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Wednesday, July 4, 2018

Biotech Manufacturing is Booming with Growth of Biologics and Gene Therapies


Manufacturing is the non-glamorous side of biopharma, although its impact on the economy shouldn’t be underestimated. For example, a recent report published by TEConomy and BIOtitled, “Investment, Innovation and Job Creation in a Growing U.S. Bioscience Industry 2018,” reported that the average wage in bioscience manufacturing was $64,860. It also reported that the six largest employer states in the drugs and pharmaceuticals manufacturing segment are California, New Jersey, North Carolina, Illinois, New York, Pennsylvania and Indiana.
In addition, much of biopharma manufacturing is conducted by contract research organizations (CROs). In 2018, the top 10 CROs in the world are LabCorpIQVIASyneos HealthPAREXELPRA Health SciencesPharmaceutical Product Development (PPD), Charles River LaboratoriesInternational (CRL), ICONWuXi AppTec and Medpace Holdings. Combined, they represent annual revenues of $34.5 billion.
And it’s notable that as biologics, gene therapy and immuno-oncology becomes more advanced and more mainstream, the demands for specialized manufacturing has increased. A 2014 reportnoted that the new technology created operational and technological challenges, largely the difficulty of reproducing commercial scale quantities of large, complex molecules. As the report observed, an aspirin molecule contains 21 atoms. But a biopharmaceutical molecule could contain anywhere from 2,000 to 25,000 atoms. For example, Genentech’s Herceptin for breast cancer contains more than 25,000 atoms.
And although the numbers are likely different four to five years later, the report noted that a small-molecule manufacturing facility would likely cost $30 million to $100 million to build, but a similar-scale biotech-manufacturing facility requires $200 million to $500 million, with similarly scaled operating expenses.
Yet business is booming and the need for biologics manufacturing facilities is only going to grow, including its various subspecialties, such as the manufacturing of viral vectors and plasmid DNA. As a June 2018 market research report, “Viral Vectors and Plasmid DNA Manufacturing Market, 2018-2030” notes, “Overall, eleven genetically modified therapies have been approved so far…. In addition, over 430 gene therapy candidates are presently in different stages of clinical development, for which over 500 clinical studies are currently underway in various regions across the globe. The growing number of gene therapy candidates, coupled with their rapid progression through various phases of clinical development, is expected to continue to create an increasing demand for vectors.”
Here’s a look at just a few recent biopharma manufacturing stories.
Rubius Therapeutics is planning to open a manufacturing plant in Rhode Island. It expects to invest up to $155 million over more than five years to renovate an existing 135,000-square-foot manufacturing plant in Smithfield, Rhode Island. The Board of the Rhode Island Commerce Corporation approved tax credits valued at $2.75 million on June 28 to support the project.
Only the day before, the company announced it is planning a $200 million initial public offering to support its personalized red blood cell therapeutics program. The company’s lead program is RTX-134, being developed to treat phenylketonuria (PKU), a metabolic disease. The company specializes in engineering red blood cells for medicinal purposes. Its therapeutic programs take stem cells and stimulate them into red blood cells, then inserts genetic material into those cells to express specific proteins.
On June 13, Cambridge, Massachusetts-based Sarepta Therapeutics announced it had signed a long-term strategic manufacturing deal with Brammer Bio. This arrangement will give Sarepta access to clinical and commercial manufacturing capacity for its micro-dystrophin Duchenne muscular dystrophy (DMD) gene therapy program, as well as a manufacturing platform for future gene therapy programs.
The company points out that it has a hybrid internal and external development and manufacturing model. This allows the company to build internal expertise on adeno-associated virus (AAV)-based manufacturing, while externally Brammer Bio will provide scalable best-in-class manufacturing capabilities. Brammer has a staff of more than 400 that operates in Massachusetts and Florida. It has a 74,000 square-foot early clinical campus made up of three buildings in Alachua, Florida. It also has a 165,000 square-feet facility in Massachusetts for Phase III and commercial cGMP viral vector manufacturing.
AveXis, a Novartis company based in Illinois, is investing $55 million to build a new manufacturing facility in Durham, North Carolina. The facility will create 200 jobs.
AveXis will use the new plant to make its first product candidate, AVXS-101, a gene therapy to treat three types of spinal muscular atrophy (SMA). SMA Type 1, also known as Werdnig Hoffmann disease, is a severe form of SMA. It usually is seen before six months of age and includes worsening muscle weakness and hypotonia (poor muscle tone) because of the loss of lower motor neurons in the spinal cord and brain stem. There are also feeding and breathing problems. The disease is caused by mutations in the SMN1 gene. Currently, the only treatment approved by the U.S. Food and Drug Administration (FDA) is Biogen’s Spinraza (nusinersen).
Durham was competing with the state of Illinois for the site. Illinois approved tax credits of almost $8 million to bring the jobs to Libertyville, Illinois. But AveXis took a $3 million incentive package in North Carolina.
“It’s notable that AveXis has chosen to expand its manufacturing operations in North Carolina,” North Carolina’s Secretary of Commerce, Tony Copeland, said in a statement. “Life science companies understand the many advantages of our state offers manufacturers, particularly the investments North Carolina has made in education and workforce training for the biotechnology industry.”

