Future

How Obsolete Virus Therapy Is Breaking Into Modern Medicine

Western medicine had abandoned the use of viruses with the advent of antibiotics. But now promising, non-chemical options are emerging in the fight against bacterial infections and some types of cancer.

Bacteriophages, the viruses getting viral
Bacteriophages, the viruses getting viral
Paul Molga

PARIS — After 39 operations to rid his body of a staphylococcus aureus, or golden staph infection, that began when he was 17, Serge Fortuna finally decided he should just have his sick leg amputated.

But then he heard about an effective non-prescription treatment available in Georgia for such infections. The treatment consists of ingesting viruses that eat bacteria, otherwise known as bacteriophages. Fortuna was there within days, with 30 euros in cash, to buy the "magic pills." Within two weeks, his body was finally and definitively cleansed of the infecting bacteria.

This is a century-old therapy that fell into disuse in Western medicine with the advent of antibiotics. There is now reason to believe it could make a vigorous return to join our drug and medical arsenal.

Some of the people encouraging its comeback work for a small French start-up called Pherecydes Pharma. The firm will soon launch a second phase of clinical trials to win approval for a cocktail of bacteriophages to treat skin infections caused by Escherichia coli (E. coli) and Pseudomonas aeruginosa, antibiotic-resistant bacteria that are the prime causes of death among patients with severe burns.

The armed forces health services are coordinating the project in collaboration with six international hospitals. The effort is part of an overall European Phagoburn program that will spend 5 million euros to test the efficacy of natural predators of bacteria. Tests will be conducted in France, Belgium and Switzerland. "If they are conclusive, these will be the first medicinal viruses approved by EU law," says Jerôme Gabar, who heads the young eight-person team at Pherecydes Pharma.

Massive curative potential

A half dozen labs around the world, including the Institut Pasteur in Paris, are participating in an international competition to register useful bacterial predators. Science has so far found about 6,000. Each is specific to a particular bacterium, but they can be combined. Pherecydes Pharma has registered three formulas after analyzing fecal matter and waste waters, and is working on four others.

At the Institut Pasteur, Laurent Debarbieux has also isolated viruses shown to be effective against lung infections affecting patients with mucoviscidosis, a disorder that makes mucous too sticky. He is also about to publish results of lab tests carried out with the Paris Hospitals Public Assistance (APHP) on an active bacterial eater that targets some of the superbugs found in hospital recovery wards.

"We really are beginning to discover the enormous potential of these therapeutic viruses," he says.

Electron micrograph of Bacteriophages — Photo: Dr Graham Beards/GFDL

Bacteriophages are not the only tools available in new viral therapies. Months ago, a U.S. team from the Mayo Clinic in Minnesota caused a stir by publicizing the case of a patient with terminal-phase bone marrow cancer (myeloma) whose body removed all detectable traces of the pathology after being injected with a modified measles virus. Nine months after the announcement, the patient remains in remission. Another patient given the same treatment has been stabilized.

To produce this "miracle," researchers exploited the properties of a mitigated lineage of the virus with a therapeutic gene. Injected once at an extremely high dosage (10,000 times a vaccine dose), the solution first colonized tumor cells that lacked anti-viral mechanisms. A portion of the cells was destroyed in the first hours, creating a niche for producing virions, or virus particles. The other tumor cells then revealed themselves to the immune system and became vulnerable by integrating the genetic material of the virus.

Viral cancer vaccines?

"This is one of the problems we find in trying to overcome cancer cells: The body's natural defenses tolerate their presence," says Marc Grégoire, head of research at the public research center INSERM. "So by contaminating them with a toxic agent, it's like pinning an "eliminate" note onto them. The immune system can no longer miss them."

Grégoire, working with a colleague from the Institut Pasteur, has created a company called Oncovita that will use this method to produce a vaccine against asbestosis, a reputedly incurable cancer affecting the lungs. Lab tests have shown "total efficacy" on tumors invading lung parts.

