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posted by janrinok on Wednesday January 08 2020, @02:28PM   Printer-friendly

Finding a new way to fight late-stage sepsis by boosting cells' antibacterial properties:

Researchers have developed a way to prop up a struggling immune system to enable its fight against sepsis, a deadly condition resulting from the body's extreme reaction to infection.

The scientists used nanotechnology to transform donated healthy immune cells into a drug with enhanced power to kill bacteria.

In experiments treating mice with sepsis, the engineered immune cells eliminated bacteria in blood and major organs, dramatically improving survival rates.

This work focuses on a treatment for late-stage sepsis, when the immune system is compromised and unable to clear invading bacteria. The scientists are collaborating with clinicians specializing in sepsis treatment to accelerate the drug-development process.

"Sepsis remains the leading cause of death in hospitals. There hasn't been an effective treatment for late-stage sepsis for a long time. We're thinking this cell therapy can help patients who get to the late stage of sepsis," said Yizhou Dong, senior author and associate professor of pharmaceutics and pharmacology at The Ohio State University. "For translation in the clinic, we believe this could be used in combination with current intensive-care treatment for sepsis patients."

The study is published today in Nature Nanotechnology.

Sepsis itself is not an infection—it's a life-threatening systemic response to infection that can lead to tissue damage, organ failure and death, according to The Centers for Disease Control and Prevention. The CDC estimates that 1.7 million adults in the United States develop sepsis each year, and one in three patients who die in a hospital have sepsis.

This work combined two primary types of technology: using vitamins as the main component in making lipid nanoparticles, and using those nanoparticles to capitalize on natural cell processes in the creation of a new antibacterial drug. Cells called macrophages are one of the first responders in the immune system, with the job of "eating" invading pathogens. However, in patients with sepsis, the number of macrophages and other immune cells are lower than normal and they don't function as they should.

Journal Reference:
Xucheng Hou, Xinfu Zhang, Weiyu Zhao, Chunxi Zeng, Binbin Deng, David W. McComb, Shi Du, Chengxiang Zhang, Wenqing Li, Yizhou Dong, Vitamin lipid nanoparticles enable adoptive macrophage transfer for the treatment of multidrug-resistant bacterial sepsis, Nature Nanotechnology (2020). DOI: 10.1038/s41565-019-0600-1 , https://nature.com/articles/s41565-019-0600-1


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  • (Score: 0) by Anonymous Coward on Wednesday January 08 2020, @02:50PM (8 children)

    by Anonymous Coward on Wednesday January 08 2020, @02:50PM (#941051)

    In critically ill patients, vitamin C deficiency is frequently observed. After almost one century of in vitro-experiments and animal models, there is an abundance of plausible data for the protective effects of vitamin C against oxidative-stress-mediated cell damage and organ dysfunction in sepsis and septic shock, respectively. Only with parenteral high-dose administration, vitamin C deficiency can be restored efficiently. The lack of randomized controlled trials and the uncertainty regarding optimal dose, timing and possible adverse effects impeded the clinical acceptance, and preclude a recommendation for vitamin C in the clinical care of septic patients. Thus, further research is needed to investigate the benefit of vitamin C in sepsis and septic shock.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996765/?report=classic [nih.gov]

    The medical industry refuses to properly study vitamin C for anything, because they would go bankrupt if everyone who was deficient in it (almost everyone who is ill) got enough. Hospitals also bizarrely refuse to do regular tests for vitamin c levels. Eg not a single person with Ebola has ever been tested for vitamin c.

  • (Score: 0) by Anonymous Coward on Wednesday January 08 2020, @03:12PM (7 children)

    by Anonymous Coward on Wednesday January 08 2020, @03:12PM (#941056)

    Wow, I looked at what this treatment is:

    vitamin C lipid nanoparticles that deliver antimicrobial peptide and cathepsin B (AMP-CatB) mRNA.

    https://www.nature.com/articles/s41565-019-0600-1 [nature.com]

    So they took the cheap and nontoxic treatment, vitamin c, and added poison to it so they could patent it.

    • (Score: 4, Insightful) by ikanreed on Wednesday January 08 2020, @04:14PM (6 children)

      by ikanreed (3164) Subscriber Badge on Wednesday January 08 2020, @04:14PM (#941086) Journal

      Jesus Christ alt-med wackos are fucking insane.

      Vitamin C isn't a fucking antibiotic, has never worked as an antibiotic, doesn't magically make your immune system better.

      And [nejm.org] of [sciencedirect.com] course [bmj.com] they've studied it's direct application for numerous diseases, with next to no results.

      Consistent regular supplementation has some benefit for the common cold, especially where dietary deficiencies of ascorbic acid exist, but taking it as a treatment is fucking insane

      • (Score: 0) by Anonymous Coward on Wednesday January 08 2020, @04:53PM (2 children)

        by Anonymous Coward on Wednesday January 08 2020, @04:53PM (#941100)

        Hear! Here!
        Vit C is not stored, and any not being used will be excreted in the urine. Thus a steady supply of it is needed, especially when you are sick and not eating and drinking as normal.

        An excess is literally pissed away.

        rts008

        • (Score: 0) by Anonymous Coward on Wednesday January 08 2020, @07:07PM (1 child)

          by Anonymous Coward on Wednesday January 08 2020, @07:07PM (#941158)

          An excess is literally pissed away.

          First, say you take vitamin C and it reacts with a free radical to quench it in your body. The process converts it to dehydroascorbate which makes it back to the blood. Red blood cells will then reduce dehydroascorbate back to the more water soluble ascorbate which (if blood levels are high enough) your kidneys will excrete.

