The feet are actually extremely
sensitive receptors, -
2:45 - 2:48on the lookout for the right surface
on a bacterial cell. -
2:48 - 2:49Once it finds it,
-
2:49 - 2:52the phage will latch on
to the bacterial cell wall -
2:52 - 2:54and then inject its DNA.
-
2:54 - 2:56DNA sits in the head of the phage
-
2:56 - 2:59and travels into the bacteria
through the long body. -
2:59 - 3:02At this point, the phage
reprograms the bacteria -
3:02 - 3:04into producing lots of new phages.
-
3:04 - 3:07The bacteria, in effect,
becomes a phage factory. -
3:08 - 3:12Once around 50-100 phages have accumulated
within the bacteria cell, -
3:12 - 3:14the phages are then able
to release a protein -
3:14 - 3:16that disrupts the bacteria cell wall.
-
3:17 - 3:20As the bacteria bursts,
the phages move out -
3:20 - 3:22and go on the hunt again
for a new bacteria to infect. -
3:23 - 3:26Now, I'm sorry, this probably
sounded like a scary virus again. -
3:27 - 3:30But it's exactly this ability of phages --
-
3:30 - 3:33to multiply within the bacteria
and then kill them -- -
3:33 - 3:36that make them so interesting
from a medical point of view. -
3:36 - 3:38The other part that I find
extremely interesting -
3:38 - 3:40is the scale at which this is going on.
-
3:40 - 3:44Now, just five years ago,
I really had no clue about phages. -
3:44 - 3:47And yet, today I would tell you
they are part of a natural principle. -
3:48 - 3:52Phages and bacteria go back
to the earliest days of evolution. -
3:52 - 3:55They have always existed in tandem,
keeping each other in check. -
3:56 - 4:00So this is really the story of yin
and yang, of the hunter and the prey, -
4:00 - 4:01at a microscopic level.
-
4:02 - 4:04Some scientists have even estimated
-
4:04 - 4:08that phages are the most
abundant organism on our planet. -
4:09 - 4:12So even before we continue
talking about their medical potential, -
4:12 - 4:15I think everybody should know
about phages and their role on earth: -
4:15 - 4:18they hunt, infect and kill bacteria.
-
4:19 - 4:22Now, how come we have something
that works so well in nature, -
4:22 - 4:24every day, everywhere around us,
-
4:24 - 4:26and yet, in most parts of the world,
-
4:26 - 4:28we do not have a single drug on the market
-
4:28 - 4:31that uses this principle
to combat bacterial infections? -
4:31 - 4:35The simple answer is: no one
has developed this kind of a drug yet, -
4:35 - 4:38at least not one that conforms
to the Western regulatory standards -
4:38 - 4:41that set the norm
for so much of the world. -
4:41 - 4:44To understand why,
we need to move back in time. -
4:45 - 4:47This is a picture of Félix d'Herelle.
-
4:48 - 4:51He is one of the two scientists
credited with discovering phages. -
4:51 - 4:55Except, when he discovered them
back in 1917, he had no clue -
4:55 - 4:56what he had discovered.
-
4:57 - 5:00He was interested in a disease
called bacillary dysentery, -
5:00 - 5:03which is a bacterial infection
that causes severe diarrhea, -
5:03 - 5:05and back then, was actually
killing a lot of people, -
5:05 - 5:09because after all, no cure for bacterial
infections had been invented. -
5:09 - 5:13He was looking at samples from patients
who had survived this illness. -
5:13 - 5:15And he found that something
weird was going on. -
5:15 - 5:18Something in the sample
was killing the bacteria -
5:18 - 5:20that were supposed to cause the disease.
-
5:20 - 5:23To find out what was going on,
he did an ingenious experiment. -
5:23 - 5:26He took the sample, filtered it
-
5:26 - 5:29until he was sure that only something
very small could have remained, -
5:29 - 5:33and then took a tiny drop and added it
to freshly cultivated bacteria. -
5:33 - 5:35And he observed
that within a number of hours, -
5:35 - 5:37the bacteria had been killed.
