[26]
Will scientists look more to prevent bacterial meningitis or treat it?
Future works will be focused on the
preventive aspect more so than the therapeutic. For example, in early 2000 the 7-valent pneumococcal protein–polysaccharide conjugate vaccine was introduced and appeared to prevent invasive infections in young children. The vaccine may have also reduced the rate of invasive disease in older adults. Developing quadrivalent conjugate vaccines (A/C/Y/W-135) for immunoprophylaxis against meningococcal infection in at-risk groups may provide more effective and longer-lasting immunity than the current polysaccharide vaccine.
Another approach to prevent bacterial meningitis will be to improve food processing and food-safety measures. Doing so may specifically reduce the incidence of L. monocytogenes meningitis, which is a growing problem in the immunocompromised.[22]
Future works will be focused on the
preventive aspect more so than the therapeutic. For example, in early 2000 the 7-valent pneumococcal protein–polysaccharide conjugate vaccine was introduced and appeared to prevent invasive infections in young children. The vaccine may have also reduced the rate of invasive disease in older adults. Developing quadrivalent conjugate vaccines (A/C/Y/W-135) for immunoprophylaxis against meningococcal infection in at-risk groups may provide more effective and longer-lasting immunity than the current polysaccharide vaccine.
Another approach to prevent bacterial meningitis will be to improve food processing and food-safety measures. Doing so may specifically reduce the incidence of L. monocytogenes meningitis, which is a growing problem in the immunocompromised.[22]
Will therapeutic approaches still be taken? If so, what type?
Antibody-based drugs are commonly used in oncology and inflammatory diseases such as bacterial meningitis. Anti-virulence approaches, phage therapy and therapeutic antibodies are strategies that will end up outputting drugs with high specificity and therefore a narrow spectra. However, there has not been a drug that has been approved for market authorization. So far, only one antivirulence non-antibody type drug that has entered clinical trials, Synsorb-Pk. It was created in response to the E.coli outbreak which can cause bacterial meningitis. These antivirulence strategies are advantageous because of the specificity of the resulting drugs and because of the low selective pressure for resistance development, but in reality none of these drugs will be seen in the market for at least another ten years and may never be used used as first-line drugs under life threatening conditions. Because of their narrow specificity, this is true for therapeutic antibodies also, but these are already further in developement.
Although a few candidates have been turned down by regulatory authorities, there is still hope for this field.[23]
Not everyone with bacterial meningitis are aware that they have the disease. Are better techniques being invented to improve diagnosis of bacterial meningitis?
Future work look to use ontologies for a deeper and clearer semantic interpretation of symptoms and signs. In today’s models, each sign and symptom of acute bacterial meningitis has been shown to arise as an independent event. The basis of gathered probabilities come from this assumption, meaning that possible interrelationships are considered. Taking interrelationships into account would lead to complicated conditional probabilities. The bayesian inference engine which exists today would need severe refurbishing to handle these relationships.
Ontologies could be a way to implicitly model those interrelationships without the need to explicitly model the conditional probabilities. These would be used through a case-based reasoning system, which do not rely on explicit mathematical models, unlike today’s bayesian systems. The use of ontologies could yield major benefits in diagnosing bacterial meningitis in the future.[24]
Antibody-based drugs are commonly used in oncology and inflammatory diseases such as bacterial meningitis. Anti-virulence approaches, phage therapy and therapeutic antibodies are strategies that will end up outputting drugs with high specificity and therefore a narrow spectra. However, there has not been a drug that has been approved for market authorization. So far, only one antivirulence non-antibody type drug that has entered clinical trials, Synsorb-Pk. It was created in response to the E.coli outbreak which can cause bacterial meningitis. These antivirulence strategies are advantageous because of the specificity of the resulting drugs and because of the low selective pressure for resistance development, but in reality none of these drugs will be seen in the market for at least another ten years and may never be used used as first-line drugs under life threatening conditions. Because of their narrow specificity, this is true for therapeutic antibodies also, but these are already further in developement.
Although a few candidates have been turned down by regulatory authorities, there is still hope for this field.[23]
Not everyone with bacterial meningitis are aware that they have the disease. Are better techniques being invented to improve diagnosis of bacterial meningitis?
Future work look to use ontologies for a deeper and clearer semantic interpretation of symptoms and signs. In today’s models, each sign and symptom of acute bacterial meningitis has been shown to arise as an independent event. The basis of gathered probabilities come from this assumption, meaning that possible interrelationships are considered. Taking interrelationships into account would lead to complicated conditional probabilities. The bayesian inference engine which exists today would need severe refurbishing to handle these relationships.
Ontologies could be a way to implicitly model those interrelationships without the need to explicitly model the conditional probabilities. These would be used through a case-based reasoning system, which do not rely on explicit mathematical models, unlike today’s bayesian systems. The use of ontologies could yield major benefits in diagnosing bacterial meningitis in the future.[24]