Razi Journal of Medical Sciences

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Behboudi E, Hamidi Sofiani V. Phage therapy as a new style of treatment for bacterial infections and its various aspects: a review study. RJMS 2020; 27 (5) :165-177
URL: http://rjms.iums.ac.ir/article-1-6194-en.html

Background: Bacteriophages are viruses that can kill bacteria with the least adverse effect on human or animal host cells). Phage therapy is the use of bacterial viruses (phage) to treat bacterial infections, a medical intervention that has long been abandoned in the West but is now experiencing resurgence. At present, therapeutic phages are often selected based on limited criteria, which are sometimes simple as the ability to bind to pathogenic bacteria. Therefore, the use of therapeutic methods and antibacterial properties of phages is known as phage therapy, especially in clinical or veterinary fields. More widely, phages have been used as biological control agents to reduce the amount of bacteria in food. In addition, modified phages can be used as tools of transmitting DNA, protein or medicine. Various problems in the treatment of many life-threatening bacterial infections have led scientists to review phages. Numerous studies on the use of phage in vitro, in laboratory animals, and in humans have been performed in the United States and Europe. For this reason, phages can be used alone or in combination with antibiotics to treat bacterial infections. This article reviews a number of aspects of the use of phages and their products in the medical and especially antibacterial fields.
Methods: In this review study, all studies to date have been reviewed and searched through databases such as Irandoc, Scopus, Google scholar, PubMed and other reputable scientific databases with keyword searches such as bacteriophage, phage therapy, Biological treatment, infection, bacterial and the latest information has been obtained.
Results: Due to the high prevalence of antibiotic resistance in different bacterial infections, the use of bacteriophages is one of the best options for the treatment of bacterial diseases. Therefore, different aspects of therapeutic use in patients at different levels have been studied and the advantages of using phages over antibiotics have been determined in all cases. Bacteriophages invade biofilms and in these cases they can be an alternative treatment to antibiotics. Most of studies are on using phages for the topical treatment of bacterial skin infections. Some chronic skin infections, such as acne, may require long-term antibiotic treatment, although they are not life-threatening. The immunosuppressive activity of pure bacteriophages may be an argument for the safety of phage therapy, especially in allograft recipients. Excessive levels of immunosuppression due to the concomitant activity of immunosuppressive drugs and phages can increase the risk of other infections. Obviously, cancer patients and people with immunodeficiency will be at greater risk for infections following phage therapy. The use of bacteriophages, in addition to its benefits for the treatment of bacterial infections, has disadvantages such as the narrow range of bacterial hosts for phage, insufficient purity of phage, difficulty in removing integrase genes, phage resistance, Antibiotic resistance, decreased phage function due to neutralizing immune system involvement, pre-prepared phage instability, lack of understanding of phage heterogeneity and function, exaggerated claims about the effectiveness of commercial phage preparation, and Lack of scientific evidence for the effectiveness of phage treatment.
Conclusion: Despite the apparent need for new and safe antibacterial drugs, the use of phages as biological therapies by most physicians has not yet been addressed, and this is probably due to a lack of familiarity with phage therapy, as well as another reason for the lack of regulatory approval. We believe that, given the widespread crisis of antibiotics, this approach requires serious attention. Because despite the many restrictions on the use of phages, these biological tools still have many unique applications in medicine.