Friday, February 17, 2012

0 Phage-holder

Rather than use the term "placeholder" I decided to use "phage-holder" because this post is going to be all about bacteriophage and phage therapy.

First, I came across this Nature blog post from Jim Caryl from last April - "No action today, no antibiotics tomorrow..." It outlines the serious problem of growing antibiotic resistance to infection and proposes different technological solutions for combatting resistance.

Jim advocates the revamping of our current drug manufacturing system to produce new antimicrobial therapies based on new targets as well as remodeling old antibiotics with high toxicity so that they are less toxic. He is not as enthusiastic about the application of phage therapy, citing a need for more efficacy testing and double blind random control trials. Those who commented on his blog, though, are strongly in support of phage therapy and think it has much promise.

 If you are a Lyme disease patient (or care about someone who is) then his fourth item on his anti-microbials-of-the-future list may interest you - if the data is there to support persister cells as part of Borrelia burgdorferi's pathogenesis:
"The current model for drug discovery is towards drugs that interfere with actively growing bacteria, however, bacteria aren't always actively growing. I've written before about how being in a different growth-phase can render a bacterial cell resistant to antibiotics. This can lead to repeated flare-ups of the infection until, eventually, true genetic resistance evolves that allows the bacteria to survive, and continue growing in the presence of the antibiotic. Thus there is the proposal that as part of enhanced efforts in drug discovery, that a platform for developing drugs at slow- or non-growing bacteria be practised."
Check out Jim's well-written post, and check out the comments.

Second, I periodically see what's new in terms of phage therapy education and outreach in the United States - and in particular, drop by Evergreen State College's (ESC - Olympia, WA) pages on bacteriophage research.

If you take an interest in learning more about phage therapy, this is a good place to start for an English-language based repository. On ESC's web site you can learn about phage research around the world, including at the well-known Eliava Institute in Tblisi, Georgia - and there are interesting links such as one to a new journal, Bacteriophage, the first international, peer-reviewed journal dedicated to all aspects of bacteriophage research, ranging from basic phage biology and taxonomy to advanced bacteriophage-host cell interactions and various practical applications of bacteriophages.

If this is really your thing, you might want to prepare for the next International Phage Biology Meeting in 2013, with more details  about this meeting to be announced here in the future:

Third, little late to the game on this one - but I have news on the business side of phage therapy in the United States. I discovered the web site of this company, Amliphi Biosciences Corporation, which states "AmpliPhi Biosciences is the first company to demonstrate the clinical efficacy of phage technology in a controlled, regulated, human clinical trial."

While their focus is on researching bacteriophage therapy for resistant Gram-negative bacterial infections, there is currently no development underway for Borrelia burgdorferi infections (which if you'll recall is not exactly Gram-negative bacteria anyway). But the research they are doing may improve and save the lives of many people struggling with resistant bacterial infections such as children suffering from chronic ear infections and adults suffering from cystic fibrosis. In fact, AmpliPhi is receiving initial funding support from Cystic Fibrosis Foundation Therapeutics, Inc. (a nonprofit affiliate of the Cystic Fibrosis Foundation).

Check out their product pipeline page to learn more about the clinical trials they have been conducting on phage therapy for helping people with these conditions as well as for other purposes.

Last but not least, I wanted to announce that one of my own pages on bacteriophage will soon be updated due to a major oversight that was called to my attention through my recent exchanges with Dr. Alan MacDonald on Lymenet Europe. He posted some images of Dr. Alan Barbour's early research on Borrelia burgdorferi where a B-3-like phage was found on and in spirochetes (Why are there so many Allens or Alans doing research in this field?). This is research that definitely should have been included in this page and I am very remiss in not including it.

I also realize that part of it needs rewriting in general because a few basic concepts about how phage therapy works need to be included - including the fact that each phage is often very strain specific. My current writing suggests to the reader that one phage will handily kill all Borrelia burgdorferi when that is not so - though a genetically modified virus which attacks Borrelia might be altered in such a way as to inject different Borrelia with something that is disruptive to a common Borrelia target. Phages "in the wild" do not operate in this fashion - they are found and they evolve on their own and are strain specific. So expect this page to be updated to include this information soon.

One may wonder why Camp Other is so interested in bacteriophage therapy. The reason is simple: There may be some way in the future to detect which strains of Borrelia someone has been infected with at the site of a tick bite and develop a phage-based ointment that will prevent infection from disseminating. It will do so without the problem of antibiotic resistance cropping up and without all the horrible side effects that antibiotics can bring including the risk of contracting C. difficile.

So I would very much like to see this be made possible, though there are inherent difficulties in finding lytic phages for Borrelia and the issue that "handedness" ("male"/"female") of the bacteria is related to finding effective phages, much like the "handedness" of sugars has different effects in the human body.


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