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Antidepressants help bacteria resist antibiotics: study

277 points14 hoursnature.com
tokai13 hours ago

Interesting and potentially dangerous. But as long as many millions of pigs are covered in antibiotic foam (which is just rinsed off into the drain), I'm not gonna lie sleepless over this. Resistant bacteria will cause humanity huge troubles if we don't manage to do something radical soon.

grammers8 hours ago

Exactly. And as long as antibiotics are produced in factories where the left overs are just sent into the drain as well (see India, China), anything else it just a tip of the iceberg. We need true emergency antibiotics - not once that are produced the way they are produced and not once that can still be used for animals.

jjtheblunt1 hour ago

I misunderstand your last sentence: what good is an antibiotic not useful on animals, given that we are animals?

metadat6 hours ago

Do you have any sources verifying the claim that these countries dump harmful chemicals directly down the drain without any neutralizing chemistry?

Tragic and stupid beyond belief if this is true. Equivalent to using one's own kitchen sink as a toilet bowl.

wizzwizz46 hours ago

These countries don't. But, in competitive industrial chemical processing, the totalitarian principle applies: to quote Sir Ronald, “everything not forbidden is compulsory”.

Ovah6 hours ago

Is there any evidence that antibiotic resistance in any significant way crosses from livestock pathogens to human pathogens? I had a medical professor lecturing a couple years back saying it was basically a myth.

heavyset_go6 hours ago

Here's a simplified diagram from the CDC about antibiotic resistance from antibiotic use in livestock: https://upload.wikimedia.org/wikipedia/commons/5/52/Antibiot...

refurb3 hours ago

You mean empiric evidence as in “here is a human with an infection that is resistant to antibiotics due to livestock use”?

No, there isnt. It’s theoretical.

stackbutterflow13 hours ago

The answer is phages. But last time I went into the rabbit hole the TLDR was that it is not patentable so there's no money in it. And everyone needs a different phages cocktail. I sleep at night knowing that push come to shove someone will step in and mass produce machines to create personal phage cocktails.

John2383212 hours ago

Phages are not the silver bullet that people think they are.

First they're difficult to make and store (antibiotics are mostly shelf stable... phages aren't). Second, they are not broad spectrum. Third, (at least in the US) phage therapy hasn't taken off because the initial forays into phages showed that they can cause reactions. Lastly, not all bacteria have phage counterparts.

So if you even could use phages, you're looking at weeks of testing to determine what bacteria to target, before production. You could keep a library of phages for known bacteria, but that library would be highly specific.

DonaldFisk11 hours ago

They're highly specific, and are harder to administer. They're usually stored in glass phials which need to be kept in a refrigerator. Stomach acid needs to be neutralized if they're taken orally. If administered by injection, the strain used can only be used once as the body develops antibodies to it. Most of the scientific literature on them is in either Georgian or (if you're lucky) Russian.

They're not without their problems, but there are also problems with antibiotics (bacterial resistance, penicillin allergy). So why not use them whenever use of antibiotics is problematic? They're cheap, and reproduce at a phenomenal rate. They were used successfully in the Soviet Union, and are still being used in Georgia.

John2383211 hours ago

I'm not saying that they can't be used. They can. People often take new(ish) tech as a cure-all.

There are still challenges though.

For bacteria with high resistance (which is what we have the biggest issue with), we've typically done a workup of the bacterium to target. In the worst case, these are what land people in the hospital. Hospital settings would be the best administration point for these therapies. The problem would still be the creation of the specific phages in a reasonable fashion. This would only really be available at major hospitals in major cities. And so... limited in usage.

I could see major hospitals keeping a large amount of gonococcal phages on hand though.

Edit::

One more thing. As far as antibiotic allergies (you mentioned beta lactams) we typically have antibiotic alternatives. Doxycycline is pretty much well tolerated by everyone. And it's available in pill form.

bratwurst300012 hours ago

Isnt it that phages can be engeneered to a specific bacteria? Also the other way around. The can be programmed with the dna of the bacteria. So pcr the bacteria then make phages that atack them. My knowledge is bad . Could you elaborate where the engeneering problem is and the cost factors? Thanks

+1
John2383212 hours ago
DonaldFisk11 hours ago

They're numerous and widespread, so it should be possible to find the phage you want. If bacteria evolve to develop resistance to it, bacteriophage can evolve to overcome that resistance.

sudosysgen9 hours ago

Viruses are generally extremely well preserved as long as you deep freeze them.

importantbrian6 hours ago

Whenever someone says that the reason some health related thing isn't being used because it's not patentable and there's no money in it it's a pretty sure signal they don't know what they're talking about. Therapy methods, manufacturing methods, etc. are all patentable. As an example here is a patent that was granted around methods for selecting bacteriophages against specific bacteria [1]. If you search patent records for phage therapy there are tons of granted patents.

The original patent for insulin was given away by it's discoverers because they wanted everyone to be able to have access to inexpensive insulin. That hasn't stopped pharma companies from coming up with patents around formulations, manufacturing methods, delivery methods, etc. and making tons of money off of insulin.

