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Samananda Singh L. Nano-emulsion encapsulation for the efficient delivery of bacteriophage therapeutics. Biologicals 2024; 85:101725. [PMID: 37951140 DOI: 10.1016/j.biologicals.2023.101725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/20/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023] Open
Abstract
Antibiotic resistance has become the major concern for global public health. Phage therapy is being considered as an alternative for antibiotics to treat the multidrug resistant bacterial infections. Bacteriophage therapeutic developments has faced many challenges, including the drug formulations for sustainable phage delivery. The nano-emulsion platform has been described as the best approach to retain phage efficacy, shelf life and stability. Encapsulated phage drugs ensure stable delivery of phages to the target site and integrate in the system. In this review, our main focus is on the nano-emulsion encapsulation of bacteriophages and its effects towards the phage therapeutic development.
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Moreno-Figueroa LD, Quiroz-Guzmán E, Tovar-Ramírez D, Palestino G, Cisneros-Covarrubias CA, Hernández-Adame L. Use of Trehalose as an Additive to Bacteriophage Vb_Pd_PDCC-1: Long-Term Preservation Analysis and Its Biocontrol Against Vibrio diabolicus Infection. Curr Microbiol 2023; 80:372. [PMID: 37843653 DOI: 10.1007/s00284-023-03487-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/20/2023] [Indexed: 10/17/2023]
Abstract
Phage therapy is a promising alternative to control bacterial diseases and the increasing problem of antibiotic resistance. In this sense, this research evaluates the viability of lyophilized vibrio phage vB_Pd_PDCC-1 using trehalose as a preservative excipient at different concentrations (4, 2, 1, and 0.5% w/v) and its potential for phage therapy application against a pathogenic bacteria Vibrio diabolicus in brine shrimp nauplii (Artemia franciscana). The lyophilized phages were stored at 4 and 23 °C and rehydrated using biological sterile saline solution to test their viability at days 1, 15, and 60 post-lyophilization. The results showed that trehalose is beneficial in maintaining the viability of post-lyophilization phages (without titer losses) at 4 °C and even at room temperature (23 °C). When lyophilized phages with 4% w/v trehalose concentration were stored at 23 °C, they had not titer losses among the trials; viability and titer concentration were maintained up to 60 days at log 7. The use of lyophilized phage PDCC-1 increased brine shrimp survival and reduced Vibrio concentrations. The present study has identified trehalose as a promising lyophilization excipient to effectively preserve lyophilized bacteriophages for biotechnological applications and long-term storage.
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Affiliation(s)
- Luis Daniel Moreno-Figueroa
- Nanotechnology and Microbial Biocontrol Group, Centro de Investigaciones Biológicas del Noroeste, 23096, La Paz, Baja California Sur, Mexico
| | - Eduardo Quiroz-Guzmán
- Centro de Investigaciones Biológicas del Noroeste S.C. (CIBNOR), Av. IPN 195, Col Playa Palo de Sta. Rita Sur, C.P. 23096, La Paz, B.C.S, Mexico
| | - Dariel Tovar-Ramírez
- Centro de Investigaciones Biológicas del Noroeste S.C. (CIBNOR), Av. IPN 195, Col Playa Palo de Sta. Rita Sur, C.P. 23096, La Paz, B.C.S, Mexico
| | - Gabriela Palestino
- Laboratorio de Biopolímeros y Nanoestructuras, Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, C.P. 78210, San Luis Potosí, Mexico
| | - Cándida A Cisneros-Covarrubias
- Laboratorio de Biopolímeros y Nanoestructuras, Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, C.P. 78210, San Luis Potosí, Mexico
| | - Luis Hernández-Adame
- Nanotechnology and Microbial Biocontrol Group, Centro de Investigaciones Biológicas del Noroeste, 23096, La Paz, Baja California Sur, Mexico.
- Cátedras CONACYT-Centro de Investigaciones Biológicas del Noroeste, 23096, La Paz, Baja California Sur, Mexico.
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3
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Flint R, Laucirica DR, Chan HK, Chang BJ, Stick SM, Kicic A. Stability Considerations for Bacteriophages in Liquid Formulations Designed for Nebulization. Cells 2023; 12:2057. [PMID: 37626867 PMCID: PMC10453214 DOI: 10.3390/cells12162057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Pulmonary bacterial infections present a significant health risk to those with chronic respiratory diseases (CRDs) including cystic fibrosis (CF) and chronic-obstructive pulmonary disease (COPD). With the emergence of antimicrobial resistance (AMR), novel therapeutics are desperately needed to combat the emergence of resistant superbugs. Phage therapy is one possible alternative or adjunct to current antibiotics with activity against antimicrobial-resistant pathogens. How phages are administered will depend on the site of infection. For respiratory infections, a number of factors must be considered to deliver active phages to sites deep within the lung. The inhalation of phages via nebulization is a promising method of delivery to distal lung sites; however, it has been shown to result in a loss of phage viability. Although preliminary studies have assessed the use of nebulization for phage therapy both in vitro and in vivo, the factors that determine phage stability during nebulized delivery have yet to be characterized. This review summarizes current findings on the formulation and stability of liquid phage formulations designed for nebulization, providing insights to maximize phage stability and bactericidal activity via this delivery method.
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Affiliation(s)
- Rohan Flint
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia;
- Wal-yan Respiratory Research Center, Telethon Kids Institute, The University of Western Australia, Perth, WA 6009, Australia; (D.R.L.); (S.M.S.)
| | - Daniel R. Laucirica
- Wal-yan Respiratory Research Center, Telethon Kids Institute, The University of Western Australia, Perth, WA 6009, Australia; (D.R.L.); (S.M.S.)
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, School of Pharmacy, University of Sydney, Sydney, NSW 2050, Australia;
| | - Barbara J. Chang
- The Marshall Center for Infectious Diseases Research and Training, School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia;
| | - Stephen M. Stick
- Wal-yan Respiratory Research Center, Telethon Kids Institute, The University of Western Australia, Perth, WA 6009, Australia; (D.R.L.); (S.M.S.)
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Perth, WA 6009, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA 6009, Australia
| | - Anthony Kicic
- Wal-yan Respiratory Research Center, Telethon Kids Institute, The University of Western Australia, Perth, WA 6009, Australia; (D.R.L.); (S.M.S.)
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Perth, WA 6009, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA 6009, Australia
- School of Population Health, Curtin University, Perth, WA 6102, Australia
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4
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Carvalho SG, Dos Santos AM, Polli Silvestre AL, Tavares AG, Chorilli M, Daflon Gremião MP. Multifunctional systems based on nano-in-microparticles as strategies for drug delivery: advances, challenges, and future perspectives. Expert Opin Drug Deliv 2023; 20:1231-1249. [PMID: 37786284 DOI: 10.1080/17425247.2023.2263360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Innovative delivery systems are a promising and attractive approach for drug targeting in pharmaceutical technology. Among the various drug delivery systems studied, the association of strategies based on nanoparticles and microparticles, called nano-in-microparticles, has been gaining prominence as it allows targeting in a specific and personalized way, considering the physiological barriers faced in each disease. AREAS COVERED This review proposes to discuss nano-in-micro systems, updated progress on the main biomaterials used in the preparation of these systems, preparation techniques, physiological considerations, applications and challenges, and possible strategies for drug administration. Finally, we bring future perspectives for advances in clinical and field translation of multifunctional systems based on nano-in-microparticles. EXPERT OPINION This article brings a new approach to exploring the use of multifunctional systems based on nano-in-microparticles for different applications, in addition, it also emphasizes the use of biomaterials in these systems and their limitations. There is currently no study in the literature that explores this approach, making a review article necessary to address this association of strategies for application in pharmaceutical technology.
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Affiliation(s)
- Suzana Gonçalves Carvalho
- Department of Drugs and Medicines, School of Pharmaceutical Sciences - São Paulo State University (UNESP), Araraquara, Brazil
| | - Aline Martins Dos Santos
- Department of Drugs and Medicines, School of Pharmaceutical Sciences - São Paulo State University (UNESP), Araraquara, Brazil
| | - Amanda Letícia Polli Silvestre
- Department of Drugs and Medicines, School of Pharmaceutical Sciences - São Paulo State University (UNESP), Araraquara, Brazil
| | - Alberto Gomes Tavares
- Department of Drugs and Medicines, School of Pharmaceutical Sciences - São Paulo State University (UNESP), Araraquara, Brazil
| | - Marlus Chorilli
- Department of Drugs and Medicines, School of Pharmaceutical Sciences - São Paulo State University (UNESP), Araraquara, Brazil
| | - Maria Palmira Daflon Gremião
- Department of Drugs and Medicines, School of Pharmaceutical Sciences - São Paulo State University (UNESP), Araraquara, Brazil
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Advancing bacteriophages as a treatment of antibiotic-resistant bacterial pulmonary infections. Curr Opin Pulm Med 2022; 28:225-231. [PMID: 35165237 DOI: 10.1097/mcp.0000000000000864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The current article summarizes the recent advances in the use of bacteriophages to treat pulmonary infections, particularly those caused by Gram-negative drug-resistant bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Burkholderia species. It provides an updated overview of the current available evidence, with a summary of published clinical cases, case series and clinical trials currently underway.Recent finding Personalized treatment with bacteriophages is still in its infancy in Europe and the USA, despite extensive experience in Eastern countries. However, more patients are expected to be treated with clinical trials in progress and others planned. SUMMARY Despite very promising initial results and the confirmation of phage safety, there are still many ethical and practical implications to be considered, from the necessary regulatory approval to optimization of dose and route of administration, to developing strategies to tackle bacterial resistance. Patients with cystic fibrosis are a group where phage therapy, if successful, could have a major impact.
