Integrated Human Practice

Introduction

Human practice has been a cornerstone in our iGEM project right from the start. We have spent a great deal of time teaching others about our ideas and methods, which we have been using. We have been able to use the feedback to improve our presentation and get ideas for new future perspectives, as well as avoiding any potential pitfalls. We have also been reaching out to companies and experts in different fields to get a more qualified view on the work we have been doing. The information they gave us have helped us to develop new goals for the future perspectives of our project and to expand our knowledge about the different sub elements. By interviewing all these experts and companies we have gained insight into today's market and we can see that there is a demand for developing solutions, which our sub elements would be good to use for.

Projects

Evaluation from KOLD College

We finished our visit at KOLD college with an evaluation in order to get a better idea of our performance and project idea. They were generally very positive about Bacto-Aid, especially because they already were aware about the problems which antimicrobial resistance poses today. It was rewarding to see, that we are trying to solve an issue, that many people worry about. Some of the comments, which we have integrated in our future presentations of the project were: "There is a lot of potential in these areas". The future potential for the different parts of the project tended to cause a positive response and therefore we added a slideshow exclusively for the potentials of the sub projects. "It lacks focus on problematics”. We took this comment into consideration and decided to start the presentation with an explanation of why this area still needs a solution. The feedback we got from KOLD college helped us especially with what was important to focus on in the presentation.

Interviewing a nurse

We interviewed a nurse, Laura Jakobsen, who is working at the plastic surgery department at the University Hospital of Odense (OUH). In Denmark, burn patients are mainly sent to OUH and Rigshospitalet (another major hospital unit in our country). This helped us getting an idea of what kind of issues the hospitals are facing when treating wounds, and what kind of requirements they would have for our Bacto-Aid. At her work, they have encountered, a couple of times now, resistant bacterial infections, which required special care and extra awareness. This confirms the problem of resistance and proving how actual the problem is.

One of the major issues there was with our product, according to Laura Jakobsen, was the suction capacity of the silk. Burn wounds have a tendency to leak a lot the first few days after the incident. This is an important aspect we should look into if our Bacto-Aid should be used for treating burns. Despite this current limitation of our product, she did see a potential for it as a bandage applied after lymph node removal surgery in the inguinal region. It is a particularly problematic healing region due to the constant pressure it is undergoing (a patient has to sit) and due to the serum accumulation. Serum tapping is an important aftercare that has to be done regularly. It consists of removing the serum produced in the limb, which lymph nodes typically would transport away, manually. It is therefore a highway to infections in this region due to the missing lymph nodes (which also is a center for the immune system), regularly breaching the skin (barrier to foreign bacteria), and it is a moist area where many types of bacteria from the normal flora of the skin are present. Bacto-Aid could create a barrier that has antimicrobial effect and help to protect the vulnerable patient to any further complication.

Interviewing Hans Jørgen Kolmos

Hans Jørn Kolmos is a professor in clinical microbiology at the University of Southern Denmark. He is an expert in the history of the use of antibiotics and he is familiar with the status of the resistance problem. We had a great talk, where he told us that the media sometimes have a tendency to worsen the situation. The danish documentary“Når penicillin ikke virker" translated to: “when Penicillin doesn’t work anymore” shows the problem in a realistic way. We talked about how to tackle the problem and he said: “Nature is smart. Humans have only been here for a few millenniums and microorganisms have been here for billions of years. It would be foolish to believe that we could outsmart nature in 100 years”. He also said: “we could limit the distribution of antibiotics by following these three steps 1) isolate the potential bacteria 2) ask the question; is the isolated bacteria the reason to the infection or is it something else? 3) evaluate whether antibiotics can be used against the infection”. As a future plan, or a prospective for our project, he said that the bacteriocins could be used in local treatment. The ones we have looked at could probably be integrated in an ointment to the nose to potentially treat MRSA carriers.