Sibling comments have pointed out the real reasons it's not commonly used despite the promise. I just wanted to point out not being able to patent something is almost never a barrier for pharmaceutical companies if they think they can come up with a profitable therapeutic.

[1] https://patents.google.com/patent/US10357522B2/en?q=phage+th...

stackbutterflow3 hours ago

Yes, I don't know what I'm talking about. As I said I went into a rabbit hole and provided a TLDR.

But do these guys know what they're talking about?

https://phage.directory/capsid/phage-patentability

You may have heard through the grapevine that “phages can’t be patented”, and yet, several phage patents exist, and biotech and pharma are starting to invest in phage-based therapeutics. What’s the deal? [...] However, the patentability of phage therapies has been called into question. Several patents in the same category as phages have actually failed to hold up in court. This suggests that even if companies can find ways to successfully file phage patents, these patents may end up being worthless.

So phages may need protection in other ways.

importantbrian26 minutes ago

I think they might not. I will grant I'm not an expert in this area, but I did read the cited paper. It's a paper from a law student published in the universities law journal. Maybe he knows what he's talking about, but I would put my money on the patent attorneys filing and being granted all the phage therapy patents. It was also published in 2019 and a lot of phage related patents have been granted since then. Is the patent office just unaware of the precedence cited in the paper? Are there any examples of phage therapy patents being challenged in court and not holding up?

Here is some info from a leading IP firm on the challenges around phage patents and how to address them when filing [1]. As they pretty clearly point out there are some challenges, but creating defensible patents in this area can be and is done. These companies can pretty much always find a way to create a defensible patent if they want to.

[1] https://www.nixonpeabody.com/insights/alerts/2021/03/03/pate...

abeppu12 hours ago

> I sleep at night knowing that push come to shove someone will step in and mass produce machines to create personal phage cocktails.

Drug resistant bacteria are here. Hasn't push already come to shove?

Phages are interesting, but given that there are substantial challenges on the road to making and administering them (and you can be in a race against the clock as someone's infection progresses), shouldn't we also be trying to use existing antibiotics far more strategically?

yawnxyz9 hours ago

Yay another phage thread!

Phages do work, and we've treated a small bunch of people at Phage Australia for our clinical trial.

There's a few things about using phages for treatments I think everyone should be aware of:

(1) phages work!! The physicians we work with (and ourselves) are surprised every time they work. It's just really labor and time-intensive.

(2) if antibiotics are "bite sized snacks" then phages are like "getting a personalized chef - a course of phages should be highly personalized to the pathogens causing trouble, and sometimes the antibiotics. Too generic and it won't work. Too personalized and it's too expensive. Tricky balance. We're collecting data and trying to figure out what that balance is. Every patient is very different though and it's hard to draw conclusions and see patterns.

(3) at Phage Australia we're not doing the cocktail approach — we're (trying to) assembling a library of phages that should be able to cover lots of common pathogens and local outbreaks. We work with antibiotic resistance reference labs and hopefully eventually get enough coverage, by building a library of phages that we can mix and match before we get an inquiry. The TGA is onboard with this. (The FDA is looking into this tentatively; look up Adaptive Phage Therapeutics). The kind of phage therapy we're looking at is closer to CAR T-cell therapy, FMT and other kinds of individual / personalized therapies.

tl;dr: Phages work, but getting them and getting/paying for them is more like a service and less like a pill. It's also very expensive and hard to do today. We to work with regulators to push more personalized therapies. The age of generic pills in a bottle is slowly fading away.

(Source: I'm the "computer person" aka research software engineer on the Phage Australia clinical trial)

dmix8 hours ago

I'm curious what drives customers to these services. Why would someone want to pay for a customized phage service? Someone who is taking lots of antibiotics or concerned about them?

importantbrian6 hours ago

No OP, but my guess would be people who have drug resistant bacterial infections and don't have another option.

omginternets12 hours ago

>TLDR was that it is not patentable so there's no money in it.

I think you are overlooking some of the major technical problems with phages. In no particular order:

1. The immune system develops antibodies for many phages.

2. Microbes develop resistance to phages.

3. Phage multiplication using host cell is a primary step for phage production, and this causes many (serious) adverse effects.

4. Only obligate lytic phages that lyse the bacterial cell directly instead of integrating its genome in bacterial DNA (temperate) are usable for phage therapy. Temperate phages play a major role in the exchange of genetic material between different bacterial strains and often contribute to the pathogenicity.

efields13 hours ago

Is the implication here that antibiotics are more commercially viable, but phages are the real solution? I'm unfamiliar with phages, but a quick lookup revealed "virus that eats bacteria" and it's like, yeah… let's do that to combat bacterial infections. I'm guessing alignment between phage/bacteria is crucial.

stackbutterflow12 hours ago

Someone can correct me if I'm wrong but what I got was that there's nothing to patent because phages are found in sewers and mud pools as is. Also every individual with a bacterial infection needs a custom cocktail so there's no one-size-fits-all pill that can be mass produced.