-
5:37 - 5:41He then repeated this,
again filtering, taking a tiny drop, -
5:41 - 5:44adding it to the next batch
of fresh bacteria. -
5:44 - 5:46He did this in sequence 50 times,
-
5:46 - 5:48always observing the same effect.
-
5:48 - 5:51And at this point,
he made two conclusions. -
5:51 - 5:54First of all, the obvious one:
yes, something was killing the bacteria, -
5:54 - 5:56and it was in that liquid.
-
5:56 - 5:59The other one: it had to be
biologic in nature, -
5:59 - 6:02because a tiny drop was sufficient
to have a huge impact. -
6:03 - 6:06He called the agent he had found
an "invisible microbe" -
6:06 - 6:08and gave it the name "bacteriophage,"
-
6:08 - 6:10which, literally translated,
means "bacteria eater." -
6:11 - 6:14And by the way, this is one
of the most fundamental discoveries -
6:14 - 6:15of modern microbiology.
-
6:15 - 6:19So many modern techniques go back
to our understanding of how phages work -- -
6:19 - 6:22in genomic editing,
but also in other fields. -
6:22 - 6:25And just today, the Nobel Prize
in chemistry was announced -
6:25 - 6:29for two scientists who work with phages
and develop drugs based on that. -
6:30 - 6:32Now, back in the 1920s and 1930s,
-
6:32 - 6:35people also immediately saw
the medical potential of phages. -
6:35 - 6:36After all, albeit invisible,
-
6:36 - 6:39you had something
that reliably was killing bacteria. -
6:39 - 6:43Companies that still exist today,
such as Abbott, Squibb or Lilly, -
6:43 - 6:45sold phage preparations.
-
6:45 - 6:48But the reality is, if you're starting
with an invisible microbe, -
6:48 - 6:51it's very difficult to get
to a reliable drug. -
6:51 - 6:53Just imagine going to the FDA today
-
6:53 - 6:55and telling them all about
that invisible virus -
6:55 - 6:57you want to give to patients.
-
6:58 - 7:01So when chemical antibiotics
emerged in the 1940s, -
7:01 - 7:03they completely changed the game.
-
7:03 - 7:05And this guy played a major role.
-
7:05 - 7:06This is Alexander Fleming.
-
7:06 - 7:08He won the Nobel Prize in medicine
-
7:08 - 7:10for his work contributing
to the development -
7:10 - 7:12of the first antibiotic, penicillin.
-
7:13 - 7:17And antibiotics really work
very differently than phages. -
7:17 - 7:20For the most part, they inhibit
the growth of the bacteria, -
7:20 - 7:23and they don't care so much
which kind of bacteria are present. -
7:23 - 7:25The ones that we call broad-spectrum
-
7:25 - 7:29will even work against
a whole bunch of bacteria out there. -
7:29 - 7:31Compare that to phages,
which work extremely narrowly -
7:31 - 7:33against one bacterial species,
-
7:33 - 7:35and you can see the obvious advantage.
-
7:36 - 7:38Now, back then, this must have felt
like a dream come true. -
7:38 - 7:42You had a patient
with a suspected bacterial infection, -
7:42 - 7:43you gave him the antibiotic,
-
7:43 - 7:46and without really needing to know
anything else about the bacteria -
7:46 - 7:48causing the disease,
-
7:48 - 7:49many of the patients recovered.
-
7:49 - 7:52And so as we developed
more and more antibiotics, -
7:52 - 7:55they, rightly so, became the first-line
therapy for bacterial infections. -
7:56 - 8:00And by the way, they have contributed
tremendously to our life expectancy. -
8:00 - 8:03We are only able to do
complex medical interventions -
8:03 - 8:04and medical surgeries today
-
8:04 - 8:06because we have antibiotics,
-
8:06 - 8:08and we don't risk the patient
dying the very next day -
8:08 - 8:12from the bacterial infection that he might
contract during the operation. -
8:12 - 8:16So we started to forget about phages,
especially in Western medicine. -
8:17 - 8:20And to a certain extent, even when
I was growing up, the notion was: -
8:20 - 8:24we have solved bacterial infections;
we have antibiotics. -
8:25 - 8:28Of course, today,
we know that this is wrong. -
8:29 - 8:31Today, most of you
will have heard about superbugs. -
8:31 - 8:33Those are bacteria
that have become resistant -
8:33 - 8:38to many, if not all, of the antibiotics
that we have developed -
8:38 - 8:39to treat this infection.