Approximately 20 therapeutic viruses are being developed around the world. The first vaccine, one that targets melanoma, could be sold this year in Europe and the United States, by the U.S. firm Amgen.

"Permission to allow its sale will be a crucial date for cancer medicine," says Jean-Marc Limacher, medical chief at Transgene, a French biopharmaceutical company. "After this, a range of modified viruses will arrive to free up the immune system and complement treatment strategies against cancers."

Limacher, a pioneer of immunotherapy, is also in the race with a treatment to boost lymphocyte production. Phases one and two of clinical tests have shown success against lung and liver cancers, with a systematic rise in patient survival rates. The last phase of testing is due this year.

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Society

The Food Truck, A Sign That The White And Wealthy Are Moving In

In San Diego, California, a researcher tracked how in the city's low-income neighborhoods that have traditionally lacked dining options, when interesting eateries arrive the gentrification of white, affluent and college-educated people has begun.

Balboa Park Spring Fling Food Truck festival

San Diego Food Trucks via Facebook
Pascale Joassart-Marcelli

SAN DIEGO — Everybody, it seems, welcomes the arrival of new restaurants, cafés, food trucks and farmers markets.

What could be the downside of fresh veggies, homemade empanadas and a pop-up restaurant specializing in banh mis?

But when they appear in unexpected places – think inner-city areas populated by immigrants – they're often the first salvo in a broader effort to rebrand and remake the community. As a result, these neighborhoods can quickly become unaffordable and unrecognizable to longtime residents.

An appetite for gentrification

I live in San Diego, where I teach courses on urban and food geographies and conduct research on the relationship between food and ethnicity in urban contexts.

In recent years, I started to notice a pattern playing out in the city's low-income neighborhoods that have traditionally lacked food options. More ethnic restaurants, street vendors, community gardens and farmers markets were cropping up. These, in turn, spurred growing numbers of white, affluent and college-educated people to venture into areas they had long avoided.

This observation inspired me to write a book, titled The $16 Taco, about how food – including what's seen as "ethnic," "authentic" or "alternative" – often serves as a spearhead for gentrification.

Take City Heights, a large multi-ethnic San Diego neighborhood where successive waves of refugees from places as far away as Vietnam and Somalia have resettled. In 2016, a dusty vacant lot on the busiest boulevard was converted into an outdoor international marketplace called Fair@44. There, food vendors gather in semi-permanent stalls to sell pupusas, lechon (roasted pig), single-sourced cold-brewed coffee, cupcakes and tamarind raspado (crushed ice) to neighborhood residents, along with tourists and visitors from other parts of the city.

Informal street vendors are casualties.

A public-private partnership called the City Heights Community Development Corporation, together with several nonprofits, launched the initiative to increase "access to healthy and culturally appropriate food" and serve as "a business incubator for local micro-entrepreneurs," including immigrants and refugees who live in the neighborhood.

On paper, this all sounds great.

But just a few blocks outside the gates, informal street vendors – who have long sold goods such as fruit, tamales and ice cream to residents who can't easily access supermarkets – now face heightened harassment. They've become causalities in a citywide crackdown on sidewalk vending spurred by complaints from business owners and residents in more affluent areas.

This isn't just happening in San Diego. The same tensions have been playing out in rapidly gentrifying areas like Los Angeles' Boyle Heights neighborhood, Chicago's Pilsen neighborhood, New York's Queens borough and East Austin, Texas.

In all of these places, because "ethnic," "authentic" and "exotic" foods are seen as cultural assets, they've become magnets for development.

Food vendor at outdoor international marketplace called Fair@44.

Fairat44 via Instagram

A call for food justice

Cities and neighborhoods have long sought to attract educated and affluent residents – people whom sociologist Richard Florida dubbed "the creative class." The thinking goes that these newcomers will spend their dollars and presumably contribute to economic growth and job creation.

Food, it seems, has become the perfect lure.