More than $100B Spent on Biotech M&A in the First 6 Months of 2018


For many biotech companies, mergers and acquisitions have become a cornerstone in building a robust pipeline that can ensure positive growth for years to come. Although 2017 was slow for M&A activity, analysts have predicted 2018 could be a return to a spending frenzy.
2017 was considered to be a lean year for M&A in biotech. BioSpace reported in January that there were 101 deals, down from 166 in 2015. Of those deals in 2017, there were only 14 deals worth $1 billion or more. That lull in activity appears to be changing.
So far during the first six months of the year, more than $100 billion has been spent on a myriad of acquisitions across the pharma and biotech industries. One reason so many predict heavy M&A activity is the passage of changes to the U.S. Tax Code that lowered the corporate tax rate to less than 20 percent for most companies and provided companies with a path to bring tens of billions of dollars in off-shore funds back to the United States. Those moves freed up a lot of money that companies could use to make deals for pipeline-expanding therapies that provide those companies an edge over competitors, all while (hopefully) developing a robust return for investors.
The year started with a $7 billion bang at the J.P Morgan Healthcare Conference when Celgeneacquired San Diego-based Impact Biomedicines and its JAK inhibitor program targeting myelofibrosis. Impact is developing fedratinib, a highly selective JAK2 kinase inhibitor, for patients with treatment-naïve myelofibrosis, a bone marrow disorder that disrupts normal production of blood cells. The move provided Celgene with a therapy that could challenge rival drugmakers Novartis and Incyte in the myelofibrosis space.
The deal for Impact wasn’t the only one undertaken by Celgene. Weeks after the company announced it would acquire Impact, Celgene plunked down another $9 billion to snap up Juno Therapeutics, a company in which it had already taken a $1 billion stake. The deal gave Celgene an avenue into the world of CAR-T and T cell receptor (TCR) therapies.
Celgene wasn’t the only company in January to make a big M&A splash. France-based Sanofi plunked down $11.6 billion to acquire Bioverativ, the Biogen spinout focused on developing treatments for hemophilia. That deal gave Sanofi two hemophilia drugs Eloctate for Hemophilia A and Alprolix for Hemophilia B. In January Sanofi also gained control of fitusiran, an RNAi therapeutic in development for hemophilia A and B through its partnership with Alnylam. One week later, Sanofi dropped another $4.8 billion to acquire Belgium-based Ablynx. The move was a complement to the acquisition of Bioverativ. Olivier Brandicourt, chief executive officer of Sanofi, said the Ablynx deal was part of the company’s strategic transformation of its R&D in rare blood disorders. Ablynx’s lead compound is caplacizumab (anti-vWF Nanobody), which is being developed to treat acquired thrombotic thrombocytopenic purpura (aTTP).
In March, GlaxoSmithKline dropped $13 billion to acquire full control of a consumer health unit. This was the biggest deal for GSK since Emma Walmsley took over the reins of the company last year. The U.K. pharma giant had partnered with Novartis on the business division. The Swiss company held a 36.5 percent interest in the business. The deal gave GSK 100 percent control of the business unit that markets products such as Sensodyne toothpaste and Panadol headache tablets. Last year the healthcare unit reported sales of nearly $11 billion (£7.8 billion).
