Monday, December 07, 2009

More on the MRSA Business - Opportunities and Updates

It is interesting how you barely notice something, and then you pay attention and you suddenly see it everywhere. Two weeks ago, I blogged here about haiwatchnews.com and MRSA in general and suddenly, here we are with more MRSA stuff.

I am reporting on two pieces of news in this post, the first of which represents another, smaller window of opportunity:

1. Community MRSA Vs. HAI-MRSA:

Community MRSA is the kind of bacteria that you pick up from "community" places - gyms, hotels, public restrooms, etc. Apparently community based MRSA is yet another arena of trouble just waiting to plunge itself upon us.

Analyzing data from 1999 to 2006, a certain Dr. Laxminarayanan and his colleagues looked at over 300 labs and concluded that community MRSA brought in by outpatients is complementing and not supplementing HAI-MRSA (the kind you get in the hospital setting).

This means that you are looking at an increased danger and cross-over of infections. While the percentage of HA-MRSA has remained steady, CA-MRSA has increased. You can read more of the details in the article linked at the end of the blog.

The Opportunity

In the last post, I talked about in-hospital devices and systems that might be designed to combat MRSA. In this particular blog, I would like to highlight the opportunity spectrum that exists in community situations, ranging from gymnasiums to hotels, to public restrooms and more.

In this opportunity space, however, it is not likely to design a disposable, clinical type of device. You would be thinking more in terms of either a disposable device, or better, a bioengineered solution where you could provide a mechanism that keeps equipment, their surfaces and so on, clean and free of community based MRSA and other strains. Given the threat from community MRSA, there is a wide market available in this space and the pitch should be easier to make, provided your solution is effective, elegant and cost effective.

2. Potentional breakthrough especially useful to fight resistant bacterial strains

A couple of days ago, I came across an article on BBC about a nifty discovery - a molecule that binds an enzyme in a bacterium in two sites, as opposed to one. This is supposedly a breakthrough that could help ensure that bacteria are unable to develop resistance to drugs at the same pace as they are doing now.

The whole principle was demonstrated through a natural molecule called "simocyclinone", supposedly made by soil bacteria. This molecule itself is not a drug, but it exhibits the above said phenomenon. More details are available in the B.B.C article.

In effect, I agree and believe this concept can be further extended in synthetic molecules.

How about molecules that bind on multiple sites on the AIDS virus and completely neutralize the virus, alongside slowing down it's ability to quickly evolve and develop resistance to the molecule (which is what the virus does now).

Such innovations will completely change medicine of the future and create new battlefields in the war on disease.

Excessive Regulation?

This clearly indicates that there is true promise. If you read the B.B.C. article, there is also talk about excessive regulation driving down research. I believe this is slightly misleading. I believe that the lack of an ample pipeline points to the fact that pharma companies and the VCs and stakeholders that prod them have been carried away by the promise of "blockbusters" for so long, they have left behind well meaning opportunities. Given all the shake up that has happened in 2009, there is a wide open playing field for anyone ready to buck the trends. Regulation comes into play only after Phase 0 has been completed really, so who are they blaming for the lack of a good number of molecules on the pipeline?

Conclusion

In effect, MRSA, whether acquired in healthcare settings or in community settings present a great threat in general. There is a wide open landscape for both device and drug players to break open into the field in many ways.

References:

1. The MedPage article on Community MRSA:

http://www.medpagetoday.com/HospitalBasedMedicine/Hospitalists/17162

2. The B.B.C. Article on double-binding molecules:

http://usproxy.bbc.com/2/hi/health/8393781.stm

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