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Pirnay JP, Merabishvili M, De Vos D, Verbeken G. Bacteriophage Production in Compliance with Regulatory Requirements. Methods Mol Biol 2024; 2734:89-115. [PMID: 38066364 DOI: 10.1007/978-1-0716-3523-0_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
In this chapter, we discuss production requirements for therapeutic bacteriophage preparations. We review the current regulatory expectancies and focus on pragmatic production processes, implementing relevant controls to ensure the quality, safety, and efficacy of the final products. The information disclosed in this chapter can also serve as a basis for discussions with competent authorities regarding the implementation of expedited bacteriophage product development and licensing pathways, taking into account some peculiarities of bacteriophages (as compared to conventional medicines), such as their specificity for, and co-evolution with, their bacterial hosts. To maximize the potential of bacteriophages as natural controllers of bacterial populations, the implemented regulatory frameworks and manufacturing processes should not only cater to defined bacteriophage products. But, they should also facilitate personalized approaches in which bacteriophages are selected ad hoc and even trained to target the patient's infecting bacterial strain(s), whether or not in combination with other antimicrobials such as antibiotics.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium.
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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Pirnay JP, Verbeken G. Magistral Phage Preparations: Is This the Model for Everyone? Clin Infect Dis 2023; 77:S360-S369. [PMID: 37932120 DOI: 10.1093/cid/ciad481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
Phage therapy is increasingly put forward as a promising additional tool to help curb the global antimicrobial resistance crisis. However, industrially manufactured phage medicinal products are currently not available on the European Union and United States markets. In addition, it is expected that the business purpose-driven phage products that are supposed to be marketed in the future would mainly target commercially viable bacterial species and clinical indications, using fixed phage cocktails. hospitals or phage therapy centers aiming to help all patients with difficult-to-treat infections urgently need adequate phage preparations. We believe that national solutions based on the magistral preparation of personalized (preadapted) phage products by hospital and academic facilities could bring an immediate solution and could complement future industrially manufactured products. Moreover, these unlicensed phage preparations are presumed to be more efficient and to elicit less bacterial phage resistance issues than fixed phage cocktails, claims that need to be scientifically substantiated as soon as possible. Just like Belgium, other (European) countries could develop a magistral phage preparation framework that would exist next to the conventional medicinal product development and licensing pathways. However, it is important that the current producers of personalized phage products are provided with pragmatic quality and safety assurance requirements, which are preferably standardized (at least at the European level), and are tiered based on benefit-risk assessments at the individual patient level. Pro bono phage therapy providers should be supported and not stopped by the imposition of industry standards such as Good Manufacturing Practice requirements. Keywords: antimicrobial resistance; antibiotic resistance; bacterial infection; bacteriophage therapy; magistral preparation.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Non-traditional Antibacterial Therapy (ESGNTA), Basel, Switzerland
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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Padalko E, Colenbie L, Delforge A, Ectors N, Guns J, Imbert R, Jansens H, Pirnay JP, Rodenbach MP, Van Riet I, Vansteenbrugge A, Verbeken G, Baltes M, Beele H. Preanalytical variables influencing the interpretation and reporting of biological tests on blood samples of living and deceased donors for human body materials. Cell Tissue Bank 2023:10.1007/s10561-023-10106-z. [PMID: 37624485 DOI: 10.1007/s10561-023-10106-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/22/2023] [Indexed: 08/26/2023]
Abstract
With the present paper, the Working Group on Cells, Tissues and Organs and other experts of the Superior Health Council of Belgium aimed to provide stakeholders in material of human origin with advice on critical aspects of serological and nucleic acid test (NAT) testing, to improve virological safety of cell- and tissue and organ donation. The current paper focusses on a number of preanalytical variables which can be critical for any medical biology examination: (1) sampling related variables (type of samples, collection of the samples, volume of the sample, choice of specific tubes, identification of tubes), (2) variables related to transport, storage and processing of blood samples (transport, centrifugation and haemolysis, storage before and after centrifugation, use of serum versus plasma), (3) variables related to dilution (haemodilution, pooling of samples), and (4) test dependent variables (available tests and validation). Depending on the type of donor (deceased donor (heart-beating or non-heart beating) versus living donor (allogeneic, related, autologous), and the type of donated human material (cells, tissue or organs) additional factors can play a role: pre- and post-mortem sampling, conditions of sampling (e.g. morgue), haemodilution, possibility of retesting.
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Affiliation(s)
- Elizaveta Padalko
- Department of Medical Microbiology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Diagnostic Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium.