The biggest deal of the year though, at least so far, was Takeda Pharmaceutical’s bid to acquire Shire Plc for $62.2 billion. The deal will help open U.S. markets for Japan-based Takeda and Shire’s drugs will have easier access to markets in Japan. As BioSpace noted when the deal was announced, Takeda will also take on a significant amount of debt through the deal, sending the price tag closer to $80 billion when that amount is included.
In addition to deals of $1 billion and more, there have also been a number of smaller deals that amount to tens of millions, or hundreds of millions of dollars. For example, in January Seattle Genetics acquired Cascadian Therapeutics in a $614 million deal to gain control of tucatinib, a tyrosine kinase inhibitor that is highly selective for HER2, which is overexpressed in breast, colorectal, ovarian and gastric cancers. In February Merck plunked down $394 million to acquire Australia-based Viralytics Ltd and its oncolytic immunotherapy treatments. Merck has already paired Viralytics Cavatak, an investigational oncolytic, with its PD-1 inhibitor Keytruda. In April New Haven, Conn.-based Alexion acquired Stockholm, Sweden-based Wilson Therapeuticsfor $855 million.
While M&A moves are often made to bolster company pipelines and strengthen bottom lines, companies also often divest their holdings for the same reasons. In May, Allergan said it will sell off two non-core businesses following a strategic review of the company’s assets. Following a strategic review, Allergan’s board of directors wants to focus on the company’s four core businesses — eye care, aesthetics, central nervous system diseases and gastrointestinal conditions. While no deal was announced, the company could snag between $4 and $6 billion when it decides to sell off its non-core assets.
Israel-based pharma giant Teva has also been in the midst of divesting itself of non-core assets as it looks to address debt of about $30 billion. At the beginning of February Teva said it completed the sale of a portfolio of products within its global women’s health business for $703 million in cash. That deal followed up several divestitures in late 2017.
In April, GSK divested its rare disease gene therapy portfolio to Orchard Therapeutics for a 19.9 percent equity stake in the U.K. company. Programs gained from the GSK deal include Strimvelis, the first autologous ex vivo gene therapy for children with adenosine deaminase severe combined immunodeficiency (ADA-SCID), which was approved by the European Medicines Association in 2016.
In June, Akebia Therapeutics and Keryx Biopharmaceuticals, Inc. merged to create a company expected to be a leader in the development of renal disease therapies. The new company, which will be known as Akebia Therapeutics, Inc., will focus on developing therapies for chronic kidney disease (CKD). The company’s platform will be built on Keryx’s Auryxia (ferric citrate), which has been approved to treat dialysis-dependent CKD patients for hyperphosphatemia and non-dialysis dependent CKD patients for iron deficiency anemia (IDA). A second CKD treatment could be forthcoming. Akebia’s vadadustat is in Phase III trials for CKD patients with anemia.
In February, Johnson & Johnson was reported to be exploring the potential sale of its advanced sterilization products unit, which goes by the acronym ASP. Like several biopharma companies J&J has been in the process of streamlining its divisions, which includes the sale of non-core assets. ASP develops instrument sterilization, high-level disinfection, and cleaning technologies to help health-care facilities. Its product portfolio includes the Sterrad systems, which is used to sterilize medical instruments, as well as the Evotech endoscope cleaner. If the company pulls the trigger on the sale J&J could command up to $2 billion for the unit. Other J&J divisions that could be sold include its over-the-counter business, diabetes-care unit and medical devices unit.

