From books to movies, in the face of antibiotic resistance, why are we talking about bacteriophages?

A recent film called "Salt in My Soul," was released overseas for one purpose to raise investment for phage and antibiotic resistance research.

The film shares the story of Mallory Smith, a deceased young woman. She suffered from cystic fibrosis. Through videos and diaries, she chronicled her daily routine, but her family didn't know about it until after her death from a multidrug-resistant Burkholderia infection. In order to treat drug-resistant infections, Mallory had to take the risk of trying to undergo phage therapy. Later, her autopsy results showed that phage therapy had begun to work, killing Onion Burkholderia as expected, but it was too late.

History of bacteriophages

The phage, aptly so named, comes from the Greek word "bacteriophagogue". A bacteriophage is a virus that can infect bacteria, and some cause bacteria to lyse (break down). The bacteriophage was first discovered in 1915 by microbiologist Felix D. Herelle and was briefly used to control cholera outbreaks. In 1934, Dehrer and the microbiologist George Eliava established a bacteriophage institute (now known as the Yeliava Institute of Phage Microbiology and Viruses) in Georgia.

Since the separation of bacteriophages is often associated with slurry and sewage, this shortcoming has raised some concerns about its purity and safety. Penicillin was then miraculously discovered and commercially produced. The rapid development of antibiotics began in 1940-1960 and continues until now. Due to the rise of antibiotics, interest in bacteriophages at the Eliava Institute and outside the SOVIET Union gradually diminished.

The resurgence of interest in phage therapy began with a growing focus on antibiotic resistance. For example, Acinetobacter multidrug-resistant has become widely known. In the early 2000s, it caused several fatal infections among military personnel in Iraq and Afghanistan.

Dr. Steffanie Strathdee, from the University of California, San Diego, once desperately searched for phages to save her husband, Tom Patterson. The two were on holiday in Egypt at the time, and her husband was infected with multidrug-resistant Acinetobacter baumann with cholelithic pancreatitis, which led to systemic multi-organ failure due to sepsis. After searching for phage matching at multiple centers, Patterson became the first person in the United States to receive an intravenous phage, and gradually recovered since then. They shared their story in the Ted-X talk and wrote a memoir, The Perfect Predator.

Application prospects for bacteriophages

In China, the application of bacteriophages is also gradually being explored. Research on periodontal disease, skin and genitourinary tract infections, burn infections and sepsis treatment has been published.

Jiang Jing's team at the First Hospital of Jilin University believes that phage display technology can also play a role in the detection of the new crown virus and the treatment and immunoprophylaxis of the new crown pneumonia. Professor Gao Zhancheng of Peking University People's Hospital wrote in an article published in the Chinese Journal of Tuberculosis and Respiratory Disease in April 2018 that "the former phage therapy has regained attention with the rise of genomics and has gradually become one of the new strategies for dealing with drug-resistant bacteria infections."

At the 7th Academic Conference of the Infectious Diseases Committee (IDSC) of the China Medical Education Association held in 2021, Professor Liu Youning of the First Medical Center of the PLA General Hospital also introduced the past and present lives of phage therapy and the latest research conducted by his team. He believes that although it is not a complete replacement for antibacterial drugs, phage therapy may be the most potential alternative therapy for traditional anti-infection treatment, and it is necessary to improve the standardization system of preparation, approval, clinical application, supervision and application treatment mechanism and establish a corresponding phage library worldwide. All in all, phage therapy is on the rise, and the future can be expected!

Write at the end

In the face of the increasing trend of antibiotic resistance, it is hoped that researchers around the world will be able to make breakthroughs from bacteriophage therapy and apply them in the clinic as soon as possible.

Image source: 123RF

Resources:

1.Can Phages Help Where Antibiotics Have Failed? - Medscape - Feb 23, 2022.

2. Pan Jiechao, Shi Junfan. Phage display antibody library technology and its application[J] . International Journal of Epidemiology and Infectious Diseases,2011,38( 03 ): 212-214. DOI: 10.3760/cma.j.issn.1673-4149.2011.03.021

3. Gao Zhancheng. The Revival of Bacteriophage Therapy: Reflections on Microbial Resistance Coping Strategies[J] . Chinese Journal of Tuberculosis and Respiratory Diseases,2018,41(4): 250-251. DOI: 10.3760/cma.j.issn.1001-0939.2018.04.004

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