The antibiotic jab that can ease back pain


An injection of acne-fighting antibiotics could revolutionise the treatment of back pain.

Doctors in the UK are testing whether a one-off jab of a new drug known as PP353 can ease — and even cure — the chronic lower back pain that affects millions.

The antibiotic kills bacteria that normally cause acne but have also been found lurking in the damaged spinal discs of patients with back pain.

Three people have already been treated, and one has said that a ‘dramatic’ reduction in pain means he can go swimming again.

Common causes of back pain include slipped discs, arthritis and spinal stenosis (where bones press on nerves) but there is growing evidence bacteria also play a role.

Slipped discs grow small blood vessels as part of the repair process, and it¿s thought this is how the bacteria enter the disc. They then produce an acid that damages the surrounding bones, irritates the nerves and causes inflammation, leading to pain [File photo]

Slipped discs grow small blood vessels as part of the repair process, and it’s thought this is how the bacteria enter the disc. They then produce an acid that damages the surrounding bones, irritates the nerves and causes inflammation, leading to pain [File photo]

In a landmark 2013 study, Danish researchers found that in up to 40 per cent of patients with slipped discs, the damaged discs were infected with Cutibacterium acnes bacteria.

The discs are spongy pieces of tissue that sit between and cushion the bones of the spine. When one slips or herniates, most commonly due to age-related wear and tear, part of its soft core bulges out and can press on nearby nerves.

Cutibacterium acnes normally causes acne but is also found in the mouth and can get into the bloodstream as a result of poor dental hygiene.

Slipped discs grow small blood vessels as part of the repair process, and it’s thought this is how the bacteria enter the disc.

They then produce an acid that damages the surrounding bones, irritates the nerves and causes inflammation, leading to pain.

Studies have shown that oral antibiotics can ease the pain. But much of the drug is broken down before it reaches the spine, so the tablets have to be taken for at least three months to be effective. 

Such prolonged use raises the risk of side effects including diarrhoea, abdominal pain and loss of appetite, as well as concerns about antibiotic resistance, where bacteria develop the ability to defeat drugs meant to kill them.

Doctors in the UK are testing whether a one-off jab of a new drug known as PP353 can ease ¿ and even cure ¿ the chronic lower back pain that affects millions

Doctors in the UK are testing whether a one-off jab of a new drug known as PP353 can ease — and even cure — the chronic lower back pain that affects millions

The new treatment, developed by Kent-based Persica Pharmaceuticals, involves injecting the PP353 antibiotic into the disc. This maximises the amount of the drug that reaches the bacteria, allowing patients to be treated with a single injection, in turn reducing the risk of side effects and antibiotic resistance.

Once injected, PP353 solidifies, which ensures it stays within the disc, stopping the bacteria from growing and causing pain.

A preliminary trial at hospitals in Preston and Coventry found it to be safe and well tolerated. One of the three trial participants, 44-year-old Scot Harris, who has had lower back pain for five years, said: ‘The pain has dramatically reduced, and I can go swimming again and lead a more normal life that others take for granted.’

A larger trial, involving 40 patients, is now under way.

Michael McNicholas, a consultant orthopaedic surgeon at Liverpool University Hospitals NHS Foundation Trust, said that the successful treatment of lower back pain with antibiotics could make surgery for it obsolete.

He added: ‘This groundbreaking work could transform life for millions of patients suffering with chronic back pain.’

Implanted electrodes can ease chronic lower back pain, according to a new study of British patients.

The electrodes, which are switched on and off by remote control, produce tiny electrical pulses to stop pain signals reaching the brain.

They can ‘provide substantial and durable benefit to patients’ who have traditionally had ‘few reliable treatment options’, say the researchers from James Cook University Hospital in Middlesbrough.

Two years after receiving implants, 57 per cent of the 42 participants were in at least half as much pain as before.

A similar number had substantially reduced pain, according to the journal Pain and Therapy.

Daily dose of beans takes heat out of hot flushes

Eating soya beans helps ease hot flushes, new research suggests.

Doctors at the George Washington University School of Medicine in the U.S. asked 38 women aged between 40 and 65 to follow a low-fat plant-based diet that included half a cup (about 60g) of cooked soya beans each day. 

