Development of Host Immune Response to Bacteriophage in a Lung Transplant Recipient on Adjunctive Phage Therapy for a Multidrug-Resistant Pneumonia

Phage-specific immunity impairs efficacy of bacteriophage targeting Vancomycin Resistant Enterococcus in a murine model

Bacteriophage therapy is a promising approach to address antimicrobial infections though questions remain regarding the impact of the immune response on clinical effectiveness. Here, we develop a mouse model to assess phage treatment using a cocktail of five phages from the Myoviridae and Siphoviridae families that target Vancomycin-Resistant Enterococcus gut colonization. Phage treatment significantly reduces fecal bacterial loads of Vancomycin-Resistant Enterococcus. We also characterize immune responses elicited following administration of the phage cocktail. While minimal innate responses are observed after phage administration, two rounds of treatment induces phage-specific neutralizing antibodies and accelerate phage clearance from tissues. Interestingly, the myophages in our cocktail induce a more robust neutralizing antibody response than the siphophages. This anti-phage immunity reduces the effectiveness of the phage cocktail in our murine model. Collectively, this study shows phage-specific immune responses may be an important consideration in the development of phage cocktails for therapeutic use.

Exploring the Bacteriophage Frontier: A Bibliometric Analysis of Clinical Trials Between 1965 and 2024

In recent years, the rise of antibiotic-resistant bacteria has posed a severe threat to global public health, necessitating innovative and alternative approaches to combat this escalating crisis. Bacteriophages, viruses that infect and replicate within bacteria, have emerged as promising candidates for therapeutic intervention against antibiotic-resistant pathogens. This study delves into the intricate landscape of bacteriophage research, unraveling the trends and impact of research in the field. The analysis considers the chronological evolution of research, identifying key contributors, collaborative networks, and thematic trends that have shaped the trajectory of this rapidly growing field. Out of 101717 search results in the PubMed database, 163 clinical trials were identified, revealing a dynamic landscape of research activity between 1965 and 2024. The annual scientific publication analysis unveiled fluctuations in the number of publications, indicating an overall increasing trend. Notably, 2011 emerged as a peak year, signifying heightened activity in bacteriophage research. Employing Lotka's law, the authors' productivity analysis illustrated an inherent imbalance in author contributions, with a majority contributing to a single clinical trial. Co-authorship analysis highlighted leading collaborators. Co-occurrence analysis of keywords unveiled thematic clusters, providing insights into the diverse aspects of bacteriophage research. A word cloud emphasized significant terms, while a thematic map categorized themes into various developmental stages. Antimicrobial Agents, Chemotherapy, and Poultry Science were the most relevant journals based on the number of publications. The analysis of countries' contributions revealed the United States as a leading contributor, with Switzerland and China following suit. Collaboration patterns suggested predominantly independent research, with potential for increased international partnerships in certain regions. Additionally, temporal analysis of authors, institutions, sources, and countries revealed productivity patterns, historical context, and research shifts. By scrutinizing a vast array of scientific literature, this investigation aims to provide a panoramic view of how the scientific community has explored the potential of bacteriophages in the context of antibiotic resistance.

Phage therapy in lung infections caused by multidrug-resistant Pseudomonas aeruginosa - A literature review

Pulmonary infections of patients with cystic fibrosis (CF) or in intensive care units are frequently caused by the Gram-negative opportunistic pathogen Pseudomonas aeruginosa. Since these bacteria are commonly inherently multidrug-resistant (MDR) and hence, antibiotic treatment options are limited, bacteriophages may provide alternative therapeutic and prophylactic measures in the combat of pneumonia caused by P. aeruginosa. This prompted us to perform a comprehensive literature survey of current knowledge regarding effects of phages applied against pulmonary P. aeruginosa infections. The included 23 studies revealed that P. aeruginosa specific phages lyse and eliminate the bacteria even in case of biofilm production in vitro, whereas application to mice and men resulted in mitigated P. aeruginosa induced clinical signs and enhanced survival. Besides distinct host immune responses, no major adverse effects limiting therapeutic and/or prophylactic phage application were noted. However, the immune system and antibiotics generate synergies with phages due to the mutable sensitivity of P. aeruginosa. In conclusion, results summarized in this review provide evidence that phages constitute promising alternative treatment options for lung infections caused by MDR P. aeruginosa. Further studies are needed, however, to underscore the efficacy and safety aspects of phages application to infected patients including immune-compromised individuals.

Characterization, antibacterial, and cytotoxic activities of silver nanoparticles using the whole biofilm layer as a macromolecule in biosynthesis

Recently, multi-drug resistant (MDR) bacteria are responsible for a large number of infectious diseases that can be life-threatening. Globally, new approaches are targeted to solve this essential issue. This study aims to discover novel antibiotic alternatives by using the whole components of the biofilm layer as a macromolecule to synthesize silver nanoparticles (AgNPs) as a promising agent against MDR. In particular, the biosynthesized biofilm-AgNPs were characterized using UV-Vis spectroscopy, electron microscopes, Energy Dispersive X-ray (EDX), zeta sizer and potential while their effect on bacterial strains and normal cell lines was identified. Accordingly, biofilm-AgNPs have a lavender-colored solution, spherical shape, with a size range of 20-60 nm. Notably, they have inhibitory effects when used on various bacterial strains with concentrations ranging between 12.5 and 25 µg/mL. In addition, they have an effective synergistic effect when combined with phage ZCSE9 to inhibit and kill Salmonella enterica with a concentration of 3.1 µg/mL. In conclusion, this work presents a novel biosynthesis preparation of AgNPs using biofilm for antibacterial purposes to reduce the possible toxicity by reducing the MICs using phage ZCSE9.

Phage therapy: From biological mechanisms to future directions

Increasing antimicrobial resistance rates have revitalized bacteriophage (phage) research, the natural predators of bacteria discovered over 100 years ago. In order to use phages therapeutically, they should (1) preferably be lytic, (2) kill the bacterial host efficiently, and (3) be fully characterized to exclude side effects. Developing therapeutic phages takes a coordinated effort of multiple stakeholders. Herein, we review the state of the art in phage therapy, covering biological mechanisms, clinical applications, remaining challenges, and future directions involving naturally occurring and genetically modified or synthetic phages.