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 educating others about our project. 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 our work. The information they gave, helped and gave us new goals and expanded our knowledge of the different sub elements. By interviewing experts and companies, we have gained insight into today's market and we can observe that there is a demand for new solutions to old problems, of which our sub elements have great potential.

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. We received constructive feedback on Bacto-Aid. The students showed awareness about the problems of antimicrobial resistance. It was rewarding to see, that we are trying to solve an issue that the society worries about. We reflected on the comments and have integrated the feedback into our future presentation. Some examples of feedback were: "There is a lot of potential in these areas". The future potential for the different parts of the project tended to give a positive response. 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 helped us especially with finding a fixed focal point throughout the presentation.

Interviewing Laura Jakobsen

We interviewed the 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. She helped us understand what kind of issues the hospitals are facing when treating burn wounds, and the requirements needed for a functional Bacto-Aid. At OUH, they have encountered resistant bacterial infections, which required special care and extra awareness. This confirms the problem of resistance and proving how current it is.

One of the main issues with our product, according to Laura Jakobsen, was the absorption 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 burn wounds. 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. 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 of 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 resident. Bacto-Aid could create a barrier that has antimicrobial effect and thus protecting vulnerable patients from any further complications.

Interviewing Hans Jørn Kolmos

Hans Jørn Kolmos is a professor in clinical microbiology at the University of Southern Denmark. He is an expert in the history 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 have a tendency to worsen the situation. The Danish documentary “Når penicillin ikke virker" translated to: “When penicillin does not work” shows the problem in a realistic perspective. 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 a 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 perspective for our project, he said that the bacteriocins could be used as a local treatment. The ones we have researched, could probably be integrated in an ointment for the nose to 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 for treating wounds. Mr. Aarestrup is a professor at the Technical University of Denmark and is the head of a research group for genomic epidemiology. His laboratory is appointed as a reference laboratory for antimicrobial resistance by WHO and EU. He believes that there are great future prospects in the use of bacteriocins because it seems that resistance is rarely developed against 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. This is not a problem since we keep the proteins on the surface of the body. Mr. Aarestrup agreed with our choice of testing S. Aureus strains and 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 plastic companies

We sent out question forms and made phone calls to 14 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 would be future customers of our plastic. The companies were very positive towards using plastic produced by bacteria. However, there were some concerns if the plastic was going to be used for foodpackaging. Likewise, the plastic should be approved by UL and FDA, before being used.

The use of bacteria for the production of plastic, would also open the doors for a product, which would be capable of competing in costs 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 a cheaper alternative could be offered, then they would be very interested. This will make them able to offer more options to their customers and provide them with a more environmental friendly solution. We will therefore keep trying to optimize the production of our plastic from bacteria, so that one day we end up with a competitive product.

The plastic companies will only be able to use our plastic if it fulfills the customer's wish for sustainability. Since our plastic is biodegradable, there will also be limitations to its use. The final choice of material will be made by the customer.

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. Morten introduced us to several experiments, which we could conduct for our plastic Nygaard, J. V., et al. (2008). "Investigation of Particle-Functionalized Tissue Engineering Scaffolds Using X-Ray Tomographic Microscopy" Biotechnology and Bioengineering 100(4): 820-829. Andersen, M. Ø.., et al. (2010). "Surface functionalisation of PLGA nanoparticles for gene silencing." Biomaterials 31: 5671-5677.. One of them was how we could use our plastic for coating different proteins. The plastic could for instance be used for coating of antimicrobial peptides onto implants. The PHB will decompose slowly, which also means that the antimicrobial peptides will be released continuously from the implant and thereby reducing possible infections and biofilm. The PHB could also be used as the implant itself in cases where e.g. the bone needs a scaffold until it has healed. However, here we should be aware of the side effects of using PHB as bone implants, if the patient is also ingesting bone stimulating drugs. These drugs can lead to the formation of bones other places in the body than intended to. Mr. Andersen made us also aware of the side effect with the use of PHB inside the body.

Mr. Andersen introduced us to how we could 3D print our plastic. He also provided us with materials about plastic polymers, which we could use for background knowledge and for inspiration of possible opportunities. Furthermore, Mr. Andersen gave us the contact to two of his master students; Martin and Casper. They had the knowledge and the equipment to make the 3D printing possible. This corporation also provided them with a new experience, since it was the first time they had the opportunity to print with this type of plastic material and see how it responded to the 3D printing.

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.

Upcoming meeting with LEGO^®

We have been in contact with LEGO^® in the weeks up to our wiki deadline, and they were very interested in our sub project with producing PHB. Due to a Danish holiday it was not possible to meet up before the deadline, but we have already set a meeting with LEGO^®'s director of materials for when we come home from Boston. LEGO^® has a large division with research and development of materials from whom we can learn a lot. LEGO^® could also end up being a future consumer of our plastic.