Phages also have their own caveats but I don't remember what it is. The TLDR is that in the worst case scenario we still have phages and as far as I understand no bacteria can adapt to phages. But we need to figure out a way to make it commercially viable as you put it.

bee_rider12 hours ago

As someone who knows nothing about biology, this as well as the limited shelf-life issue mentioned in other comments makes me wonder if something like “A collection of less specialized phages and a process by which they can be quickly programmed to go after a bacteria” could be patented.

I’m sure this is dumb because if it wasn’t somebody would have done it by now, though.

ronsor10 hours ago

Sounds like the solution is to kill patents so they can forget about money entirely.

CollinEMac12 hours ago

Could someone explain this to me like I'm 5?

meindnoch12 hours ago

phages = bacteriophages = viruses that kill bacteria [1]

There's an arms race between bacteria and humans: bacteria infect humans → humans develop antibiotics to kill bacteria → bacteria evolves resistance against antibiotics → humans develop new antibiotics to kill resistant bacteria → bacteria evolves resistance to new antibiotics → ...

Developing more and more new antibiotics for resistant bacteria is slow and expensive. Bacteriophages (viruses that infect bacteria) on the other hand would naturally evolve with the bacteria, like how COVID evolved new strains in response to our vaccines.

[1] https://en.wikipedia.org/wiki/Phage_therapy

Traubenfuchs12 hours ago

Not just higher life is plagued by viruses, bacteria as well. And bacteriophages are viruses that only target specific bacteria.

They are among the most abundant "forms of life" in the whole world, as google details:

> There are up to ten times more phages in the oceans than there are bacteria, reaching levels of 250 million bacteriophages per millilitre of seawater.

If we were able to quickly find the right phage for bacteria that causes infection, that bacteria would have no chance. And we do know that for every bacteria there would be infinite phage variants they just can not defend themselves against by design. From what we know bacteria, all life in general will always stay vulnerable to viruses.

The problem is that our science on finding, producing and using bacteriophages is extremely limited for technical and financial reasons.

yawnxyz9 hours ago

There's always a virus out there that can kill a bacteria. Or, we can just engineer one to kill a bacteria.

It's just... really hard, takes weeks to months (if you're engineering, and then it's GMO, which is another can of regulatory worms).

It's not even expensive; we just use regular lab equipment. But people are doing lot of things by hand today. But we're finding ways to scale up and insert robots like OpenTrons and Singer!

> extremely limited for technical and financial reasons

The severance packages of each tech layoffs is more than what our entire field gets every year in funding.

+1
CorrectHorseBat9 hours ago
+1
hfsh9 hours ago
adrianmonk7 hours ago

> In bacteria grown in well-oxygenated laboratory conditions, the antidepressants caused the cells to generate reactive oxygen species: toxic molecules that activated the microbe’s defence mechanisms. [ ... ]

> However, in bacteria grown in anaerobic conditions, levels of reactive oxygen species were much lower and antibiotic resistance developed much more slowly. [ ... ]

> But in healthy humans, E. coli is found mainly in the large intestine, where conditions are anaerobic, meaning that the process described in the paper might not occur at the same rate in people, says Maier.

So the study shows that antidepressants help bacteria resist antibiotics if you test in oxygen-rich conditions. But that doesn't match conditions in the human body, so this may not even be relevant to humans.

Their next step is to study it in mice, which makes sense, but to me it seems like you can't conclude much right now.

jklinger41013 hours ago

Factory farm companies have known that anti-biotics, hormones, and pesticides are causing increased rates of cancer and other (cough cough) disorders in the same way big oil knew that it was contributing to/causing global warming.

Every person in the comments across the internet saying the rise in all of these disorders was just about self-reporting have been unknowingly shilling for big food.

Being anti conspiracy and overly trusting of certain (cough cough) fields of science denotes an inability to rationalize.

londons_explore13 hours ago

> Factory farm companies have known that anti-biotics, hormones, and pesticides are causing increased rates of cancer and other (cough cough) disorders

This may be true in specific cases... But surely isn't true in general.

It's the role of science and government to find out which anti-biotics, which hormones, and which pesticides case increased rates of which cancers.

As soon as there is evidence suggesting a specific pesticide has downsides that outweigh the advantages, it's time for the government to promptly ban it.

So far, I think the main failure in that process is that governments don't put enough money into science to find said evidence. Simply having a tax on biotech of say 1% to pay for independent scientists to do research would easily be enough to give us good evidence of the upsides/downsides of everything widely deployed.

airstrike12 hours ago

> It's the role of science and government to find out which anti-biotics, which hormones, and which pesticides case increased rates of which cancers.

