The WHO estimates up to 700,000 patients died in of multidrug resistant bacterial infections globally in 2016. This rise of multidrug resistant (MDR) bacteria is mainly driven by the excessive use of antibiotics in meat production. Some estimates claim 80% of antibiotics produced globally are used on poultry and pigs. The health threat posed by MDR infections prompted researchers to explore phage therapy again. Several publications have recently reported spectacular successes in the fight against MDR bacterial infections in humans but also livestock. While in the past phage therapy was shunned by pharma companies for various challenges (see below), now the commercial potential and advances in genetics have enticed biotech companies to exploit the deadly potential of phagetherapy as a secret weapon to kill superbugs.
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Now about the amazing nanoworld of bacteriophages:
More than 100 years ago the Franco-Canadian scientist Felix d’Herelle identified bacteriophages! They look like spaceships from another world and are most fearsome killing machines, fortunately they are targeting exclusively bacteria. D’Herelle and his colleague George Eliava immediately realised phages could be weaponised to help patients to fight off bacterial infections. However, in the western hemisphere the control of life-threatening bacterial infections was soon achieved with antibiotics, while phages and viruses became favourite research tools of geneticists. This explains why the bacteriophage T4, which is depicted here, is one of the most intensely studied biological objects. However, phage therapy was pioneered by the Eliava Institute in Georgia, where it has been advanced ever since its discovery.
Phages stick to bacteria with their leg-like fibres, which triggers a change in the protein conformation ramming their shaft into the bacterial hull. The interior of the shaft contains a needle, which punctures the bacterial envelope enabling the phage to inject its genetic material. The phage genome within minutes overcomes the bacterial defences, phage components are assembled within the cell before it ruptures to release a new wave of phages. Several biotech companies are now ready to exploit the deadly potential of phage therapy as a secret weapon to kill superbugs.
Phage therapy frequently relies on extensive phage collections.
One of them is maintained with the support of students searching phages, which can be found virtually everywhere. SEA-PHAGES () is a two-semester, discovery-based undergraduate research course that begins with simple digging in the soil to find new viruses, but progresses through a variety of microbiology techniques and eventually to complex genome annotation and bioinformatic analyses. It has assembled under the supervision of Graham Hatfull’s group at the University of Pittsburgh and the Howard Hughes Medical Institute’s Science Education division a collection of more than phages. In 2019 the Hatfull lab hit the headlines, when they reported in Nature Medicine, that geneticall engineered phages had cured a terminally ill cystic fibrosis patient, who was suffering from multidrug resistant bacterial infections in the lung:
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References:
WHO on antimicrobial resistant bacteria:
The dawn of phage therapy. Sana Rehman et al.
Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus. Rebekah M. et al. Nature Medicine volume 25, pages730–733 (2019)
Specific and Selective Bacteriophages in the Fight against Multidrug-resistant Acinetobacter baumannii. Bagińska N, et al. Virol Sin. 15. doi:
Successful adjunctive use of bacteriophage therapy for treatment of multidrug-resistant Pseudomonas aeruginosa infection in a cystic fibrosis patient. Law N, et al., Infection. 2019 May 17. doi:
Synergistic effect of phage therapy using a cocktail rather than a single phage in the control of severe colibacillosis in quails. Naghizadeh M et al., Poult Sci. 2019 Feb 1;98(2):653-663. doi:
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