The Bollyky lab at Stanford reports recently in Science that phage can PROMOTE bacterial infections by triggering maladaptive anti-viral responses in human cells and suppressing anti-bacterial ones.
Incredible work needs to be authorized and mainlined so that those with limited time can hopefully benefit and survive this disease.
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Thank you, Mark and Diane Smith for bringing awareness to phages therapy and hopefully it will become available to others like Mallory when antibiotics don't work. It is an amazing tribute to them both and so close to saving Mallory.
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But let's not make the same mistakes with phages that we made with antibiotics. Bacteria can become resistant to bacteriophage infection. We need to use bacteriophage wisely.
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Phages have been releases in the commercial health markets The life enhancement group has released a product that provides a probiotic intermixed with phages which only will kill the bad actors that would compete with the probiotic.
I have no interest with this firm
FLORASSIST® GI with Phage Technology
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Let’s get on this and publicize it more. The alleviation of CF has made a lot of progress in the decades but this should be on the front burner for research and $. This is the USA and we should be saving lives, not building bombs.
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thanks for the update..this is a vital way to disseminate information..is this relevant for no cf bronchiectasis w the same bugs? is there away toaccess the clinical trial without buying the JAMA article?
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@mendela
Ideally also, couples should be tested for the CF gene before conceiving. If both partners are positive for it, they can choose to conceive in vitro and only implant embryos that do not carry the gene at all.
Despite progress that has extended life expectancy from less than 10 years to over 30, it is a horrible disease that causes great suffering. The treatments are not exactly a picnic either: think for a few minutes what it would be like to undergo a double lung transplant.
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As a child, I was surrendered for adoption following my Cystic Fibrosis diagnosis. After accepting the doctor’s guidance that my birth parents “shouldn’t get too attached to ‘the baby,’ because she’ll be dead by 10,” my parents guarded their hearts & gave me away. As their final act of “kindness,” they told no one of my medical condition - in hopes I would be better accepted.
What followed were years of pneumonia, chronic bronchitis, and digestive struggles that no one understood. I did not learn of my CF diagnosis until meeting my birth mother after a particularly extended hospitalization at age 29 - when I was myself already a parent to 2 very sickly children; and when I had (ironically) already outlived my original life expectancy by 20 years.
Not all Cystic Fibrosis disease is the same: some variants are particularly vicious, while others are much less so. Even knowing the medical difficulties I have faced, I would never, ever counsel families NOT to bear children with CF. We are so much more than our diagnosis suggests.
Despite our struggles, it is perfectly possible for CF patients to live amazing, life-affirming, brilliant lives. We can - and do - contribute immeasurably to the fabric of human life. To exclude all CF children from the world because the “healthy” among us deem our lives not to be worth living would be a tragic mistake.
Signed, A 43yo writer, Varsity basketball player, Valedictorian, and mom of four
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Sinclair Lewis - won the Pulitzer Prize for his novel "Arrowsmith", in 1926.
Lewis was feeling cranky at the time, and declined to accept the Prize. The act of declining the Pulitzer distracted the public from the novel itself.
Which is possibly why the potential for using bacteriophage as very serious treatment for infection is "news" at this time.
The novel is not about phage; but about the human world of medical research. But - a major part of the story hinges on the point where Martin Arrowsmith, brilliant and obstreperous medical researcher, finds a phage which infects and kills - bubonic plague. Human idiocies and absurdities follow; we are not the first fools the world has seen.
Phages may be our best bet for an answer to the evolution of antibiotic resistance. Particularly since - the phages also evolve, to adapt to the changes in their prey.
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@Greenpa
Interesting. Another reason could be that by Stalin inviting Felix D' Herrell, the microbiologist who discovered phage, to the Soviet Union, that's where Phage therapy flourished. Soldiers carried canisters of phage with them on the battle field to prevent gangrene and phage therapy is a commonly used in the former Soviet Union to this day..
If I'm not mistaken, antibiotics were in development in the west around the same time. Thinking from the view of the mindset in that era: What use did we have with what that "Commie" medicine. Let alone the sources they were getting it from i.e. sewers, sputum, puss-filled bandages. One can't help feeling that ego or pride served as a road block as well.
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I studied the Russian language in college in the 1970s and my professor was an American woman of Russian descent. She had spent a lot of time in Russia and I remember her talking about their medical system as compared to ours, and specifically she mentioned that they still used leeches. It doesn’t surprise me to hear that they use other medicines that Americans would never consider.
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Anybody know how repeated phage therapy can overcome an immune response by the body?
Phages were tried in the 90's to introduce correct copies of the gene messed up in CF, but required repeated doses which didn't work because patients built up immune responses to the phages.