Sixty per cent of the participants experienced no hot flushes at all during the 12-week trial — despite usually having at least two a day, the journal Menopause reports.

Soya beans contain compounds called isoflavones that the body converts into equol, a plant form of the hormone oestrogen.

A compound from the milk thistle plant is being tested for weight loss. In a trial at the Catholic University of Murcia in Spain, 60 obese volunteers will take three capsules of silibinin a day for three months. The researchers believe the compound blocks the digestion of fat, reducing calories absorbed.

Pill to tackle sight loss caused by eye disease

A new pill might help prevent vision loss in those with inherited eye diseases.

Retinitis pigmentosa is a group of genetically inherited conditions where degeneration of the light-sensitive cells in the retina at the back of the eye leads to vision loss.

It is hoped that the new drug, called NPI-001, will slow the damage, which is caused by oxidative stress — the result of the body not producing enough antioxidants, allowing free-radical molecules to harm tissues.

Animal studies have shown the tablet, which contains an antioxidant, to be effective. Scientists at the Queensland Eye Institute in Australia will compare it with a placebo pill in a trial involving 48 patients.

Brisk exercise could be best medicine for an ailing heart

One year of moderately vigorous weekly exercise in middle age may be enough to reverse signs of heart problems, according to researchers at UT Southwestern Medical Centre in America.

They asked 31 adults in their 50s with early indications of heart failure — where heart muscle becomes too weak to pump blood properly — to do either yoga or more intense exercise (walking, cycling or swimming) for at least an hour a week, plus regular strength training.

After a year, those doing more vigorous weekly exercise had better heart function and healthier heart muscle. Those on the gentler exercise regimen did not improve at all, reports the journal Circulation.

The results add weight to the idea that ‘exercise is medicine’, the study says. 

Face mask to detect Covid in wearer’s breath

A face mask that checks for Covid in the wearer’s breath has been invented by scientists at Harvard University in America. The mask contains a tiny ‘biosensor’ — a pad packed with biological material capable of detecting the virus.

The button-activated test gives a result in 90 minutes and is as accurate as gold-standard PCR tests, the journal Nature Biotechnology reports.

‘We have essentially shrunk an entire diagnostic laboratory down into a small, biology-based sensor that works with any face mask,’ say the researchers. The technology can be adapted to detect other infections, as well as chemicals, they add.

They explain: ‘This technology could be incorporated into lab coats for scientists working with hazardous materials or pathogens, scrubs for doctors and nurses, or the uniforms of first responders and military personnel.’ 

Jargon buster

Scientific terms decoded. This week: Metabolism

Commonly used to describe how quickly we digest food, metabolism actually covers a vast number of chemical reactions constantly occurring in the body.

These fall broadly into two main types. The first is catabolism, where larger substances such as food are broken down, releasing energy. With the second, anabolism, smaller substances (such as nutrients in food) combine to form other substances, using up energy.

Doctors use the phrase ‘basal metabolic rate’ (BMR) to refer to the lowest base level of energy needed for these constant chemical reactions to take place, but we commonly refer to this as metabolism.

The speed of metabolism depends on age, gender, genes and weight — younger people, men and those with more muscle tend to have faster rates. But there is no evidence that a slow metabolism is a reason for weight gain.

Rude health

Autoimmune conditions — where the body attacks its own tissues — could be a cause of male infertility, suggests research published in The American Journal of Pathology. 

Scientists have found mice that lacked the AIRE gene, which is known to prevent the mistaken attack — including in the reproductive organs — had lower sperm quality and were less fertile. 

Tooth truths

Tweaks to dental hygiene that could make a difference. This week: Drink milk at mealtimes

Although a good source of vitamins and protein, milk and milk-based drinks should only be drunk at mealtimes. This is because lactose — the sugar found in milk — can damage the teeth, says Oga Eze, a dentist based in Essex.

‘That’s why you shouldn’t leave milk by a child’s bed at night — if they drink it constantly the sugar can cause decay over time.

‘After you’ve brushed your teeth at night, you should drink nothing other than water. And even then, only do so about 30 minutes after brushing, to avoid rinsing off the enamel-boosting fluoride from the toothpaste,’ she adds.

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