It's uncontroversial and has broad appeal. It taps into the American Dream and appeals to the multicultural values of many educated, wealthy foodies. Small food businesses, with their relatively low cost of entry, have been a cornerstone of ethnic entrepreneurship in American cities. And initiatives like farmers markets and street fairs don't require much in the way of public investment; instead, they rely on entrepreneurs and community-based organizations to do the heavy lifting.

In City Heights, the Community Development Corporation hosted its first annual City Heights Street Food Festival in 2019 to "get people together around table and food stalls to celebrate another year of community building." Other recent events have included African Restaurant Week, Dia de Los Muertos, New Year Lunar Festival, Soul Food Fest and Brazilian Carnival, all of which rely on food and drink to attract visitors and support local businesses.

Meanwhile, initiatives such as the New Roots Community Farm and the City Heights Farmers' Market have been launched by nonprofits with philanthropic support in the name of "food justice," with the goal of reducing racial disparities in access to healthy food and empowering residents – projects that are particularly appealing to highly educated people who value diversity and democracy.

Upending an existing foodscape

In media coverage of changing foodscapes in low-income neighborhoods like City Heights, you'll rarely find any complaints.

San Diego Magazine's neighborhood guide for City Heights, for example, emphasizes its "claim to authentic international eats, along with live music venues, craft beer, coffee, and outdoor fun." It recommends several ethnic restaurants and warns readers not to be fooled by appearances.

Longtime residents find themselves forced to compete against the "urban food machine"

But that doesn't mean objections don't exist.

Many longtime residents and small-business owners – mostly people of color and immigrants – have, for decades, lived, worked and struggled to feed their families in these neighborhoods. To do so, they've run convenience stores, opened ethnic restaurants, sold food in parks and alleys and created spaces to grow their own food.

All represent strategies to meet community needs in a place mostly ignored by mainstream retailers.

So what happens when new competitors come to town?

Food vendor at outdoor international marketplace called Fair@44.

Fairat44 via Instagram

Starting at a disadvantage

As I document in my book, these ethnic food businesses, because of a lack of financial and technical support, often struggle to compete with new enterprises that feature fresh façades, celebrity chefs, flashy marketing, bogus claims of authenticity and disproportionate media attention. Furthermore, following the arrival of more-affluent residents, existing ones find it increasingly difficult to stay.

My analysis of real estate ads for properties listed in City Heights and other gentrifying San Diego neighborhoods found that access to restaurants, cafés, farmers markets and outdoor dining is a common selling point. The listings I studied from 2019 often enticed potential buyers with lines like "shop at the local farmers' market," "join food truck festivals" and "participate in community food drives!"

San Diego Magazine's home buyer guide for the same year identified City Heights as an "up-and-coming neighborhood," attributing its appeal to its diverse population and eclectic "culinary landscape," including several restaurants and Fair@44.

When I see that City Heights' home prices rose 58% over the past three years, I'm not surprised.

Going up against the urban food machine

Longtime residents find themselves forced to compete against what I call the "urban food machine," a play on sociologist Harvey Molotch's "urban growth machine" – a term he coined more than 50 years ago to explain how cities were being shaped by a loose coalition of powerful elites who sought to profit off urban growth.

I argue that investors and developers use food as a tool for achieving the same ends.

When their work is done, what's left is a rather insipid and tasteless neighborhood, where foodscapes become more of a marketable mishmash of cultures than an ethnic enclave that's evolved organically to meet the needs of residents. The distinctions of time and place start to blur: An "ethnic food district" in San Diego looks no different than one in Chicago or Austin.

Meanwhile, the routines and rhythms of everyday life have changed so much that longtime residents no longer feel like they belong. Their stories and culture reduced to a selling point, they're forced to either recede to the shadows or leave altogether.

It's hard to see how that's a form of inclusion or empowerment.The Conversation

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Pascale Joassart-Marcelli is a Professor of Geography and Director, Urban Studies and Food Studies Programs at San Diego State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.


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