Not if you subscribe to the precautionary principle

https://en.wikipedia.org/wiki/Precautionary_principle

"The principle is often used by policy makers in situations where there is the possibility of harm from making a certain decision (e.g. taking a particular course of action) and conclusive evidence is not yet available. For example, a government may decide to limit or restrict the widespread release of a medicine or new technology until it has been thoroughly tested. The principle acknowledges that while the progress of science and technology has often brought great benefit to humanity, it has also contributed to the creation of new threats and risks. It implies that there is a social responsibility to protect the public from exposure to such harm, when scientific investigation has found a plausible risk. These protections should be relaxed only if further scientific findings emerge that provide sound evidence that no harm will result."

jklinger41012 hours ago

But imagine how much revenue we'd be missing out on if every new invention that could shave a few cents off the bottom line had to be researched first?

Just one of many brilliant decisions that the primarily white men who have ran this country throughout history made on behalf of all of us. Without our consent, of course.

Good luck proving your dad's colon cancer was caused by industrial solvents in our water supply. Call your congressman! It's a democracy!

nerdponx10 hours ago

I assume you're being downvoted because of the unnecessary reference to "white men". The sentiment here is spot on, but really, this is one area where race doesn't matter much. There are plenty of white people suffering from this stuff as well. There's definitely some value in looking at this through a critical race theory lens, as with most issues in the USA, but in this case you might say that the CRT model has poor explanatory power.

anigbrowl8 hours ago

I think it's more useful to look at this as a class/economic leverage issue, as selfishness and the use of administrative power to extract economic rents seems to be a universal phenomenon. 'White' as a proxy for the racialized dynamics of European colonialism is sometimes a convenient shorthand, but glosses over other important contexts like white being a symbol of monarchy, because the aristocratic class were not required to labor outdoors. This intraracial social marker was significant enough to appear in flags: https://en.wikipedia.org/wiki/White_flag#Ancien_R%C3%A9gime_...

The 'white Russians' that fought against the 'red' communists carried the association of whiteness with traditional monarchy forwards into the 20th century and this revanchist monarchism continues to shape radical politics and factional identities in the present, although the symbolism is so diluted as to be unrecognizable to most: https://en.wikipedia.org/wiki/White_movement

If we only look at 'white identities' in terms of racial coding, we fall into the trap of inadvertently criticizing people for a fact about themselves they didn't choose and can't change, and whose structural social privileges (vs those of non-European origin) are so unevenly distributed that the resulting intra-ethnic discontent has to be micromanaged through an elaborate ideological apparatus.

nerdponx12 hours ago

> It's the role of science and government to find out which anti-biotics, which hormones, and which pesticides case increased rates of which cancers.

Not necessarily.

One of several roles of government is to overcome coordination problems that would otherwise inhibit the production of public goods, such as new antibiotics and other better treatments for bacterial infections.

Another role of government is to regulate markets by creating incentives in the form of laws and legal regulations. In this case, government could estimate the societal cost of agricultural antibiotic use, and then impose taxes on agricultural antibiotic use equal to the amount of that cost. if those costs turn out to be punitive, then tough shit, they'll need to figure it out. The proceeds from tax is levied could then be redirected to basic research as needed.

Of course, this doesn't tend to work so well in practice due to any number of corruption and regulatory capture channels, so it tends to be easier to just ban harmful practices outright, which of course governments also have the power to do.

anigbrowl9 hours ago

But surely isn't true in general.

Why not? Wealth-making attracts two kinds of people: those who are interested in mutually beneficial exchanges, and those who see trade as a zero- or negative-sum game. Research suggests these groups exist in a roughly 60:40 proportion to each other in human populations: https://www.science.org/doi/10.1126/sciadv.1600451

I do think your disagreement is sincere, since you propose allocating a tax on technological deployment to fund research and backing that up with strong regulation. But you overlook the phenomenon of regulatory capture by industry and bad-faith politicking. Just recently we saw how a regulator's observations about the surprisingly high negative externalities of gas stoves was quickly turned into a political football, pre-empting any meaningful policy discussion.

jklinger41012 hours ago

> So far, I think the main failure in that process is that governments don't put enough money into science to find said evidence.

Couldn't agree more. The evidence of how ineffective the American scientific regulatory community is all around us.

An easy example is how fast rising yeast impacts gluten intolerance, or how high fructose corn syrup impacts insulin resistance or glucose response. Highly negative correlations here, even from the advent, but the potential revenue has outweighed the desire to protect Americans.

The truth is that American business sees citizens as two ways, suckers for making bad choices (while forcing those same choices down their throat), or simply unlucky. The rich avoid the obviously harmful aspects of America, while accepting the odds on the things they can't avoid.

Personally if I were very wealthy I would spend very little time in the United States.

standardUser10 hours ago

Better to have comprehensive information available about every aspect of our food supply so individuals can make decisions based on the science as it evolves and not have to wait for government action (which always comes last).

fithisux13 hours ago

"It's the role of science and government to find out which anti-biotics, which hormones, and which pesticides case increased rates of which cancers."

and until they find the answer these farms should be shut down

formerly_proven11 hours ago

> increased rates of cancer and other (cough cough) disorders

Can someone translate dogwhistle to english here please?

jklinger4108 hours ago

The cough cough is not a reference towards respiration. At this point, I wish I would have left it out.

