By Traci Edwards
A tailor-made treatment combined three phages. THE HATFULL LABORATOR
She then endured a double lung transplant to treat the disease.
Her skin was covered in lesions and her liver began to fail, she lost weight and could barely breathe.
No previous transplant patient to have been infected with Mycobacterium abscessus at the hospital has survived.
This hijacks the bacterial cell, turning it into a phage factory until the viruses eventually burst out of the cell.
Isabelle’s mother, Jo, who made the initial suggestion of phage therapy to doctors at Great Ormond Street after reading about it online, said her daughter was “the luckiest child on earth” to have received the treatment in time.
Jason Gill, a senior scientist at the center for phage technology at Texas A&M University, said phages could have huge potential to tackle drug-resistant infections. But, he adds, “This needs to be tested rigorously with a real clinical trial”.
Hatfull said: “We didn’t think we’d ever get to a point of using these phages therapeutically”.
In the study, a teenager from England was suffering from an infection with a strain of Mycobacterium, a relative of the bacterium that causes tuberculosis.
But to use phage more widely would require careful matching of phages to a patient’s infection.
‘It shows how bacteriophages can be successfully developed as therapeutics even in very hard circumstances where bacteria are resistant to many antibiotics and the bacteria are hard to treat. Drug-resistant TB strains are an especially tempting target for phage therapy.
The US team settled on three phages – two of which they genetically modified to make them more effective. The girl had cystic fibrosis (CF) and had been on antibiotics to control bacterial infections that cause complications related to the genetic condition. The infections can lead to severe lung damage, for which a transplant is a last resort. By summer 2017, her lungs had less than a third of their normal function and she had been plagued by two stubborn bacterial strains for eight years.
Isabelle’s consultant at Great Ormond Street, Dr Helen Spencer, said: ‘It hasn’t cured her – and I think it’s important to be clear about that.
He had about 15,000 vials of phage but it took months to work out which combination of phages might work against Isabelle’s infection. Hatfull and his team spent 3 months searching for phages that could kill M. abscessus isolated from Isabelle’s wounds and sputum.
“It is plausible that phage resistance is associated with reduced virulence”, the study said. The other two weren’t as effective, so Hatfull and his colleagues tweaked the phages’ genomes, removing a gene, so the phages would kill the bacteria. A billion phages were infused into Isabelle’s bloodstream twice a day in June 2018. And after six weeks of intravenous treatment every 12 hours, the infection was all but gone.
“We’re sort of in uncharted territory”, Hatfull said.
Spencer, Hatfull, and co-authors stress that Isabelle might have improved without phage therapy.
She’s also learning to drive. Still, the apparent success has encouraged phage researchers.
“They’re often so specific that even though they may infect and be useful for the strain that infects one patient, they may not attack very similar bacteria that infect other patients”, Hatfull said.
“It’s incredible medical science, it’s been a miracle”, she said.
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Via source Sb Dirty South Soccer | Genetically Modified Viral Cocktail Treats Deadly Bacteria in Teen
For more information regarding news from the Department of Animal Science, College of Agriculture and Life Sciences, Texas A&M University, please contact Kaitlyn Harkin at ansccommunications@tamu.edu or (979) 845-1542.