Overcoming Challenges to Make Bacteriophage Therapy Standard Clinical Treatment Practice for Cystic Fibrosis

Area of Science:

• Microbiology
• Pulmonology
• Bacteriophage Therapy

Background:

• Cystic fibrosis (CF) patients frequently receive antimicrobial prophylaxis, leading to multidrug-resistant (MDR) bacterial infections.
• Pseudomonas aeruginosa, a common CF pathogen, possesses significant protective and virulence mechanisms, hindering treatment.
• Current challenges in translating phage therapy into CF care include the lack of validated in vivo safety models.

Purpose of the Study:

• To review and provide insights into using primary airway epithelial cells as a model for assessing phage therapy safety and efficacy in the CF lung mucoenvironment.
• To highlight the potential of combining phage therapy with antimicrobials to combat MDR infections in CF.
• To discuss the progress and requirements for the clinical translation of phage therapy in CF.

Main Methods:

• Review of existing literature on phage therapy applications in cystic fibrosis.
• Discussion of the utility of primary airway epithelial cells to mimic the CF lung mucoenvironment.
• Exploration of the safety and efficacy of phage therapy, including combination approaches.

Main Results:

• Primary airway epithelial cells can serve as a relevant model to evaluate phage therapy's safety and efficacy in the context of CF lung conditions.
• Combining phage therapy with antimicrobials demonstrates potential in delaying the emergence of MDR infections.
• Significant traction has been observed in translating phage therapy into standard clinical practice over the last five years.

Conclusions:

• Phage therapy, particularly in combination with antimicrobials, presents a promising strategy to manage MDR bacterial infections in cystic fibrosis.
• The use of primary airway epithelial cells offers a viable alternative for preclinical safety and efficacy assessments.
• Clinical translation requires enhanced collaboration, transparent data sharing, and standardized policies.