Bacteria that are resistant to antibiotics are on the rise around the world and finding new drugs is becoming increasingly difficult, making diseases such as tuberculosis or pneumonia difficult and sometimes impossible to treat. Science is looking for alternatives, and one of the most promising is phage therapy. Still in the experimental stages, but with success stories in hospitals around the world, such as the case of a woman infected with Klebsiella pneumoniae during the 2016 Brussels airport attack, the treatment uses viruses called bacteriophages, which are specialized Infection with bacteria.
Researchers Iñaki Comas and Pilar Domingo-Calap concluded that they proved capable of fighting the most complex bacterial infections, especially when combined with antibiotics.
Antibiotics represent one of the most revolutionary discoveries. The Superior Council for Scientific Research (CSIC) mentioned in a monograph in its collection that they laid the foundation for modern medicine, not only curing previously fatal infections but also enabling transformative interventions such as transplantation. Public policy science. Unfortunately, he added, its overuse leads to a dramatic increase in bacterial resistance and thus mutation. The World Health Organization (WHO) says this is one of the biggest threats to global health, food security and development today, and its growth has reached dangerous levels.
According to published in lancetAn analysis of 204 countries found that 1.2 million people die each year from antibiotic-resistant infections, a number that could increase 10-fold by 2050. Urgent action is required.
“It is increasingly difficult to find truly new antibiotics, so we have to look for alternatives, and one of the most interesting ones is It’s phage therapy.” CSIC Global Health Platform.
Hundred years of history
Bacteriophages were discovered more than a century ago by French-Canadian microbiologist Félix d’Herelle, who first used the therapy on patients in 1919. However, the discovery of penicillin in 1928 and its subsequent commercialization and antibiotic boom overturned phage therapy research, except in some countries of the former Soviet Union, such as Georgia, which despite its ups and downs has today become a benchmark through his George Eliava Institute in Tbilisi (Elyava worked with Dehrel and was executed in 1937).
But over the years, mainly due to misuse—years of antibiotics without prescriptions and misuse in agronomy—drug resistance began to emerge, leading to longer hospital stays, increased mortality and costs; for example, in Europe, treating a normal case of tuberculosis The cost is approximately €200, but if the Mycobacterium tuberculosis is multidrug-resistant, it will cost €30,000. In extreme cases, when it is extremely resistant, they can increase to €200,000.
It is this multi-drug resistance and super-resistance (for which commercially available antimicrobial drugs do not work) that is worrisome and that has brought the scientific focus back to phages.
arms race
Pilar Domingo-Calap from the Institute of Integrated Systems Biology (I2SysBio, CSIC-Universitat de València) explains that bacteriophages are viruses that infect and kill bacteria, and they are very abundant and very specific viruses in nature. They identify and exploit specific bacteria; they use its cellular machinery to create new viruses and engage in a kind of “arms race” with the bacteria until they eliminate it. Therefore, they can only eliminate disease-causing pathogenic bacteria, an ability that makes this therapy a good candidate for personalized precision medicine.
But this specificity can also be a disadvantage, since it is necessary to find the right mixture of phages for each type of infection, and because it is a virus, unlike drugs with a chemical structure, its pharmacodynamics is almost impossible Predict and measure.
Outcomes are different for every patient, which is why we must change the way clinical trials are conducted and the way we understand the results. “We are developing a very personalized medicine,” Domingo-Calap added.
Although work has been carried out at European level, appropriate regulation is lacking. Only phages are now available as compassionate therapy, and there are many successful cases, some of which are also in Spanish hospitals using phages imported from the United States and Belgium.
Production of these products has also begun in Spain. Domingo-Calap’s lab has successfully isolated them, characterized them and developed them into therapeutic tools. In fact, the researcher created in April Evolving Therapeutics SL, a spin-out company based in the Science Park of the University of Valencia, with the aim of producing biotechnological solutions based on these viruses, which are already being tested in some patients. test.