Can we harvest viruses to fight wicked bacteria?

In his most recent book, The Invisible Empire, Pranay Lal introduces me to an aspect of the history of modern medicine that I was unaware of. In the late 1800s, the British bacteriologist Ernest Hankin observed that the Ganges had surprisingly little bacterial contamination, despite the fact that so many people bathed in it, dumping waste in its waters and found dead on its banks. used to perform the last rites. While this has long been given a mythological explanation, through a process of scientific investigation Hankin identified a “protective substance” in water that was small enough to pass through the filter, but powerful enough to be suspended in it. Destroyed all cholera bacteria. In 1896, he published his findings on the antibacterial properties of river water, but his research remained largely unheard of.

Over the next decades, other scientists began to notice similar phenomena – invisible agents seem capable of attacking and destroying a range of different bacteria with high efficiency. These little killers, or ‘bacteriophages’ as they would later be called, were found to be viruses that targeted specific bacterial cells, multiplying within them until they killed their hosts before moving on to the next cell. . Among the many distinguishing features of these viruses is the fact that they are host-specific, each attacking only specific strains of the bacterium to which they are associated, leaving each other untouched. For example, viruses that attack the bacteria that cause paratyphoid fever do not harm other gut bacteria.

The discovery of these organisms led to the development of phage therapy, a treatment protocol involving the administration of specific bacteriophage viruses to individuals suffering from identified bacterial diseases. Early experiments proved successful against a variety of diseases, from bubonic plague to cholera and dysentery.

While phage therapy was somewhat popular prior to World War II, since then – largely fueled by the military-industrial complex that invested heavily in developing these treatments for the war effort – antibiotics have been our part of treatment. has become the preferred method. Unlike typical bacteriophages, antibiotics are effective in a broad spectrum of infections, making them easy to administer even when the exact pathogen is not identified. Today, they are used for a variety of purposes, from treating disease to accelerating the growth of livestock, while work on phage therapy is limited to a few countries and generally viewed with distrust.

Our over-reliance on antibiotics, as useful as they are in improving the quality of health around the world, is beginning to have dire consequences. The phenomenon of antibiotic resistance is now a matter of such serious concern that the World Health Organization has had to establish a global action plan on antimicrobial resistance. A report by the US Centers for Disease Control suggests that there are more than 2.8 million antibiotic-resistant infections each year in the US alone, resulting in more than 35,000 deaths. In India, antibiotic resistance has led to the rise of superbugs, diseases that appear to be resistant to many drugs (or in some cases to all known antibiotics).

There has never been a better time to resume active research into phage therapy. Given the targeted effectiveness of bacteriophages, these treatments have relatively few side effects and almost always result in a cure. Thanks to advances in genetic sequencing, it is now easier than ever to identify the pathogens that cause infections. Other advances in bacterial technology have made it possible for us to harvest phages from cured patients, giving us a relatively unlimited supply of therapeutic material.

The problem with switching to phage therapy is that it requires us to completely change our current thinking about pharmaceuticals. Phage therapies need to be developed locally, as a virus that is effective against one strain of a disease in Europe may be ineffective against another strain of the same disease in India. This in turn means that the vast centralized facilities we rely on to manufacture drugs to supply worldwide will be of little use if we start using bacteriophages for medicine.

Instead we will need to create decentralized stores of bacteriophages that work most effectively against local disease strains. This will require us to retrain medical professionals to focus on accurate diagnosis of specific pathogens, identifying and administering specific phages matching that particular strain of bacteria.

For millennia, viruses have developed specialized weapons to eliminate bacteria. We all know that there is a virus capable of targeting and destroying every bacteria on the planet. It is time to use these to our advantage.

Rahul Mathan is a participant in Trilegal and also has a podcast called Ex Machina. His twitter handle @matthan . Is