| | - Luc Colenbie
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Transplant Center, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Alain Delforge
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Laboratory of Clinical Cellular Therapy, Institute J. Bordet, Rue Meylemeersch 90, 1070, Brussels, Belgium
| | - Nadine Ectors
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Faculty of Medicine, KU Leuven (Catholic University of Leuven), Oude Markt 13, 3000, Leuven, Belgium
| | - Johan Guns
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Laboratory Quality, Free University of Brussels VUB/University Hospital, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Romain Imbert
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Medically Assisted Reproduction, CHIREC, Boulevard du Triomphe 201, 1160, Brussels, Belgium
| | - Hilde Jansens
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Medical Microbiology, Antwerp University/University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
| | - Jean-Paul Pirnay
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, B-1120, Brussels, Belgium
| | - Marie-Pierre Rodenbach
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Service du Sang, Croix-Rouge de Belgique, Rue du Fond du Maréchal 8, 5021, Suarlée, Belgium
| | - Ivan Van Riet
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Hematology, University Hospital Brussels (UZ Brussel), Jette, Belgium
| | - Anne Vansteenbrugge
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Medically Assisted Reproduction, CHIREC, Boulevard du Triomphe 201, 1160, Brussels, Belgium
| | - Gilbert Verbeken
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, B-1120, Brussels, Belgium
| | - Muriel Baltes
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
| | - Hilde Beele
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Dermatology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
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Latka A, Aertsen A, Boeckaerts D, Blasdel B, Ceyssens PJ, Garcia-Pino A, Gillis A, Lavigne R, Lima-Mendez G, Matthijnssens J, Onsea J, Peeters E, Pirnay JP, Thiry D, Vandenheuvel D, Van Mechelen E, Venneman J, Verbeken G, Wagemans J, Briers Y. Foundation of the Belgian Society for Viruses of Microbes and Meeting Report of Its Inaugural Symposium. Viruses 2023; 15:v15051213. [PMID: 37243298 DOI: 10.3390/v15051213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
The Belgian Society for Viruses of Microbes (BSVoM) was founded on 9 June 2022 to capture and enhance the collaborative spirit among the expanding community of microbial virus researchers in Belgium. The sixteen founders are affiliated to fourteen different research entities across academia, industry and government. Its inaugural symposium was held on 23 September 2022 in the Thermotechnical Institute at KU Leuven. The meeting program covered three thematic sessions launched by international keynote speakers: (1) virus-host interactions, (2) viral ecology, evolution and diversity and (3) present and future applications. During the one-day symposium, four invited keynote lectures, ten selected talks and eight student pitches were given along with 41 presented posters. The meeting hosted 155 participants from twelve countries.
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Affiliation(s)
- Agnieszka Latka
- Laboratory of Applied Biotechnology, Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Gent, Belgium
- Department of Pathogen Biology and Immunology, University of Wroclaw, 51-148 Wroclaw, Poland
| | - Abram Aertsen
- Laboratory of Food Microbiology, Department of Microbial and Molecular Systems, Faculty of Bioscience Engineering, KU Leuven, 3001 Leuven, Belgium
| | - Dimitri Boeckaerts
- Laboratory of Applied Biotechnology, Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Gent, Belgium
- KERMIT, Department of Data Analysis and Mathematical Modelling, Ghent University, 9000 Ghent, Belgium
| | - Bob Blasdel
- Vésale Bioscience, Vésale Pharmaceutica, 5310 Noville-sur-Mehaigne, Belgium
| | | | - Abel Garcia-Pino
- Cellular and Molecular Microbiology, Faculté des Sciences, Université Libre de Bruxelles, Campus La Plaine, 1050 Brussels, Belgium
| | - Annika Gillis
- Laboratory of Food and Environmental Microbiology, Earth and Life Institute, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, Department of Biosystems, Faculty of Bioscience Engineering, KU Leuven, 3001 Leuven, Belgium
| | - Gipsi Lima-Mendez
- Biology of Microorganisms Research Unit (URBM), Namur Research Institute for Life Sciences (NARILIS), Université de Namur ASBL, 5000 Namur, Belgium
| | - Jelle Matthijnssens
- Laboratory of Viral Metagenomics, Rega Institute, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Jolien Onsea
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Eveline Peeters
- Research Group of Microbiology, Department of Bioengineering Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium
| | - Damien Thiry
- Veterinary Bacteriology, Department of Infectious and Parasitic Diseases, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
| | - Dieter Vandenheuvel
- Department of Bioscience Engineering, University of Antwerp, 2020 Antwerp, Belgium
| | - Els Van Mechelen
- Research Centre Health & Water Technology, University of Applied Sciences, 9000 Gent, Belgium
| | - Jolien Venneman
- Flanders Research Institute for Agriculture, Fisheries and Food (ILVO), 9820 Merelbeke, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium
| | - Jeroen Wagemans
- Laboratory of Gene Technology, Department of Biosystems, Faculty of Bioscience Engineering, KU Leuven, 3001 Leuven, Belgium
| | - Yves Briers
- Laboratory of Applied Biotechnology, Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Gent, Belgium
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Pirnay JP, Selhorst P, Hong SL, Cochez C, Potter B, Maes P, Petrillo M, Dudas G, Claes V, Van der Beken Y, Verbeken G, Degueldre J, Dellicour S, Cuypers L, T’Sas F, Van den Eede G, Verhasselt B, Weuts W, Smets C, Mertens J, Geeraerts P, Ariën KK, André E, Neirinckx P, Soentjens P, Baele G. Variant Analysis of SARS-CoV-2 Genomes from Belgian Military Personnel Engaged in Overseas Missions and Operations. Viruses 2021; 13:1359. [PMID: 34372565 PMCID: PMC8310367 DOI: 10.3390/v13071359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023] Open
Abstract