Statement from Frank Møller Aarestrup

We received a statement from Frank Møller Aarestrup, because we were interested in hearing an expert’s opinion about the use of bacteriocins as an alternative way of treating wounds. Mr. Aarestrup is a professor at the Technical University of Denmark and is the head of a research group for genomic epidemiology. He believes that there are great future prospects in the use of bacteriocins as new antimicrobial components, because it seems that resistance is rarely developed towards them. However, mr. Aarestrup points out that if we choose to inject the proteins into the body, we should be aware of the fact that they easily can be decomposed. Since we keep the proteins at the body’s surface, this should not be a problem for us. Mr. Aarestrup agreed with our choice of testing with S. Aureus strains and he also suggested that we tested our bacteriocins in relation to Streptococcus. If we had any time left, we would have been interested in testing Mr Aarestrup's suggestion.

Interviewing PHB companies

We sent out question forms and made phone calls to 15 different plastic companies, in order to evaluate the sustainability and future perspectives of our biodegradable plastic. Their opinions are very important to us, because they could be the future consumer of our plastic. The companies were very positive toward using plastic that have been produced from bacteria. However, there were some concerns if the plastic was going to be used to food. Likewise, the plastic should be approved by UL and FDA, before they will use it.

The use of bacteria for the production of plastic, would also open the doors for a product, which would be capable of competing in price with the current forms of plastic. The companies were very interested in using biodegradable plastic, but not with today’s prices. Several companies have already investigated some biodegradable plastics, but due to its much higher cost they did not end up using it. If we can offer them a cheaper alternative, then they would be very interested. This will make them able to offer more options for their customers and provide them with a more environmental friendly solution. We will therefore keep on trying to optimize the production of our plastic from bacteria, so that we one day can end up with a competitive product.

The plastic companies will only be able to use our plastic if it fulfills the customer's requirement for sustainability. Since our plastic is biodegradable, there will also be limitations to its application forms. The final choice of material will be made by the customer. It is therefore the customers, which will make the decision of whether they want to the use biodegradable plastic or not. Therefore, it could be them we need to persuade and not the plastic companies. Some of these companies are dependent on people like us to buy their products, which means that we can influence whether companies are using biodegradable plastic or not.

Interviewing Morten Østergaard Andersen

In relation to the possible functions our biodegradable plastic can fulfill in medicine, we consulted Morten Østergaard Andersen. Morten is an Associate Professor at the Southern University of Denmark, researching in different biomaterials.

Interviewing Ming Ding

We had a great talk with Ming Ding, professor in orthopaedic surgery at the Southern University of Denmark, about how we can use our plastic as coating for implants and how the material can be used for slow release of antimicrobial peptides. Mr. Ding’s team is currently working on some experiments with release of E-vitamin from implants in animals. This method could also be tested with combining our plastic and antimicrobial peptides. Especially since our plastic is biodegradable, which is a requirement for this type of coating. Mr. Ding also pointed out that it would be an advantage if the material would be able to stimulate blood vessel formation and thereby increase the speed of wound healing. This is some of the qualifications that our spider silk contains, so the silk could also be worth considering when working with implants. The interview gave us information about the possibilities in our project and reassurance of the great potential there is in developing new biomaterials for implants.

Interviewing Coloplast

We presented our project to Coloplast with the intention of getting their point of view on our project as a whole and in relation to our three sub elements. They believe that our spider silk and bacteriocins are the most interesting and relevant elements in relation to a commercial product perspective of our Bacto-Aid. The reason why PHB is not the most relevant, is that the use of plastic materials in wound care dressings are low compared to other uses of plastics. Instead, the topic of biodegradable polymers is more relevant in other areas and applications. Coloplast are already aware of the great qualities of recombinant spider silk and bacteriocins, however the idea of combining the two elements are completely new to them. They see a big opportunity in this idea and encourage us to continue the work on this project. Their feedback really helped us finding our focus in relation to future development of our product and in relation to how we could improve our project.