Phage Therapy in the US

Natural Science
Natural Science

Have you ever heard of phages? aka bacteriophages? I had not, nor phage therapy.

Mother Jones reports:

The Food and Drug Administration has not licensed phage therapy, keeping it out of pharmacies and hospitals. Few physicians have used it even experimentally, and most civilians have never heard of it. But phages are a natural phenomenon, frequently deployed in the former Soviet Union. When used properly, they can save lives.

To understand how phage therapy works, it helps to know a little biology, starting with the distinction between bacteria and viruses. Most of the drug-resistant superbugs that cause medical havoc are bacteria, microscopic single-celled organisms that do most of the things that other living things do: seek nutrition, metabolize it into energy, produce offspring. Viruses, which are much smaller than bacteria, exist only to reproduce: They attach to a cell, hijack its reproductive machinery to make fresh viruses, and then, in most cases, explode the cell to let viral copies float free.

Phages are viruses. In the wild, they are the cleanup crew that keeps bacteria from taking over the world. Bacteria reproduce relentlessly, a new generation every 20 minutes or so, and phages kill them just as rapidly, preventing the burgeoning bacterial biomass from swamping the planet like a B-movie slime monster. But phages do not kill indiscriminately: Though there are trillions in the world, each is tuned evolutionarily to destroy only particular bacteria. In 1917, a self-taught microbiologist named Félix d’Herelle recognized phages’ talent for targeted killing. He imagined that if he could find the correct phages, he could use them to cure deadly bacterial infections.

That was a gleaming hope, because at the time, nothing else could. (Sir Alexander Fleming wouldn’t find the mold that makes penicillin, the first antibiotic, until 1928.) Treatments were primitive: aspirin and ice baths to knock down fever, injections of crude immunotherapy extracted from the blood of horses and sheep, and amputation when a scratch or cut let infection burgeon in a limb and threaten the rest of the body with sepsis. Phages—whose full name, bacteriophages (or “bacteria eaters”), was given by d’Herelle in 1916—did something that medicine had never before been able to accomplish: They vanquished the infections for which they were administered without otherwise harming patients. A medical sensation and a cultural phenomenon, they provided the key plot device in the novel Arrowsmith, about an idealistic doctor, that won the Pulitzer Prize in 1926, and they saved the life of the Hollywood cowboy actor Tom Mix, a 1930s superstar.

D’Herelle was a restless researcher who seems to have felt undervalued despite being awarded jobs in Paris and Vietnam and at Yale. That insecurity made him vulnerable to an offer he received in 1933 to relocate to Tbilisi in Georgia, home territory of Soviet dictator Joseph Stalin. With a protégé, Georgi Eliava, d’Herelle co-founded the Eliava Institute of Bacteriophages, Microbiology and Virology. Stalin showered the institute with attention and money because it offered something he badly wanted: a scientific achievement that he could portray as a pure product of communism. Antibiotics became the basis of infectious-disease medicine in the West, but behind the Iron Curtain, phages took their place.

Eliava was murdered in a political purge in 1937, and d’Herelle died in 1949. Their institute dwindled, but it survived the collapse of the Soviet Union in 1991 and the Georgian civil war the following year. When the former USSR opened up to the West, physicians in the United States and Europe learned the Eliava Institute was one of the few places in the world where researchers were still studying and administering phages. That was fortunate timing, because antibiotics in the West were losing their power under the onslaught of antibiotic resistance.

(click here to continue reading He Was Dying. Antibiotics Weren’t Working. Then Doctors Tried a Forgotten Treatment. – Mother Jones.)

Fascinating article, well worth reading. 

Will phage therapy ever catch on in the US? Maybe, but our medical system is dependent upon the profit motive, thus pharmaceutical corporations are less interested in phage therapy because the resultant drugs won’t be so easily monetized. Plus the FDA’s bureaucratic infrastructure impedes studying these kinds of medicines.

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