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6
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Combination and nanotechnology based pharmaceutical strategies for combating respiratory bacterial biofilm infections. Int J Pharm 2022; 616:121507. [PMID: 35085729 DOI: 10.1016/j.ijpharm.2022.121507] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/31/2021] [Accepted: 01/20/2022] [Indexed: 12/14/2022]
Abstract
Respiratory infections are one of the major global health problems. Among them, chronic respiratory infections caused by biofilm formation are difficult to treat because of both drug tolerance and poor drug penetration into the complex biofilm structure. A major part of the current research on combating respiratory biofilm infections have been focused on destroying the matrix of extracellular polymeric substance and eDNA of the biofilm or promoting the penetration of antibiotics through the extracellular polymeric substance via delivery technologies in order to kill the bacteria inside. There are also experimental data showing that certain inhaled antibiotics with simple formulations can effectively penetrate EPS to kill surficially located bacteria and centrally located dormant bacteria or persisters. This article aims to review recent advances in the pharmaceutical strategies for combating respiratory biofilm infections with a focus on nanotechnology-based drug delivery approaches. The formation and characteristics of bacterial biofilm infections in the airway mucus are presented, which is followed by a brief review on the current clinical approaches to treat respiratory biofilm infections by surgical removal and antimicrobial therapy, and also the emerging clinical treatment approaches. The current combination of antibiotics and non-antibiotic adjuvants to combat respiratory biofilm infections are also discussed.
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Wang X, Xie Z, Zhao J, Zhu Z, Yang C, Liu Y. Prospects of Inhaled Phage Therapy for Combatting Pulmonary Infections. Front Cell Infect Microbiol 2021; 11:758392. [PMID: 34938668 PMCID: PMC8685529 DOI: 10.3389/fcimb.2021.758392] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/04/2021] [Indexed: 12/30/2022] Open
Abstract
With respiratory infections accounting for significant morbidity and mortality, the issue of antibiotic resistance has added to the gravity of the situation. Treatment of pulmonary infections (bacterial pneumonia, cystic fibrosis-associated bacterial infections, tuberculosis) is more challenging with the involvement of multi-drug resistant bacterial strains, which act as etiological agents. Furthermore, with the dearth of new antibiotics available and old antibiotics losing efficacy, it is prudent to switch to non-antibiotic approaches to fight this battle. Phage therapy represents one such approach that has proven effective against a range of bacterial pathogens including drug resistant strains. Inhaled phage therapy encompasses the use of stable phage preparations given via aerosol delivery. This therapy can be used as an adjunct treatment option in both prophylactic and therapeutic modes. In the present review, we first highlight the role and action of phages against pulmonary pathogens, followed by delineating the different methods of delivery of inhaled phage therapy with evidence of success. The review aims to focus on recent advances and developments in improving the final success and outcome of pulmonary phage therapy. It details the use of electrospray for targeted delivery, advances in nebulization techniques, individualized controlled inhalation with software control, and liposome-encapsulated nebulized phages to take pulmonary phage delivery to the next level. The review expands knowledge on the pulmonary delivery of phages and the advances that have been made for improved outcomes in the treatment of respiratory infections.
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Affiliation(s)
- Xiang Wang
- Department of Pulmonary and Critical Care Medicine, The Second People's Hospital of Kunming, Kunming, China
| | - Zuozhou Xie
- Department of Pulmonary and Critical Care Medicine, The Second People's Hospital of Kunming, Kunming, China
| | - Jinhong Zhao
- Department of Pulmonary and Critical Care Medicine, The Second People's Hospital of Kunming, Kunming, China
| | - Zhenghua Zhu
- Department of Pulmonary and Critical Care Medicine, The Second People's Hospital of Kunming, Kunming, China
| | - Chen Yang
- Department of Pulmonary and Critical Care Medicine, The Second People's Hospital of Kunming, Kunming, China
| | - Yi Liu
- Department of Pulmonary and Critical Care Medicine, The Second People's Hospital of Kunming, Kunming, China
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Iszatt JJ, Larcombe AN, Chan HK, Stick SM, Garratt LW, Kicic A. Phage Therapy for Multi-Drug Resistant Respiratory Tract Infections. Viruses 2021; 13:v13091809. [PMID: 34578390 PMCID: PMC8472870 DOI: 10.3390/v13091809] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/30/2022] Open
Abstract
The emergence of multi-drug resistant (MDR) bacteria is recognised today as one of the greatest challenges to public health. As traditional antimicrobials are becoming ineffective and research into new antibiotics is diminishing, a number of alternative treatments for MDR bacteria have been receiving greater attention. Bacteriophage therapies are being revisited and present a promising opportunity to reduce the burden of bacterial infection in this post-antibiotic era. This review focuses on the current evidence supporting bacteriophage therapy against prevalent or emerging multi-drug resistant bacterial pathogens in respiratory medicine and the challenges ahead in preclinical data generation. Starting with efforts to improve delivery of bacteriophages to the lung surface, the current developments in animal models for relevant efficacy data on respiratory infections are discussed before finishing with a summary of findings from the select human trials performed to date.
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Affiliation(s)
- Joshua J. Iszatt
- Occupation, Environment and Safety, School of Population Health, Curtin University, Perth 6845, Australia; (J.J.I.); (A.N.L.)
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth 6009, Australia; (S.M.S.); (L.W.G.)
| | - Alexander N. Larcombe
- Occupation, Environment and Safety, School of Population Health, Curtin University, Perth 6845, Australia; (J.J.I.); (A.N.L.)
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth 6009, Australia; (S.M.S.); (L.W.G.)
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Sydney Pharmacy School, University of Sydney, Camperdown 2006, Australia;
| | - Stephen M. Stick
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth 6009, Australia; (S.M.S.); (L.W.G.)
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Perth 6009, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, Harry Perkins Institute of Medical Research, The University of Western Australia, Nedlands 6009, Australia
| | - Luke W. Garratt
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth 6009, Australia; (S.M.S.); (L.W.G.)
| | - Anthony Kicic
- Occupation, Environment and Safety, School of Population Health, Curtin University, Perth 6845, Australia; (J.J.I.); (A.N.L.)
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth 6009, Australia; (S.M.S.); (L.W.G.)
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Perth 6009, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, Harry Perkins Institute of Medical Research, The University of Western Australia, Nedlands 6009, Australia
- Correspondence:
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9
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Current and Emerging Therapies to Combat Cystic Fibrosis Lung Infections. Microorganisms 2021; 9:microorganisms9091874. [PMID: 34576767 PMCID: PMC8466233 DOI: 10.3390/microorganisms9091874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022] Open
Abstract
The ultimate aim of any antimicrobial treatment is a better infection outcome for the patient. Here, we review the current state of treatment for bacterial infections in cystic fibrosis (CF) lung while also investigating potential new treatments being developed to see how they may change the dynamics of antimicrobial therapy. Treatment with antibiotics coupled with regular physical therapy has been shown to reduce exacerbations and may eradicate some strains. Therapies such as hypertonic saline and inhaled PulmozymeTM (DNase-I) improve mucus clearance, while modifier drugs, singly and more successfully in combination, re-open certain mutant forms of the cystic fibrosis transmembrane conductance regulator (CFTR) to enable ion passage. No current method, however, completely eradicates infection, mainly due to bacterial survival within biofilm aggregates. Lung transplants increase lifespan, but reinfection is a continuing problem. CFTR modifiers normalise ion transport for the affected mutations, but there is conflicting evidence on bacterial clearance. Emerging treatments combine antibiotics with novel compounds including quorum-sensing inhibitors, antioxidants, and enzymes, or with bacteriophages, aiming to disrupt the biofilm matrix and improve antibiotic access. Other treatments involve bacteriophages that target, infect and kill bacteria. These novel therapeutic approaches are showing good promise in vitro, and a few have made the leap to in vivo testing.
