Hitting the Books: An Ode to the Joy of Antibiotics

The stress and uncertainty surrounding the COVID pandemic, along with misinformation about life-saving vaccines developed in response, has broken many weak minds in the last two years, leading people to try everything from injecting bleach and inhaling nebulized hydrogen peroxide to suffocating horses. worms in erroneous attempts to outwit modern medicine. Surprisingly, none of that actually works. The worst thing is that this kind of behavior is nothing new. Surplus homeopathic remedies have been around for centuries – treating bubonic plague by letting go of blood, self-flagellation, or sitting in a hot sewer to ward off fever, for example – and backed up by little more than anecdotal evidence.

In his latest book, Zero patient: An interesting history of the worst diseases in the world,, Dr. Lydia Kang and Nate Pedersen enter the fascinating history of some of the most deadly diseases of humanity and the work of scientists who developed drugs, vaccines and treatments to preserve society. In the section below, we will look at the use of antibiotics and antitoxins in the fight against diphtheria, anthrax and other deadly diseases.

Workman Publishing

Excerpt from zero patient: An interesting history of the worst diseases in the world by Lydia Kang, MD, and Nate Pedersen. Workman Publishing © 2021

In addition to setting up barriers between us and the plague, the next primary approach to fighting them was direct attack, thanks to discoveries in science that created and discovered antibiotics and antitoxins. Some of these drugs are not only used against microorganisms such as bacteria, but also act as antifungals, antiviral and antiparasitic drugs. Today, there are more than a hundred types of drugs in this group. The World Health Organization (WHO) maintains a list of drugs deemed necessary for the country’s health system to take the best care of its citizens, and much of these essential drugs fight infectious diseases.

Some might assume that penicillin was the first final weapon discovered in our fight against pathogens, but there were a few that preceded it and broke through significant steps when they were discovered.

Emil von Behring, born in Prussia, was a doctor and assistant to the famous Robert Koch at the Institute of Hygiene in Berlin. In 1888 he developed a way to treat those suffering from diphtheria and tetanus. Not a disease known to many these days, diphtheria is prevented by a vaccine that is usually combined with your routine tetanus vaccination. In the 1800s, diphtheria was a terrible killer that inflamed the victim’s heart, caused paralysis and caused the throat-choking membrane to cover the throat. In Spain, the disease was so widespread in 1613 that it was nicknamed Year Garrotillaor “Year of strangulation.”

Most of the diseases caused by diphtheria are caused by the toxin it produces Corynebacterium diphtheriae. Von Behring infected rats, rabbits and guinea pigs with his weakened (weakened) forms, and then collected their serum – the liquid part of their blood, minus the red and white blood cells. This light honey-colored liquid, which contained antibodies to the diphtheria toxin, was then injected into another group of animals that were sick with a completely virulent diphtheria bacterium.

Newly infected animals that were given serum did not die because they acquired a passive form of protection against toxins with the donated serum. In 1891, the life of a child was saved for the first time with this new method. The serum was produced in large quantities using animals such as sheep and horses. At a time when 50,000 children were dying of diphtheria each year, it was a miraculous treatment.

Tetanus serum was created soon after, which became an effective treatment in 1915. Today, antitoxins are used to treat botulism, diphtheria and anthrax. The same principles of antitoxin treatment are used for antidote therapy to eliminate the bites of poisonous animals, including those of the black widow spider, scorpion, jellyfish, and cobra. Treatment called passive antibody therapy, in which the serum of patients recovering from infection is given to other sick patients (also called convalescent plasma therapy), may have been helpful during the COVID-19 pandemic, although data are still coming. Antibodies against infections can not only treat diseases such as toxic shock syndrome, but also prevent infections during exposure, such as hepatitis A and B and botulism. But the antibodies themselves have been used to treat more than just bites, stings and infections. Intravenous immunoglobulins from associated donors treat a variety of disorders, such as ITP (immune thrombocytopenia) and severe immunodeficiency diseases.

