We tend to think of viruses as absolute evil. But what if they are able to provide benefits, such as treating serious infections? And to make it more effective and safer than antibiotics? Of course, we are not talking about any viruses, but about one of their varieties – bacteriophages.
Unsuccessfully falling in the country, 47-year-old Taisiya injured her lower leg. “The wound was small,” she recalls, “but there was nothing to treat it with, and an infection got there.” Against the background of diabetes and varicose veins, the damage turned into a trophic ulcer, which did not heal for six months.
“What have I not tried,” Taisiya sighs. – Children brought ointments from abroad, ordered homeopathy from China. Not to mention antibiotics. Doctors shrugged, frightened with gangrene. Every day I did the dressings. And then a friend told me that in Georgia a couple of years ago she was cured of chronic sinusitis by phage therapy. I started looking for information.”
It turned out that in the Tbilisi Eliava Research Institute of Microbiology and Virology, since Soviet times, the most complex infections have been defeated with the help of viruses – bacteriophages.
The Old New Thing
Phage therapy has been known to mankind for over 100 years. The English scientist Frederick Twort in 1915 described a “virus that devours bacteria”. This phenomenon is known as the “Twort phenomenon”. And two years later, the French researcher Felix d’Herelle made a similar observation and coined the name “bacteriophage” by combining the words “bacteria” and phagos (translated from Greek “devourer”).
Following this, experts around the world began to study the therapeutic potential of phages. Researchers have reported “almost miraculous” cures for typhoid fever, cholera, urinary tract infections, and healing of festering wounds. In the 1920s, bacteriophage-based preparations for a wide variety of ailments could be found in pharmacies. Then phage therapy was undeservedly forgotten.
Now the interest in it is again huge all over the world. And in Georgia, it never declined. “I went to Tbilisi,” says Taisiya. – It is not so easy to get an appointment at the research institute itself. People from all over the world go there. The cost of treatment for foreigners reaches several thousand euros. Fortunately, many specialists work in commercial phage therapy centers.
I contacted one of them, and they quickly found a suitable drug for me. They took a scraping from the wound, studied it for the presence of bacteria and tested the reaction to bacteriophages. For my case, there was already a ready-made medicine. I applied it to a sterile napkin and bandaged the wound. A week later, the ulcer began to heal, and a month later it disappeared.
Theoretically, phage therapy can cure all diseases caused by harmful bacteria, because each of them has its own phage predator. “When it “meets” a target bacterium, it is first adsorbed on its surface, then its RNA or DNA enters the cell and starts the formation of new phages,” explains Ksenia Selezneva, nutritionist, gastroenterologist at Atlas Medical Center. “Accumulating up to 100-200 pieces in a cell, phages destroy it from the inside.” They multiply in the hundreds every 30 minutes and destroy bacteria in a few hours.
And hello again!
In the 1940s, with the advent of antibiotics, interest in phages declined. The new drugs worked faster, cost less, and were more versatile. After all, treatment with phages is selected individually, you need to do an analysis to find out which bacteria the patient is infected with. Gradually, phage therapy was forgotten everywhere except the USSR.
Why is she remembered today? “In recent years, the effectiveness of antibiotic treatment has decreased significantly,” explains Igor Shcherbenkov, a gastroenterologist at the CELT clinic. – Bacteria develop drug resistance. They have been adapting to their environment for billions of years.” To create a new potent antibiotic, pharmaceutical companies have to spend 10 years and $800 million.
If action is not taken, the world will enter a post-antibiotic era, when common infections and small wounds can kill again.
“One day, humanity may encounter a strain of bacteria that will be resistant to all existing antibiotics, and this will end in a fatal epidemic,” confirms Ksenia Selezneva. This is due to the excessive and uncontrolled passion for antibiotics, which are used not only to treat diseases, but also in the cultivation of poultry and livestock. These drugs enter the body every day with food, and gradually addiction is formed to them.
“If action is not taken, the world will enter a post-antibiotic era, when common infections and small wounds can kill again,” worries Keiji Fukuda, WHO official in charge. By the way, phages can again become a solution to the problem. “In some places they are already used in agriculture, veterinary medicine and the food industry,” says Valentin Vlasov, Academician of the Russian Academy of Sciences, Head of the Department of Molecular Biology of the FEN NGU.
Where is the proof?
Why, then, did the whole world not switch from antibiotics to bacteriophages? The fact is that the studies conducted in the USSR were not properly documented and did not meet modern standards of clinical trials. So, from the point of view of science, the effectiveness of phages requires an evidence base.
Work in this direction is underway. In the UK, experiments on the treatment of chronic otitis media with bacteriophages have been successfully completed. Seven medical centers in France, Belgium and Switzerland are conducting clinical trials of a phage cocktail to prevent infections in burns.
But so far, bacteriophages have not been certified as a medicine either in Europe or in America. The Declaration of Helsinki of the World Medical Association of 1964 allows the use of such drugs when other means have already been tried. The patient himself agrees to therapy and finds a doctor. That is why so many patients with complex bacterial infections are sent to Georgia today.
Prescription only
In Russia, drugs based on bacteriophages can be bought at any pharmacy. The demand for them, however, is small. Most specialists know about their existence, but few prescribe them to patients.
Unlike drugs with an exact chemical formula, a bacteriophage preparation is a solution with live viral particles. An agent with the same name, produced at different times at different enterprises, may contain dissimilar combinations of phages. “In addition, studies have shown that one type of pathogenic bacteria can react unpredictably to the same phages assigned to different people,” says Ksenia Selezneva. In one patient, the bacterium is sensitive to the phage and the therapy will be successful. And in another, the same bacterium will be resistant, and the treatment will be ineffective.
Phage therapy can bring hope to patients whose diseases are considered incurable
“The appointment of bacteriophages, like antibiotics, should be justified,” agrees Anna Petrukhina, researcher at the Institute of Immunology of the Russian Academy of Sciences. – Phages can cause an allergic reaction or, for example, an exacerbation of atopic dermatitis, so it is better to accompany the treatment with enterosorbents. In addition, the uncontrolled use of antibacterial drugs contributes to the development of microbial resistance.”
It’s true. Bacteria also develop resistance to phages, although not as quickly as to antibiotics. So it is still premature to consider phage therapy as a panacea, but it is still useful to know about this method of treatment. After all, he can give hope to patients whose diseases are considered incurable.
Preventive works
On the eve of winter and a possible flu epidemic, many are asking the question: “What pill would you take to be guaranteed not to get sick?” Some manufacturers of phage preparations are now actively promoting their products on the Internet as a means of preventing seasonal infections.
But the preventive use of bacteriophages is a controversial topic, says gastroenterologist Ksenia Selezneva: “We live in close proximity to trillions of bacteria. Even a new human organ is isolated – the intestinal microbiota. She is responsible for immunity, the synthesis of certain vitamins and … mood.
This is a community of bacteria with complex relationships. Among these bacteria, there are many opportunistic pathogens, but normally they are effectively controlled by other bacteria. Unreasonable intake of bacteriophages can disrupt this harmonious world, which in the end will only reduce immunity. In addition, with a balanced microbiota, we do not need support from phages: our bacteria cope on their own.
Antibiotics, of course, have a more negative effect on the composition of the microbiota, destroying beneficial bacteria at the same time. In an “empty” place, pathogenic microorganisms often multiply the fastest. And after such therapy, it is difficult to restore a beneficial balance, it can take months, and some types of bacteria cannot be returned.” Therefore, starting self-medication with antibiotics at the first symptoms of a cold is a mistake. The use of both antibiotics and bacteriophages should be justified. Only a doctor can prescribe them.