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Phage treatment: Bacterial viruses can treat stubborn infections

Phage treatment: Bacterial viruses can treat stubborn infections

Sciences alternative to antibiotics

Bacterial viruses heal patients with incurable infections

Illustration of bacterial locomotion, a horizontal mechanism of gene transfer that can lead to antimicrobial resistance.  This illustration illustrates the transduction process in which phages can mistakenly transfer antibiotic resistance genes from one bacterium to another.  First, the phage attaches to a bacterium (top left), injects its DNA (deoxyribonucleic acid) into the cell, and uses the cell's machinery to break up the cell's genome.  The fragmented genome is then packed into individual phages (yellow phages), some of which (green phages) contain DNA fragments of the bacteria (deoxyribonucleic acid) that may contain antibiotic resistance genes.  Bacterial cell lysis then (middle, right) releases all phages.  The phage containing the antibiotic resistance genes then continues to infect other bacteria (lower left).

Bacteria most often threatened (in blue): contact with phages

Source: Getty Images / Science Photo Library RF

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More and more dangerous germs no longer interact with antibiotics. A new study shows that phage therapy can sometimes help. The majority of patients were able to treat bacterial viruses. Now a larger investigation should clarify whether this also applies to other pathogens.

ePhage therapy can help fight hard-to-treat bacterial infections. In one study, an international research team treated a total of 20 patients with the help of so-called phages – viruses that kill bacteria. All participants had a very stubborn bacterial infection. The treatment was successful in eleven patients, according to a report by the team led by Graham Hatfoul of the University of Pittsburgh. In the journal “Clinical Infectious Diseases”. Accordingly, there were no side effects.

Holger Zeer, Head of the Department of Pharmaceutical Biotechnology at the Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM) in Braunschweig, refers to the highly heterogeneous group of study participants, which included both children and adults with different clinical pictures, complex infections and different types of etiology diseases. The expert, who was not involved in the work, says that the fact that, under these conditions, more than half of the participants responded to treatment is impressive. “This result cannot be argued with.”

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Germs are viruses that fight bacteria, especially in infectious diseases

Germs are viruses that infect bacteria. Some phages specialize on individual types of bacteria, often only on specific strains of the type. Viruses penetrate bacteria through special receptors and multiply in the cell – until the mass of newly produced viruses causes the bacterial cell to explode and thus kill it.

Because they are highly specialized, phages do not destroy any beneficial bacteria during treatment, for example in the intestine, nor do they attack the cells of the body. On the other hand, a suitable gap must be found for the specific pathogen strain of the patient. While phage therapy has a long tradition in the former Eastern Bloc countries, it became unused in Western countries after the advent of antibiotics.

Developed in the Eastern Bloc – long ignored in the rich West

That has changed over the past few years Especially due to increased antibiotic resistance to bacterial pathogens. Study leader Hatfull conducted individual case studies in the past Posted with promising results In each case, in patients for whom all previous methods have failed. Then he received inquiries from doctors about 200 patients around the world.

With this in mind, the team selected 20 participants who were infected with so-called mycobacteria, most of whom were strains of Mycobacterium abscess. 16 patients with metabolic disease cystic fibrosisalso cystic fibrosis (CF) called. Due to a genetic defect, mucus is no longer able to drain from many organs such as the lungs. This allows bacteria to exist in their nests, among other things ignition Effects.

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Illustration of bacterial cystitis.  Cystitis (inflammation of the bladder) can be caused by the bacteria Escherichia coli (red).

Hatfull was quoted as saying in a statement issued by his university that M. An abscess is a nightmare for doctors. “Although it is not as common as some other infections, it is among the most difficult to treat with antibiotics.”

Participants, including adults and children over the age of five, received the phages — each different — either by injection or inhalation, one billion units twice daily for mostly six months. The team rated the treatment as successful in eleven participants, found no improvement in four patients, and the outcome was inconclusive in the remaining five.

Doctors found no evidence that pathogens became immune to phages during treatment. In addition, they did not notice any side effects. “It adds a lot of weight to the impression that the treatment is safe,” Hatfoul says.

The big question: Why doesn’t therapy help everyone?

It is not clear why the treatment worked for some participants and not for others. Hatfoul says this may have something to do with the phages used. “We have not yet figured out how to find or make the phages that will capture each strain of these patients. This remains one of the most important challenges for the future.”

In Germany, a clinical study of phage therapy should begin in the second half of the year, says phage expert in Braunschweig, ZER. In contrast to the current study, this fairly standardized group of participants is thus exclusively cystic fibrosis patients who have been infected with the lung bacteria Pseudomonas aeruginosa. You get a mixture of three different phages that cover about 75 percent of P. aeruginosa strains. Zohr expects the first results to appear within the next year.