          When you measure urine vitamin C levels how do you know whether it was "used" or not?

          Second, say you need to fight a forest fire but when dumping the water on it your accuracy is very low. Basically to get enough water on the actual fire to quench it, you need to just drench the entire forest. In a case like this you would need an extreme excess of water to quench the fire. This is just like a hundred gram dose of vitamin C quenching inflammation due to, eg, a viral infection in your lung.

          • (Score: 0) by Anonymous Coward on Wednesday January 08 2020, @10:05PM

            by Anonymous Coward on Wednesday January 08 2020, @10:05PM (#941217)

            Typo: "Red blood cells will then *oxidize* dehydroascorbate back to the more water soluble ascorbate"

      • (Score: 1, Interesting) by Anonymous Coward on Wednesday January 08 2020, @05:40PM

        by Anonymous Coward on Wednesday January 08 2020, @05:40PM (#941126)

        Vitamin C isn't a fucking antibiotic, has never worked as an antibiotic

        It's a reducing agent. Anaerobes only grow if the redox potential of their environment is sufficiently low (roughly less than +60-100 mV), so in that case we would expect it to stimulate growth. The reverse is true for aerobic bacteria though, they only grow if the potential is *high* enough. In that case ascorbate acts as a bacteriostatic agent.

        It also reduces ferric (Fe3+) to ferrous (Fe2+) iron. Ferrous iron reacts with oxygen to form superoxide radical, and with hydrogen peroxide to form hydroxyl radical (ie, the fenton reaction). Same with copper. Thus, ascorbate can act as a source of electrons to replenish ferric iron levels and generate free radicals which are bacteriocidal. Now, ascorbate can also quench these free radicals so how it all works out depends on the concentrations involved.

        This has been known since like the 1930s, but you can find many more recent papers on this if you look.

        doesn't magically make your immune system better

        Correct, it is not magic. It is the best reducing agent in the universe at physiological pH because its first stage oxidation product is the exceptionally long lived resonance stabilized ascorbate radical. This is *also* a great reducing agent, upon which you get dehydroascorbate. This is also a great molecule because it can be easily recycled back to ascorbate by glutathione, but if not is quickly hydrolyzed to a non-oxidant compound (2,3-diketo-L-gluconic acid).

        Thus *anywhere there are excess free radicals vitamin c acts as a great nontoxic source of electrons*. The end result is non-toxic compounds and lipids and proteins that have been saved from oxidative damage. This is why when *sufficient* amounts of vitamin c reach an inflamed tissue the symptoms of inflammation and threat of structural damage is reduced. So it helps *anywhere free radicals and inflammation is a problem*, which is basically every single illness.

        And [nejm.org] of [sciencedirect.com] course [bmj.com] they've studied it's direct application for numerous diseases, with next to no results

        I'll respond to this and the rest in a follow up.

      • (Score: 0) by Anonymous Coward on Wednesday January 08 2020, @06:53PM

        by Anonymous Coward on Wednesday January 08 2020, @06:53PM (#941150)

        Moertel 1985:

        This paper calls 10 grams of water soluble vitamin C once a day "high dose". Severely ill people need hundreds of grams split up over the course of the day. This is evidenced by the ability for sick people to absorb more vitamin C than healthy people:

        https://i.ibb.co/3MxX81T/jaffe2.png [i.ibb.co]
        https://www.ncbi.nlm.nih.gov/pubmed/7321921 [nih.gov]

        Vitamin C does selectively kill cancer cells at 1-20 mM concentrations in vitro. Supposedly this via the fenton reaction and lipid/protein oxidation as described earlier, since cancer cells are famously high in iron and glucose transporters (dehydroascorbate competes with glucose for transport). However, there is going to be much less free iron in actual tumor tissue, and much more other stuff for the ascorbate to react with. So likely you need to get even more (40+ mM) to the tumor to get substantial fenton reaction activity.

        As mentioned earlier, the primary role of vitamin C is as a reducing agent. So where I would expect to see an effect in cancer patients is when inflammation is a problem. In this paper they gloss over that aspect and even say most patients were asymptomatic (even though 85% died?).

        Also, it is strange because they couldn't follow the simple instructions of the paper they were attempting to replicate (give IV vitamin C plus oral supplements all day).

        Halperin 1993:
        This is a weird one I have never seen. They made a 100 mg/ml (568 mM, assuming ascorbic acid rather than sodium ascorbate) ointment and say that 8% of this penetrated half a mm into the skin. So I guess the skin received a 45 mM dose. For comparison the solubility of ascorbic acid is 330 mg/ml (1,874 mM). Then they had radiotherapy patients apply it and came up with a custom "preference" score based on a 0-4 toxicity scale. They found that (after dropping 45% of the subjects), if anything, the skin/hair was worse off when this ointment was applied.

        Well, I have no idea how they came up with that random dose and how it compares to the oxidizing effect of the radiation therapy, but I bet that ointment was acidic and irritating to the skin. There isn't much to make of this study.

        Siriwardena2007:
        This study gave 2 grams of vitamin C (mixed with other stuff) IV for 2 days and then 1 gram for another 5 days. Then they assessed organ dysfunction. This dose of vitamin C is not going to do anything for cancer patients. Also, they missed a chance to report serum Vitamin C levels in these patients, instead only reporting change from baseline.

      • (Score: 2) by RS3 on Wednesday January 08 2020, @07:16PM

        by RS3 (6367) on Wednesday January 08 2020, @07:16PM (#941160)

        I'm no "alt-med" person, let along wacko. But is there harm in taking extra vitamin C?

        And consider that some people might need more vitamin C than others, and maybe in some diseases and/or conditions, vitamin C helps the healing process?