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10
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Improving Phage-Biofilm In Vitro Experimentation. Viruses 2021; 13:v13061175. [PMID: 34205417 PMCID: PMC8234374 DOI: 10.3390/v13061175] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
Bacteriophages or phages, the viruses of bacteria, are abundant components of most ecosystems, including those where bacteria predominantly occupy biofilm niches. Understanding the phage impact on bacterial biofilms therefore can be crucial toward understanding both phage and bacterial ecology. Here, we take a critical look at the study of bacteriophage interactions with bacterial biofilms as carried out in vitro, since these studies serve as bases of our ecological and therapeutic understanding of phage impacts on biofilms. We suggest that phage-biofilm in vitro experiments often may be improved in terms of both design and interpretation. Specific issues discussed include (a) not distinguishing control of new biofilm growth from removal of existing biofilm, (b) inadequate descriptions of phage titers, (c) artificially small overlying fluid volumes, (d) limited explorations of treatment dosing and duration, (e) only end-point rather than kinetic analyses, (f) importance of distinguishing phage enzymatic from phage bacteriolytic anti-biofilm activities, (g) limitations of biofilm biomass determinations, (h) free-phage interference with viable-count determinations, and (i) importance of experimental conditions. Toward bettering understanding of the ecology of bacteriophage-biofilm interactions, and of phage-mediated biofilm disruption, we discuss here these various issues as well as provide tips toward improving experiments and their reporting.
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11
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Khalid A, Lin RCY, Iredell JR. A Phage Therapy Guide for Clinicians and Basic Scientists: Background and Highlighting Applications for Developing Countries. Front Microbiol 2021; 11:599906. [PMID: 33643225 PMCID: PMC7904893 DOI: 10.3389/fmicb.2020.599906] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/10/2020] [Indexed: 12/14/2022] Open
Abstract
Approximately 10% of global health research is devoted to 90% of global disease burden (the so-called “10/90 Gap”) and it often neglects those diseases most prevalent in low-income countries. Antibiotic resistant bacterial infections are known to impact on healthcare, food security, and socio-economic fabric in the developing countries. With a global antibiotic resistance crisis currently reaching a critical level, the unmet needs in the developing countries are even more striking. The failure of traditional antimicrobials has led to renewed interest in century-old bacteriophage (phage) therapy in response to the urgent need to develop alternative therapies to treat infections. Phage therapy may have particular value in developing countries where relevant phages can be sourced and processed locally and efficiently, breaking specifically the economic barrier of access to expensive medicine. Hence this makes phage therapy an attractive and feasible option. In this review, we draw our respective clinical experience as well as phage therapy research and clinical trial, and discuss the ways in which phage therapy might reduce the burden of some of the most important bacterial infections in developing countries.
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Affiliation(s)
- Ali Khalid
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Sydney, NSW, Australia.,Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Ruby C Y Lin
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Sydney, NSW, Australia.,Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Jonathan R Iredell
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Sydney, NSW, Australia.,Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia.,Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
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12
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Marqus S, Lee L, Istivan T, Kyung Chang RY, Dekiwadia C, Chan HK, Yeo LY. High frequency acoustic nebulization for pulmonary delivery of antibiotic alternatives against Staphylococcus aureus. Eur J Pharm Biopharm 2020; 151:181-188. [PMID: 32315699 DOI: 10.1016/j.ejpb.2020.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 01/17/2023]
Abstract
The increasing prevalence of multidrug resistant bacteria has warranted the search for new antimicrobial agents as existing antibiotics lose their potency. Among these, bacteriophage therapy, as well as the administration of specific bacteriolysis agents, i.e., lytic enzymes, have emerged as attractive alternatives. Nebulizers offer the possibility for delivering these therapeutics directly to the lung, which is particularly advantageous as a non-invasive and direct route to treat bacterial lung infections. Nevertheless, nebulizers can often result in significant degradation of the bacteriophage or protein, both structurally and functionally, due to the large stresses the aerosolization process imposes on these entities. In this work, we assess the capability of a novel low-cost and portable hybrid surface and bulk acoustic wave platform (HYDRA) to nebulize a Myoviridae bacteriophage (phage K) and lytic enzyme (lysostaphin) that specifically targets Staphylococcus aureus. Besides its efficiency in producing phage or protein-laden aerosols within the 1-5 μm respirable range for optimum delivery to the lower respiratory tract where lung infections commonly take place, we observe that the HYDRA platform-owing to the efficiency of driving the aerosolization process at relatively low powers and high frequencies (approximately 10 MHz)-does not result in appreciable denaturation of the phages or proteins, such that the loss of antimicrobial activity following nebulization is minimized. Specifically, a low (0.1 log10 (pfu/ml)) titer loss was obtained with the phages, resulting in a high viable respirable fraction of approximately 90%. Similarly, minimal loss of antimicrobial activity was obtained with lysostaphin upon nebulization wherein its minimum inhibitory concentration (0.5 μg/ml) remained unaltered as compared with the non-nebulized control. These results therefore demonstrate the potential of the HYDRA nebulization platform as a promising strategy for pulmonary administration of alternative antimicrobial agents to antibiotics for the treatment of lung diseases caused by pathogenic bacteria.
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Affiliation(s)
- Susan Marqus
- Micro/Nanophysics Research Laboratory, School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - Lillian Lee
- Micro/Nanophysics Research Laboratory, School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - Taghrid Istivan
- School of Science, RMIT University, Bundoora, VIC 3083, Australia
| | - Rachel Yoon Kyung Chang
- Advanced Drug Delivery Group, School of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
| | - Chaitali Dekiwadia
- RMIT Microscopy and Microanalysis Facility, RMIT University, Melbourne, VIC 3000, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, School of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
| | - Leslie Y Yeo
- Micro/Nanophysics Research Laboratory, School of Engineering, RMIT University, Melbourne, VIC 3000, Australia.
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13
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Trileucine and Pullulan Improve Anti-Campylobacter Bacteriophage Stability in Engineered Spray-Dried Microparticles. Ann Biomed Eng 2019; 48:1169-1180. [PMID: 31845128 DOI: 10.1007/s10439-019-02435-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
Spray drying biologics into a powder can increase thermal stability and shelf-life relative to liquid formulations, potentially eliminating the need for cold chain infrastructure for distribution in developing countries. In this study, process modelling, microparticle engineering, and a supplemented phase diagram were used to design physically stable fully amorphous spray-dried powder capable of stabilizing biological material. A greater proportion of anti-Campylobacter bacteriophage CP30A remained biologically active after spray drying using excipient formulations containing trehalose and a high glass transition temperature amorphous shell former, either trileucine or pullulan, as compared to the commonly used crystalline shell former, leucine, or a low glass transition temperature amorphous shell former, pluronic F-68. Particle formation models suggest that the stabilization was achieved by protecting the bacteriophages against the main inactivating stress, desiccation, at the surface. The most promising formulation contained a combination of trileucine and trehalose for which the combined effects of feedstock preparation, spray drying, and 1-month dry room temperature storage resulted in a titer reduction of only 0.6 ± 0.1 log10(PFU mL-1). The proposed high glass transition temperature amorphous formulation platform may be advantageous for stabilizing biologics in other spray drying applications in the biomedical engineering industry.
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14
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Cui Z, Guo X, Feng T, Li L. Exploring the whole standard operating procedure for phage therapy in clinical practice. J Transl Med 2019; 17:373. [PMID: 31727099 PMCID: PMC6857313 DOI: 10.1186/s12967-019-2120-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/31/2019] [Indexed: 12/23/2022] Open
Abstract
We have entered the post-antibiotic era. Phage therapy has recently been given renewed attention because bacteriophages are easily available and can kill bacteria. Many reports have demonstrated successful phage treatment of bacterial infection, whereas some studies have shown that phage therapy is not as effective as expected. In general, establishment of a standard operating procedure will ensure the success of phage therapy. In this paper, the whole operating procedure for phage therapy in clinical practice is explored and analyzed to comprehensively understand the success of using phage for the treatment of bacterial infectious disease in the future. The procedure includes the following: enrollment of patients for phage therapy; establishment of phage libraries; pathogenic bacterial isolation and identification; screening for effective phages against pathogenic bacteria; phage formulation preparation; phage preparation administration strategy and route; monitoring the efficacy of phage therapy; and detection of the emergence of phage-resistant strains. Finally, we outline the whole standard operating procedure for phage therapy in clinical practice. It is believed that phage therapy will be used successfully, especially in personalized medicine for the treatment of bacterial infectious diseases. Hopefully, this procedure will provide support for the entry of phage therapy into the clinic as soon as possible.