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@Robert The CF treatment was done with Adenoviruses, not phages. They are about as distantly related as viruses can get. Humans respond to Adenoviruses very readily, because they are common human pathogens. They may respond less strongly to phages, because they are not human pathogens but viruses that infect bacteria. I'm not read up on the literature as far as human immune responses to phages, though, so I can't say for sure there wouldn't be one.
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@Heferen Innate and adaptive immune responses are definitely mounted against phages. They are essentially ubiquitous with bacteria so recognizing them would be a strong evolutionary advantage for protection against bacteria. In fact, some experimental, not used in human, vaccines are made by engineering phages to display proteins for a specific pathogen, and since the phage itself is immunogenic, it acts as an adjuvant to boost the immune response and make the vaccine more effective.
See: Krut, O., & Bekeredjian-Ding, I. (2018). Contribution of the immune response to phage therapy. The Journal of Immunology, 200(9), 3037-3044.
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If you're interested in the idealism inherent in science, I recommend Sinclair Lewis's Pulitzer Prize-winning Arrowsmith.
Martin Arrowsmith is a young doctor who discovers phage and uses it to fight a deadly epidemic. Along the way he meets numerous characters who shape his devotion to scientific discovery.
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People need to wake up and open their minds to new treatments. There's an old saying, "Necessity is the mother of all invention." If someone is at death's door who cares if the FDA considers the treatment experimental or not?
The doctors and scientists need to fully investigate phage therapy and use it more often, especially in the case of anti-biotic resistant infections.
The bottom line: Not too long ago, many people suffered from C. Dif to the point where they did not respond to antii -biotics and were at death's door. Their only hope? A feca ltransplant. Many people considered that outrageous, unsavory and just plain terrible, but many patients have been saved by that simple technique.
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As an 82 year-old, I am continuously impressed by the steps forward in medicine. In fact, I have benefitted from them. We must all hope these new approaches continue.
Bless science.
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I was diagnosed with CF at the age of 63 after a lifetime of illness —bronchitis, acute sinus infections, digestive problems— which kept me out of school, and work much of my life. I was thankful to finally put a name to all my troubles. I was no longer “just weak”. It breaks my heart to read about young patients with CF. Research is moving to slowly. My sincere condolences to Mallory’s family.
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My beloved son (Joshua) passed at 27 its been 2 yrs. I still cry he was my youngest child. Please try anything that might even work a little bit. Joshua was not eligible for for a transplant because he had a lot of other serious medical issues. I love & miss him so mush crying texting this.
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@colleen cholewka
Dear Colleen,
I send you my deepest sympathy. I have lost two sons to this horrible disease, and I share your broken heart.
New treatment developments may help others and that is wonderful. The pain in knowing that your family member will not merit from this science, is at times overwhelming.
Bless you and take care.
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@colleen cholewka Your comment has brought tears to my eyes. I am so very sorry for your loss.
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@colleen cholewka I'm a Respiratory Therapist (retired).
In the 90's I worked at the CF clinic at Oregon Health Sciences University in Portland. CF is a tough disease. Thinking about those kids brings tears to my eyes to this day.
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I was diagnosed with CF last year at age 73! I obviously a "mild" case. In addition to asthma/allergies and CF-specific infertility, I was quarantined for a week in 2017 after a sputum sample yielded presence of acid-fast bacteria, the class that includes TB and leprosy! It turned out to be M. Abscessus, which is not contagious. The critter colonized in my lungs, so far without signs of infection, but it is still there. It is apparently a fairly common colonizer in compromised lungs, and it is pretty resistant to antibiotics. For the sake of younger and more seriously impacted CF patients, as well as myself, I hope phage researchers will work on a cocktail for M. Abscessus, too!
Thanks for this very informative article!
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@Robert L
You might be interested in this story:
https://www.npr.org/sections/health-shots/2019/05/08/719650709/genetically-modified-viruses-help-save-a-patient-with-a-superbug-infection
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The history of the discovery, research, and therapeutic use of “bacteriophages” is fascinating, and largely centers around the work carried out by Canadian microbiologist Felix d’Herelle and Georgian scientist George Eliava, who founded the Eliava Institute in Tbilisi, Georgia in 1923. Despite promising results in treating such infections as typhoid, with Alexander Fleming's discovery of penicillin in 1928, interest in phages largely died out except in Georgia, where, working under the direst of conditions and despite Stalin’s execution of George Eliava as an “enemy of the people,” the scientists there managed to save the “phage bank” they had created.
With MRSA infections gaining ever more ground, we may be very grateful that those dedicated scientists in Tbilisi did not allow this promising therapy to die.
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@Susan
phages helped launch the molecular biology field. There was much more research that used phages than what you refer to.
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@Susan
That's right. There was a story about d’Herelle and Eliava in the NYT.
https://www.nytimes.com/2000/02/06/magazine/a-stalinist-antibiotic-alternative.html
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@A J
Perhaps you would like to tell us about it.
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