More than a year after the first identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent of the 2019 coronavirus disease (COVID-19) in China, the emergence and spread of genomic variants of this virus through travel raise concerns regarding the introduction of lineages in previously unaffected regions, requiring adequate containment strategies. Concomitantly, such introductions fuel worries about a possible increase in transmissibility and disease severity, as well as a possible decrease in vaccine efficacy. Military personnel are frequently deployed on missions around the world. As part of a COVID-19 risk mitigation strategy, Belgian Armed Forces that engaged in missions and operations abroad were screened (7683 RT-qPCR tests), pre- and post-mission, for the presence of SARS-CoV-2, including the identification of viral lineages. Nine distinct viral genotypes were identified in soldiers returning from operations in Niger, the Democratic Republic of the Congo, Afghanistan, and Mali. The SARS-CoV-2 variants belonged to major clades 19B, 20A, and 20B (Nextstrain nomenclature), and included "variant of interest" B.1.525, "variant under monitoring" A.27, as well as lineages B.1.214, B.1, B.1.1.254, and A (pangolin nomenclature), some of which are internationally monitored due to the specific mutations they harbor. Through contact tracing and phylogenetic analysis, we show that isolation and testing policies implemented by the Belgian military command appear to have been successful in containing the influx and transmission of these distinct SARS-CoV-2 variants into military and civilian populations.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Philippe Selhorst
- Unit of Virology and Outbreak Research Team, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Christel Cochez
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Barney Potter
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Mauro Petrillo
- European Commission, Directorate-General Joint Research Centre (JRC), 21027 Ispra, Italy;
| | - Gytis Dudas
- Gothenburg Global Biodiversity Centre, 413 19 Gothenburg, Sweden;
- Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08410 Vilnius, Lithuania
| | - Vincent Claes
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Yolien Van der Beken
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Julie Degueldre
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Lize Cuypers
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
| | - France T’Sas
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Guy Van den Eede
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium;
| | - Bruno Verhasselt
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium;
| | - Wouter Weuts
- Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | | | - Jan Mertens
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Philippe Geeraerts
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Kevin K. Ariën
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Emmanuel André
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Pierre Neirinckx
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
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Duyvejonck H, Merabishvili M, Vaneechoutte M, de Soir S, Wright R, Friman VP, Verbeken G, De Vos D, Pirnay JP, Van Mechelen E, Vermeulen SJT. Evaluation of the Stability of Bacteriophages in Different Solutions Suitable for the Production of Magistral Preparations in Belgium. Viruses 2021; 13:v13050865. [PMID: 34066841 PMCID: PMC8151234 DOI: 10.3390/v13050865] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/28/2021] [Accepted: 05/04/2021] [Indexed: 01/20/2023] Open
Abstract
In Belgium, the incorporation of phages into magistral preparations for human application has been permitted since 2018. The stability of such preparations is of high importance to guarantee quality and efficacy throughout treatments. We evaluated the ability to preserve infectivity of four different phages active against three different bacterial species in five different buffer and infusion solutions commonly used in medicine and biotechnological manufacturing processes, at two different concentrations (9 and 7 log pfu/mL), stored at 4 °C. DPBS without Ca2+ and Mg2+ was found to be the best option, compared to the other solutions. Suspensions with phage concentrations of 7 log pfu/mL were unsuited as their activity dropped below the effective therapeutic dose (6–9 log pfu/mL), even after one week of storage at 4 °C. Strong variability between phages was observed, with Acinetobacter baumannii phage Acibel004 being stable in four out of five different solutions. We also studied the long term storage of lyophilized staphylococcal phage ISP, and found that the titer could be preserved during a period of almost 8 years when sucrose and trehalose were used as stabilizers. After rehydration of the lyophilized ISP phage in saline, the phage solutions remained stable at 4 °C during a period of 126 days.
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Affiliation(s)
- Hans Duyvejonck
- Research Center Health & Water Technology, University College Ghent, Keramiekstraat 80, B-9000 Gent, Belgium; (H.D.); (E.V.M.)
- Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium; (M.M.); (M.V.)
| | - Maya Merabishvili
- Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium; (M.M.); (M.V.)
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussel, Belgium; (S.d.S.); (G.V.); (D.D.V.); (J.-P.P.)
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium; (M.M.); (M.V.)
| | - Steven de Soir
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussel, Belgium; (S.d.S.); (G.V.); (D.D.V.); (J.-P.P.)
| | - Rosanna Wright
- Department of Biology, University of York, Wentworth Way, York YO10 5DD, UK; (R.W.); (V.-P.F.)
- Division of Evolution and Genomic Sciences, University of Manchester, Dover Street, Manchester M13 9PT, UK
| | - Ville-Petri Friman
- Department of Biology, University of York, Wentworth Way, York YO10 5DD, UK; (R.W.); (V.-P.F.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussel, Belgium; (S.d.S.); (G.V.); (D.D.V.); (J.-P.P.)
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussel, Belgium; (S.d.S.); (G.V.); (D.D.V.); (J.-P.P.)
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussel, Belgium; (S.d.S.); (G.V.); (D.D.V.); (J.-P.P.)
| | - Els Van Mechelen
- Research Center Health & Water Technology, University College Ghent, Keramiekstraat 80, B-9000 Gent, Belgium; (H.D.); (E.V.M.)
| | - Stefan J. T. Vermeulen
- Research Center Health & Water Technology, University College Ghent, Keramiekstraat 80, B-9000 Gent, Belgium; (H.D.); (E.V.M.)