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Affiliation(s)
- Zelin Cui
- Department of Laboratory Medicine, Shanghai General Hospital, 6th Floor, No. 3 Building, 100# Haining Road, Shanghai, 200080, China. .,Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA.
| | - Xiaokui Guo
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Tingting Feng
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai, 200080, China
| | - Li Li
- Department of Laboratory Medicine, Shanghai General Hospital, 6th Floor, No. 3 Building, 100# Haining Road, Shanghai, 200080, China.
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15
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Khanal D, Chang RYK, Morales S, Chan HK, Chrzanowski W. High Resolution Nanoscale Probing of Bacteriophages in an Inhalable Dry Powder Formulation for Pulmonary Infections. Anal Chem 2019; 91:12760-12767. [DOI: 10.1021/acs.analchem.9b02282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Dipesh Khanal
- Advanced Drug Delivery Group, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney Nano Institute, Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Rachel Yoon Kyung Chang
- Advanced Drug Delivery Group, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Sandra Morales
- AmpliPhi Biosciences AU, Brookvale, Sydney, NSW 2001, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Wojciech Chrzanowski
- Sydney Pharmacy School, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney Nano Institute, Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales 2006, Australia
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16
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Prophylaxis of Mycobacterium tuberculosis H37Rv Infection in a Preclinical Mouse Model via Inhalation of Nebulized Bacteriophage D29. Antimicrob Agents Chemother 2019:AAC.00871-19. [PMID: 31527037 DOI: 10.1128/aac.00871-19] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Globally, more people die annually from tuberculosis than from any other single infectious agent. Unfortunately, there is no commercially-available vaccine that is sufficiently effective at preventing acquisition of pulmonary tuberculosis in adults. In this study, pre-exposure prophylactic pulmonary delivery of active aerosolized anti-tuberculosis bacteriophage D29 was evaluated as an option for protection against Mycobacterium tuberculosis infection. An average bacteriophage concentration of approximately 1 PFU/alveolus was achieved in the lungs of mice using a nose-only inhalation device optimized with a dose simulation technique and adapted for use with a vibrating mesh nebulizer. Within 30 minutes of bacteriophage delivery, the mice received either a low dose (∼50-100 CFU), or an ultra-low dose (∼5-10 CFU), of M. tuberculosis H37Rv aerosol to the lungs. A prophylactic effect was observed with bacteriophage aerosol pre-treatment significantly decreasing M. tuberculosis burden in mouse lungs 24 hours and 3 weeks post-challenge (p < 0.05). These novel results indicate that a sufficient dose of nebulized mycobacteriophage aerosol to the lungs may be a valuable intervention to provide extra protection to health care professionals and other individuals at risk of exposure to M. tuberculosis.
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17
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Huh H, Wong S, St Jean J, Slavcev R. Bacteriophage interactions with mammalian tissue: Therapeutic applications. Adv Drug Deliv Rev 2019; 145:4-17. [PMID: 30659855 DOI: 10.1016/j.addr.2019.01.003] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 11/30/2018] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
Abstract
The human body is a large reservoir for bacterial viruses known as bacteriophages (phages), which participate in dynamic interactions with their bacterial and human hosts that ultimately affect human health. The current growing interest in human resident phages is paralleled by new uses of phages, including the design of engineered phages for therapeutic applications. Despite the increasing number of clinical trials being conducted, the understanding of the interaction of phages and mammalian cells and tissues is still largely unknown. The presence of phages in compartments within the body previously considered purely sterile, suggests that phages possess a unique capability of bypassing anatomical and physiological barriers characterized by varying degrees of selectivity and permeability. This review will discuss the direct evidence of the accumulation of bacteriophages in various tissues, focusing on the unique capability of phages to traverse relatively impermeable barriers in mammals and its relevance to its current applications in therapy.
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Affiliation(s)
- Haein Huh
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener N2G 1C5, Canada
| | - Shirley Wong
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener N2G 1C5, Canada
| | - Jesse St Jean
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener N2G 1C5, Canada
| | - Roderick Slavcev
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener N2G 1C5, Canada.
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18
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Ly A, Carrigy NB, Wang H, Harrison M, Sauvageau D, Martin AR, Vehring R, Finlay WH. Atmospheric Spray Freeze Drying of Sugar Solution With Phage D29. Front Microbiol 2019; 10:488. [PMID: 30949139 PMCID: PMC6436606 DOI: 10.3389/fmicb.2019.00488] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/25/2019] [Indexed: 01/11/2023] Open
Abstract
Therapeutic bacteriophages offer a potential alternative approach in the treatment of drug resistant bacteria. In the present study, we examine the ability of atmospheric spray freeze-drying (ASFD) to process bacteriophage D29 into a solid dry formulation. Bacteriophage D29 is of particular interest due to its ability to infect Mycobacterium tuberculosis. A sugar solution containing bacteriophage D29 was sprayed and instantly frozen in a cold chamber. Cold drying gas was then passed through the chamber at a high flow rate and atmospheric pressure. Convective transport combined with the low temperature of the drying gas results in sublimation of ice, yielding a free-flowing, porous powder. The bacteriophages were atmospheric spray freeze-dried in solutions with varying concentrations of trehalose and mannitol. A solution of trehalose and mannitol at a mass ratio of 7:3 and a total mass concentration of 100 mg/mL led to powder with 4.9 ± 0.1% moisture content and an acceptable titer reduction of ∼0.6 logs. In comparison, a pure trehalose solution and a 1:1 ratio of trehalose and mannitol both had titer reductions of >1.5 logs. Spectroscopic analysis showed that trehalose in the powder was amorphous while mannitol completely crystallized during the drying process, both of which are desirable for preserving phage viability and storage in powders. The results highlight the potential for using ASFD as an alternative process in preserving biopharmaceutical products.
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Affiliation(s)
- Alvin Ly
- Department of Engineering, University of Alberta, Edmonton, AB, Canada
| | | | - Hui Wang
- Department of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Melissa Harrison
- Department of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Dominic Sauvageau
- Department of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Andrew R Martin
- Department of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Reinhard Vehring
- Department of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Warren H Finlay
- Department of Engineering, University of Alberta, Edmonton, AB, Canada
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19
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Patey O, McCallin S, Mazure H, Liddle M, Smithyman A, Dublanchet A. Clinical Indications and Compassionate Use of Phage Therapy: Personal Experience and Literature Review with a Focus on Osteoarticular Infections. Viruses 2018; 11:E18. [PMID: 30597868 PMCID: PMC6356659 DOI: 10.3390/v11010018] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 01/30/2023] Open
Abstract
The history of phage therapy started with its first clinical application in 1919 and continues its development to this day. Phages continue to lack any market approval in Western medicine as a recognized drug, but are increasingly used as an experimental therapy for the compassionate treatment of patients experiencing antibiotic failure. The few formal experimental phage clinical trials that have been completed to date have produced inconclusive results on the efficacy of phage therapy, which contradicts the many successful treatment outcomes observed in historical accounts and recent individual case reports. It would therefore be wise to identify why such a discordance exists between trials and compassionate use in order to better develop future phage treatment and clinical applications. The multitude of observations reported over the years in the literature constitutes an invaluable experience, and we add to this by presenting a number of cases of patients treated compassionately with phages throughout the past decade with a focus on osteoarticular infections. Additionally, an abundance of scientific literature into phage-related areas is transforming our knowledge base, creating a greater understanding that should be applied for future clinical applications. Due to the increasing number of treatment failures anticipatedfrom the perspective of a possible post-antibiotic era, we believe that the introduction of bacteriophages into the therapeutic arsenal seems a scientifically sound and eminently practicable consideration today as a substitute or adjuvant to antibiotic therapy.
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Affiliation(s)
- Olivier Patey
- Service of Infectious and Tropical Diseases, CHI Lucie et Raymond Aubrac, 94190 Villeneuve Saint Georges, France.
| | - Shawna McCallin
- Department of Musculoskeletal Medicine DAL, Centre Hospitalier Universitaire Vaudois CHUV, Service of Plastic, Reconstructive & Hand Surgery, Regenerative Therapy Unit (UTR), CHUV-EPCR/Croisettes 22, 1066 Epalinges, Switzerland.
| | - Hubert Mazure
- HGM Consultants, 63 Rebecca Parade, Winston Hills, NSW 2153, Australia.
| | - Max Liddle
- School of Life Sciences, University of Technology, Ultimo, NSW 2007, Australia.
| | - Anthony Smithyman
- Cellabs Pty Ltd, and Founder Special Phage Services Pty Ltd, both of 7/27 Dale St, Brookvale, NSW 2100, Australia.
| | - Alain Dublanchet
- Service of Infectious and Tropical Diseases, CHI Lucie et Raymond Aubrac, 94190 Villeneuve Saint Georges, France.