But there are a myriad of illnesses that have been linked to environmental pollutants and a very high number of people will get offended if you point it out. Because the science isn't settled yet. I'll let you fill in the blanks there.

bawolff7 hours ago

Oh what BS. If you are going to say something have the guts to say it. I honestly have no idea what disease you are referring to. Acne? Erictile dysfunction? Could be anything.

xen2xen110 hours ago

Assumed Covid, but hard to say.

standardUser10 hours ago

Generous of you to think it's "unknowingly". There is a strange phenomenon online where people rush to oppose things like basic animal welfare and improved food labelling or any other change to the food industry. I find it hard to swallow that there's so many regular people out there passionately defending the rights of corporations to torture animals and hide what's in their food in their free time.

notamy8 hours ago

> There is a strange phenomenon online where people rush to oppose things like basic animal welfare and improved food labelling or any other change to the food industry. I find it hard to swallow that there's so many regular people out there passionately defending the rights of corporations to torture animals and hide what's in their food in their free time.

I am disabled. I cannot walk very well without an assistive device. I've noticed that, when you're disabled, the average person's level of caring about your disability extends right up until the point where you're even a mild inconvenience to them. And it's for any number of reasons: "you're faking it" "you're too young to have those issues" "it's bothersome to install a ramp for people in wheelchairs" "people's assistive devices (canes, walkers, ...) take up too much space" "you're too slow getting in/out of transportation" and the list goes on. I imagine it may at least in part be the bystander effect[0], but that doesn't explain people who can be actively malicious -- and that happens more often than you may think.

The point of this anecdote is that I think something similar applies here. IMO people _do_ genuinely care about what's in their food / how it's produced... but then _they_ would have to change for the situation to improve. Suddenly it's an inconvenience to them. If the relative suffering of a disabled person isn't enough to convince someone that an inconvenience is worth it, then caring about a bunch of animals in a factory farm is just an abstract concern that they don't care about too much, but changing it is something they care about because it affects them.

That's not to say that people are _selfish_, per se, or anything like that. There's only so much time in the day, life is busy for many people, social media demands attention, food costs and inflation and housing costs and ..., and many more are all issues that are a lot more immediate to people. It's hard to care about things that are mostly just abstract concepts you aren't exposed to, when you have much more meaningful day-to-day concerns.

[0] https://en.wikipedia.org/wiki/Bystander_effect

bawolff7 hours ago

> Factory farm companies have known that anti-biotics, hormones, and pesticides are causing increased rates of cancer and other (cough cough) disorders in the same way big oil knew that it was contributing to/causing global warming.

I feel like 2 out of these 3 are not like the other (i.e. pesticides are by definition usually pretty toxic and hormones can mess up living things in all sorts of ways). And even then you need to get more specific than the broad groups to say anything intelligent about them.

> Being anti conspiracy and overly trusting of certain (cough cough) fields of science denotes an inability to rationalize.

First step to being rationale is to be able to talk about it. You wont even say which field of science you don't like. Is it biology in general?

phphphphp12 hours ago

I'm just a layman so perhaps you're referring to some top secret scientist internet but here on the normal internet it has been drilled into me through comments for as long as I can remember that a large part of anti-biotic resistance is being developed because of animal agriculture and that big food is responsible.

kranke15510 hours ago

Can you share sources, studies, be more specific ?

comboy8 hours ago

Interesting tidbit is Bret Weinstein's finding how all mice used for drug testing all over the world were coming from a single source and because of how they were bred, they had very long telomeres which made them much less susceptible to cancer.

Somebody got a Nobel for that, the situation supposedly has improved since, but a lot of assumptions (and substances approved) are still based on research which was using these mice.

kranke1555 hours ago

That’s not much?

yucky12 hours ago

It sounds like you're saying the government has completely shit the bed in their regulatory duties, but I don't see you assign blame there at all for some reason.

jklinger41012 hours ago

That is completely fair. But I'm not going to act like there aren't thousands of scientists and business people who are 100% aware of what is going on. Many of whom work jobs whose PURPOSE is to destroy the effectiveness of the government.

bitxbitxbitcoin13 hours ago

That last sentence is often used to criticize economics but haven’t heard it on harder “sciences” before.

dysoco13 hours ago

Not to diss on OP's comment, but out of context it sounds exactly like what COVID deniers usually say.

frereubu12 hours ago

That's exactly what I took from "(cough cough) disorders".

+1
jklinger41012 hours ago
throwaway0x7E612 hours ago

it's remarkable how little time it took for the big pharma to become our greatest ally

jklinger41012 hours ago

The beauty if disinformation is that it includes nuggets of truth, or uses seemingly solid rational that is flawed in a very subtle way.

I am a pro conspiracy theory person. But to be clear, there was a ton of disinformation around COVID, and this thread has nothing to do with COVID. I believe COVID is real, and that the vaccines were a good idea.

richbell13 hours ago

It's fairly common, if you're familiar with how big agro-chemical firms influence research into the harms of their products (lookup Oki's Weird Stories video about Syngenta and Tyrone Hayes), how Purdue influences academia and the medical industry, etc.

