Reimagining Cancer Care: the Promise of Theranostics
Bacteriophages (phages) are simultaneously the most lethal and abundant organisms on earth (Pinto et. al, 2020). While seemingly antithetical to their fatal nature, phage therapies offer a vital and potentially life-saving promise to the personalized medical and global health disciplines. This is due to their ability to effectively target, infect, and kill their respective bacterial hosts.
The historic accomplishments that define the era of antibiotics have long overshadowed the public and personalized medical prospects offered by a bacteriophage paradigm (Kutter et. al, 2015). Recent public health developments, however, challenge the dominance of antibiotics in treatment of bacterial infection. A rise in antibiotic resistance coupled with increasing research and support of successful bacteriophage therapies, respectively illuminates an emerging global health crisis and a new frontier of potential solutions (Altamirano et. al, 2019). Bacteriophage therapies that target a range of illnesses or diseases, may offer multidimensional treatment options that are more effective than traditional means of antibiotic medications. A bacteriophage paradigm may provide medical experts with the ability to optimally align the duality of individual outcomes and population well being.
Keywords: bacteriophage, phage, prospective phage paradigm, personalized medicine, nanomedicine
A Bacteriophage At Work
As lytic or temperate viruses that solely target a respective bacterial strain, phage(s) exist as powerful antibacterial agents within the overlapping fields of regenerative, personalized/precision, and nano-medicine (Brzozowska et. al, 2011). Phages necesitate a bacterial host to survive and successfully reproduce. Fundamentally, bacteriophages fasten themselves to a specific bacteria host cell via their tail fibers, penetrate their host, and inncolulate a bacteria cell with their subsequent viral genomic material. Once these processes are complete, the phage proceeds to reproduce, which leads to the eventual death and destruction of its bacterial host, the rupture of the bacteria cell, and the release of new bacteriophages. The virulence and specificity of phages is determined by their respective adhesins, enzymes, and the structures of their proteins (Furfaro et. al, 2018). Bacteriophages are specifically noteworthy as they do not adversely affect their surrounding environment, but solely and fatally impact their respective bacterial pathogen.
The Scientific Efficacy of Bacteriophages in Personalized and Global Health
Many medical and scientific experts have argued that bacteriophage therapies may represent “the epitome of personalized medicine as it is a process involving tailor-made phage combinations specific for an individual patient's bacterial infection/s” (Furfaro et. al, 2018). Bacteriophages have proven to be useful and effective in terms of a diversity of different medical treatments. A couple of studies which highlight the efficacy of bacteriophage treatments to both public health and personalized medicine are highlighted in this article. The results compiled in“Bacteriophage Therapy” highlight many of the “significant studies performed in Poland and the former Soviet Union” which have historically demonstrated the efficacy of phage therapies (Sulakvelidze et. al, 2020). One of the most notable studies from this article was also covered in a 2020 study entitled “Bacteriophages for Chronic Wound Treatment: From Traditional to Novel Delivery Systems” (Pinto et. al, 2020). Through these studies it was concluded that “non-healing wounds are an increasing health and global financial burden and are challenging to treat” and their experiments involving individual and phage cocktails proved to be a “promising alternative to conventional antibiotics” (Pinto et. al, 2020). Additionally, “phages administered subcutaneously or through surgical drains in 236 patients having antibiotic-resistant infections eliminated the infections in 92% of the patients” (Sulakvelidze et. al, 2020). Such studies highlight the personal and public health remedies offered by bacteriophage treatments.
The Potential Prospects of A Phage Paradigm
The prospects of an emerging Phage Paradigm include personalized treatments for patients who have been adversely impacted by multidrug resistant bacteria, degenerative disorders, chronic diseases, respiratory illnesses, and numerous other bacterial infectious diseases and ailments. Beyond utilizing bacteriophages to overcome resistance built from an extensive usage of antibiotics, phages can additionally be utilized “for precise disease diagnosis and nanotherapeutics for targeted disease treatment” (Sunderland et. al, 2016). More specifically, phages are currently being utilized in “ultrasensitive biomarker detection, enhanced bioimaging for disease diagnosis, targeted drug and gene delivery, directed stem cell differentiation, accelerated tissue formation, effective vaccination, and nanotherapeutics for targeted disease treatment” (Sunderland et. al, 2017). Bacteriophage therapies thus extend beyond traditional and conventional means of antibiotic treatment to offer both a precise and personalized means of treatment.
In offering additional and vital promises to global and public health systems, a Phage Paradigm may allow medical experts to align the duality of individual outcomes and population wellbeing via bacteriophage therapy. Historically, personalized treatments may have been sacrificed to ensure population outcomes/wellbeing and vice versa. However, it may be argued that phage therapy could offer a means of reckoning with this inherent medical duality. This is because bacteriophage therapies not only allow for personalized treatments, but additionally confront an emerging global health issue regarding increasing antibiotic resistance due to its decades long usage.