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20
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Chang RYK, Wallin M, Lin Y, Leung SSY, Wang H, Morales S, Chan HK. Phage therapy for respiratory infections. Adv Drug Deliv Rev 2018; 133:76-86. [PMID: 30096336 PMCID: PMC6226339 DOI: 10.1016/j.addr.2018.08.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/06/2018] [Accepted: 08/01/2018] [Indexed: 01/12/2023]
Abstract
A respiratory infection caused by antibiotic-resistant bacteria can be life-threatening. In recent years, there has been tremendous effort put towards therapeutic application of bacteriophages (phages) as an alternative or supplementary treatment option over conventional antibiotics. Phages are natural parasitic viruses of bacteria that can kill the bacterial host, including antibiotic-resistant bacteria. Inhaled phage therapy involves the development of stable phage formulations suitable for inhalation delivery followed by preclinical and clinical studies for assessment of efficacy, pharmacokinetics and safety. We presented an overview of recent advances in phage formulation for inhalation delivery and their efficacy in acute and chronic rodent respiratory infection models. We have reviewed and presented on the prospects of inhaled phage therapy as a complementary treatment option with current antibiotics and as a preventative means. Inhaled phage therapy has the potential to transform the prevention and treatment of bacterial respiratory infections, including those caused by antibiotic-resistant bacteria.
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Affiliation(s)
| | - Martin Wallin
- Faculty of Pharmaceutical Sciences, University of Copenhagen, Denmark
| | - Yu Lin
- Advanced Drug Delivery Group, School of Pharmacy, University of Sydney, Sydney, Australia
| | - Sharon Sui Yee Leung
- Advanced Drug Delivery Group, School of Pharmacy, University of Sydney, Sydney, Australia; Faculty of Pharmacy, The Chinese University of Hong Kong, Hong Kong, China
| | - Hui Wang
- Advanced Drug Delivery Group, School of Pharmacy, University of Sydney, Sydney, Australia
| | - Sandra Morales
- AmpliPhi Biosciences AU, Brookvale, Sydney, NSW, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, School of Pharmacy, University of Sydney, Sydney, Australia.
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21
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Leung SSY, Parumasivam T, Nguyen A, Gengenbach T, Carter EA, Carrigy NB, Wang H, Vehring R, Finlay WH, Morales S, Britton WJ, Kutter E, Chan HK. Effect of storage temperature on the stability of spray dried bacteriophage powders. Eur J Pharm Biopharm 2018; 127:213-222. [PMID: 29486303 PMCID: PMC5948144 DOI: 10.1016/j.ejpb.2018.02.033] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/14/2018] [Accepted: 02/23/2018] [Indexed: 01/24/2023]
Abstract
This study aimed to assess the robustness of using a spray drying approach and formulation design in producing inhalable phage powders. Two types of Pseudomonas phages, PEV2 (Podovirus) and PEV40 (Myovirus) in two formulations containing different amounts of trehalose (70% and 60%) and leucine (30% and 40%) were studied. Most of the surface of the produced powders was found to be covered in crystalline leucine. The powders were stored at 4 °C and 20 °C under vacuum. The phage stability and in vitro aerosol performance of the phage powders were examined on the day of production and after 1, 3 and 12 months of storage. A minor titer loss during production was observed for both phages (0.2-0.8 log10 pfu/ml). The storage stability of the produced phage powders was found to be phage and formulation dependent. No further reduction in titer occurred for PEV2 powders stored at 4 °C across the study. The formulation containing 30% leucine maintained the viability of PEV2 at 20 °C, while the formulation containing 40% leucine gradually lost titer over time with a storage reduction of ∼0.9 log10 pfu/ml measured after 12 months. In comparison, the PEV40 phage powders generally had a ∼ 0.5 log10 pfu/ml loss upon storage regardless of temperature. When aerosolized, the total in vitro lung doses of PEV2 were of the order of 107 pfu, except the formulation containing 40% leucine stored at 20 °C which had a lower lung dose. The PEV40 powders also had lung doses of 106-107 pfu. The results demonstrate that spray dried Myoviridae and Podoviridae phage in a simple formulation of leucine and trehalose can be successfully stored for one year at 4 °C and 20 °C with vacuum packaging.
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Affiliation(s)
- Sharon S Y Leung
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | - Thaigarajan Parumasivam
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia; School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - An Nguyen
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | - Thomas Gengenbach
- CSIRO Manufacturing, Bayview Avenue, Clayton, Melbourne, Victoria, Australia
| | - Elizabeth A Carter
- Vibrational Spectroscopy Core Facility & The School of Chemistry, University of Sydney, Sydney, NSW, Australia
| | - Nicholas B Carrigy
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Hui Wang
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Reinhard Vehring
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Warren H Finlay
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Sandra Morales
- AmpliPhi Biosciences AU, 7/27 Dale Street, Brookvale, Sydney, NSW, Australia
| | - Warwick J Britton
- Tuberculosis Research Program, Centenary Institute, and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | | | - Hak-Kim Chan
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.
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23
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Tie K, Yuan Y, Yan S, Yu X, Zhang Q, Xu H, Zhang Y, Gu J, Sun C, Lei L, Han W, Feng X. Isolation and identification of Salmonella pullorum bacteriophage YSP2 and its use as a therapy for chicken diarrhea. Virus Genes 2018; 54:446-456. [PMID: 29564689 DOI: 10.1007/s11262-018-1549-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/05/2018] [Indexed: 11/28/2022]
Abstract
Salmonella pullorum is the major pathogen that is harmful to the poultry industry in developing countries, and the treatment of chicken diarrhea caused by S. pullorum has become increasingly difficult. In this study, a virulent bacteriophage YSP2, which was able to specifically infect Salmonella, was isolated and characterized. Phage YSP2 was classified in the Siphoviridae family and had a short latent period of 10 min. No bacterial virulence- or lysogenesis-related ORF is present in the YSP2 genome, making it eligible for use in phage therapy. Experiments in vivo investigated the potential use of phages as a therapy against diarrhea in chickens caused by S. pullorum in a chicken diarrhea model, demonstrating that a single oral administration of YSP2 (1 × 1010 PFU/mL, 80 μL/chicken) 2 h after S. pullorum oral administration at a double median lethal dose was sufficient to protect chickens against diarrhea. Gross inspection showed that YSP2 can effectively reduce organ damage and significantly relieve hemorrhage in the intestine and liver tissue. Moreover, YSP2 can maintain a high curative effect when diluted to 108 PFU/mL. In light of its therapeutic effect on chicken diarrhea, YSP2 may serve as an alternative treatment strategy for infections caused by S. pullorum.
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Affiliation(s)
- Kunyuan Tie
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Yuyu Yuan
- College of Life Science and Technology, Dalian University of Technology, No. 2 Lingshui Road, Dalian, 116024, Liaoning, People's Republic of China
| | - Shiqing Yan
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Xi Yu
- College of Animal Science, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Qiuyang Zhang
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Huihui Xu
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Yang Zhang
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Jingmin Gu
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Changjiang Sun
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Liancheng Lei
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Wenyu Han
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China
| | - Xin Feng
- College of Veterinary Medicine, Jilin University, No. 5333 Xi'an Road, Changchun, 130062, Jilin, People's Republic of China.
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Chang RY, Wong J, Mathai A, Morales S, Kutter E, Britton W, Li J, Chan HK. Production of highly stable spray dried phage formulations for treatment of Pseudomonas aeruginosa lung infection. Eur J Pharm Biopharm 2017; 121:1-13. [PMID: 28890220 DOI: 10.1016/j.ejpb.2017.09.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 01/16/2023]
Abstract
The potential of bacteriophage therapy for the treatment of pulmonary infections caused by antibiotic-resistant bacteria has been well recognised. The purpose of this study was to investigate the effect of excipients on stabilisation and aerosolisation of spray dried powders of morphologically different phages - PEV podovirus and PEV myovirus. Seven anti-pseudomonal phages were screened against 90 clinical strains of bacterial hosts and three of the phages were selected for formulation study based on the host range. Design of experiments was utilised to assess the effect of different excipients on the stabilisation and aerosolisation of spray dried phages. Both podovirus and myovirus phages were stable in spray dried formulations containing trehalose or lactose and leucine as excipients with less than 1-log10 titre reduction during spray drying, with lactose providing superior phage protection over trehalose. Furthermore, the spray dried phage formulations dispersed in an Osmohaler at 85L/min produced a high fine particle fraction of over 50%. The results showed that the phages in this study can form respirable dry powder phage formulations using the same excipient composition. Spray dried various types of lytic phages hold significant potential for the treatment of pulmonary infections.
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Affiliation(s)
- Rachel Y Chang
- Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia
| | - Jennifer Wong
- Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia
| | - Ash Mathai
- Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia
| | - Sandra Morales
- AmpliPhi Biosciences AU, 7/27 Dale Street, Brookvale, Sydney, NSW 2100, Australia
| | | | - Warwick Britton
- Centenary Institute of Cancer Medicine and Cell Biology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Jian Li
- Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Clayton, Victoria 3800, Australia
| | - Hak-Kim Chan
- Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia.
