Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Aug 6, 2017; 8(3): 162-173
Published online Aug 6, 2017. doi: 10.4292/wjgpt.v8.i3.162
Phage therapy: An alternative to antibiotics in the age of multi-drug resistance
Derek M Lin, Britt Koskella, Henry C Lin
Derek M Lin, Henry C Lin, Section of Gastroenterology, New Mexico VA Health Care System, Albuquerque, NM 87108, United States
Britt Koskella, Department of Integrative Biology, University of California, Berkeley, Berkeley, CA 94720, United States
Henry C Lin, Department of Medicine, University of New Mexico, Albuquerque, NM 87131, United States
Author contributions: All authors contributed equally to this work with regard to the scope of the subject, the literature review and analysis, drafting, revision, editing, and final approval of the manuscript.
Supported by Winkler Bacterial Overgrowth Research Fund (in part).
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Henry C Lin, MD, Section of Gastroenterology, New Mexico VA Health Care System, 1501 San Pedro SE, Albuquerque, NM 87108, United States. helin@salud.unm.edu
Telephone: +1-505-2561711-4552
Received: November 2, 2016
Peer-review started: November 4, 2016
First decision: December 15, 2016
Revised: May 13, 2017
Accepted: May 30, 2017
Article in press: May 31, 2017
Published online: August 6, 2017
Processing time: 271 Days and 21.9 Hours
Abstract

The practice of phage therapy, which uses bacterial viruses (phages) to treat bacterial infections, has been around for almost a century. The universal decline in the effectiveness of antibiotics has generated renewed interest in revisiting this practice. Conventionally, phage therapy relies on the use of naturally-occurring phages to infect and lyse bacteria at the site of infection. Biotechnological advances have further expanded the repertoire of potential phage therapeutics to include novel strategies using bioengineered phages and purified phage lytic proteins. Current research on the use of phages and their lytic proteins against multidrug-resistant bacterial infections, suggests phage therapy has the potential to be used as either an alternative or a supplement to antibiotic treatments. Antibacterial therapies, whether phage- or antibiotic-based, each have relative advantages and disadvantages; accordingly, many considerations must be taken into account when designing novel therapeutic approaches for preventing and treating bacterial infection. Although much about phages and human health is still being discovered, the time to take phage therapy serious again seems to be rapidly approaching.

Keywords: Bacteriophage; Bacteriophage therapy; Phage; Phage therapy; Endolysin; Lysin; Multidrug resistance; Antibiotic resistance; Phage safety; Methicillin-resistant S. aureus

Core tip: Phage therapy is widely being reconsidered as an alternative to antibiotics. The use of naturally-occurring phages to treat bacterial infection has a contentious history in western medicine. However, the emergent landscape of phage-based antimicrobials has advanced well beyond traditional methods. In this rapidly evolving field, novel technologies such as bioengineered chimeras of phage-derived lytic proteins show potential as a new class of antibacterial pharmaceuticals. This review aims to provide a topical perspective on the historical context of phage therapy, in order to highlight modern advances in phage research and innovations in the field.