Length: 7 mins 17 secs
The growing menace of antibiotic resistance has been the subject of increasing press attention in recent years. In this clip from the BBC’s medical magazine show Trust Me I’m A Doctor surgeon Gabriel Weston investigates a potential alternative to antibiotics, the use of bacteriophage in an approach known as Phage Therapy. This apparently novel approach has actually been the subject of extensive research over many decades in the former Soviet Union, especially in the Republic of Georgia. Patients whose diseases are proving resistance to more traditional Western treatments based on antibiotics are now travelling to the Eliava Institute in Tbilisi to try this alternative.
Bacteriophage are naturally-occurring viruses that inject their genetic material into bacteria and exploit the host cells to replicate before bursting out, killing the bacterial cell. If that bacterium was the cause of illness for a human (or indeed an animal) then this action has potential therapeutic benefit. There is little risk to the patient as phage are highly specific to a certain strain of bacteria and do not directly affect us. In fact, the narrow specificity of phage is both a benefit and a hindrance. Unlike broad-spectrum antibiotics, phage therapy should not have adverse effects on other microbes in our body, including those that are aiding in our digestion. On the downside it does mean that you need to carefully identify the specific bacterial species causing the illness in order to match it to the right phage. In practice, phage therapy often involves the provision of a cocktail of different bacteriophage (either tailored to the specific patient or as a more “off the shelf” combination). Providing a cocktail also helps to reduce the possibility of a given bacterium developing resistance that would jeopardise this approach.
Although there is a long history of phage research behind the iron curtain, much of it was poorly documented and trails were not conducted to the standards expected in contemporary medicine. New trials to these more exacting standards are now underway.
For an accessible recent review on phage therapy see Nobrega et al (2015), Trends in Microbiology 23:185-191