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Living medicine

See also: Biological therapy for inflammatory bowel disease and Biologics for immunosuppression
Genetically engineered probiotics as living medicines to treat intestinal inflammation. a Genetically engineered E. coli Nissle 1917 (EcN) with csg (curli) operon deletion (PBP8 strain) containing plasmids encoding a synthetic curli operon capable of producing chimeric CsgA proteins (yellow chevrons with appended bright green domains), which are secreted and self-assembled extracellularly into therapeutic curli hybrid fibers. b CsgA (yellow), the main proteinaceous component of the E. coli biofilm matrix, was genetically fused to a therapeutic domain—in this case, TFF3 (PDB ID: 19ET, bright green), which is a cytokine secreted by mucus-producing cells. The flexible linker (black) includes a 6xHis tag for detection purposes. c Engineered bacteria are produced in bulk before delivery to the GI tract. A site of colonic inflammation is highlighted in red. d Interaction of E. coli and the colonic mucosa. Inflammatory lesions in IBD result in loss of colonic crypt structure, damage to epithelial tissue, and compromised barrier integrity (left panel, (−) E. coli). The resulting invasion of luminal contents and recruitment of immune cells to the site exacerbates the local inflammation. The application of E. coli (right panel, (+) E. coli) reinforces barrier function, promotes epithelial restitution, and dampens inflammatory signaling to ameliorate IBD activity.[1]

A living medicine is a type of biologic that consists of a living organism that is used to treat a disease. This usually takes the form of a cell (animal, bacterial, or fungal) or a virus that has been genetically engineered to possess therapeutic properties that is injected into a patient.[2][3] Perhaps the oldest use of a living medicine is the use of leeches for bloodletting, though living medicines have advanced tremendously since that time.

Examples of living medicines include cellular therapeutics (including immunotherapeutics), phage therapeutics, and bacterial therapeutics, a subset of the latter being probiotics.

  1. ^  This article incorporates text by Pichet Praveschotinunt, Anna M. Duraj-Thatte, Ilia Gelfat, Franziska Bahl, David B. Chou & Neel S. Joshi available under the CC BY 4.0 license.
  2. ^ editor, Ian Sample Science (16 January 2019). "'Living medicine' helps make toxic ammonia breakthrough". The Guardian. Retrieved 5 April 2020. {{cite news}}: |last1= has generic name (help)
  3. ^ "Engineering Living Medicines for Chronic Diseases | SBE | Society for Biological Engineering". www.aiche.org.

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