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(MAC/MAI) Mycobacterium Avium Complex Pulmonary Disease: Join us
MAC & Bronchiectasis | Last Active: Oct 29 5:15pm | Replies (9350)Comment receiving replies
Me too Heather -- I wish that also.
Most drugs fighting all kinds of bacteria are petri-dish-tested using mainly the planktonic ('free- floating') stage of bacteria, not really testing much sessile bacteria living inside biofilms. The drug companies do that to show their drugs work. (They would need drug doses far far higher to fight through biofilm to get to the bacteria, and nobody can survive that).
Some NTM drugs do manage to get into the outer layers of the biofilm though -- just not into the inner bacteria in biofilm. (Azithromycin is one that can do this a bit -- at least for a while). So it's no wonder the drugs can take such a long time trying to kill this bug.
Unfortunately our lungs a rather delicate things -- we can't treat them like "old leather bags" as many people do when we're young! While our stomachs can handle vinegar and things like that, our lungs cannot. (Neat vinegar kills mycobacteria, folks!). But even inhaling vinegar gas into our lungs can cause severe damage to our lungs, unfortunately. The lungs are a difficult place to treat bugs.
And it's very difficult to find things that break up biofilms in the lungs that are also safe to use in the lungs.
Some people, with cystc fibrosis for example, have tried nebulising drops of essential oits that are meant to be antimicrobial and fight biofilm. But then they can develop severe hypersensitivity reactions to them in their lungs, and can't use them again. Some other people have started using sound vibrations on their chests (some sound vibrations are used to help prevent biofilms from developing on surgical equipment). But it's difficult and I wish there was much, much more research on mycobacteria treatments and biocides for biofilms that are safe to use in the lungs. We all do.
Replies to "Me too Heather -- I wish that also. Most drugs fighting all kinds of bacteria are..."
A while ago, I opened a topic on biofilms by posting a couple of early references on the issue.
There has been considerable research on biofilms in distinct environments, from industrial to health. Just as an example, consider how much has been done on dental plaque, a serious and ubiquitous biofilm.
Unfortunately, we need more and better research on biofilm management in lungs. One promising alternative is the use of enzymes to promote the destruction of the polysaccharide chains that surround the biofilms.
Thank you so much for this extremely informative post. I believe the lipisomes in Arikayce are intended to pierce the biofilm so that the amikaycin can get in.
My lungs are fragile and do not like anything foreign inhaled into them so I had a hard time doing Arikayce and created an imagery that helped.
With every inhale, I pictured the milky substance aerosolized had thousands of warriors running into my airways. The warriors were Roman gladiators or Vikings, huge, brawny, hairy men wearing metal breastplate and helmets and carrying weapons, including assault weapons. As they ran, thousands of male voices shouted, "KILL! KILL! KILL!"
The warriors were stopped by a wall. I knew that mycobacteria had some kind of protective shell but I know now it is biofilm. As they approached the biofilm, a small pack on each of their backs opened and a tiny female sprite flew out. The sprites were Tinkerbells but instead of wands, they carried spears. They thrilled loudly above the shouts of "kill" from the men. Quickly they flew to the biofilm and pierced it with their spears and the warriors drew their weapons and ran in killing mycobacteria left and right.
Next inhale.
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@anniepie thank you for that information, there are a few drugs in the pipeline for gram negative bugs, so hopefully some of these will be successful at getting through the biofilms. So difficult!