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Phage Therapy for Respiratory Infections: Opportunities and Challenges
Arya Khosravi1,2, Qingquan Chen3, Arne Echterhof3
1Division of Infectious Diseases, School of Medicine, Stanford University, Stanford, CA, USA. akhosrav@stanford.edu.
Abstract:
We are entering the post-antibiotic era. Antimicrobial resistance (AMR) is a critical problem in chronic lung infections resulting in progressive respiratory failure and increased mortality. In the absence of emerging novel antibiotics to counter AMR infections, bacteriophages (phages), viruses that infect bacteria, have become a promising option for chronic respiratory infections. However, while personalized phage therapy is associated with improved outcomes in individual cases, clinical trials demonstrating treatment efficacy are lacking, limiting the therapeutic potential of this approach for respiratory infections. In this review, we address the current state of phage therapy for managing chronic respiratory diseases. We then discuss how phage therapy may address major microbiologic obstacles which hinder disease resolution of chronic lung infections with current antibiotic-based treatment practices. Finally, we highlight the challenges that must be addressed for successful phage therapy clinical trials. Through this discussion, we hope to expand on the potential of phages as an adjuvant therapy in chronic lung infections, as well as the microbiologic challenges that need to be addressed for phage therapy to expand beyond personalized salvage therapy.
Insights
Antimicrobial resistance (AMR) necessitates new treatments for chronic lung infections. Bacteriophages (phages) show promise, but clinical trials are needed to confirm their efficacy beyond personalized use.
Area of Science:
- Microbiology
- Infectious Diseases
- Pulmonology
Background:
- The rise of antimicrobial resistance (AMR) poses a significant threat to treating chronic lung infections, leading to increased mortality.
- The lack of novel antibiotics makes alternative therapies crucial for managing these complex infections.
- Bacteriophages (phages), viruses targeting bacteria, are emerging as a potential alternative to antibiotics for respiratory infections.
Purpose of the Study:
- To review the current status of phage therapy in chronic respiratory diseases.
- To explore how phage therapy can overcome microbiologic challenges in resolving chronic lung infections.
- To identify hurdles for conducting successful phage therapy clinical trials.
Main Methods:
- Literature review of existing studies on phage therapy for respiratory infections.
- Analysis of microbiologic obstacles in chronic lung infections.
- Discussion of challenges and future directions for clinical trials.
Main Results:
- Personalized phage therapy has shown promise in individual cases but lacks robust clinical trial data.
- Phages offer a potential strategy to combat AMR and address specific bacterial pathogens.
- Significant challenges remain in standardizing phage therapy and demonstrating efficacy through rigorous trials.
Conclusions:
- Phage therapy presents a promising adjuvant treatment for chronic lung infections, particularly those with AMR.
- Overcoming microbiologic challenges and conducting well-designed clinical trials are essential for broader adoption.
- Expanding phage therapy beyond salvage use requires addressing regulatory and scientific validation.
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