Today, a century after their discovery, phages are poised to fulfill their early promise and make a significant contribution to the treatment of bacterial disease.
Welcome to the new frontier in the fight against bacterial disease - a frontier defined by technology that is nearly one century old, but which remains new to western science. "Phage therapy" - a technology that employs "good viruses" called bacteriophages (commonly known as "phages") to destroy infection-causing bacteria, has been used safely and successfully for more than ninety years to treat and prevent a wide array of illnesses in the former Soviet Union. Capable of application in liquid, tablet, or powder form, phages obliterate the specific bacterial strains nature designed them to attack, while remaining harmless to the surrounding environment.
A "phage" - short for "bacteriophage" - is a virus that only destroys bacteria. Scientific estimates have suggested that phages constitute the most plentiful life-like substance on earth, and that they eradicate half of the world's bacteria every day. Phages naturally exist in all places where one finds bacteria, including the human body.
French-Canadian scientist Felix d'Herelle first identified phages one century ago. He soon found that phages could treat and even prevent bacterial disease in human beings - and he successfully used phages to cure cholera and plague in India and Egypt, respectively, during the 1920s. Soon, pharmaceutical companies like Eli Lilly were marketing phage therapy in the United States and elsewhere. Regrettably, the hype quickly outstripped the science - and aside from d'Herelle and other experts, few truly understood how to produce efficacious phage medicines. As improperly prepared phage treatments failed, phage therapy lost vital credibility - and when penicillin appeared on the scene, Western doctors and scientists abandoned phage therapy altogether.
Meanwhile, the Soviet Union could not afford penicillin and other antibiotics - and when d'Herelle visited fellow phage discoverer Georges Eliava in the Soviet Republic of Georgia, Soviet dictator Joseph Stalin seized upon the opportunity. D'Herelle reportedly fled the Soviet Union when Eliava was executed as an "enemy of the people" at the behest of Stalin secret police chief Lavrentiy Beria - but phage research continued in earnest at the institute in Tbilisi which today bears Eliava's name. Soviet troops relied on phages to treat and prevent infection during World War II - and by the 1980s, the Eliava Institute reportedly manufactured tons of phage products per week. Financial support from Moscow ended with Georgian independence in 1991 - but a determined and resourceful group of Georgian scientists braved civil war and economic deprivation to preserve a half-century of incomparable research and experience in phage technology. Over the next 20 years, a small but vibrant commercial phage industry emerged. Today, it is possible to walk into most Georgian pharmacies and find at least two different brands of phage therapy products which treat strep throat, staph infections, dysentery, and several other common bacterially-induced ailments. Most significant for Western nations, these products can successfully address MRSA and other deadly antibiotic-resistant "superbugs."
Without question, antibiotics have earned their reputation as modern medicine's "magic bullet." Yet, throughout most of the world, antibiotic treatment of bacterial infections has become both a blessing and a curse. The "broad spectrum" action of antibiotics causes them to eliminate the "good" bacteria which help us fight infection along with the dangerous pathogens which threaten our health. In the short term, many people suffer debilitating side effects. Over time, the most virulent pathogens find a way to adapt, survive, and thrive; evolving resistance to the chemical poisons antibiotics use to kill them. Such "antibiotic resistant" bacteria ultimately win nature's "survival of the fittest" contest; becoming dominant and seemingly indestructible - hence the moniker "Superbug."
Western media reports cite "abuse" and "overuse" of antibiotics as the source of the emerging crisis of antibiotic resistance. This analysis is mostly correct - but arguably, we have always been living on "borrowed time" with antibiotics. Throughout human history, nature has demonstrated its relentless capacity to defeat our "best laid plans" - and the notion that static chemical compounds which take a decade or more to research, develop, and test could keep pace with perpetually changing living organisms now seems fantastical at best. Thankfully, phage therapy not only offers a viable alternative to antibiotics; it provides a safer and more durable solution, as well. Phages are "strain-specific;" meaning that they do not kill the "good" bacteria which help us digest food and ward off disease. As a result, phage therapy has manifested no major side effects during almost one century of use in Georgia and the other republics of the former Soviet Union.
Most important, phages evolve in concert with the bacteria nature specially designed them to eradicate; rendering bacterial resistance to phages a theoretical - but not real - concern. Perhaps the best way to characterize the developments in microbiology and medicine over the last century is to suggest that antibiotics provided us with essential "breathing space" while we learned how to implement a more challenging - but eventually more effective and more permanent - solution in phage therapy.
"New and better" antibiotics do not constitute a realistic alternative for both economic and practical reasons. Companies investing in the research and development of new antibiotics will likely never recover their investment, as the economic life of a new antibiotic will likely be short; primarily due to the rapid emergence of antibiotic-resistant strains of bacteria. This economic calculus suggests why major pharmaceutical companies are not focusing their energy and resources on antibiotic research and development. Notwithstanding the size of the potential market, the costs far outweigh the potential rewards.
Phages are entirely natural. As the most abundant form of life on our planet, phages constitute an essential and innate mechanism through which nature controls the growth of bacteria. Each milliliter of ocean water may contain more than 10 million phages, and phages are naturally present in everything we eat and drink. Our bodies even host a wide variety of phages in our oral cavity and digestive system.
ABTI does not market or promote phages that have been genetically modified in any way. While several efforts to produce GMO phages are currently underway in the Western scientific community, ABTI is not engaged in any of these efforts, as we have yet to see any data that suggests that such an approach can improve upon the proven natural phage therapy protocols which Georgian scientists have mastered and applied with substantial success over more than ninety years.
Yes. Phages can destroy potentially dangerous bacterial pathogens before they cause disease.
The answer to this question is multifaceted, but ultimately very simple. The U.S. Food and Drug Administration and other Western regulatory agencies expect proof of phage therapy's efficacy which matches Western scientific standards. These standards are premised a) upon laboratory facilities and a general level of economic development which Georgia cannot yet meet; and b) regimented testing requirements designed for static chemical compounds like antibiotics. This characteristic of antibiotics constitutes a major source of the antibiotic resistance crisis (by contrast, phages evolve in concert with antibiotics - meaning that bacteria have a much harder time developing resistance to phages), and one would expect regulatory agencies like the FDA to adjust their regulatory approach accordingly. Indeed, they have done so when the need was clearly apparent to them (as in the case of the flu vaccine, the components of which change regularly). In the instance of phage therapy, however, the FDA and other regulatory authorities take their cues from the Western scientific community, much of which remains skeptical regarding phage therapy's efficacy.
Some progress has occurred during the last decade. For example, the FDA approved a phage therapy product for use in food preparation, labeling it "Generally Regarded as Safe." A sustained, determined advocacy effort is necessary, however, to generate a groundswell of public opinion in favor of phage therapy. That popular support, in turn, will create the political pressure necessary to produce regulatory reform.
Yes. The American Society for Microbiology (ASM) and many university researchers are following developments in phage technology very closely. Many concerns have embarked upon efforts to discover commercial applications, either by themselves or as part of international concerns.
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