CF START study - What is the most effective and safest antibiotic strategy for infants diagnosed with cystic fibrosis?
Professor Kevin Southern, Alder Hey Childrens’ Hospital, Liverpool, UK
Our contribution: £50,000
Partner: NIHR, £1.46 million
There are two ways that doctors can protect children from developing Staphylococcus aureus (S. aureus): either by giving them antibiotics to prevent them from getting the bug, known as ‘prevent and treat’ (as is the practice in the UK), or by giving them antibiotics when they get the infection, known as ‘detect and treat’ (as is the practice in the US). While ‘prevent and treat’ does stop children getting S. aureus, there is a concern that it might lead to earlier infection with another bug Pseudomonas aeringosa. The CF Start study is comparing ‘prevent and treat’ vs ‘detect and treat’ by asking children with CF to follow one of these treatment methods, and monitoring how they do over the long term by analysing their UK CF Registry records.
There’s more information on taking part in this study on the CF Start webpage (including videos from the researchers leading the study) plus a background to the study on our website. There’s also a more technical summary on the National Institute for Health Research’s website.
NIHR Partner, Registry study
Understanding and detecting early stages of Pseudomonas infection
Dr Jo Fothergill, University of Liverpool, UK
Our contribution: £62,000
Partner: Action Medical Research, £124,000
Pseudomonas will initially infect the nose and upper airways before moving down to infect the lungs. Once people are infected with Pseudomonas it adapts to its living environment, becomes chronic and much harder to treat. Dr Fothergill wants to find out when Pseudomonas begins to adapt to the body, and discover ways to spot when this adaptation is taking place by finding biomarkers. She thinks that it might happen in the nose and throat, before the bug reaches the lungs. The results of her research could help doctors to target the infection much earlier, before it has had a chance to adapt. It could also provide more information to support drug trials targeting Pseudomonas in the nose and upper airways.
You can read a longer summary of this research project on the Action Medical Research website.
RAPID-test – developing a home monitoring test
Professor Jane Davies, Imperial College London and Dr Collin Sones, University of Southampton, UK
Our contribution: £90,000
Partner: Engineering and Physical Sciences Research Council (EPSRC), £786,000
Currently detecting what bugs people with CF are growing requires hospital tests of a sample, followed by a few days to wait for the bug to grow, before treatment can begin. Dr Sones and Professor Davies are developing a dipstick-like test that people will be able to use at home, meaning that they will be able to start their treatment quicker. Currently they’re developing the test to detect infection with Pseudomonas and Burkholderia cepacia. As well as detecting the presence of the bug, they aim to be able to identify which antibiotics the bugs are resistant to at the same time.
More information is available on our website and there is also a more technical summary of the project on the Gateway to Research website.
Government agency partner
Using bacteriophages to develop quicker tests in the clinic
Professor Chris van der Gast, Manchester Metropolitan University, Manchester, UK
Our contribution: £45,950
Partner: Manchester Metropolitan University, £45,950
Currently, detecting which bugs people with CF are growing requires hospital tests of a sample, and a delay of a few days to wait for the bug to grow before treatment can begin. Professor van der Gast and his PhD student Lauren Hatfield are aiming to develop a test that will identify which infections someone has within a few hours. They hope that if a sample is taken at the start of a clinic appointment, the results will be back by the end of the appointment!
More information is available in an article on our website.
Is glatiramer acetate an effective antibiotic against Pseudomonas?
Professor Jane Davies, Imperial College, London, UK
Our contribution: £30,000
Partner: Cycle Pharmaceuticals, £30,000
Pseudomonas is a bacteria that more than 40% of adults with CF have growing in their lungs. After initial infection, the bug adapts to the lungs and becomes extremely difficult to treat, forming ‘biofilms’ to make itself resistant to many antibiotics. Chronic infection can cause lung inflammation and permanent lung damage. New treatments for Pseudomonas are urgently needed. Glatiramer acetate is a complex drug that is used to treat multiple sclerosis (MS). Researchers in Denmark established that glatiramer acetate also has antibiotic properties, and Professor Davies is working with her Danish colleagues and the pharmaceutical company Cycle Pharmaceuticals to test whether glatiramer acetate might be effective as an antibiotic against Pseudomonas in people with cystic fibrosis. Specifically, their studies are currently testing how GA might work in animal models of CF, before they test whether it is an effective antibiotic against Pseudomonas in people.
More information is available in an article on our website.
Learning more about how Pseudomonas biofilms form, and how to disrupt them
Dr Tanmay Bharat, University of Oxford, UK
Our contribution: £89,917
Partner: Action Medical Research, £89,917
Pseudomonas becomes resistant to antibiotics by forming protective ‘biofilms’. How biofilms work to protect the bacteria from antibiotics is not understood. It has recently been shown that the formation of biofilms is helped by chemicals that are produced and secreted by Pseudomonas. In this research project Dr Bharat at the University of Oxford will focus on learning more about these chemicals and their role in biofilm formation. Reducing the level of these chemicals could make antibiotics against Pseudomonas more effective.
You can read more about this project on the Action Medical Research website.
Fine tuning to develop a drug that breaks antibiotic resistance
Neem Biotech, South Wales, UK (VIA056)
Our contribution: £100,000
Partner: Neem Biotech £100,000
A new class of drugs known as ‘antibiotic resistance breakers’ or ‘adjuvant therapies’ work by breaking up the biofilm of bacteria. Biofilms are one way that bugs like Pseudomonas or S Aureus become resistant to antibiotics. Antibiotic resistance breakers are designed to be taken in addition to antibiotics, increasing their effectiveness.
Neem Biotech will be fine tuning the properties of a possible new antibiotic resistant breaker, a chemical called ajoene. The design of new drugs is a delicate balance between keeping the beneficial effects that researchers first noticed, and refining the chemistry to ensure: the effects are long lasting, the potential for side effects is reduced and the drug is practical and economic to produce.
Read more about this project in a news story on our website.
Development of a rapid diagnosis of infection with non-tuberculous mycobacteria (NTM) in immune compromised patients
Diagnostig Ltd, Bangor
Our contribution: £20,000
Partners: Diagnostig Ltd £15,000; Innovate UK £86,000 (joint funding with Professor Andres Floto, Cambridge University)
Current methods for confirming an NTM diagnosis are very time consuming and expensive; an initial positive sputum test for NTM requires confirmation in a number of other cultures (each taking eight weeks) followed by confirmation with a CT scan.
All bacteria have a unique pattern of chemicals within their cell wall, and fragments of this cell wall can be found in the blood of infected people. These bacterial fragments are recognised by the body as foreign and a defence is mounted by raising antibodies. Diagnostig have developed a method for detecting bacterial infection, by detecting the antibodies to the unique bacterial fragments in a blood sample. So far, they’ve developed a diagnostic test for related bacteria. In this laboratory project they will test the possibility that such an approach might be successful for NTM in cystic fibrosis.
Biotech partner, Government agency partner