E. coli bacteremia and sepsis are the classic gram negative sepsis that BPI will work against. They have in common with all the gram negative the LPS from the cell wall or endotoxin, name because is inside and integral part of the cell and release when the bacteria is killed, so the defenses are overwhelm, the more you kill the more bullets the bacteria sent out. It is like the mythological snake that you cut one head and two more developed.
BPI will be effective in all these gram negative bacteria if proven effective in the meningococcemia model in the ongoing Xoma's Neuprex trial because they share LPS.
This group of infections and sepsis are the ones refer to in the Bayer report of 200,000 deaths and the main market. $5 billion for two weeks of hospitalization, well If BPI could cut this by one week, then Xoma could charge $1 billion the rest of the savings is for the patients, insurers and hospital. If the science is sound, the finances also are.
E coli serotype O 157:H7 is a different story, it is not an endotoxin. It is an exotoxin produced by the alive bacteria. Originally in evolutionary and clinical grounds was first described in Shigella, so it is call the Shiga-toxin. The E. coli O 157:H7 took a loan (via a plasmid aka chunk of DNA infecting piece from Shigella) and now has the exotoxin in its arsenal for damage. Both are rare in the USA, modern hygiene has cut the infection in developed countries. The occasional reports are usually from hamburgers. This is not the BPI aim at the moment to my knowledge and probably the BPI approach is not feasible in these cases. |