Scams are overwhelming the US asylum system


People hoping to settle in the United States wait years for a green card to be legal residents. They play by the rules. Yet these law-abiding newcomers must feel like idiots, watching what’s happening on the southern border.
Hundreds of thousands of Central American migrants are walking right in. They’re not waiting in line. They’re using “asylum” requests as their E-ZPass. Just 12 percent of requests from El Salvadorans, 11 percent from Guatemalans and 7.5 percent from Hondurans are actually granted, according to the Department of Homeland Security. Never mind, the request gets them in the door.
It’s a shameful distortion of a program intended to provide a haven for true victims of state-sponsored religious, ethnic and political persecution. The United States offered asylum to Hungarian anti-Communists after their uprising was crushed by the Soviets in 1956; to Cubans fleeing Castro’s prisons; to Vietnamese after the fall of Saigon in 1975; to Chinese political dissidents escaping the crackdown after Tiananmen Square in 1989; and, more recently, to Chinese Christians and Muslims threatened for practicing their religion.
That’s not what’s happening on the southern border. There, migrants walk up to a border agent with a familiar story. Women typically plead they’re victims of an abusive boyfriend or husband, and men claim they’re escaping gang violence. They’re detained briefly, but many are then released into the United States and given a date for an asylum hearing.
Being granted asylum means hitting the jackpot. Asylees get access to the Refugee Cash Assistance program, including medical care, a housing allowance and hundreds of dollars a month in cash. In contrast, immigrants who go the green-card route are ineligible for most benefits for years.
Half of those who use asylum as their excuse for crossing the border never even file a claim or show up at a hearing. They’re also winners. After all, they made it inside, unlike the East Asian waiting 12 years to enter as a legal worker.
Last weekend, open-borders advocates held 700 marches across the country, protesting the Trump administration’s policies. One target was Attorney General Jeff Sessions’ recent clarification that domestic abuse is not sufficient grounds for seeking asylum. A few immigration judges have granted asylum on those grounds, but it’s not how asylum is defined.
House Democratic Leader Nancy Pelosi accused Sessions of “staggering cruelty.” But Sessions is right. The asylum law “is not a general hardship statute,” he says. If every hardship qualifies for asylum, it means everyone can come in.
That’s the marchers’ objective — and increasingly the goal of the progressive flank of the Democratic Party. Their rhetoric suggests any limit on immigration is a crime against humanity. New Yorkers like Sen. Kirsten Gillibrand, Gov. Cuomo foe Cynthia Nixon and Alexandria Ocasio-Cortez, who toppled Rep. Joe Crowley last week, are calling for the abolition of the Immigration and Customs Enforcement Agency.
A similar battle is raging inside the European Union, which is overwhelmed by mostly bogus asylum claims from North African migrants. More than 70 percent of their claims are rejected, according to special envoy of the UN High Commission on Refugees Vincent Cochetel.
But the migrants who are turned down for asylum stay, eluding deportation. They’re straining public schools and government benefits and provoking a backlash against German Chancellor Angela Merkel’s government. Last weekend EU leaders tentatively devised a plan to screen asylum seekers in disembarkation centers along the North African coast, before they make their way across the Mediterranean to Europe. Trump is proposing something similar to vet asylum applicants on the Mexican side of our southern border, before they enter the US.
In America and Europe, demagogues tell us to have a heart and let everybody in. But the public understands that immigration affects public schools, wages, taxes — even cultural identity. That’s why we have immigration laws.
The aspiring Americans who obey those laws and wait their turn deserve our respect. Allowing other immigrants to jump in front of them using flimsy asylum claims is a slap in the face.

Scientists ‘completely surprised’ by immunity-boosting virus


Though you may not hear of it often, cytomegalovirus is a fairly common virus. It is usually harmless, but once contracted, it remains in the system for the rest of a person’s life.
According to the BMJ Best Practice resource, “Cytomegalovirus (CMV) is a ubiquitous beta-herpes virus that infects the majority of humans.”
Infected individuals typically do not experience any symptoms. The virus can be transmitted by coming into direct contact with the bodily fluids, such as blood, of an already-infected individual.
Once acquired, it remains in a person’s body for their entire life.
In a new study that was conducted in mice, Dr. Janko Nikolich-Žugich — of the University of Arizona College of Medicine in Tucson — and team decided to look into how, and under what conditions, aging individuals would mount a stronger immune response against viral infections.
Typically, young bodies have stronger defenses. But as we age, our immunity begins to decrease. “That’s why older people are more susceptible to infections than younger people,” explains Dr. Nikolich-Žugich.
The scientists involved with the new study were interested in finding out how the immune systems of aging individuals might be fortified and rendered more efficient once more.

Does CMV keep the immune system busy?

In this process, Dr. Nikolich-Žugich and team compared older mice infected with CMV with mice in the same age range but without the virus, expecting to see that the CMV-infected mice had a weaker immune system and thus mounted a poorer defense against other viruses.
“CMV doesn’t usually cause outward symptoms,” notes first study author Megan Smithey, “but we still have to live with it every day since there’s no cure.”
“Our immune system always will be busy in the background dealing with this virus,” she adds.
“We assumed [therefore that] it would make mice more vulnerable to other infections because it was using up resources and keeping the immune system busy,” Smithey goes on to explain.
However, the researchers were in for a surprise.

