In the Soviet Union, western antibiotics couldn't make it past the Iron Curtain. So Eastern Bloc doctors figured out how to use viruses to kill infectious bacteria. Now, with antibiotic-resistant bugs vexing doctors, that eerie yet effective method might come our way. In post-antibiotic world, infection cures you!
The technique actually dates back thousands of years, in a very rudimentary form: people observed that the water from certain rivers could cure infectious diseases like leprosy and cholera. In the early 20th century, scientists figured out that these waters contained very specific types of viruses, which killed the bacteria that caused the infections. No bacteria, no infection.
You already know this from high school biology (of course), but a virus works by injecting its DNA into a living cell, hijacking the cell's replication machinery to make more viruses. When the cell can't hold all those replicated viruses any more, it explodes, releasing the baby viruses to continue the cycle again — and of course, killing the cell.
Bacteriophages are a type of virus that targets, you guessed it, bacterial cells. Starting in the 1920s, scientists in both the U.S. and Georgia (the country, not the Peach State) began purifying bacteriophages and using them to treat bacterial infections. But right around WWII, western medicine latched on to the miraculous power of antibiotics, leaving the Soviet Union to perfect what's now called "phage therapy."
(Tip: pronounce "phage" to rhyme with "rage." Or rhyme it with "lodge" if you're fancy.)
Fast forward to today. Western medicine's (over)reliance on antibiotics has led to the evolution of new superbugs that can resist even our most powerful bacteria killers. And as Nature reports, that's got researchers looking into phage therapy:
In March, the US National Institute of Allergy and Infectious Diseases listed phage therapy as one of seven prongs in its plan to combat antibiotic resistance. And at the American Society for Microbiology (ASM) meeting in Boston last month, Grégory Resch of the University of Lausanne in Switzerland presented plans for Phagoburn: the first large, multi-centre clinical trial of phage therapy for human infections, funded by the European Commission.
And there are some serious benefits to phage therapy. While antibiotics work indiscriminately, killing both the disease causing bacteria and the healthy, necessary bacterial bystanders, each type of phage is precisely targeted to one very specific type of bacteria.
The downside is, if a doctor doesn't know exactly which species of bacteria is infecting a patient, he or she must create a cocktail of many different types of phages to ensure effectiveness. But compare that to traditional antibiotics, which can wipe out all of the healthy, normal bacteria in a patient's gut and leave an open playing field for the really nasty, antibiotic-resistant bacteria that are usually crowded out by the benign bugs. That can lead to some vicious, sometimes life-threatening complications when the bad bugs take over.
"Antibiotics are a big hammer," microbiologist Michael Schmidt of the Medical University of South Carolina in Charleston told Nature. "You want a guided missile." And phage therapy could be just that type of weapon.
And with a near-limitless supply of different phages (no two identical phages have ever been identified), bacterial resistance isn't such a problem: if a bug develops resistance to one type of phage, researchers can just add different phages to the cocktail.
There are, of course, drawbacks. Isolating, purifying, and storing phages is a much more finicky and time-consuming process than producing traditional antibiotics. And then there's the most practical of concerns: money. Since phages occur naturally, and their therapeutic use is nearly a century old, it would be incredibly difficult for a drug company to patent a phage therapy cocktail as intellectual property.
Indeed, the U.S. Supreme Court ruled last year that naturally-occurring genes cannot be patented, a law which would likely extend to phages. Like it or not, pharmaceutical companies are unlikely to invest in a therapy when they cannot ensure they will make that money back with a patent-protected product that can't be copied by the competition.
Still, there is hope that phage therapy — which is still widely used in Russia, Poland, and Georgia — could make its way west. Nature reports that the European Union has kicked in $US5.2 million into the research on Phagoburn, which will begin limited human trials in burn victims starting in September.
Who knows? Maybe someday, your doctor will cure you by infecting the thing that's infecting you — with a virus that comes from Russia with love.
Illustration: Michael Hession