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25
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Carrigy NB, Chang RY, Leung SSY, Harrison M, Petrova Z, Pope WH, Hatfull GF, Britton WJ, Chan HK, Sauvageau D, Finlay WH, Vehring R. Anti-Tuberculosis Bacteriophage D29 Delivery with a Vibrating Mesh Nebulizer, Jet Nebulizer, and Soft Mist Inhaler. Pharm Res 2017. [PMID: 28646325 DOI: 10.1007/s11095-017-2213-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To compare titer reduction and delivery rate of active anti-tuberculosis bacteriophage (phage) D29 with three inhalation devices. METHODS Phage D29 lysate was amplified to a titer of 11.8 ± 0.3 log10(pfu/mL) and diluted 1:100 in isotonic saline. Filters captured the aerosolized saline D29 preparation emitted from three types of inhalation devices: 1) vibrating mesh nebulizer; 2) jet nebulizer; 3) soft mist inhaler. Full-plate plaque assays, performed in triplicate at multiple dilution levels with the surrogate host Mycobacterium smegmatis, were used to quantify phage titer. RESULTS Respective titer reductions for the vibrating mesh nebulizer, jet nebulizer, and soft mist inhaler were 0.4 ± 0.1, 3.7 ± 0.1, and 0.6 ± 0.3 log10(pfu/mL). Active phage delivery rate was significantly greater (p < 0.01) for the vibrating mesh nebulizer (3.3x108 ± 0.8x108 pfu/min) than for the jet nebulizer (5.4x104 ± 1.3x104 pfu/min). The soft mist inhaler delivered 4.6x106 ± 2.0x106 pfu per 11.6 ± 1.6 μL ex-actuator dose. CONCLUSIONS Delivering active phage requires a prudent choice of inhalation device. The jet nebulizer was not a good choice for aerosolizing phage D29 under the tested conditions, due to substantial titer reduction likely occurring during droplet production. The vibrating mesh nebulizer is recommended for animal inhalation studies requiring large amounts of D29 aerosol, whereas the soft mist inhaler may be useful for self-administration of D29 aerosol.
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Affiliation(s)
- Nicholas B Carrigy
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Rachel Y Chang
- Advanced Drug Delivery Group, Faculty of Pharmacy, University of Sydney, Sydney, Australia
| | - Sharon S Y Leung
- Advanced Drug Delivery Group, Faculty of Pharmacy, University of Sydney, Sydney, Australia
| | - Melissa Harrison
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB, Canada
| | - Zaritza Petrova
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Welkin H Pope
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Graham F Hatfull
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Warwick J Britton
- Centenary Institute of Cancer Medicine and Cell Biology, and Sydney Medical School, University of Sydney, Sydney, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Faculty of Pharmacy, University of Sydney, Sydney, Australia
| | - Dominic Sauvageau
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB, Canada
| | - Warren H Finlay
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Reinhard Vehring
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada.
- Department of Mechanical Engineering, 10-203 Donadeo Innovation Centre for Engineering, University of Alberta, 9211 116th Street NW, Edmonton, AB, T6G 1H9, Canada.
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26
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Parumasivam T, Chang RYK, Abdelghany S, Ye TT, Britton WJ, Chan HK. Dry powder inhalable formulations for anti-tubercular therapy. Adv Drug Deliv Rev 2016; 102:83-101. [PMID: 27212477 DOI: 10.1016/j.addr.2016.05.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 05/13/2016] [Accepted: 05/14/2016] [Indexed: 12/31/2022]
Abstract
Tuberculosis (TB) is an intracellular infectious disease caused by the airborne bacterium, Mycobacterium tuberculosis. Despite considerable research efforts, the treatment of TB continues to be a great challenge in part due to the requirement of prolonged therapy with multiple high-dose drugs and associated side effects. The delivery of pharmacological agents directly to the respiratory system, following the natural route of infection, represents a logical therapeutic approach for treatment or vaccination against TB. Pulmonary delivery is non-invasive, avoids first-pass metabolism in the liver and enables targeting of therapeutic agents to the infection site. Inhaled delivery also potentially reduces the dose requirement and the accompanying side effects. Dry powder is a stable formulation of drug that can be stored without refrigeration compared to liquids and suspensions. The dry powder inhalers are easy to use and suitable for high-dose formulations. This review focuses on the current innovations of inhalable dry powder formulations of drug and vaccine delivery for TB, including the powder production method, preclinical and clinical evaluations of inhaled dry powder over the last decade. Finally, the risks associated with pulmonary therapy are addressed. A novel dry powder formulation with high percentages of respirable particles coupled with a cost effective inhaler device is an appealing platform for TB drug delivery.
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Affiliation(s)
- Thaigarajan Parumasivam
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia
| | - Rachel Yoon Kyung Chang
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia
| | - Sharif Abdelghany
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Jordan, Amman 1192, Jordan
| | - Tian Tian Ye
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia
| | - Warwick John Britton
- Tuberculosis Research Program, Centenary Institute, The University of Sydney, NSW 2006, Australia; Infectious Diseases and Immunology, Sydney Medical School, The University of Sydney, NSW 2006, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia.
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Vandenheuvel D, Lavigne R, Brüssow H. Bacteriophage Therapy: Advances in Formulation Strategies and Human Clinical Trials. Annu Rev Virol 2016; 2:599-618. [PMID: 26958930 DOI: 10.1146/annurev-virology-100114-054915] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recently, a number of phage therapy phase I and II safety trials have been concluded, showing no notable safety concerns associated with the use of phage. Though hurdles for efficient treatment remain, these trials hold promise for future phase III clinical trials. Interestingly, most phage formulations used in these clinical trials are straightforward phage suspensions, and not much research has focused on the processing of phage cocktails in specific pharmaceutical dosage forms. Additional research on formulation strategies and the stability of phage-based drugs will be of key importance, especially with phage therapy advancing toward phase III clinical trials.
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Affiliation(s)
- Dieter Vandenheuvel
- Laboratory of Gene Technology, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; ,
| | - Rob Lavigne
- Laboratory of Gene Technology, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; ,
| | - Harald Brüssow
- Nestlé Research Center, Nestec Ltd., Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland;
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28
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Leung SSY, Parumasivam T, Gao FG, Carrigy NB, Vehring R, Finlay WH, Morales S, Britton WJ, Kutter E, Chan HK. Production of Inhalation Phage Powders Using Spray Freeze Drying and Spray Drying Techniques for Treatment of Respiratory Infections. Pharm Res 2016; 33:1486-96. [PMID: 26928668 DOI: 10.1007/s11095-016-1892-6] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/22/2016] [Indexed: 01/05/2023]
Abstract
PURPOSE The potential of aerosol phage therapy for treating lung infections has been demonstrated in animal models and clinical studies. This work compared the performance of two dry powder formation techniques, spray freeze drying (SFD) and spray drying (SD), in producing inhalable phage powders. METHOD A Pseudomonas podoviridae phage, PEV2, was incorporated into multi-component formulation systems consisting of trehalose, mannitol and L-leucine (F1 = 60:20:20 and F2 = 40:40:20). The phage titer loss after the SFD and SD processes and in vitro aerosol performance of the produced powders were assessed. RESULTS A significant titer loss (~2 log) was noted for droplet generation using an ultrasonic nozzle employed in the SFD method, but the conventional two-fluid nozzle used in the SD method was less destructive for the phage (~0.75 log loss). The phage were more vulnerable during the evaporative drying process (~0.75 log further loss) compared with the freeze drying step, which caused negligible phage loss. In vitro aerosol performance showed that the SFD powders (~80% phage recovery) provided better phage protection than the SD powders (~20% phage recovery) during the aerosolization process. Despite this, higher total lung doses were obtained for the SD formulations (SD-F1 = 13.1 ± 1.7 × 10(4) pfu and SD-F2 = 11.0 ± 1.4 × 10(4) pfu) than from their counterpart SFD formulations (SFD-F1 = 8.3 ± 1.8 × 10(4) pfu and SFD-F2 = 2.1 ± 0.3 × 10(4) pfu). CONCLUSION Overall, the SD method caused less phage reduction during the powder formation process and the resulted powders achieved better aerosol performance for PEV2.
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Affiliation(s)
- Sharon S Y Leung
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Fiona G Gao
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia
| | - Nicholas B Carrigy
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, T6G 2G8, Canada
| | - Reinhard Vehring
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, T6G 2G8, Canada
| | - Warren H Finlay
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, T6G 2G8, Canada
| | - Sandra Morales
- AmpliPhi Biosciences AU, 7/27 Dale Street, Brookvale, Sydney, NSW, 2100, Australia
| | - Warwick J Britton
- Tuberculosis Research Program, Centenary Institute and Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Hak-Kim Chan
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia.
