Viruses could help fight antibiotic resistance

Antibiotic-resistant bacteria are on the rise all over the world and it is increasingly difficult to find new drugs, so diseases such as tuberculosis or pneumonia they are difficult (sometimes impossible) to treat. Science is looking for alternatives, and one of the most promising is phage therapy.

Still in the experimental phase, but with success stories in various hospitals around the world, such as that of the woman with “Klebsiella pneumoniae” infection, the victim of the attack on the Brussels airport in 2016, this treatment uses viruses called bacteriophages or phages, They only infect bacteria.

It has been shown that they are capable of fighting even the most complex bacterial infections, especially in combination with antibiotics, researchers Iñaki Comas (from the Institute of Biomedicine in Valencia) and Pilar Domingo-Calap (Institute for Integrative Systems Biology (Institute for Integrative Systems) point out. Biology ) summarized for EFE. I2SysBio, CSIC-Universitat de València).

Antibiotics are one of them the most revolutionary discoveries. They laid the foundations of modern medicine, making it possible not only to cure previously deadly infections, but also to perform transformative interventions such as transplantation, according to the High Council for Scientific Research (CSIC) in a monograph from its “Science for Public Policy” collection.

Unfortunately, he adds, its excessive use has caused a spectacular increase in resistance in bacteria – which mutate -.

Today, it is one of the biggest threats to global health, food security and development, and its growth is reaching dangerous levels, according to the World Health Organization.

According to a study by The Lancet, which analyzed 204 countries, 1.2 million people die each year from antibiotic-resistant infections, and this number could increase tenfold by 2050. Urgent action is needed.

“It is increasingly difficult to find a truly new antibiotic, which is why we have to look for alternatives, and one of the most interesting is phage therapy,” says Iñaki Comas, from the Institute of Biomedicine in Valencia (IBV) and coordinator of the CSIC Global Health Platform.

Bacteriophages were discovered a little more than a century ago by the French-Canadian microbiologist Félix d’Herelle, who first applied the therapy to patients in 1919.

However, the discovery of penicillin in 1928 and its subsequent commercialization and the boom in antibiotics suppressed phage therapy research, except in some countries of the former Soviet Union, such as Georgia, which although with the ups and downs of today’s career he is a reference through his George Eliava Institute in Tbilisi (Eliava worked with d’Herelle and was executed in 1937).

But over the years, and mainly due to abuse (years of over-the-counter antibiotics and abuse in agronomy), resistance began to emerge, causing longer hospital stays and increased mortality and costs; For example, the treatment of a normal case of tuberculosis in Europe costs about 200 euros, but 30,000 euros if the bacterium “Mycobacterium tuberculosis” is multiresistant.

And in extreme cases, when it is extremely resistant, costs can rise up to 200,000 euros, reminds Comas.

It is this multiple and super-resistance, on which antimicrobials on the market do not work, that worries and returns the scientific focus on phages.

Bacteriophages are viruses that infect and kill bacteria, they are very numerous viruses in nature and are very specific, explains Pilar Domingo-Calap, from the Institute for Integrative Systems Biology (I2SysBio, CSIC-Universitat de València).

They recognize a certain bacteria and use it; they use the cellular machinery to create new viruses and engage in a kind of “arms race” against the bacteria until they can eradicate it.

Therefore, they eliminate only the pathogenic bacteria that cause it diseasea skill that makes this therapy a good candidate for personalized, precision medicine.

But this specificity can also be a disadvantage because you have to find the right mix of phages for each type of infection, and since it is a virus, unlike a drug with a chemical structure, its pharmacodynamics are almost impossible to predict and measure.

Each patient’s result is different, so the way in which clinical tests are performed and the understanding of the results must change. “We are moving towards highly personalized medicine,” adds Domingo-Calap, who along with Comas attended the CSIC Cicero conference to talk about their research against superbugs.