List of questions

What is your view on which bacterias that are most prone to become resistant against antibiotics in the future, i.e the next generation of resistance likelyhood?
How can one study which bacterias are most prone to become resistance as well as finding new ways of scientific solutions and test methods ?

LIF has during ghe spring raised the issue of resistance

How can healthcare be convinced without healtheconomics data that increased use of diagnostic tests can reduce malpractice and overall cost for healthcare

Today relatively small resources are spent on diagnostic tests even though its widely recognized that both under and over treatment is mainly caused by insufficient diagnostic information, i.e from IVD tests.

We are looking for a collaboration in producing different recombinant HIV-1 RT versions.

Cavidi is an Uppsala-based diagnostics company. Cavidi has developed and produced Reverse Transcriptase based kits for research and diagnostic purposes since 1994. Our main product is an HIV virus load (VL) diagnostic kit used to monitor HIV treatment in AIDS patients in countries around the globe. Cavidi has collaborated with Uppsala University many times during this period and we would be happy to work with you again.

If the interest is mutual, we’d like to raise the following question during an AIMDay.

In both existing products and different product development projects at Cavidi we use recombinant HIV-1 Reverse Transcriptase (RT). RT is an enzyme that is only present in retroviruses and that makes a DNA copy from the viral RNA genome. The recombinant RT enzymes are used by Cavidi as calibrators and positive controls in different assays for example.

Right now we are developing a new HIV drug resistance test that will be used by clinicians to quickly (i.e. within a working day) be able to determine if a patient is infected with an HIV strain that is resistant to a certain class of antiretroviral drugs, NNRTIs. The NNRTIs ( Non-Nucleoside Reverse Transcriptase Inhibitors) act by blocking the enzymatic activity of RT. Resistance to NNRTIs may develop and is caused by specific mutations in the RT. This type of drug resistance test for HIV will be the first available of its kind.

In this work we are looking for a collaboration in producing recombinant HIV-1 RT. The work will include creating certain point mutations and then express, purify and analyze/evaluate each recombinant enzyme’s activity.
We have previously worked with recombinant RTs from Prof. Torsten Unge who had a program around HIV but who has now retired from Uppsala University.
We hope to find a new partner that would allow us to continue with our successful collaboration with Uppsala University.

If this sounds interesting we would be happy to present and discuss this topic in more detail.

"Platelia enzyme immunoassay" is a diagnostic test related to fungal blood infections (yeast and mold) in humans, detecting e.g. the Aspergillus galactomannan antigen in serum samples. Once diagnosed, patients get an expensive anti-infective medicine treatment. What are the scope and especially limitations of this test?

Fresenius Kabi is a global healthcare company that specializes in lifesaving medicines and technologies for infusion, transfusion and clinical nutrition. The Platelia enzyme immunoassay seems to be (mis)used by care providers as a direct ‘release’ test for our TPN (total parenteral nutrition, containing glucose, amino acids and fatty acids) products, giving false positive results used directly with TPN. From literature research the test seems to be known for generation of false positive test, exact reasons seem to be unknown.

Are there novel pathogen-specific pathways in viruses or bacteria that you believe could be utilized in drug discovery, to develop novel and innovative drug candidates which could improve clinical outcomes?

www.jnjinnovation.com

Hur kan vi utveckla rekommenderade existerande antibiotika på ett innovativt sätt så att fortsatt tillhandahållande av dessa säkras, trots enstaka tillverkare av dessa och sjunkande volymer? Hur kan samhället (vård/akademi/myndighet/industri) samverka för att skapa möjligheter/intresse för innovativ utveckling av dessa antibiotika?

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Hur kan dagens prismodell för befintliga antibiotika förbättras för att säkra tillgång, utveckla, öka intresse för inlicensiering av unika substanser/beredningar? Kan en prismodell snabbt införas som säkrar tillgång trots sjunkande volymer. Hur skulle en sådan modell kunna se ut, införas samt fungera.

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We are interested in narrow spectrum vs broad spectrum antibiotics. Which diagnostic tools are currently being used in the hospitals and are susceptibility testing done in a routine manner? What is the future for using a carbapenem co-dosed with an MBL inhibitor or is there a need for a broader spectrum resistance mechanism inhibitor?

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Which are the most challenging hospital-acquired infections currently in Sweden, is it MRSA, is it CRE, Pseudomonas, C. diff, etc?

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We are interested in developing a metallo-beta-lactamase (MBL) inhibitor which would be co-administered i.v. with a beta-lactam antibiotic to patients with drug resistant infections due to the expression of an MBL such as NDM-1, VIM-2 or IMP-1. How does the pharmacokinetic behavior of our MBL inhibitor needs to be matched to the companion antibiotic to obtain the optimal pharmacodynamic behavior?

If the PK of a beta-lactam antibiotic is affected by whether or not the patient is infected by a beta-lactamase expressing resistant bacteria one could anticipate quite a complex interplay between the two drugs but otherwise maybe just sufficiently similar PK to allow convenient co-administration would be required.

Where (in which setting) will future testing for bacteria detection, and/or bacterial resistance be performed?

New techniques are developed for both large, integrated platforms in multi-dicipline labs, as well as "point-of-care" testing.

How and when can big pharma make profit by developing new antibiotics

Big pharma is no longer interested in antibiotics and and their involvement is necessary in order to bring new antibiotics to registration.