Who would have thought that the cure for Methicilin-resistant Staphylococcus aureus (MRSA) may have been hiding in a book written in the 10th century?
“This is not something we ‘discovered’ searching through the text. The recipes have been translated by others for some time,” says Steve Diggle, Ph.D., associate professor at University Nottingham.
Finding the Cure
Christina Lee, Ph.D., from the University of Nottingham School of English met with Dr. Diggle and microbiologist Freya Harrison, Ph.D., to chat about her interest in ancient infections. Dr. Lee asked if they could build the 10th century potion intended for eye infections from an ancient Anglo Saxon book, called Bald’s Leechbook, in their lab and test it.
"We used two types of Staph aureus. In in vitro biofilm experiments, we used a laboratory strain (Newman wild type), and for the mouse chronic wound assays, we used an MRSA strain," says Dr. Diggle.
The recipe contains garlic, Allium, wine from 9th century wine vineyard and oxgal — bile from a cow’s stomach.
“The book describes the recipe to be effective against a lump or wen in the eye. We might translate this nowadays to mean a ‘stye,’” says Dr. Diggle. “Most styes are caused by Staph aureus, and so we figured we should test it against the bug it was probably designed to treat.
“We also tested it against Staphylococcus epidermidis (another commensal that can cause infection) and it worked on this as well,” he says.
In order for the team to test the potion, they had to grow Staphylococcus biofilm, which consisted of sticky, multicellular blobs of Staphylococcus aureus in a synthetic model that mimics a soft tissue infection. After growing the bacteria, the researchers added the recipe like a topical ointment, left it for 24 hours. Then they recovered the cells and counted how many bacteria were still alive. They found Bald’s eye salve is a very potent anti-staphylococcal antibiotic.
More Testing Needed
Dr. Diggle says testing is in its early stages and currently it works topically on a mouse chronic wound infection and there is no evidence it would work inside the body, nor would he recommend trying it.
“What we need to do is find why the combination of ingredients we have found to be effective actually works,” he says. “Then we might be able to isolate the active ingredients and start to build something we can do proper pharmacological tests on. This would be one of our next key goals.
“More generally, the approach of combining several ingredients might lead to us discovering new ways of treating infection and identifying potent combinations of molecules and chemicals that work against a range of bacteria,” says Dr. Diggle.
Impact of Remedy
While the remedy and testing seems to show early signs of success, it’s stirred up a mix of opinions on what this really means for the dermatology industry.
“This type of remedy would need to be tested rigorously before relying on it to treat someone in need,” says Peter Lio, M.D., dermatologist and partner at Medical Dermatology Associates of Chicago. “It also sounds fairly complex to make, and with requirements including needing wine from a specific vineyard, may not be able to be produced in sufficient amounts to help people.
“However, it seems more likely that some of the ideas and perhaps compounds within the concoction may inspire new approaches to treating modern day infections. That alone would be a huge victory,” he says.
Dr. Lio says it’s exciting to think that a long-forgotten remedy could turn out to be important, even in the modern day.
“From what I understand, this ‘potion’ as they call it, has real antibacterial potential against a serious pathogen. This is the kind of out-of-the-box thinking that we need to help us solve these tough problems,” he says. “One of the things we often lament, is that despite the incredible amount of information out there, so many times the oldest reference one will see in a modern paper is less than a decade old.
“In fact, it is often frowned upon to have a reference from the '80s — the 1980s, not the 1880s — in order to be considered ‘up to date.’ However, there is no doubt that some of the ancient (and not-so-ancient) wisdom has been lost. It's important to try to rediscover it for our own good,” says Dr. Lio.
But, not everyone is quick to believe in the findings.
“No question we are in need of antimicrobial agents to which bacteria, fungi, viruses have limited ability to develop resistance,” says Adam Friedman, M.D., F.A.A.D., assistant professor at the Albert Einstein College of Medicine. “The acidity and natural ingredients — which have multiple mechanisms of action — could overcome many of the current limitations of antibiotics, for example, which have only one biological target.
“Reporting promising findings in cell culture and mouse studies all sound promising, but without evaluating the methodology and the data, it would be very difficult to foresee this formulation’s promise, not to mention mouse to human is a huge leap,” he says.
For Dr. Diggle and his team, there is much work to be done, but this small breakthrough is a step in the right direction.
“Our work is incredibly early-stage in this regard but for me, a really interesting part of this story is that the Anglo Saxons may have been experimenting with different recipes to test specific conditions,” he says. “I think that is exciting.”