-
8:40 - 8:41How did we get here?
-
8:41 - 8:44Well, we weren't as smart
as we thought we were. -
8:45 - 8:48As we started using
antibiotics everywhere -- -
8:48 - 8:51in hospitals, to treat and prevent;
at home, for simple colds; -
8:51 - 8:53on farms, to keep animals healthy --
-
8:53 - 8:55the bacteria evolved.
-
8:56 - 8:59In the onslaught of antibiotics
that were all around them, -
8:59 - 9:02those bacteria survived
that were best able to adapt. -
9:03 - 9:06Today, we call these
"multidrug-resistant bacteria." -
9:06 - 9:08And let me put a scary number out there.
-
9:08 - 9:11In a recent study commissioned
by the UK government, -
9:11 - 9:13it was estimated that by 2050,
-
9:13 - 9:17ten million people could die every year
from multidrug-resistant infections. -
9:18 - 9:21Compare that to eight million deaths
from cancer per year today, -
9:21 - 9:23and you can see
that this is a scary number. -
9:24 - 9:27But the good news is,
phages have stuck around. -
9:27 - 9:30And let me tell you, they are not
impressed by multidrug resistance. -
9:30 - 9:31(Laughter)
-
9:31 - 9:37They are just as happily killing
and hunting bacteria all around us. -
9:38 - 9:41And they've also stayed selective,
which today is really a good thing. -
9:41 - 9:45Today, we are able to reliably identify
a bacterial pathogen -
9:45 - 9:47that's causing an infection
in many settings. -
9:47 - 9:50And their selectivity will help us
avoid some of the side effects -
9:51 - 9:54that are commonly associated
with broad-spectrum antibiotics. -
9:55 - 9:58But maybe the best news of all is:
they are no longer an invisible microbe. -
9:58 - 10:00We can look at them.
-
10:00 - 10:01And we did so together before.
-
10:01 - 10:03We can sequence their DNA.
-
10:03 - 10:05We understand how they replicate.
-
10:05 - 10:07And we understand the limitations.
-
10:07 - 10:08We are in a great place
-
10:08 - 10:12to now develop strong and reliable
phage-based pharmaceuticals. -
10:12 - 10:14And that's what's happening
around the globe. -
10:14 - 10:17More than 10 biotech companies,
including our own company, -
10:17 - 10:21are developing human-phage applications
to treat bacterial infections. -
10:21 - 10:25A number of clinical trials
are getting underway in Europe and the US. -
10:26 - 10:28So I'm convinced
that we're standing on the verge -
10:28 - 10:30of a renaissance of phage therapy.
-
10:30 - 10:34And to me, the correct way to depict
the phage is something like this. -
10:35 - 10:37(Laughter)
-
10:37 - 10:41To me, phages are the superheroes
that we have been waiting for -
10:41 - 10:44in our fight against
multidrug-resistant infections. -
10:45 - 10:47So the next time you think about a virus,
-
10:47 - 10:49keep this image in mind.
-
10:49 - 10:52After all, a phage might
one day save your life. -
10:53 - 10:54Thank you.
-
10:54 - 11:00(Applause)
- Title:
- How a long-forgotten virus could help us solve the antibiotics crisis
- Speaker:
- Alexander Belcredi
- Description:
-
Viruses have a bad reputation -- but some of them could one day save your life, says biotech entrepreneur Alexander Belcredi. In this fascinating talk, he introduces us to phages, naturally-occurring viruses that hunt and kill harmful bacteria with deadly precision, and shows how these once-forgotten organisms could provide new hope against the growing threat of antibiotic-resistant superbugs.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 11:13
Oliver Friedman edited English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis | ||
Brian Greene approved English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis | ||
Brian Greene edited English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis | ||
Brian Greene edited English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis | ||
Camille Martínez accepted English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis | ||
Camille Martínez edited English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis | ||
Camille Martínez edited English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis | ||
Ivana Korom edited English subtitles for How a long-forgotten virus could help us solve the antibiotics crisis |