Bacteriophages for bronchiectasis: treatment of the future?

IF 2.8 3区 医学 Q2 RESPIRATORY SYSTEM Current Opinion in Pulmonary Medicine Pub Date : 2024-05-01 Epub Date: 2024-02-12 DOI:10.1097/MCP.0000000000001050
Catherine Dominic, Hannah V Pye, Eleanor K Mishra, Evelien M Adriaenssens
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Abstract

Purpose of review: Bronchiectasis is a chronic respiratory disease characterized by dilated airways, persistent sputum production and recurrent infective exacerbations. The microbiology of bronchiectasis includes various potentially pathogenic microorganisms including Pseudomonas aeruginosa which is commonly cultured from patients' sputum. P. aeruginosa is difficult to eradicate and frequently exhibits antimicrobial resistance. Bacteriophage therapy offers a novel and alternative method to treating bronchiectasis and can be used in conjunction with antibiotics to improve patient outcome.

Recent findings: Thirteen case reports/series to date have successfully used phages to treat infections in bronchiectasis patients, however these studies were constrained to few patients ( n  = 32) and utilized personalized phage preparations and adjunct antibiotics. In these studies, phage therapy was delivered by inhalation, intravenously or orally and was well tolerated in most patients without any unfavourable effects. Favourable clinical or microbiological outcomes were seen following phage therapy in many patients. Longitudinal patient follow-up reported regrowth of bacteria and phage neutralization in some studies. There are five randomized clinical controlled trials ongoing aiming to use phage therapy to treat P. aeruginosa associated respiratory conditions, with limited results available to date.

Summary: More research, particularly robust clinical trials, into how phages can clear respiratory infections, interact with resident microbiota, and how bacteria might develop resistance will be important to establish to ensure the success of this promising therapeutic alternative.

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细菌噬菌体治疗支气管扩张症:未来的治疗方法?
审查目的:支气管扩张症是一种慢性呼吸道疾病,其特点是气道扩张、持续痰液分泌和反复感染加重。支气管扩张症的微生物包括各种潜在的致病微生物,其中铜绿假单胞菌通常是从患者的痰中培养出来的。铜绿假单胞菌很难根除,而且经常表现出抗菌药耐药性。噬菌体疗法为治疗支气管扩张症提供了一种新颖的替代方法,可与抗生素联合使用,改善患者的治疗效果:迄今为止,已有 13 份病例报告/系列研究成功使用噬菌体治疗支气管扩张症患者的感染,但这些研究仅限于少数患者(n = 32),并使用了个性化的噬菌体制剂和辅助抗生素。在这些研究中,噬菌体疗法通过吸入、静脉注射或口服给药,大多数患者都能很好地耐受,没有任何不良反应。许多患者在接受噬菌体疗法后都取得了良好的临床或微生物效果。在一些研究中,对患者进行的纵向随访报告了细菌再生和噬菌体中和的情况。总结:为了确保这种前景广阔的替代疗法取得成功,必须开展更多的研究,尤其是强有力的临床试验,以了解噬菌体如何清除呼吸道感染、如何与常驻微生物群相互作用以及细菌如何产生抗药性。
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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
109
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Pulmonary Medicine is a highly regarded journal offering insightful editorials and on-the-mark invited reviews, covering key subjects such as asthma; cystic fibrosis; infectious diseases; diseases of the pleura; and sleep and respiratory neurobiology. Published bimonthly, each issue of Current Opinion in Pulmonary Medicine introduces world renowned guest editors and internationally recognized academics within the pulmonary field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.
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