The Story
“What if a virus could reverse antibiotic resistance?”
https://knowablemagazine.org/content/article/health-disease/2024/phage-therapy-helps-to-fight-antibiotic-resistance
by Patience Asanga
Knowable Magazine, September 9, 2024
The Pitch
Phage therapy could make common antibiotics useful again
Evolution is helping bacteria thrive in their hosts. How about we allow evolution to help us beat them?
Phage therapy is the most promising non-conventional method of treating bacterial infections because of the high safety profile of phages, host-specificity, and ability to self-amplify. Currently, two types of phage therapy stand out: Phage training and steering. A paper in the Annual Review of Virology says these approaches can resensitize bacteria to traditional antibiotics and reduce the pace at which bacteria develop resistance to phages.
In the first approach, phages are trained to gain better killing abilities by allowing them to co-evolve with highly-resistant bacteria in the laboratory with the end goal of reducing the bacterial population in patients, thus making it easy for the patient’s immune system or antibiotics to clear off the infection. This is very important because a low bacterial population lowers the chances of developing resistance.
On the other hand, the steering method is primarily concerned with resensitizing bacteria to traditional antibiotics. Evolutionary biologists like Paul Turner of Yale School of Medicine support the steering approach because, as Turner puts it, “evolution is good at solving problems.” He said the steering method involves deploying a phage to interact with structures on the bacterial cell surface to initiate the infection process of killing the bacteria. To prevent future adsorption, the bacteria modify the genes encoding these structures. Since some of these structures are channels bacteria use to push antibiotics outside the cells, their mutation resensitizes them to antibiotics.
I’m proposing an article that discusses how phage therapies can be harnessed to minimize bacterial resistance to both phages and antibiotics. In the article, I will discuss why microbiologists are skeptical about phage training and highlight the dangers of phage therapy (a part of it is that the phages can work so well that they become a problem to the patient).
I chatted with Paul Turner to get a deeper look at this topic (and he is available to speak with me again if I’m assigned this story). I would also interview Aleksandre Ujmajuridze, who has used the phage training approach to treat urinary tract infections, and Breck Duerkop, a microbiologist at the University of Colorado School of Medicine.
Please let me know what you think.