phage

Right now, phage therapy is most often used in dire cases, where side effects like that are less of a thing.

CTX is a temperate phage that makes cholera produce toxin.

There's more in the treatment section [3], which doesn't mention phage therapy however.

Involves keeping "banks" of phages around, and creating custom cocktails of them.

Georgia has been the center of phage research since the 20s and has a massive bank of phages for all sorts of infections.

You can select for a high-fitness phage with serial passages: Plate the host bacterium along with some phage.

That's not the only reason no-one uses phage therapy - there's also a strong cultural resistance in the west.

I've seen studies that compared oral dosing to intramuscular phage and IM seems to be the way to go for higher blood titers.

[1]Nobody's going to fund or approve this in the West anytime soon:- phage therapists often use cocktails of phages to treat their patient.

Foremost among these is when compared to antibiotics, phage suck for treating disease.

But antibody production is not instantaneous and can have a lag time of 7 to 10 days, which should be sufficient time for the phages to do their work.

The FDA would likely view this a a crime and prosecute anyone trying it.- phage therapies have been around for over 100 years and are likely unpatentable.

But it's also quite hard, and right now we lack a generalizable form of phage therapy - it tends to be a bespoke solution to specific intractable cases.

If you did serial passages to ensure that the phage was near some local fitness maxima, it's unlikely that selective effects would move it away from that maxima.

Theoretically we can identify a new phage a week after resistance is detected, factor in all of the other costs and time involved and it's even worse.

The phage acquired mutations in its capsid proteins and over several generations blood titers increased by something like two orders of magnitude.

I've worked on phage targeting various Salmonella serovars, and while you do require cocktails for the most effective treatment, but phage evolve along with the pathogen.

It's unfortunate that regulatory environment in the US is not more favorable for advancing phage therapy.

The concentration of phage injected intramusucularly falls very fast.

That's tough.- There's no promise a bacteria has a phage associated with it, and synthetic phages are, at this point, a pretty distant prospect.- When bacterial cell walls rupture, they create endotoxins.

Endotoxins are bad - indeed, in the early experiments with phage therapy in the West, insufficiently pure phage solutions with endotoxins in them were responsible for some deaths.

This type of treatment isn't even on the FDA's map - it even takes years for compounds of conventional drugs to be approved.- phage therapists often prepare customized phage cultures to treat a specific patient's infection.

I remember hearing about Soviet research into phage therapy, where bacteriophages are cultured to consume particular strains of bacteria.

Following the afore mentioned article one commenter remarked that Dr. Srinivasan did a great job or spooking us, but there was absolutely no mention of bacteriophage during the interview, which got me curious.

Based on the Wikipedia page for phage therapy [2], it should be an effective treatment option where the bacteria have polysacharride layer in the cell envelope, which most antibiotics cannot penetrate.

If you wanted to maintain phage effectiveness in a heavily selected environment you'd also need to design phage "reactors" where the phages can be continually evolved against current bacterial populations.

One alternative to antibiotics that may work, but will have a tremendous difficulty in clearing the regulatory burden for approving new drugs and medical procedures, is bacteriophage therapy.

We wouldn't want to coerce large scale farmers running indisputably torturous husbandry operations into preventing a spike in infant mortality now!by the way, the phage therapy described in the comment you linked was largely developed by the soviets.

This is, as mentioned, expensive as hell, and manpower intensive.- Phage therapy is fairly novel in the West, due to some problems in the early days of phage therapy followed swiftly by the discovery of penicillin.

However, they were abandoned for general use in the West for several reasons:\n\n - Medical trials were carried out, but a basic lack of understanding of phages made these invalid.\n - Phage therapy was seen as untrustworthy, because many of the trials were conducted on totally unrelated diseases such as allergies and viral infections.\n - Antibiotics were discovered and marketed widely.

I haven't read the therapeutic phage literature, but my assumption would be that you may need to optimizePhage have some issues with immune clearance.