CMV determines ‘more robust’ defense

Working with a group of aging mice — some carrying CMV and others not — the team tried to infect them all with Listeria, a type of harmful bacteria that is usually found in contaminated foodsListeriacan cause a disease known as “listeriosis,” characterized by fever, sickness, and diarrhea.
The researchers expected the CMV-infected mice to be more susceptible to the bacteria — in fact, they turned out to be more resilient than their CMV-free counterparts.
We were completely surprised; we expected these mice to be worse off. But they had a more robust, effective response to the infection.”
Megan Smithey
Although they are not yet sure how or why CMV enhances the immune response, the researchers are happy to have made an important discovery about the functioning of the immune system as it ages — namely, that it is capable of mounting a better defense against foreign agents that specialists had previously believed.
“This study shows us,” says Smithey, “that there is more capacity in the immune system at an older age than we thought.”
Specifically, the researchers found that both the CMV-infected and the CMV-free mice, though fairly advanced in age, had diverse population of T cells, which are specialized immune cells with various functions.
“Diversity is good,” says Dr. Nikolich-Žugich. “Different types of T cells respond to different types of infections; the more diverse T cells you have, the more likely you’ll be able to fight off infections.”

T cells no less diverse in old age

This revelation also took the scientists by surprise; for a long time, the assumption had been that T cell populations become less diverse with age, and this had been considered a main factor in the decreased effectiveness of immune responses.
Now, Dr. Nikolich-Žugich and team saw that the T cells in aging mice were no less diverse than in younger animals.
The problem was that the T cells were not typically recruited to defend the systems. However, older CMV-infected mice did not seem to encounter this issue, and their T cells were more active.
“It’s as if CMV is issuing a signal that gets the best defenses out onto the field,” Dr. Nikolich-Žugich observes.
“This shows that the ability to generate a good immune response exists in old age — and CMV, or the body’s response to CMV, can help harness that ability,” Smithey hypothesizes.
The scientists’ findings are now reported in PNAS. And already, they are planning to deepen their understanding of CMV’s effect on the immune system in further studies.
In the future, the team hopes to be able to replicate its recent results in another study with human participants.
Should this happen, Dr. Nikolich-Žugich and colleagues would aim to design a vaccine that could more effectively boost the immune systems of older adults.

Dementia linked to ‘chronic, rather than temporary’ inflammation


Heightened levels of brain inflammation biomarkers have been linked to the development of dementia, but it remains unclear whether inflammation must be present long-term in order to affect brain health.
Last year, Medical News Today reported on a study suggesting that elevated inflammationlevels in midlife increased a person’s risk of experiencing loss of brain function and developing dementia later in life.
And recently, researchers from Johns Hopkins University in Baltimore, MD, have conducted a study analyzing data collected from 1,532 participants.
Of these, 61 percent were women and 28 percent were African-American.
Specifically, the team tracked levels of a blood biomarker of inflammation called C-reactive proteinand looked at its relationship with the risk of dementia.
“We found that individuals who had an increase in inflammation during midlife that was maintained from mid- to late life have greater abnormalities in the brain’s white matter structure, as measured with MRI scans,” says lead researcher Keenan Walker.
This suggests to us that inflammation may have to be chronic, rather than temporary, to have an adverse effect on important aspects of the brain’s structure necessary for cognitive function.”
Keenan Walker
The team’s findings are reported in the journal Neurobiology of Aging.

