Phage Therapy Principles
Disadvantages of Phage Therapy (and Advantages)"
Due to the personalized nature of this therapy, it is indeed lengthier and thus more expensive to apply than antibiotic treatment. Indeed, it takes time to collect a sample of the patient’s bacteria, cultivate it, and conduct a phagogram (researching the most effective phage). This process already takes 7 to 10 days.
Then, it’s necessary to take a sufficient amount of phages to effectively and properly ‘infect’ the pathogenic bacteria. Treating a urinary infection with phage therapy may require 2 to 3 months to ensure the eradication of the bacteria.
On the other hand, the huge advantage of bacteriophages is that they do not cause serious or lasting side effects, unlike antibiotics. Additionally, if a bacterium becomes resistant to the administered phages, science can recreate a more effective phage based on the patient’s bacteria, ensuring that there is never an absolute therapeutic deadlock.
Finally, the great advantage of phage therapy is that it represents the ultimate solution for patients facing therapeutic dead ends.
Furthermore, another advantage of this therapy is that if a bacterium becomes resistant to the administered phages, science can create a more effective and more tailored phage for the patient’s bacteria, ensuring there are no absolute therapeutic impasses.
And lastly, the huge benefit of phage therapy is that it currently presents the ultimate solution for patients facing therapeutic impasses.
Phage therapy is a therapeutic technique that utilizes the beneficial properties of phages (bacteriophages) to combat bacterial infections. Phages are viruses that infect and destroy bacteria, but do not cause any damage to human or animal cells. That's why this therapy has no recognized side effects after 100 years of use. The process involves finding and identifying the specific viruses suitable for the infection. Then, they need to be applied to the site infected by bacteria (and only bacteria) so they can destroy them. These viruses then multiply and continue to destroy other identical bacteria that they seek out and find. Phage therapy is successfully used in the treatment of antibiotic-resistant bacterial infections, such as, among others, Staphylococcus aureus infections, Pseudomonas aeruginosa infections, Escherichia coli infections, and Klebsiella infections. It is also used in the treatment of gastric issues (gastroenterology) to regulate the microbiota, as well as in ophthalmology to treat eye infections. It's important to note that consultation with a specialized doctor is necessary before resorting to this therapeutic technique. Furthermore, it's crucial to work with qualified professionals who have experience in the use of phages to avoid potential risks and maximize benefits. Over time and with experience, doctors have grown more skilled in how to apply phage therapy.
What are bacteriophages?
That's why phages can heal us!
There are different types of phages, including lysing phages that destroy bacteria by "lysing" (destroying) them. Lysing phages are the ones used in phage therapy.
Phages are present everywhere in the environment and are very abundant in aquatic ecosystems and soils. They were first discovered at the beginning of the 20th century and have been studied in depth and used since then. Particularly for their therapeutic capacity in phage therapy.
How are phages prepared?
Of course, the industrial process is more complex and advanced, but artisanally, it is not difficult to do it in .
Phages are produced in a way that ensures they are safe and effective for patients.
Phage preparation begins with the isolation of phages from different sources, such as soils and primarily waters (especially sewer waters!). The phages are then grown and multiplied using specific bacterial cultures.
This collected water is centrifuged and decanted in a sterile environment. It is then exposed to a culture broth of the bacterium one wishes to treat. All that will remain are the phages allocated to destroy this bacterium without the bacterium, which will have been destroyed by the phages. However, there may still be bacterial debris left. A bit of chloroform is added to destroy any remaining bacteria without harming the phages. The result is then mixed at high speed to eliminate unwanted cells. This mixture will finally be extremely filtered and purified to eliminate all bacteria (on a membrane with a porosity of less than 0.45 microns), then incubated for 24 hours at 37°C.
The quality of the phages is then checked using purity, concentration, and activity tests. The phages are also tested to ensure they do not contain bacteria or harmful contaminants for patients. Phages are then formulated using excipients (like salts, proteins) to stabilize their activity and facilitate their administration. The phages are then packaged in sterile bottles for their use in therapy.
It's important to note that phage preparation is done under strict conditions of hygiene and quality, and it's regulated by health authorities to ensure the effectiveness of the phages used in therapy.
In summary, bacteriophages are prepared in the lab by isolating, cultivating, purifying, and testing phages to ensure they are safe and effective for patients. The phages are then formulated and packaged for their use in therapy. The preparation of phages is carried out under strict hygiene and quality conditions. It is regulated to ensure the safety and effectiveness of the phages used in therapy.
What is the difference between phages and antibiotics?
How are phages applied to treat patients?
Who discovered phage therapy?
Why are phages not used in the West?
Today, due to the rapidly increasing problem of antibiotic resistance, the media and scientists are starting to discuss this natural therapeutic solution again. The issue with phages is that they weren't invented but simply taken from nature. As a result, they can't be patented. But, clinical studies cost millions of euros and usually last a decade. No one wants to invest a lot of money into a non-profitable process because it can't be patented. In addition, clinical studies would need to be done for each type of phages for each disease: pseudomonas in the lungs, pseudomonas in the bones, pseudomonas in the sinuses, etc. This multiplies the clinical studies indefinitely. Here's an excerpt from the March 4, 2021 report from the French Parliamentary Office for the Evaluation of Scientific and Technological Choices (full report available by clicking on the following link: https://www.assemblee-nationale.fr/dyn/15/comptes-rendus/ots/l15ots2021101_compte-rendu) :
"A company based in France has started developing phages, Pherecydes Pharma, which will conduct clinical trials. But it must go through all regulatory steps before any market authorization. The National Agency for the Safety of Medicines and Health Products (ANSM) has told us they are absolutely not opposed to phages, but they must comply with the regulatory framework for medicines.
The lack of progress on phages in France is leading some desperate patients to turn to "medical tourism".
I want to point out that one of the barriers for phages is also economic: they can't be patented as such because they come from nature. Furthermore, phage therapy is not a long-term treatment and therefore cannot be profitable like a medicine for a chronic disease. Another barrier is scientific: each phage is very specific, it's difficult to find many similar cases and thus to conduct randomized trials testing their effectiveness and safety. Yet, European and national drug regulations require proof to admit a new drug to the market. We can therefore question the suitability of the legal framework for phages."
Dr. DUBLANCHET, a French expert in phage therapy, has been fighting for more than 20 years to try to bring back phage therapy in Europe :
Alain DUBLANCHET
The american society for Microbology is also a strong advocate for phage therapy:
https://asm.org/Articles/2022/August/Phage-Therapy-Past,-Present-and-Future
Why is phage therapy authorized in Georgia?
During the communist era, antibiotics were used less than in the West, and phages continued to be widely adopted, studied, and researched. This has made Georgia the most experienced place in the world (with 100 years of practice) and one of the largest collections of phages in the world (estimated to be over 6000).
To this day, phage therapy is still taught in medical schools in Georgia, which is not the case in the West. Georgian doctors have the knowledge, experience, authorizations, and a significant arsenal of phages to effectively treat patients.