- Correspondence: ; Tel.: +32-498-496-997
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7
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Fauconnier A, Nagel TE, Fauconnier C, Verbeken G, De Vos D, Merabishvili M, Pirnay JP. The Unique Role That WHO Could Play in Implementing Phage Therapy to Combat the Global Antibiotic Resistance Crisis. Front Microbiol 2020; 11:1982. [PMID: 33013742 PMCID: PMC7500132 DOI: 10.3389/fmicb.2020.01982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/27/2020] [Indexed: 01/26/2023] Open
Affiliation(s)
| | - Tobi E Nagel
- Phages for Global Health, Oakland, CA, United States
| | | | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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8
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Pirnay JP, Selhorst P, Cochez C, Petrillo M, Claes V, Van der Beken Y, Verbeken G, Degueldre J, T’Sas F, Van den Eede G, Weuts W, Smets C, Mertens J, Geeraerts P, Ariën KK, Neirinckx P, Soentjens P. Study of a SARS-CoV-2 Outbreak in a Belgian Military Education and Training Center in Maradi, Niger. Viruses 2020; 12:v12090949. [PMID: 32867108 PMCID: PMC7552053 DOI: 10.3390/v12090949] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 01/14/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compromises the ability of military forces to fulfill missions. At the beginning of May 2020, 22 out of 70 Belgian soldiers deployed to a military education and training center in Maradi, Niger, developed mild COVID-19 compatible symptoms. Immediately upon their return to Belgium, and two weeks later, all seventy soldiers were tested for SARS-CoV-2 RNA (RT-qPCR) and antibodies (two immunoassays). Nine soldiers had at least one positive COVID-19 diagnostic test result. Five of them exhibited COVID-19 symptoms (mainly anosmia, ageusia, and fever), while four were asymptomatic. In four soldiers, SARS-CoV-2 viral load was detected and the genomes were sequenced. Conventional and genomic epidemiological data suggest that these genomes have an African most recent common ancestor and that the Belgian military service men were infected through contact with locals. The medical military command implemented testing of all Belgian soldiers for SARS-CoV-2 viral load and antibodies, two to three days before their departure on a mission abroad or on the high seas, and for specific missions immediately upon their return in Belgium. Some military operational settings (e.g., training camps in austere environments and ships) were also equipped with mobile infectious disease (COVID-19) testing capacity.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
- Correspondence: ; Tel.: +32-244-32172
| | - Philippe Selhorst
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Christel Cochez
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Mauro Petrillo
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium; (M.P.); (G.V.d.E.)
| | - Vincent Claes
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Yolien Van der Beken
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Julie Degueldre
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - France T’Sas
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Guy Van den Eede
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium; (M.P.); (G.V.d.E.)
| | - Wouter Weuts
- Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | | | - Jan Mertens
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Philippe Geeraerts
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Kevin K. Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Pierre Neirinckx
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
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9
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Duyvejonck H, Merabishvili M, Pirnay JP, De Vos D, Verbeken G, Van Belleghem J, Gryp T, De Leenheer J, Van der Borght K, Van Simaey L, Vermeulen S, Van Mechelen E, Vaneechoutte M. Development of a qPCR platform for quantification of the five bacteriophages within bacteriophage cocktail 2 (BFC2). Sci Rep 2019; 9:13893. [PMID: 31554892 PMCID: PMC6761158 DOI: 10.1038/s41598-019-50461-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/05/2019] [Indexed: 11/09/2022] Open
Abstract
To determine phage titers accurately, reproducibly and in a non-laborious and cost-effective manner, we describe the development of a qPCR platform for molecular quantification of five phages present in bacteriophage cocktail 2 (BFC2). We compared the performance of this molecular approach, with regard to quantification and reproducibility, with the standard culture-based double agar overlay method (DAO). We demonstrated that quantification of each of the five phages in BFC2 was possible by means of qPCR, without prior DNA extraction, but yields were significantly higher in comparison to DAO. Although DAO is assumed to provide an indication of the number of infective phage particles, whereas qPCR only provides information on the number of phage genomes, the difference in yield (qPCR/DAO ratio) was observed to be phage-dependent and appeared rather constant for all phages when analyzing different (freshly prepared) stocks of these phages. While DAO is necessary to determine sensitivity of clinical strains against phages in clinical applications, qPCR might be a valid alternative for rapid and reproducible quantification of freshly prepared stocks, after initial establishment of a correction factor towards DAO.
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Affiliation(s)
- Hans Duyvejonck
- Laboratory Bacteriology Research (LBR), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. .,Department of Biosciences, Faculty of Education, Health and Social Work, University College Ghent, Keramiekstraat 80, 9000, Ghent, Belgium.
| | - Maya Merabishvili
- Laboratory Bacteriology Research (LBR), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Laboratory for Molecular and Cellular Technology (LabMCT), Burn Wound Center, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium.,The Eliava Institute of Bacteriophages, Microbiology and Virology, Gotua 3, Tbilisi, 0160, Georgia
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Wound Center, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Wound Center, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Wound Center, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Jonas Van Belleghem
- Laboratory Bacteriology Research (LBR), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Tessa Gryp
- Laboratory Bacteriology Research (LBR), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Julie De Leenheer
- Department of Biosciences, Faculty of Education, Health and Social Work, University College Ghent, Keramiekstraat 80, 9000, Ghent, Belgium
| | - Kelly Van der Borght
- Department of Biosciences, Faculty of Education, Health and Social Work, University College Ghent, Keramiekstraat 80, 9000, Ghent, Belgium
| | - Leen Van Simaey
- Laboratory Bacteriology Research (LBR), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Stefan Vermeulen
- Department of Biosciences, Faculty of Education, Health and Social Work, University College Ghent, Keramiekstraat 80, 9000, Ghent, Belgium
| | - Els Van Mechelen
- Department of Biosciences, Faculty of Education, Health and Social Work, University College Ghent, Keramiekstraat 80, 9000, Ghent, Belgium
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research (LBR), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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10
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Abstract
Bacteriophages could help address the antibiotic resistance crisis that impacts health systems all over the world. In 2011, the European Commission formally confirmed that phage products used as therapeutics are medicinal products and thus manufacturers need to navigate the extremely arduous and enormously expensive medicine development and marketing pathway. However, up until now, not one therapeutic phage product has made it to the European market, and yet clinicians are under increasing pressure to use phages in the treatment of multidrug-resistant bacterial infections. While a handful of small European enterprises are struggling to squeeze therapeutic phage products through the conventional and centralised European medicinal products funnel, some clinicians and academics are exploring (European) national solutions to accelerate the availability of phages for the treatment of an increasing number of desperate patients. This mini-review summarises the actual status and perspectives of clinical phage application in Europe.
