Endolysin: the antibiotic alternative?

Antiobiotic alternatives

Dutch biotech Micreos spoke at the recent RSM Medical Innovations Programme Spring Summit about the potential of endolysin technology in preventing and treating bacterial infections, even those caused by superbugs, such as MRSA.

At a time when the Department of Health is prioritising the fight against antimicrobial resistance, stressing that there are few public health issues of greater importance, Mark Offerhaus (CEO of Micreos) and Bjorn Herpers (Clinical Microbiologist and Medical Advisor at Micreos) discussed the concept of the colonisation-infection continuum, and how endolysin technology can combat pathogenic bacteria before colonisation leads to infection, enabling a novel approach to anti-bacterial therapy and a potential candidate for antiobiotic alternatives.

Bacteria interact with the human body across a spectrum of stages, called the colonisation-infection continuum. Antibiotics are not selective in the bacterial species they kill and overuse of antibiotics has driven the emergence of resistance. Therefore, antibiotic use should be limited to the infection stage of this continuum. New data presented at the Royal Society of Medicine showed that Staphefekt (an endolysin) kills Staphylococcus aureus - including MRSA - without inducing bacterial resistance. Staphefekt is specific to its target species, leaving beneficial bacteria unharmed. This makes it suitable for longer-term ‘maintenance therapy’, as it can be used in the early stages of the colonisation-infection continuum in certain patient populations, for example in S. aureus-related skin conditions, such as eczema, acne and rosacea. Data presented showed reduced symptoms of inflammation in these conditions.

Endolysins are enzymes produced by phages, the family of viruses that naturally infect and destroy bacteria. Staphefekt is the first endolysin available for human use. It causes lysis of the bacterial cell wall, targeting highly conserved areas; this is why resistance development against endolysins is neither observed nor expected.

Mark Offerhaus (CEO of Micreos) said: “Endolysin technology enables us to deal with the bacteria around us in a completely different way, preserving the beneficial species, and the biodiversity of the bacteria on our skin. This is necessary, and it represents a paradigm shift, allowing for prophylactic and maintenance treatment of bacterial skin diseases at an early stage, alleviating pressure on antibiotics in these indications and preserving antibiotics for when we really need them.”

In vitro and observational in vivo studies have confirmed these characteristics. Laboratory results have shown that lysis of S. aureus by Staphefekt is specific to S. aureus, efficient, and unlikely to induce resistance.

Dr Bjorn Herpers, Clinical Microbiologist, said: “The results demonstrate the potential this technology has for effective action in the earlier stages of the colonisation – infection continuum. The UK Five-Year Antimicrobial Resistance Strategy 2013 to 2018 outlines the need for new strategies for the treatment of bacterial infections, and this could be one of the answers.”

Products containing Staphefekt for skin-conditions with an infectious component are sold under the Gladskin brand. Staphefekt XDR.300 against S. aureus and MRSA is available for research purposes for free in an open source setting.