The second antibody therapy – monoclonal antibodies – has changed the game in treatments in the last decade, the first was approved by the FDA in 1986. These specially designed antibodies are used to treat several types of cancer (melanoma, breast and stomach, among many others) and autoimmune diseases (including Crohn’s disease, rheumatoid arthritis and psoriasis). Antibodies themselves are Y-shaped proteins that bind to a particular protein. By doing so, they can cause a whole range of effects: activating or deactivating the cascades of the immune system, destroying cells, blocking or activating cell activity. Antibodies bind to only one antigen, i.e. “mono”, and are produced by cell clones that emit antibodies in large quantities. They can sometimes bind to radioactive particles, delivering radioactivity directly to the cancer cell. Others may be related to chemotherapy. They often work alone.

In the domain of cancer therapy, most of us have some understanding about chemotherapy. But the origin of the very term chemotherapy actually stems from the struggle to treat infections, not cancer. At the turn of the twentieth century, antibiotics had yet to establish themselves as a cure for infections. That changed with a doctor and scientist named Paul Ehrlich. He was born in 1854 in East Prussia (now Poland) where his father ran the lottery. During his career, he took advantage of the developing German dye industry to experiment with how cells look stained with different chemicals. His love of color has led to some significant idiosyncrasies, such as carrying colored pencils in his pockets. But Ehrlich’s work led to what would become the famous Ziehl-Neelsen acid resistant stain for tuberculosis. (Unfortunately, he also stained his own TB bacteria from his sputum, although fortunately he survived the disease.) He later collaborated with the aforementioned Emil von Bering, a Nobel Prize-winning physiologist, on serum therapy for tetanus and diphtheria.

But perhaps Ehrlich’s most notable discovery happened by accident while he was looking for a chemical drug to treat a particular disease – “chemotherapy”. In particular, he hoped to cure sleep sickness, a disease caused by a microscopic parasite called Trypanosoma brucei. He worked with a chemical called atoxyl (meaning “non-toxic”), ironically, an arsenic compound. Ehrlich coined the term “magic bullet” in connection with his hope of finding the perfect chemical that would hopefully kill a very specific pathogen, Trypanosoma a parasite, not a patient. In the end, he tested nine hundred variations of arsenic compounds on mice. None were particularly effective, but he looked at # 606 again because it seemed to have an effect on a newly discovered bacterium believed to cause syphilis. In 1910, a drug called Salvarsan (sometimes simply called “606”) was shown to be effective – it killed syphilis spirochetes and left guinea pigs, rabbits and mice alive.

In the next few decades, new research would be applied to fight not only old pandemics, but also everyday infections that could change people’s lives. A scratch or bite could kill Staphylococcus or Streptococcus infections out of control. A German scientist named Gerhard Domagk began working with a group of chemicals called azo dyes that had a characteristic double nitrogen bond. Azo colors can dye textiles, leather and food in different shades of brilliant orange, red and yellow. When a sulfonamide group was attached to the azo compound (a nitrogen-sulfur bond with two oxygen atoms doubly bonded to sulfur, if you need to impress friends at a party), they knew they had found something special. The sulfonamide group inhibits the ability of bacteria to produce folate, an essential vitamin B. Humans, on the other hand, can get folate through their diet. And so another magic bullet was born. The new compound appeared to work in infected mice Streptococcus, otherwise known as strep.

Domagk used a new drug, called KL 730 and later patented as Prontosil, on his own daughter Hildegard. Suffering from a severe strep infection, she received an injection of Prontosil and recovered, although the drug left a treacherously colored, reddish discoloration at the injection site.

“Sulfa” drugs would continue to be used in a variety of medications, including antibiotics (trimethoprim and sulfamethoxazole, called Bactrim), diabetes medications (glyburide, sulfonylureas), diuretics (furosemide or Lasix), pain medications (celecoxib or Celebrex), and today they are also used to treat pneumonia, skin and soft tissue infections, and urinary tract infections, among others.

Domagko’s work earned him the Nobel Prize in 1935. However, the Nazis, who did not approve of the Nobel Committee’s attempt to help German pacifist Karl von Ossietzky, forced their Gestapo to arrest Domagko for accepting the prize and forced him to return it. He managed to receive it later in 1947.

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Naveen Kumar

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