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11
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Padalko E, Lagrou K, Delforge ML, Jansens H, Ectors N, Pirnay JP, Klykens J, Sokal E, Muylle L, Libois A, Vanderkelen A, Verbeken G, Matthys C, Goossens D, Hanssens G, Baltes M, Beele H. Biological tests carried out on serum/plasma samples from donors of human body material for transplantation: Belgian experience and practical recommendations. Cell Tissue Bank 2018; 19:681-695. [PMID: 30159824 PMCID: PMC6280847 DOI: 10.1007/s10561-018-9721-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 08/22/2018] [Indexed: 12/22/2022]
Abstract
This paper on the biological tests carried out on serum/plasma samples from donors of human body material (HBM) is the result of a project of the working Group of Superior Health Council of Belgium formed with experts in the field of HBM and infectious serology. Indeed, uncertainty about the interpretation of biological test results currently leads to the sometimes unjustified cancelling of planned donations or the rejection of harvested HBM, whilst more sophisticated diagnostic algorithms would still allow the use of organs or HBM that would otherwise have been rejected. NAT tests will not be discussed in this publication. In the first part some general aspects as the need for a formal agreement between the Tissue Establishment l and the laboratory responsible for the biological testing, but also some specifications regarding testing material, the choice of additional biological tests, and some general aspects concerning interpretation and reporting are discussed. In a second part, detailed information and recommendations concerning the interpretation are presented for each of the mandatory tests (human immunodeficiency virus, hepatitis B virus, hepatitis C virus and syphilis) is presented. A number of not mandatory, but regularly used optional serological tests (e.g. for the detection of antibodies to Toxoplasma gondii, Epstein-Barr virus, human T cell leukemia virus and cytomegalovirus) are also extensively discussed. Although the project was meant to provide clarification and recommendations concerning the Belgian legislation, the majority of recommendations are also applicable to testing of donors of tissues and cells in other (European) countries.
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Affiliation(s)
- Elizaveta Padalko
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University/University Hospital, De Pintelaan 185, 2P8, 9000, Ghent, Belgium.
- School of Life Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium.
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium.
| | - Katrien Lagrou
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- KU Leuven and University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Marie-Luce Delforge
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Université Libre de Bruxelles/Hopital Erasme, Route de Lennik 808, 1070, Brussels, Belgium
| | - Hilde Jansens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Antwerp University and Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Nadine Ectors
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- KU Leuven and University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Jean-Paul Pirnay
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Johan Klykens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- KU Leuven and University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Etienne Sokal
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Centre de Thérapie Cellulaire, Cliniques Universitaires St Luc, Université Catholique de Louvain, 10 av Hippocrate, B 1200, Brussels, Belgium
| | - Ludo Muylle
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Antwerp University and Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Agnes Libois
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- CHU Saint-Pierre, Université Libre de Bruxelles, 322 rue haute, 1000, Brussels, Belgium
| | - Alain Vanderkelen
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Gilbert Verbeken
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Conny Matthys
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University/University Hospital, De Pintelaan 185, 2P8, 9000, Ghent, Belgium
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
| | - Dominique Goossens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Red Cross, Namur, Belgium
| | - Geert Hanssens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- , Sint-Genesius-Rode, Belgium
| | - Muriel Baltes
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
| | - Hilde Beele
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University/University Hospital, De Pintelaan 185, 2P8, 9000, Ghent, Belgium
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
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12
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Padalko E, Lagrou K, Delforge ML, Jansens H, Ectors N, Pirnay JP, Klykens J, Sokal E, Muylle L, Libois A, Vanderkelen A, Verbeken G, Matthys C, Goossens D, Hanssens G, Baltes M, Beele H. Correction to: Biological tests carried out on serum/plasma samples from donors of human body material for transplantation: Belgian experience and practical recommendations. Cell Tissue Bank 2018; 19:835-836. [PMID: 30367287 PMCID: PMC6280857 DOI: 10.1007/s10561-018-9728-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Elizaveta Padalko
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University/University Hospital, De Pintelaan 185, 2P8, 9000, Ghent, Belgium.
- School of Life Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium.
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium.
| | - Katrien Lagrou
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- KU Leuven and University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Marie-Luce Delforge
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Université Libre de Bruxelles/Hopital Erasme, Route de Lennik 808, 1070, Brussels, Belgium
| | - Hilde Jansens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Antwerp University and Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Nadine Ectors
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- KU Leuven and University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Jean-Paul Pirnay
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Johan Klykens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- KU Leuven and University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Etienne Sokal
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Centre de Thérapie Cellulaire, Cliniques Universitaires St Luc, Université Catholique de Louvain, 10 av Hippocrate, B 1200, Brussels, Belgium
| | - Ludo Muylle
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Antwerp University and Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Agnes Libois
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- CHU Saint-Pierre, Université Libre de Bruxelles, 322 rue haute, 1000, Brussels, Belgium
| | - Alain Vanderkelen
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Gilbert Verbeken
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Conny Matthys
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University/University Hospital, De Pintelaan 185, 2P8, 9000, Ghent, Belgium
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
| | - Dominique Goossens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- Red Cross, Namur, Belgium
| | - Geert Hanssens
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
- , Sint-Genesius-Rode, Belgium
| | - Muriel Baltes
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
| | - Hilde Beele
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University/University Hospital, De Pintelaan 185, 2P8, 9000, Ghent, Belgium
- Working Group on Cells, Tissues and Organs of the Superior Health Council of Belgium, Brussels, Belgium
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13
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Abstract
In this chapter we review bacteriophage production requirements to help institutions, which wish to manufacture bacteriophage products for human use in compliance with the applicable regulatory expectancies, defining production processes and implementing relevant controls ensuring quality, safety, and efficacy of the final products. The information disclosed in this chapter can also serve as a basis for discussions with competent authorities regarding the development of expedited bacteriophage product development and licensing pathways, including relevant and pragmatic requirements, and allowing for the full exploitation of bacteriophages as natural controllers of bacterial populations.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium.