Empirical evidence and data can be used to selectively deceive. Companies can run hundreds of trials and only select ones that showed favorable results.

tekmate13 hours ago

because it makes absolutely no sense here. what op is criticizing is on businesspeople lying to make more profit, not scientists

lazyfanatic13 hours ago

once I know you have an agenda, I invalidate what you have to say.

ceejayoz12 hours ago

Everyone has an agenda.

nerdponx12 hours ago

I'm not sure if this is a corollary or a counterpoint to what you're trying to say here, but not all agendas are equivalent.

One person's agenda might be to make as much money as possible irrespective of consequences. Another person's agenda might be to decrease asthma rates. The fact that both people have some kind of agenda is basically irrelevant.

This is the same hole as in the classic "both sides" political attitude.

+2
debacle11 hours ago
unity100111 hours ago

Indeed. Its amazing how people can still rationalize the existing situation and help defend corporate sociopathy after all the corporate scandals that were revealed over the last few decades in which the corporations did not stop short of outright murder for profit. Avandia drug scandal comes to mind...

idontpost13 hours ago

> Being anti conspiracy and overly trusting of certain (cough cough) fields of science denotes an inability to rationalize.

That's some word salad right there.

jklinger41011 hours ago

Fair criticism, not my cleanest rep. Will do better

bfgoodrich12 hours ago

[dead]

andy_ppp13 hours ago

I wonder if antidepressants protect your gut microbiome and the SSRI aspect is over stated. Would be very hard to disambiguate those two effects I suspect.

zackmorris8 hours ago

Good insight. I went through a profound burnout in 2019 after I lost my digestive health and got low serotonin due to a combination of work stress, overtraining at the gym, dehydration and a finger of booze after particularly hard days. Also food sensitivities to legumes, nightshades and almond butter, which I wasn't aware of at the time. I just learned that 25% of people who get food poisoning go on to develop IBS. Don't eat gas station sushi when you're on vacation!

https://experiencelife.lifetime.life/article/the-food-poison...

Ashwagandha basically restored my gut health in 3 months, in combination with psyllium husk capsules, kefir, and large plain lettuce salads with a vinegar-based dressing. My theory is that my cortisol levels got so high after decades of stress and negative reinforcement that I had symptoms like Cushing's syndrome. So ashwagandha mopped that up, which raises testosterone/estrogen and probably fixes a whole host of issues. But I never tested those levels, so take that with a grain of salt.

I've experienced the connection between gut health and mood, now I do everything I can to stay in good shape. But I've noticed a resistance to this line of thinking, especially in older people who just want a pill from their doctor.

PragmaticPulp2 hours ago

> profound burnout in 2019 after I lost my digestive health and got low serotonin due to a combination of work stress, overtraining at the gym, dehydration and a finger of booze after particularly hard days. Also food sensitivities to legumes, nightshades and almond butter, which I wasn't aware of at the time

Ashwagandha is a nightshade, so you likely weren't allergic to nightshades if it helps.

Also, I'm not sure how you concluded that you have "low serotonin" due to gut issues. Serotonin in the gut doesn't migrate to the central nervous system. It serves different purposes throughout the body, but the synthesis in your brain remains local to the brain.

There are a lot of unrealistically specific claims in your post about cortisol and serotonin, but it's impossible to make such specific diagnoses. You might be reading too much into the alternative medicine world that misuses surface-level knowledge about hormones and neurotransmitters to provide false comfort. Real medical diagnoses aren't so specifically centered on singular chemicals.

nick__m2 hours ago

Your are sensitive to plants from the nightshade family and you take ashwagandha? Either your ashwagandha doesn't contains active substances or you are not really sensitive to plants from the nightshade family.

alienalp4 hours ago

Most SSRI doesn't do much. The ones that work seems like related to dopamine metabolism. SSRI aspect is already debunked. Fluoxetine for example works and i think additionally confirmed by dramatically increased mortality since depression should decrease mortality which is why it exists.

nerdponx12 hours ago

But SSRIs reverse depression symptoms, they don't prevent it from happening in the first place. so the mechanism would have to be not just protection but some kind of restoration or rebalancing, maybe by selectively protecting some bacteria but not others. That seems a little less plausible to me.

tokai12 hours ago

SSRIs do lower the risk of further depressive episodes.

"To conclude, this review provides evidence that continuing SSRIs for 1 year reduces risk of MDD and relapse."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761909/

password115 hours ago

I took SSRIs for 14 months and after I stopped this was my subjective experience as well. (And luckily only mild withdrawal/discontinuation symptoms.)

lr4444lr12 hours ago

That was exactly my first thought. We could definitely throw the SSRI efficacy into doubt though by sampling CS fluid or something for actual serotonin content in cohorts who are subjectively feeling improved by SSRIs.

NickM10 hours ago

SSRI efficacy is already in doubt, as roughly 80% of the beneficial effects are replicated by placebos; some research has suggested that the remaining difference is due to the side effects, which make SSRIs active placebos and mess with study blinding.

