Life-saving bacteriophages
A patient with cystic fibrosis was cured of a mycobacterial infection with the help of bacteriophages
Ekaterina Petrova, PCR.news
For the first time, scientists have successfully cured an antibiotic—resistant mycobacterial lung infection in a patient with cystic fibrosis with the help of bacteriophages - viruses that kill bacteria.
Cystic fibrosis is a genetic disease in which thick mucus accumulates in the lungs. This leads to recurrent bacterial infections of the lungs and even respiratory failure. Many patients require lung transplantation.
Jared Johnson is a 26—year-old patient with cystic fibrosis. He has suffered from recurring lung infections all his life and has been suffering from a persistent infection for the past five years Mycobacterium abscessus. Antibiotics didn't help. By 2020, his lungs were functioning by only 30% — without a lung transplant, according to doctors, he would have lived only a few years. Hospitals refused Jared a transplant due to a mycobacterial infection.
The lead author of the study, doctor Jerry Nick and his team from the National Jewish Hospital suggested that it is possible to try to cure the infection with the help of bacteriophages.
The researchers tested dozens of candidate phages and identified two that effectively killed the mycobacteria that infected Johnson's lungs. Scientists have genetically modified phages to optimize their potential.
Johnson was admitted to St. Joseph's Hospital in Denver. Two mycobacteriophages were injected intravenously into a man for 500 days from September 2020. M.abscessus isolates before and after phage treatment demonstrated genetic stability, a general decrease in diversity, and the absence of increased resistance to phages. The titers of antiphage neutralizing antibodies increased over time, but did not prevent clinical improvement throughout the treatment. Two months after the start of treatment, it was already clear that the therapy was working.
A year after the start of treatment (in October 2021), the patient received a lung transplant at the UCHealth Transplant Center. Phage therapy was not stopped during the operation and during recovery. No infection was found after the transplant, and Johnson stopped treatment.
"I am so grateful for the efforts, perseverance and creativity of all the people who participated in my treatment," Jarrod Johnson said. — I thought I was going to die. They literally saved my life."
Article by Nick et al. Host and pathogen response to bacteriophage engineered against Mycobacterium abscessus lung infection is published in the journal Cell.
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