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Hilde Van Raemdonck
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
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14
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Merabishvili M, Monserez R, van Belleghem J, Rose T, Jennes S, De Vos D, Verbeken G, Vaneechoutte M, Pirnay JP. Stability of bacteriophages in burn wound care products. PLoS One 2017; 12:e0182121. [PMID: 28750102 PMCID: PMC5531522 DOI: 10.1371/journal.pone.0182121] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 07/12/2017] [Indexed: 12/05/2022] Open
Abstract
Bacteriophages could be used along with burn wound care products to enhance antimicrobial pressure during treatment. However, some of the components of the topical antimicrobials that are traditionally used for the prevention and treatment of burn wound infection might affect the activity of phages. Therefore, it is imperative to determine the counteraction of therapeutic phage preparations by burn wound care products before application in patients. Five phages, representatives of two morphological families (Myoviridae and Podoviridae) and active against 3 common bacterial burn wound pathogens (Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus) were tested against 13 different products commonly used in the treatment of burn wounds. The inactivation of the phages was quite variable for different phages and different products. Majority of the anti-infective products affected phage activity negatively either immediately or in the course of time, although impact was not always significant. Products with high acidity had the most adverse effect on phages. Our findings demonstrate that during combined treatment the choice of phages and wound care products must be carefully defined in advance.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- Laboratory for Bacteriology Research, Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
- George Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi, Georgia
- * E-mail:
| | - Riet Monserez
- Hospital Pharmacy, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jonas van Belleghem
- Laboratory for Bacteriology Research, Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Thomas Rose
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Serge Jennes
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Mario Vaneechoutte
- Laboratory for Bacteriology Research, Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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15
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Jennes S, Merabishvili M, Soentjens P, Pang KW, Rose T, Keersebilck E, Soete O, François PM, Teodorescu S, Verween G, Verbeken G, De Vos D, Pirnay JP. Use of bacteriophages in the treatment of colistin-only-sensitive Pseudomonas aeruginosa septicaemia in a patient with acute kidney injury-a case report. Crit Care 2017; 21:129. [PMID: 28583189 PMCID: PMC5460490 DOI: 10.1186/s13054-017-1709-y] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Serge Jennes
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Patrick Soentjens
- Phage therapy center, Queen Astrid military hospital, Brussels, Belgium
| | - Kim Win Pang
- Phage therapy center, Queen Astrid military hospital, Brussels, Belgium
| | - Thomas Rose
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | | | - Olivier Soete
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | | | - Simona Teodorescu
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | - Gunther Verween
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium.
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16
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Beele H, de la Brassine M, Lambert J, Suys E, De Cuyper C, Decroix J, Boyden B, Tobback L, Hulstaert F, De Schepper S, Brissinck J, Delaey B, Draye JP, De Deene A, De Waele P, Verbeken G. A Prospective Multicenter Study of the Efficacy and Tolerability of Cryopreserved Allogenic Human Keratinocytes to Treat Venous Leg Ulcers. INT J LOW EXTR WOUND 2016; 4:225-33. [PMID: 16286374 DOI: 10.1177/1534734605282999] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Allogeneic human keratinocyte cultures have been used to treat burn wounds, donor sites, and chronic skin ulcers with some success. Cryopreservation of these cultures allows for the production of large standardized batches that are readily available for use. The aim of the study presented in this report was to study effects of cryopreserved cultured allogenic human keratinocytes (Cryo Ceal) on chronic lower extremity wounds. Parameters were measured to study efficacy, tolerability, pain associated with chronic wounds, and quality of life of patients. Twenty-seven patients with hard-to-heal venous leg ulcers received a maximum of 9 applications of Cryo Ceal in a prospective, uncontrolled multicenter study lasting 48 weeks. Eleven out of 27 patients (41%; 95% CI: 22%-61%) had complete wound closure within 24 weeks (1 week). The time required for complete wound closure in these 11 patients ranged from 4.1 to 24.9weeks. Only 1 patient had recurrence of the ulcer at 48 weeks. Local (wound) pain scores decreased from a mean of 2.5 at baseline to 0.9 at week 24. Fifty percent of the patients attained a pain score of 0 after 12 weeks and remained stable at this score until the end of the study. Overall, the patient quality of life was better at week 24, compared to baseline values. The treatment was well tolerated, and wound infection was the most frequently occurring adverse event.
