Bacteriophages: Clinical significance and application prospects

Andrey I. Danilov, A. V. Evseev
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Abstract

A review of the literature data covering topical issues of the use of bacteriophages in clinical practice is presented. Traditionally, phage therapy is based on the use of natural phages for the lysis of bacteria at the infection site. Despite some limitations, it has significant advantages over antibiotic therapy. The use of biotechnological methods currently makes it possible to eliminate the disadvantages of phage therapy by creating recombinant drugs and, in the future, expand its capabilities through the use of lytic phage proteins and their modified derivatives. Currently, bacteriophages are used not only for the treatment of infections but also for prevention and diagnosis (phagotyping to identify the source of infection). Bacteriophages are also used in genetic engineering as vectors for transferring DNA sections. Few side effects have been described about bacteriophages. Particularly, they do not negatively affect the intestinal microbiota, and compared with antibiotics, they are much less likely to be associated with allergic reactions. Moreover, existing randomized clinical trials, which are the gold standard of clinical trials, in phage therapy are extremely insufficient, which dictates the need to concentrate the efforts of all stakeholders in this direction.
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噬菌体:临床意义和应用前景
本文综述了有关在临床实践中使用噬菌体的热点问题的文献资料。传统的噬菌体疗法是利用天然噬菌体溶解感染部位的细菌。尽管存在一些局限性,但与抗生素疗法相比,噬菌体疗法具有明显的优势。目前,生物技术方法的使用使得通过制造重组药物来消除噬菌体疗法的缺点成为可能,未来还可以通过使用溶菌噬菌体蛋白及其改良衍生物来扩大噬菌体疗法的能力。目前,噬菌体不仅用于治疗感染,还用于预防和诊断(通过噬菌体分型确定感染源)。噬菌体还可用于基因工程,作为转移 DNA 片段的载体。噬菌体几乎没有副作用。特别是,噬菌体不会对肠道微生物群产生负面影响,与抗生素相比,噬菌体引起过敏反应的可能性要小得多。此外,噬菌体疗法的现有随机临床试验(临床试验的黄金标准)还极不充分,这就决定了所有利益相关者都需要集中精力朝这个方向努力。
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