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29
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Friman VP, Soanes-Brown D, Sierocinski P, Molin S, Johansen HK, Merabishvili M, Pirnay JP, De Vos D, Buckling A. Pre-adapting parasitic phages to a pathogen leads to increased pathogen clearance and lowered resistance evolution with Pseudomonas aeruginosa cystic fibrosis bacterial isolates. J Evol Biol 2015; 29:188-98. [PMID: 26476097 DOI: 10.1111/jeb.12774] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/12/2015] [Indexed: 12/17/2022]
Abstract
Recent years have seen renewed interest in phage therapy--the use of viruses to specifically kill disease-causing bacteria--because of the alarming rise in antibiotic resistance. However, a major limitation of phage therapy is the ease at with bacteria can evolve resistance to phages. Here, we determined whether in vitro experimental coevolution can increase the efficiency of phage therapy by limiting the resistance evolution of intermittent and chronic cystic fibrosis Pseudomonas aeruginosa lung isolates to four different phages. We first pre-adapted all phage strains against all bacterial strains and then compared the efficacy of pre-adapted and nonadapted phages against ancestral bacterial strains. We found that evolved phages were more efficient in reducing bacterial densities than ancestral phages. This was primarily because only 50% of bacterial strains were able to evolve resistance to evolved phages, whereas all bacteria were able to evolve some level of resistance to ancestral phages. Although the rate of resistance evolution did not differ between intermittent and chronic isolates, it incurred a relatively higher growth cost for chronic isolates when measured in the absence of phages. This is likely to explain why evolved phages were more effective in reducing the densities of chronic isolates. Our data show that pathogen genotypes respond differently to phage pre-adaptation, and as a result, phage therapies might need to be individually adjusted for different patients.
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Affiliation(s)
- V-P Friman
- Biosciences, University of Exeter, Penryn, UK.,Department of Biology, University of York, York, UK
| | | | - P Sierocinski
- Biosciences, University of Exeter, Penryn, UK.,European Centre for Environment and Human Health in Cornwall, University of Exeter, Penryn, UK
| | - S Molin
- Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark
| | - H K Johansen
- Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark.,Department of Clinical Microbiology 9301, Rigshospitalet, København Ø, Denmark
| | - M Merabishvili
- Burn Wound Center, Queen Astrid Military Hospital, Brussel, Belgium.,Research and Development Department, George Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi, Georgia.,Laboratory for Bacteriology Research, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - J-P Pirnay
- Burn Wound Center, Queen Astrid Military Hospital, Brussel, Belgium
| | - D De Vos
- Burn Wound Center, Queen Astrid Military Hospital, Brussel, Belgium
| | - A Buckling
- Biosciences, University of Exeter, Penryn, UK
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30
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Verreault D, Marcoux-Voiselle M, Turgeon N, Moineau S, Duchaine C. Resistance of Aerosolized Bacterial Viruses to Relative Humidity and Temperature. Appl Environ Microbiol 2015; 81:7305-11. [PMID: 26253683 PMCID: PMC4579431 DOI: 10.1128/aem.02484-15] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/02/2015] [Indexed: 11/20/2022] Open
Abstract
The use of aerosolized bacteriophages as surrogates for hazardous viruses might simplify and accelerate the discovery of links between viral components and their persistence in the airborne state under diverse environmental conditions. In this study, four structurally distinct lytic phages, MS2 (single-stranded RNA [ssRNA]), ϕ6 (double-stranded RNA [dsRNA]), ϕX174 (single-stranded DNA [ssDNA]), and PR772 (double-stranded DNA [dsDNA]), were nebulized into a rotating chamber and exposed to various levels of relative humidity (RH) and temperature as well as to germicidal UV radiation. The aerosolized viral particles were allowed to remain airborne for up to 14 h before being sampled for analysis by plaque assays and quantitative PCRs. Phages ϕ6 and MS2 were the most resistant at low levels of relative humidity, while ϕX174 was more resistant at 80% RH. Phage ϕ6 lost its infectivity immediately after exposure to 30°C and 80% RH. The infectivity of all tested phages rapidly declined as a function of the exposure time to UVC radiation, phage MS2 being the most resistant. Taken altogether, our data indicate that these aerosolized phages behave differently under various environmental conditions and highlight the necessity of carefully selecting viral simulants in bioaerosol studies.
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Affiliation(s)
- Daniel Verreault
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada
| | - Mélissa Marcoux-Voiselle
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada
| | - Nathalie Turgeon
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada
| | - Sylvain Moineau
- Département de Biochimie, de Microbiologie, et de Bio-Informatique, Faculté des Sciences et de Génie, Université Laval, Quebec City, Quebec, Canada Félix d'Hérelle Reference Center for Bacterial Viruses and GREB, Faculté de Médecine Dentaire, Université Laval, Quebec City, Quebec, Canada
| | - Caroline Duchaine
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada Félix d'Hérelle Reference Center for Bacterial Viruses and GREB, Faculté de Médecine Dentaire, Université Laval, Quebec City, Quebec, Canada
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31
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Peters DL, Lynch KH, Stothard P, Dennis JJ. The isolation and characterization of two Stenotrophomonas maltophilia bacteriophages capable of cross-taxonomic order infectivity. BMC Genomics 2015; 16:664. [PMID: 26335566 PMCID: PMC4559383 DOI: 10.1186/s12864-015-1848-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/14/2015] [Indexed: 12/25/2022] Open
Abstract
Background A rapid worldwide increase in the number of human infections caused by the extremely antibiotic resistant bacterium Stenotrophomonas maltophilia is prompting alarm. One potential treatment solution to the current antibiotic resistance dilemma is “phage therapy”, the clinical application of bacteriophages to selectively kill bacteria. Results Towards that end, phages DLP1 and DLP2 (vB_SmaS-DLP_1 and vB_SmaS-DLP_2, respectively) were isolated against S. maltophilia strain D1585. Host range analysis for each phage was conducted using 27 clinical S. maltophilia isolates and 11 Pseudomonas aeruginosa strains. Both phages exhibit unusually broad host ranges capable of infecting bacteria across taxonomic orders. Transmission electron microscopy of the phage DLP1 and DLP2 morphology reveals that they belong to the Siphoviridae family of bacteriophages. Restriction fragment length polymorphism analysis and complete genome sequencing and analysis indicates that phages DLP1 and DLP2 are closely related but different phages, sharing 96.7 % identity over 97.2 % of their genomes. These two phages are also related to P. aeruginosa phages vB_Pae-Kakheti_25 (PA25), PA73, and vB_PaeS_SCH_Ab26 (Ab26) and more distantly related to Burkholderia cepacia complex phage KL1, which together make up a taxonomic sub-family. Phages DLP1 and DLP2 exhibited significant differences in host ranges and growth kinetics. Conclusions The isolation and characterization of phages able to infect two completely different species of bacteria is an exciting discovery, as phages typically can only infect related bacterial species, and rarely infect bacteria across taxonomic families, let alone across taxonomic orders. Electronic supplementary material The online version of this article (doi:10.1186/s12864-015-1848-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Danielle L Peters
- Department of Biological Sciences, 6-065 Centennial Centre for Interdisciplinary Science, University of Alberta, Edmonton, AB, T6G 2E9, Canada.
| | - Karlene H Lynch
- Department of Biological Sciences, 6-065 Centennial Centre for Interdisciplinary Science, University of Alberta, Edmonton, AB, T6G 2E9, Canada.
| | - Paul Stothard
- Department of Agricultural, Food and Nutritional Science, University of Alberta, 1400 College Plaza, Edmonton, AB, T6G 2C8, Canada.
| | - Jonathan J Dennis
- Department of Biological Sciences, 6-065 Centennial Centre for Interdisciplinary Science, University of Alberta, Edmonton, AB, T6G 2E9, Canada.