And, even if they are better than just an active placebo, the mechanism is probably not the effects on serotonin levels. (Discussed previously here: https://news.ycombinator.com/item?id=32160703)

andy_ppp12 hours ago

It would also explain why SSRIs take time to work - as I understand it the SSRI action is immediate and yet it takes weeks for people to notice the effects.

kayodelycaon12 hours ago

SSRIs aren’t the only medication that requires weeks to work.

theGnuMe13 hours ago

Yeah the gut microbiome is the next big thing for sure. It should be easy to study. Food logs, mood logs, medication logs, next generation sequencing and maybe some metabolic profiling and we should be able to find interesting correlations.

I know my mood changes drastically down when I fail to eat properly for a period of time.

__MatrixMan__12 hours ago

As if omics research isn't hard enough, there's a confounding layer of privacy and incentive problems here.

From a science angle it makes more sense to just collect this data from everybody all the time and let the studies be post hoc explorations of that giant dataset. But how do you get people to cooperate when they have reason to believe that the data will be used against them?

Either we accept the diminished value of isolated study-at-a-time datasets (as we're doing now), we figure out how to do this kind of research through a layer of homeomorphic encryption which the layman trusts (a tall order), or we wait for an era with more trustworthy institutions (potentially a long time).

For this reason, I think it'll be like fusion power: the perpetual "next big thing".

Pilottwave9 hours ago

give out equity to the study participants. I'll hand over data of you give me some equity on future ideas built on that data. l Like artists getting payed royalties.

John238327 hours ago

> Yeah the gut microbiome is the next big thing for sure. It should be easy to study.

It won't be. We aren't able to culture most gut bacteria. Most die immediately in oxygen.

The best we can do at the moment is correlation.

pmayrgundter2 hours ago

Add to the list of nootropics that are possibly universal.

It's like discovering that some plant derived psychiatric drugs are behavior modifiers for the plants too

The suggestion that mental process begins at the cellular level.

psychphysic13 hours ago

Fascinating, the idea is that by inducing a stress response bacteria are virilized in a sense.

It's interesting they picked antidepressants to do so but the logic should apply to many substances people like to kill bugs

Like green tea and spices which hinder bacteria should also make them resistant to antibiotics.

jonplackett11 hours ago

Is there any way that this could be how they help with depression - there’s a lot of research now about various good bacteria affecting your mental well being - and we are living in a soup of antibiotics

krautt11 hours ago

Their dna sees our over=stressed modern lifestyles as an opportunity. shouldn't surprise us i guess.

peteradio13 hours ago

Probably helps the bugs deal with their existential dread of trying to do battle inside of a body doped to kill them.

malfist13 hours ago

This seems a really week connection.

> In bacteria grown in well-oxygenated laboratory conditions, the antidepressants caused the cells to generate reactive oxygen species: toxic molecules that activated the microbe’s defence mechanisms. Most prominently, this activated the bacteria’s efflux pump systems, a general expulsion system that many bacteria use to eliminate various molecules, including antibiotics. This probably explains how the bacteria could withstand the antibiotics without having specific resistance genes.

So the study was:

* Done in a petri dish

* Done in an environment dissimilar to the human body

* Showed an adaptation to the environment unrelated to antibiotic resistance

Showing adaptation "efflux pumps" for oxygen removal and claiming it's applicable to antibiotics seems like claiming yoga mats are made from jet fuel because they both contain water.

It would be really interesting if they tested a null here which I don't see noted anywhere. If the adaptation happened in the oxygen rich environment without the antibiotic it would indicate that antibiotics are not causal.

psychphysic13 hours ago

It seems the mechanism is general enough that green tea, spices that are lauded for harming bacteria might be making them more virulent

cratermoon13 hours ago

This article mentions that a study was done in humans and found no effect. https://english.elpais.com/science-tech/2023-01-24/study-sug...

wasjosh11 hours ago

How is something 3 or 4 on the front page here thats been known since the 40s?

chucksmash11 hours ago

Article is about non-antibiotic medications contributing to antibiotic resistance. Has that been known?

yawnxyz9 hours ago

I work with a bunch of researchers and physicians on antibiotic resistance every day and I had no idea (though tbf I'm just the "computer guy" here)

pfannkuchen13 hours ago

I’m a bit confused why antibiotic resistant bacteria is so scary.

My layman understanding is that antibiotics gum up the mechanism to produce the cell wall.

Sure, bacteria may develop where the mechanism works a bit differently and is not affected by a certain chemical. But it seems like “disrupt cell wall production” is a huge target and we could probably disrupt it in many other ways. Humans lack a cell wall entirely, so we “just” need to avoid side effects in some other system.

Is the concern that studies to confirm lack of effects will take too long? Not that it’s a difficult engineering challenge? Couldn’t we be doing this research already, of finding other ways to disrupt the mechanism?

Calavar11 hours ago

This is a very good question. The practical issues with antibiotic resistance may not be that obvious to a layperson because they tend to pop up in the hospital setting as opposed to the clinic setting that most people are familiar with.