As Bacteriophage treatments have been neither a historically traditional nor conventional means of treatment, numerous concerns and continued needs for research have emerged, specifically within westernized medical systems and regimens. It is thought given that “human clinical trials reported so far show no adverse effects of the use of phage therapy”, “ the use of phages can be assumed to be safe when clear guidelines on genetic analysis and exclusion of transducing, lysogenic, and virulence-related phages are carefully followed” (Vandenheuvel et. al, 2015). Regardless of such success, further research is needed to identify “the most adequate phage(s) against a given infection, the risk of phage resistance development, the immune response to phages by the host, as well as novel regulatory requirements” (Oechslin, 2018).
Given the present rise of antibiotic resistance and scarcity of alternative treatments, bacteriophage therapies have emerged as a potential new frontier by which both public and personalized medicine may benefit. Phage treatments are receiving increasing scientific and medical attention, specifically in terms of the potential contributions they offer to personalized medicine and nanotherapeutics. While continued research is needed to confirm the safety and efficacy of bacteriophage therapies, a phage paradigm may prove unequivocally advantageous in aligning the historical duality of individual outcomes and population well being within the discipline of medicine.
Altamirano, F. L. G., & Barr, J. J. (2019, March 20). Phage Therapy in the Postantibiotic Era. Clinical Microbiology Reviews. https://cmr.asm.org/content/32/2/e00066-18.full
A;, B. E. B. J. G. (n.d.). [the functions of bacteriophage proteins]. Postepy higieny i medycyny doswiadczalnej (Online). Retrieved November 14, 2021, from https://pubmed.ncbi.nlm.nih.gov/21502693/
C;, S. K. S. Y. M. M. (n.d.). Phage-enabled nanomedicine: From probes to Therapeutics in Precision Medicine. Angewandte Chemie (International ed. in English). Retrieved November 14, 2021, from https://pubmed.ncbi.nlm.nih.gov/27491926/.
Furfaro, L. L., Payne, M. S., & Chang, B. J. (2018, October 23). Bacteriophage therapy: Clinical trials and regulatory hurdles. Frontiers in cellular and infection microbiology. Retrieved November 14, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205996/.
Encyclopædia Britannica, inc. (n.d.). Bacteriophage. Encyclopædia Britannica. Retrieved November 15, 2021, from https://www.britannica.com/science/bacteriophage.
Kutter, E. M., Kuhl, S. J., & Abedon, S. T. (2015). Re-establishing a place for phage therapy in western medicine. Future Microbiology, 10(5), 685–688. https://doi.org/10.2217/fmb.15.28
Oechslin, F. (2018, June 30). Resistance development to bacteriophages occurring during bacteriophage therapy. MDPI. Retrieved November 14, 2021, from https://www.mdpi.com/1999-4915/10/7/351/htm.
Pinto, A. M., Cerqueira, M. A., Bañobre-Lópes, M., Pastrana, L. M., & Sillankorva, S. (2020, February 20). Bacteriophages for chronic wound treatment: From traditional to novel Delivery Systems. Viruses. Retrieved November 14, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077204/.
Sulakvelidze, A., Alavidze, Z., & Morris, J. G. (2001, March). Bacteriophage therapy. Antimicrobial agents and chemotherapy. Retrieved November 14, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC90351/.
Sulakvelidze, A., Alavidze, Z., Jr., J. G. M., Alexander Sulakvelidze Division of Molecular Epidemiology, D. of E. and P. M., Zemphira Alavidze Division of Molecular Epidemiology, D. of E. and P. M., & J. Glenn Morris Jr. Division of Molecular Epidemiology, D. of E. and P. M. (2001, March 1). Bacteriophage therapy. Antimicrobial Agents and Chemotherapy. Retrieved November 14, 2021, from https://journals.asm.org/doi/full/10.1128/AAC.45.3.649-659.2001.
Sunderland, K. S., Yang, M., & Mao, C. (2017, January 24). Phage‐enabled nanomedicine: From probes to Therapeutics in Precision Medicine. Wiley Online Library. Retrieved November 14, 2021, from https://onlinelibrary.wiley.com/doi/abs/10.1002/anie.201606181.
Vandenheuvel, D., Lavigne, R., & Brüssow, H. (2015). Bacteriophage therapy: Advances in
formulation strategies and human clinical trials. Annual Review of Virology, 2(1), 599–618. https://doi.org/10.1146/annurev-virology-100114-054915