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Affiliation(s)
- H Beele
- Department of Dermatology, University Hospital, Ghent, Belgium
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17
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De Vos D, Pirnay JP, Bilocq F, Jennes S, Verbeken G, Rose T, Keersebilck E, Bosmans P, Pieters T, Hing M, Heuninckx W, De Pauw F, Soentjens P, Merabishvili M, Deschaght P, Vaneechoutte M, Bogaerts P, Glupczynski Y, Pot B, van der Reijden TJ, Dijkshoorn L. Molecular Epidemiology and Clinical Impact of Acinetobacter calcoaceticus-baumannii Complex in a Belgian Burn Wound Center. PLoS One 2016; 11:e0156237. [PMID: 27223476 PMCID: PMC4880317 DOI: 10.1371/journal.pone.0156237] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 05/11/2016] [Indexed: 12/21/2022] Open
Abstract
Multidrug resistant Acinetobacter baumannii and its closely related species A. pittii and A. nosocomialis, all members of the Acinetobacter calcoaceticus-baumannii (Acb) complex, are a major cause of hospital acquired infection. In the burn wound center of the Queen Astrid military hospital in Brussels, 48 patients were colonized or infected with Acb complex over a 52-month period. We report the molecular epidemiology of these organisms, their clinical impact and infection control measures taken. A representative set of 157 Acb complex isolates was analyzed using repetitive sequence-based PCR (rep-PCR) (DiversiLab) and a multiplex PCR targeting OXA-51-like and OXA-23-like genes. We identified 31 rep-PCR genotypes (strains). Representatives of each rep-type were identified to species by rpoB sequence analysis: 13 types to A. baumannii, 10 to A. pittii, and 3 to A. nosocomialis. It was assumed that isolates that belonged to the same rep-type also belonged to the same species. Thus, 83.4% of all isolates were identified to A. baumannii, 9.6% to A. pittii and 4.5% to A. nosocomialis. We observed 12 extensively drug resistant Acb strains (10 A. baumannii and 2 A. nosocomialis), all carbapenem-non-susceptible/colistin-susceptible and imported into the burn wound center through patients injured in North Africa. The two most prevalent rep-types 12 and 13 harbored an OXA-23-like gene. Multilocus sequence typing allocated them to clonal complex 1 corresponding to EU (international) clone I. Both strains caused consecutive outbreaks, interspersed with periods of apparent eradication. Patients infected with carbapenem resistant A. baumannii were successfully treated with colistin/rifampicin. Extensive infection control measures were required to eradicate the organisms. Acinetobacter infection and colonization was not associated with increased attributable mortality.
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Affiliation(s)
- Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- * E-mail:
| | - Florence Bilocq
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Serge Jennes
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thomas Rose
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | | | - Petra Bosmans
- Hospital Hygiene and Infection Control Team, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thierry Pieters
- Hospital Hygiene and Infection Control Team, Queen Astrid Military Hospital, Brussels, Belgium
| | - Mony Hing
- Clinical Laboratory, Queen Astrid Military Hospital, Brussels, Belgium
| | - Walter Heuninckx
- Clinical Laboratory, Queen Astrid Military Hospital, Brussels, Belgium
| | - Frank De Pauw
- Medical Communication and Information Systems, ACOS WB/Health Division, Queen Astrid Military Hospital, Brussels, Belgium
| | - Patrick Soentjens
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- Laboratory Bacteriology Research, University of Ghent, Ghent, Belgium
| | - Pieter Deschaght
- Laboratory Bacteriology Research, University of Ghent, Ghent, Belgium
| | | | - Pierre Bogaerts
- Laboratoire de Bactériologie, CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Youri Glupczynski
- Laboratoire de Bactériologie, CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Bruno Pot
- Applied Maths, Sint-Martens-Latem, Belgium
| | - Tanny J. van der Reijden
- Department of Infectious Diseases C5-P, Leiden University Medical Center, Leiden, The Netherlands
| | - Lenie Dijkshoorn
- Department of Infectious Diseases C5-P, Leiden University Medical Center, Leiden, The Netherlands
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Boone M, Draye JP, Verween G, Pirnay JP, Verbeken G, De Vos D, Rose T, Jennes S, Jemec GBE, Del Marmol V. Real-time three-dimensional imaging of epidermal splitting and removal by high-definition optical coherence tomography. Exp Dermatol 2016; 23:725-30. [PMID: 25047067 DOI: 10.1111/exd.12516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2014] [Indexed: 01/06/2023]
Abstract
While real-time 3-D evaluation of human skin constructs is needed, only 2-D non-invasive imaging techniques are available. The aim of this paper is to evaluate the potential of high-definition optical coherence tomography (HD-OCT) for real-time 3-D assessment of the epidermal splitting and decellularization. Human skin samples were incubated with four different agents: Dispase II, NaCl 1 M, sodium dodecyl sulphate (SDS) and Triton X-100. Epidermal splitting, dermo-epidermal junction, acellularity and 3-D architecture of dermal matrices were evaluated by High-definition optical coherence tomography before and after incubation. Real-time 3-D HD-OCT assessment was compared with 2-D en face assessment by reflectance confocal microscopy (RCM). (Immuno) histopathology was used as control. HD-OCT imaging allowed real-time 3-D visualization of the impact of selected agents on epidermal splitting, dermo-epidermal junction, dermal architecture, vascular spaces and cellularity. RCM has a better resolution (1 μm) than HD-OCT (3 μm), permitting differentiation of different collagen fibres, but HD-OCT imaging has deeper penetration (570 μm) than RCM imaging (200 μm). Dispase II and NaCl treatments were found to be equally efficient in the removal of the epidermis from human split-thickness skin allografts. However, a different epidermal splitting level at the dermo-epidermal junction could be observed and confirmed by immunolabelling of collagen type IV and type VII. Epidermal splitting occurred at the level of the lamina densa with dispase II and above the lamina densa (in the lamina lucida) with NaCl. The 3-D architecture of dermal papillae and dermis was more affected by Dispase II on HD-OCT which corresponded with histopathologic (orcein staining) fragmentation of elastic fibres. With SDS treatment, the epidermal removal was incomplete as remnants of the epidermal basal cell layer remained attached to the basement membrane on the dermis. With Triton X-100 treatment, the epidermis was not removed. In conclusion, HD-OCT imaging permits real-time 3-D visualization of the impact of selected agents on human skin allografts.
