Phage therapy: past history and future prospects.
Bacterial viruses (bacteriophages, also called "phages") can be robust antibacterial agents in vitro. However, their use as therapeutic agents, during a number of trials from the 1920s to the 1950s, was greatly handicapped by a number of factors. In part, there were certain limitations inherent in phage physiology (e. g. narrow host range, and rapid clearance from the body); in part there were technological limitations in the era (e.g. lysogeny not yet discovered); but the greatest limitation was the highly inadequate scientific methodologies used by practitioners at the time (e.g., their failure to conduct placebo-controlled studies, to remove endotoxins from the preparations, and to re-confirm phage viability after adding sterilizing agents to the preparations). In recent years, well-controlled animal models have demonstrated that phages can rescue animals from a variety of fatal infections, while non-controlled clinical reports published in Eastern Europe have shown that phages can be effective in treating drug-resistant infections in humans. This encouraging data, combined with the fact that drug-resistant bacteria have become a global crisis, have created a window of opportunity for phage therapy to be tested anew, this time using modem technologies and placebo-controlled designs. If successful, it can be used as a stand-alone therapy when bacteria are fully resistant to antibiotics, and as a valuable adjunct to antibiotics when the bacteria are still susceptible.
Carlton
R M
RM
Exponential Biotherapies, Inc., Port Washington, NY 11050, USA.
D000284:Administration, Oral; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000914:Antibodies, Viral / Q000096:biosynthesis; D016470:Bacteremia / Q000628:therapy; D001424:Bacterial Infections / Q000188:drug therapy / Q000628:therapy*; D010582:Bacteriophage lambda / Q000276:immunology / Q000378:metabolism; D001435:Bacteriophages; D002645:Chickens; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D004927:Escherichia coli Infections / Q000628:therapy; D005061:Europe, Eastern; D005544:Forecasting; D005818:Genetic Engineering; D006801:Humans; D008242:Lysogeny; D008657:Metabolic Clearance Rate; D051379:Mice; D010599:Pharmacokinetics; D011817:Rabbits; D051381:Rats; D012107:Research Design; D013812:Therapeutics / Q000639:trends; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000914:Antibodies, Viral