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Phage Therapy Coming Back into Vogue

Best ABX were not available behind the Iron Curtain so the Soviet Union used bacteriophages
Still widely used in Russia, Georgia, Poland to tx infx
Increasing microbial resistance to antibiotics makes phage therapy more appealing worldwide
3/2014: US National Institute of Allergy and Infectious Diseases listed phage therapy as one of seven prongs in its plan to combat antibiotic resistance
5/2014: American Society for Microbiology (ASM) meeting: Grégory Resch of the University of Lausanne in Switzerland presented plans for Phagoburn: the first large human trial funded by the Euro Commission
Phage therapy kills just one strain of bacteria, not broad spectrum
“Antibiotics are a big hammer,” Schmidt says. “You want a guided missile.”
Easy to find phage for bacterial target
No two identical phages have been found
Bacteria become resistant to phages by shedding the receptor that the virus uses to enter
Next phase of phage tx is to add more phages to mix, cocktail mix reduces odds of resistance developing
Phage cocktail products are updated each 8 mo, needs to be updated often for public health
European Union (EU) is contributing €3.8 million (US$5.2 million) to the Phagoburn study
Study begins in September, in France, Belgium and the Netherlands
n = 220 burn victims whose wounds are infx with E.coli or Pseudomonas aeruginosa
Txed with phage preparations from Pherecydes Pharma in Romainville, France
This co has isolated 1,000+ viruses from sewage/river water and screened them for the ability to kill pathogenic bacteria
Govts are looking at this for public health, big Pharma resistant
Phage therapy is nearly 100 years old, can't claim intellectual property
2013 ruling by the US Supreme Court against the patenting of natural genes will apply
Jérôme Gabard = chief executive of Pherecydes says co hopes to patent combinations of phages
Also might be able to patent an engineered phage (use DNA-editing system called CRISPR to make phage that kills abx resistant bacteria by injection RNA that matches DNA of resistance gene, binds this and causes Cas9 enzyme to destroy cell's DNA)
Initial trials: phage kill 99%+ of E. coli cells w specific anti­biotic-resistance gene sequences
Left susceptible cells alone
First tested in waxworm larvae (it worked), now experimenting on mice
Phage therapy not expected to replace abx
People with abx resistant infx are travelling to Georgia for TX
Docs in some EU countries send pt samples to the Eliava Institute, get specific phage cocktail

Nature 510, 15–16 (05 June 2014) doi:10.1038/510015a



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