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32
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Inhaled antimicrobial therapy – Barriers to effective treatment. Adv Drug Deliv Rev 2015; 85:24-43. [DOI: 10.1016/j.addr.2014.08.013] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/20/2014] [Accepted: 08/25/2014] [Indexed: 02/08/2023]
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33
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Abedon ST. Phage therapy of pulmonary infections. BACTERIOPHAGE 2015; 5:e1020260. [PMID: 26442188 PMCID: PMC4422798 DOI: 10.1080/21597081.2015.1020260] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 11/01/2022]
Abstract
It is generally agreed that a bacteriophage-associated phenomenon was first unambiguously observed one-hundred years ago with the findings of Twort in 1915. This was independently followed by complementary observations by d'Hérelle in 1917. D'Hérelle's appreciation of the bacteriophage phenomenon appears to have directly led to the development of phages as antibacterial agents within a variety of contexts, including medical and agricultural. Phage use to combat nuisance bacteria appears to be especially useful where targets are sufficiently problematic, suitably bactericidal phages exist, and alternative approaches are lacking in effectiveness, availability, safety, or cost effectiveness, etc. Phage development as antibacterial agents has been strongest particularly when antibiotics have been less available or useful, e.g., such as in the treatment of chronic infections by antibiotic-resistant bacteria. One relatively under-explored or at least not highly reported use of phages as therapeutic agents has been to combat bacterial infections of the lungs and associated tissues. These infections are diverse in terms of their etiologies, manifestations, and also in terms of potential strategies of phage delivery. Here I review the literature considering the phage therapy of pulmonary and pulmonary-related infections, with emphasis on reports of clinical treatment along with experimental treatment of pulmonary infections using animal models.
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Affiliation(s)
- Stephen T Abedon
- Department of Microbiology; The Ohio State University ; Mansfield, OH USA
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34
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Sahota JS, Smith CM, Radhakrishnan P, Winstanley C, Goderdzishvili M, Chanishvili N, Kadioglu A, O'Callaghan C, Clokie MRJ. Bacteriophage Delivery by Nebulization and Efficacy Against Phenotypically Diverse Pseudomonas aeruginosa from Cystic Fibrosis Patients. J Aerosol Med Pulm Drug Deliv 2015; 28:353-60. [PMID: 25714328 DOI: 10.1089/jamp.2014.1172] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The rise in antibiotic-resistant Pseudomonas aeruginosa and the considerable difficulty in eradicating it from patients has re-motivated the study of bacteriophages as a therapeutic option. For this to be effective, host range and viability following nebulization need to be assessed. Host-range has not previously been assessed for the Liverpool Epidemic Strain (LES) isolates that are the most common cystic fibrosis-related clone of P. aeruginosa in the UK. Nebulization studies have not previously been linked to clinically relevant phages. METHODS 84 phenotypically variable isolates of the LES were tested for susceptibility to seven bacteriophages known to have activity against P. aeruginosa. Five of the phages were from the Eliava Institute (IBMV) and 2 were isolated in this study. The viability of the two bacteriophages with the largest host ranges was characterized further to determine their ability to be nebulized and delivered to the lower airways. Phages were nebulized into a cascade impactor and the phage concentration was measured. RESULTS The bacteriophages tested killed between 66%-98% of the 84 Liverpool Epidemic Strain isolates. Two isolates were multi phage resistant, but were sensitive to most first line anti-Pseudomonal antibiotics. The amount of viable bacteriophages contained in particles that are likely to reach the lower airways (<4.7 μm) was 1% for the Omron and 12% AeroEclipse nebulizer. CONCLUSIONS Individual P. aeruginosa bacteriophages can lyse up to 98% of 84 phenotypically diverse LES strains. High titers of phages can be effectively nebulized.
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Affiliation(s)
- Jaspreet Singh Sahota
- 1 Department of Infection, Immunity and Inflammation, University of Leicester , Leicester, United Kingdom
| | - Claire Mary Smith
- 1 Department of Infection, Immunity and Inflammation, University of Leicester , Leicester, United Kingdom .,2 Respiratory, Critical Care, and Anaesthesia, University College London , Institute of Child Health, London, Great Ormond Street Hospital, London, United Kingdom
| | - Priya Radhakrishnan
- 2 Respiratory, Critical Care, and Anaesthesia, University College London , Institute of Child Health, London, Great Ormond Street Hospital, London, United Kingdom
| | - Craig Winstanley
- 3 Department of Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool , Liverpool, United Kingdom
| | | | - Nina Chanishvili
- 4 Eliava Institute of Bacteriophages , Microbiology, and Virology, Tbilisi, Georgia
| | - Aras Kadioglu
- 3 Department of Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool , Liverpool, United Kingdom
| | - Chris O'Callaghan
- 1 Department of Infection, Immunity and Inflammation, University of Leicester , Leicester, United Kingdom .,2 Respiratory, Critical Care, and Anaesthesia, University College London , Institute of Child Health, London, Great Ormond Street Hospital, London, United Kingdom
| | - Martha Rebecca Jane Clokie
- 1 Department of Infection, Immunity and Inflammation, University of Leicester , Leicester, United Kingdom
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35
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Cao Z, Zhang J, Niu YD, Cui N, Ma Y, Cao F, Jin L, Li Z, Xu Y. Isolation and characterization of a "phiKMV-like" bacteriophage and its therapeutic effect on mink hemorrhagic pneumonia. PLoS One 2015; 10:e0116571. [PMID: 25615639 PMCID: PMC4304800 DOI: 10.1371/journal.pone.0116571] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 12/11/2014] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to investigate the potential of using phages as a therapy against hemorrhagic pneumonia in mink both in vitro and in vivo. Five Pseudomonas aeruginosa (P. aeruginosa) strains were isolated from lungs of mink with suspected hemorrhagic pneumonia and their identity was confirmed by morphological observation and 16S rDNA sequence analysis. Compared to P. aeruginosa strains isolated from mink with hemorrhagic pneumonia in 2002, these isolates were more resistant to antibiotics selected. A lytic phage vB_PaeP_PPA-ABTNL (PPA-ABTNL) of the Podoviridae family was isolated from hospital sewage using a P. aeruginosa isolate as host, showing broad host range against P. aeruginosa. A one-step growth curve analysis of PPA-ABTNL revealed eclipse and latent periods of 20 and 35 min, respectively, with a burst size of about 110 PFU per infected cell. Phage PPA-ABTNL significantly reduced the growth of P. aeruginosa isolates in vitro. The genome of PPA-ABTNL was 43,227 bp (62.4% G+C) containing 54 open reading frames and lacked regions encoding known virulence factors, integration-related proteins and antibiotic resistance determinants. Genome architecture analysis showed that PPA-ABTNL belonged to the "phiKMV-like Viruses" group. A repeated dose inhalational toxicity study using PPA-ABTNL crude preparation was conducted in mice and no significantly abnormal histological changes, morbidity or mortality were observed. There was no indication of any potential risk associated with using PPA-ABTNL as a therapeutic agent. The results of a curative treatment experiment demonstrated that atomization by ultrasonic treatment could efficiently deliver phage to the lungs of mink and a dose of 10 multiplicity of infection was optimal for treating mink hemorrhagic pneumonia. Our work demonstrated the potential for phage to fight P. aeruginosa involved in mink lung infections when administered by means of ultrasonic nebulization.
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Affiliation(s)
- Zhenhui Cao
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, Liaoning, China
| | - Jiancheng Zhang
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, Liaoning, China
| | - Yan D. Niu
- Alberta Agriculture and Rural Development, Agriculture Centre, Lethbridge, Alberta, Canada
| | - Naizhong Cui
- School of Life Science, Datong University, Datong, Shanxi, China
| | - Yongsheng Ma
- College of Food Science and Engineering, Dalian Ocean University, Dalian, Liaoning, China
| | - Fang Cao
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, Liaoning, China
| | - Liji Jin
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, Liaoning, China
- Ministry of Education Center for Food Safety of Animal Origin, Dalian, Liaoning, China
| | - Zhen Li
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, Liaoning, China
| | - Yongping Xu
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, Liaoning, China
- Ministry of Education Center for Food Safety of Animal Origin, Dalian, Liaoning, China
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36
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Taking bacteriophage therapy seriously: a moral argument. BIOMED RESEARCH INTERNATIONAL 2014; 2014:621316. [PMID: 24868534 PMCID: PMC4020481 DOI: 10.1155/2014/621316] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 04/14/2014] [Accepted: 04/21/2014] [Indexed: 01/21/2023]
Abstract
The excessive and improper use of antibiotics has led to an increasing incidence of bacterial resistance. In Europe the yearly number of infections caused by multidrug resistant bacteria is more than 400.000, each year resulting in 25.000 attributable deaths. Few new antibiotics are in the pipeline of the pharmaceutical industry. Early in the 20th century, bacteriophages were described as entities that can control bacterial populations. Although bacteriophage therapy was developed and practiced in Europe and the former Soviet republics, the use of bacteriophages in clinical setting was neglected in Western Europe since the introduction of traditional antibiotics. Given the worldwide antibiotic crisis there is now a growing interest in making bacteriophage therapy available for use in modern western medicine. Despite the growing interest, access to bacteriophage therapy remains highly problematic. In this paper, we argue that the current state of affairs is morally unacceptable and that all stakeholders (pharmaceutical industry, competent authorities, lawmakers, regulators, and politicians) have the moral duty and the shared responsibility towards making bacteriophage therapy urgently available for all patients in need.
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