Inflammation and white matter damage

To gain a better understanding of how inflammation can affect an individual’s brain and cognitive abilities over a long period of time, Walker and colleagues looked at data collected through the Atherosclerosis Risk in Communities Study (ARIC), which examined cardiovascular risk factors among middle-aged and older people.
For the new study, the researchers evaluated participants’ brain structure, and to what extent its integrity was preserved over a period of 21 years from middle age to late life.
Alongside this, the investigators also assessed levels of the inflammation marker C-reactive protein, which is produced in the liver.
Throughout the 21-year period, the participants had five visits with ARIC researchers — around one every 3 years, on average. At their final follow-up visits, the participants had an average age of 76.
During the final visit, each person had an MRI scan to check for white matter damage. White matter — containing axons coated in a protective layer of myelin — is tasked with carrying information between nerve cells. In brain scans, white matter damage appears as intensely white patches.
At the second, fourth, and final visit, the researchers also collected blood samples from the participants, so that they could measure levels of inflammation.
Those who had under 3 milligrams per liter of C-reactive protein were judged to have low levels of inflammation throughout their bodies. Conversely, those with 3 milligrams per liter or more of the tell-tale biomarker were said to have high levels of inflammation.
Walker and colleagues’ analyses revealed that, of all the participants, the 90 individuals whose inflammation had increased to chronic (that is, persistently high) levels during midlife also presented the most white matter damage in the brain.
This remained valid even after potentially modifying factors — such as participants’ age, sex, levels of education, and risk of cardiovascular disease — were taken into account.
Furthermore, when the researchers looked at measurements of brain structural integrity, they also concluded that those participants who had elevated levels of C-reactive protein in middle age showed brain structure damage similar to that seen in people about 16 years older.

‘Inflammation may be a reversible factor’

Walker believes that the results obtained in this study suggest that there may be a cause and effect relationship between growing levels of inflammation in middle age that remain high until later in life and the development of dementia.
But, he cautions that this is still just an observational study, and more research into any underlying mechanisms is required in order to establish causality.
Walker explains that chronic inflammation is often caused by conditions such as cardiovascular disease, heart failurehypertension, and diabetes, as well as particular infectious diseases, including HIV and hepatitis C.
Although inflammation also normally increases with age, he adds that certain factors — including poor overall health — could make it worse.
“Our work is important,” notes senior study author Dr. Rebecca Gottesman, “because currently there aren’t treatments for neurodegenerative diseases, and inflammation may be a reversible factor to prolong or prevent disease onset.”
“Now, researchers have to look at how we might reduce inflammation to reduce cognitive decline and neurodegeneration,” she concludes.

Canopy Growth to detail Latam strategy


Canopy Growth is a company focused on firsts. As part of the Company’s ongoing global growth strategy, Mark Zekulin, President and Co-CEO will be holding a media availability by conference call to provide several exciting updates for Canopy Growth, its medical focused subsidiary Spectrum Cannabis, and the industry as a whole.
Mark will lead the call from the announcement location and following his updates, will hold a Q&A.
All interested media are asked to please RSVP for conference call details.
Date: Thursday, July 5, 2018
Time: 1:00-1:30pm EST
RSVP: Please contact Aly-Khan Virani to register your interest and receive the call-in details.

As drug resistance grows, combining antibiotics could turn up new treatments


Combining certain antibiotics could help them pack a one-two punch against harmful bacteria, according to a new study published Wednesday in Nature.
Nassos Typas and his colleagues at the European Molecular Biology Laboratory in Germany tested 3,000 different combinations of antibiotics with each other or with drugs, food additives, and other compounds on three common types of bacteria that infect humans.
“Antibiotic resistance is increasing, and because we haven’t been developing new drugs for the past 20 years, we’re running out,” Typas said. He and his colleagues set out to discover combinations that might be helpful in the clinic — and were on the hunt for patterns that might illustrate why certain pairs work.
They turned up hundreds of combinations that made antibiotic treatment more effective (along with many that didn’t). Pairs of drugs that targeted the same cellular processes were much more likely to be successful than combinations that worked in two different ways.
And many of the interactions were species-specific — that is, a combination might work well together to tackle one type of bacteria, but not another. That finding might one day be beneficial for finding drug combinations that don’t harm the rest of the gut’s microbes.
“If you have a broad-spectrum antibiotic, it doesn’t only eradicate your infection, it also eradicates your gut microbes,” Typas explained. That’s why antibiotics can sometimes come with gastrointestinal side effects. But the effects of the drug combinations are highly selective and, in many cases, only affect a few kinds of bacteria. In the future, it might be possible for researchers to find drug combinations that attack harmful pathogens while preventing any damage to healthy bacteria.
“You could find the drug that works as an antidote for the commensal microbes, but not as an antidote for the pathogens,” Typas said.
In theory, that could also curb the development of antibiotic resistance, Typas said, since healthy bacteria might not have to evolve antibiotic resistance, which can be transferred to harmful pathogens.
The researchers also found that several of the combinations were effective at treating bacteria that’s resistant to several other antibiotics, both in cell models and in studies on moths. They’re now testing some of the combinations in mice.