It’s summer 2017, and the lungs try to do one third of their normal function. He suffered from cystic fibrosis, a genetic disease that clogs the lungs with mucus and infects patients with persistent infections. For eight years he has used antibiotics to
fight two types of stubborn bacteria.
A few weeks after the transplant, the doctors noticed redness at the site of the surgical wound and signs of infection in the liver. Then they see nodules bags of bacteria that squeeze the skin in the hands, feet and buttocks. The girl’s infection has spread and traditional antibiotics are no longer effective. New personal care now helps the girl recover.
This treatment is based on genetically modified bacteriophages, viruses that can infect and kill bacteria. In the next six months, almost all of the girl’s skin spots disappeared, her surgical wounds began to close and her liver function improved, scientists reported on May 8, 2019, in the journal Nature Medicine.
This work is the first to show the use of safe and effective technical bacteriophages in patients, said Graham Hatfoul, a professor at the Howard Hughes Medical Institute (HHMI) at the University of Pittsburgh.
Such treatments can provide a personalized approach to counteract drug-resistant bacteria. It can even be used to fight diseases such as tuberculosis. The idea is to use bacteriophages as antibiotics – something we can use to kill bacteria that cause infections,” Hatfull said.
In October 2017, Hatfull received an email with his team searching for a full month for bacteriophages. A colleague from a London hospital explained the case: two patients, both teenagers. Both have cystic fibrosis and receive duplicate lung transplants to restore lung function. Both are chronically infected with strains of Mycobacterium, the family of bacteria that cause tuberculosis.
Infection begins many years ago and breaks after transplantation. This error does not respond to antibiotics, Hefthul said. – They are very resistant to bacterial strains of medicine.
But maybe there are other things that can help. Hatfull, a molecular geneticist, spent more than three decades in collecting bacteriophages or phages from the environment. Partner Hatfull asks if there are phages that can affect patient tension.
That was a fantastic idea, said Hattful, and he was fascinated. The phage collection – the world’s largest – lives in around 15,000 bottles and fills the shelves of two freezers at a height of 6 meters in his laboratory.
They have been collected in thousands of different locations throughout the world – and mostly by students. Hatfull operates an HHMI program called SEA-PHAGES, which provides hunting opportunities for phages in the first and second year. In 2018, nearly 120 universities and colleges and 4,500 students from all over the country participated in this program, which has attracted more than 20,000 students over the past decade.
On land, water and air there are more than one million phages (one quadrillion billion). After testing samples to find phages, students learn them.
They will see how they look under an electron microscope, sort the genomes, test how well they infect and kill bacteria, and where fage trees are.
This program involves students at the beginning of real science,” said David Asayi, HHMI senior director for science education and director of the SEA-PHAGES program. “Whatever they find is new information, basic biological information is valuable, he said.” Now gathering phages actually helps patients. This is not the original intention of this program, said Asai and Hattful. “I feel that this collection is very strong when it comes to biological problems,” Hatfoul said. “But we don’t think we will use this phage therapeutically to some degree.
The idea of fagotherapy has been around for almost a century. However, until now, there has been little data on the safety and efficacy of treatment. In 2017, doctors in San Diego, California, have successfully used phage to treat patients with bacteria that are resistant to some drugs.
This case and increased antibiotic resistance have aroused interest in phages, said Hattful. Less than a month after learning about two infected patients in London, he received samples from a strain of bacteria. His team searched for their phage collection, which could potentially infect bacteria.