The antibiotic bottleneck centers around patients who show up to the hospital with very vague signs of infection (fever, sweats, rigors, lethargy, etc.) and are sick. Like on the verge of going to the ICU sick. Or already in the ICU sick. These people need an effective antibiotic and they need one fast. You don't have the luxury of sending a culture to the lab and waiting for the antibiotic susceptibility profile to come back because that can take multiple days. So you need a toolbelt of "broad spectrum" antibiotics that are highly effective against the dozen or so bacteria that are the most common culprits of serious infection - something that you can use in the critical first 48 hours, while you're still waiting for culture results.

In practice (at least in the US), your selection of broad spectrum antibiotics is limited to vancomycin plus either cefepime or combination piperacillin/tazobactam. That's it. There really aren't very many other antibiotics that are effective against a sufficiently wide range of bacteria. We do have "back up" antibiotics to use if those fail, but these are powerful agents that come with some really nasty side effects, like seizures (for carbapenems) or widespread muscle breakdown (for daptomycin). And they are pretty limited in number too.

If vancomycin, cefepime, or piperacillin/tazobactam resistance starts to become a lot more common before the next generation of antibiotics comes in, we're screwed. And antibiotic development has been stuck in a rut for decades.

pfannkuchen5 hours ago

Oh that's very interesting. So the problem isn't just finding a way to gum up the /single/ cell wall production process that is common across all bacteria species-- it's doing it in a way that targets some commonality between the many such mechanisms that differ per species, across all relevant species. And I suppose that between species this difference can be non trivial.

Literally 4D chess and we don't even know what the board looks like (okay it isn't chess but it is 4D).

Calavar24 minutes ago

Yes, exactly. For example, Gram positive and Gram negative bacteria have very different structures to their cell walls, and penicillins tend to be effective for Gram positive bacteria, but not Gram negative bacteria. There can be other considerations too. Rickettsial species, as an example, live inside their host cells, so you need an antibiotic that can penetrate into a human cell, which most antibiotics can't.

Basically, there's plenty of antibiotics that are effective against, say, 25% of the critical bacterial species, but very few that cover 90%+. So emerging resistance to any one of those few would be a very, very big problem.

John2383212 hours ago

> I’m a bit confused why antibiotic resistant bacteria is so scary.

It's scary because if you can't kill the bacteria, the bacteria kills you.

--

> My layman understanding is that antibiotics gum up the mechanism to produce the cell wall.

This layman's idea is incorrect. Not all antibiotics work on cell walls. Not all bacteria have defined cell walls. Look up Mycoplasma.

--

> Is the concern that studies to confirm lack of effects will take too long? Not that it’s a difficult engineering challenge? Couldn’t we be doing this research already, of finding other ways to disrupt the mechanism?

Most of the antibiotics we have were either found by accident, or computed derivatives of something that was found by accident. We've exhausted the low hanging fruit. More complex antibiotics often have bad side effects (ciprofloxacin) or are effective enough that we use them in the most guarded fashion to keep them in the chamber when needed (carbapenem derivations).

--

There's a metric crap ton of money going into the research of new antibiotics, it's just not straight forward.

shagie9 hours ago

> There's a metric crap ton of money going into the research of new antibiotics

It's getting more attention, but its been faltering for a long time.

https://news.bloomberglaw.com/health-law-and-business/antibi...

> Venture capitalists are investing far less funds to develop new antibiotics than they are for oncology drugs, according to a new report that highlights the need for more financial incentives to fight off the growing threat of drug-resistant bacteria.

> The report, published Monday by the Biotechnology Innovation Organization, found that investors are increasingly shying away from antibiotic research due in part to large companies exiting the space. That’s left small companies, that typically rely on investment capital, struggling to carry out new clinical trials.

> Newer antibiotics are more important than ever as the Covid-19 pandemic has forced people into hospitals for longer periods of time, increasing the chances for the spread of antibiotic-resistant germs, the biotech trade group said.

> But in the past 10 years, venture capital funding for U.S. antibiotic development amounted to $1.6 billion, compared to $26.5 billion for oncology, according to Monday’s report. The group noted that there are currently 64 new antibacterial therapeutics in the clinical trial pipeline, 80% of which originated from small companies.

The report mentioned is The State of Innovation in Antibacterial Therapeutics - https://www.bio.org/sites/default/files/2022-04/BIO-Antibact...

toast012 hours ago

> I’m a bit confused why antibiotic resistant bacteria is so scary.

Because it can makes otherwise simple to treat bacterial infections into an ICU stay. ICUs don't have a lot of spare capacity, and it's difficult to add more.

make312 hours ago

the products that both attacks the bacterias & are perfectly safe are probably very very hard to find, right. the product needs to be safe to flood your whole system with, because that's how pills work, you eat it and it diffuses everywhere in your system, there is zero targeting. Plus ideally it should kill all the bacterias very fast so none can develop resistance. it seems like it would be an incredibly hard balance.