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Affiliation(s)
- Marc Boone
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
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Verbeken G, Huys I, Ceulemans C, Jennes S, De Vos D, Pirnay J. Bacteriophage therapy: Fast-forward to the past lessons identified from the advanced therapy regulation. Burns 2016; 42:11-12. [DOI: 10.1016/j.burns.2015.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
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20
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Verbeken G, Huys I, De Vos D, De Coninck A, Roseeuw D, Kets E, Vanderkelen A, Draye JP, Rose T, Jennes S, Ceulemans C, Pirnay JP. Access to bacteriophage therapy: discouraging experiences from the human cell and tissue legal framework. FEMS Microbiol Lett 2015; 363:fnv241. [PMID: 26678555 DOI: 10.1093/femsle/fnv241] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 01/12/2023] Open
Abstract
Cultures of human epithelial cells (keratinocytes) are used as an additional surgical tool to treat critically burnt patients. Initially, the production environment of keratinocyte grafts was regulated exclusively by national regulations. In 2004, the European Tissues and Cells Directive 2004/23/EC (transposed into Belgian Law) imposed requirements that resulted in increased production costs and no significant increase in quality and/or safety. In 2007, Europe published Regulation (EC) No. 1394/2007 on Advanced Therapy Medicinal Products. Overnight, cultured keratinocytes became (arguably) 'Advanced' Therapy Medicinal Products to be produced as human medicinal products. The practical impact of these amendments was (and still is) considerable. A similar development appears imminent in bacteriophage therapy. Bacteriophages are bacterial viruses that can be used for tackling the problem of bacterial resistance development to antibiotics. Therapeutic natural bacteriophages have been in clinical use for almost 100 years. Regulators today are framing the (re-)introduction of (natural) bacteriophage therapy into 'modern western' medicine as biological medicinal products, also subject to stringent regulatory medicinal products requirements. In this paper, we look back on a century of bacteriophage therapy to make the case that therapeutic natural bacteriophages should not be classified under the medicinal product regulatory frames as they exist today. It is our call to authorities to not repeat the mistake of the past.
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Affiliation(s)
- G Verbeken
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium Faculty of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Behavioural Sciences, Royal Military Academy, Renaissancelaan 30, 1000 Brussels, Belgium
| | - I Huys
- Faculty of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium KU Leuven Centre for IT & IP law, Sint Michielsstraat 6, box 3443, 3000 Leuven, Belgium
| | - D De Vos
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium Department of Behavioural Sciences, Royal Military Academy, Renaissancelaan 30, 1000 Brussels, Belgium
| | - A De Coninck
- Department of Dermatology, University Hospital Brussels (UZ Brussel), Free University Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - D Roseeuw
- Department of Dermatology, University Hospital Brussels (UZ Brussel), Free University Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - E Kets
- Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - A Vanderkelen
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - J P Draye
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - T Rose
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - S Jennes
- Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - C Ceulemans
- Department of Behavioural Sciences, Royal Military Academy, Renaissancelaan 30, 1000 Brussels, Belgium
| | - J P Pirnay
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
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Debarbieux L, Pirnay JP, Verbeken G, De Vos D, Merabishvili M, Huys I, Patey O, Schoonjans D, Vaneechoutte M, Zizi M, Rohde C. A bacteriophage journey at the European Medicines Agency. FEMS Microbiol Lett 2015; 363:fnv225. [PMID: 26656541 PMCID: PMC5812529 DOI: 10.1093/femsle/fnv225] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 11/27/2022] Open
Abstract
The seriously and globally increasing bacterial multi-drug resistance calls out on concerted counteractive measures: international health authorities give consideration to the therapeutical use of bacteriophage therapy.
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Affiliation(s)
- Laurent Debarbieux
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Jean-Paul Pirnay
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Gilbert Verbeken
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Daniel De Vos
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Maia Merabishvili
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Isabelle Huys
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Olivier Patey
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Dirk Schoonjans
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Mario Vaneechoutte
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Martin Zizi
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Christine Rohde
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
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22
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Boone MALM, Draye JP, Verween G, Aiti A, Pirnay JP, Verbeken G, De Vos D, Rose T, Jennes S, Jemec GBE, del Marmol V. Recellularizing of human acellular dermal matrices imaged by high-definition optical coherence tomography. Exp Dermatol 2015; 24:349-54. [DOI: 10.1111/exd.12662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 01/28/2023]
Affiliation(s)
- Marc A. L. M. Boone
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Jean Pierre Draye
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Gunther Verween
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Annalisa Aiti
- Regional Skin Bank; Emilia Romagna and Cell Factory; Burn Center; Bufalini Hospital; Cesena Italy
| | - Jean-Paul Pirnay
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Gilbert Verbeken
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Daniel De Vos
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Thomas Rose
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Serge Jennes
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Gregor B. E. Jemec
- Department of Dermatology; Roskilde Hospital; Health Sciences Faculty; University of Copenhagen; Roskilde Denmark
| | - Veronique del Marmol
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
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23
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Pirnay JP, Baudoux E, Cornu O, Delforge A, Delloye C, Guns J, Heinen E, Van den Abbeel E, Vanderkelen A, Van Geyt C, van Riet I, Verbeken G, De Sutter P, Verlinden M, Huys I, Cockbain J, Chabannon C, Dierickx K, Schotsmans P, De Vos D, Rose T, Jennes S, Sterckx S. Access to human tissues for research and product development: From EU regulation to alarming legal developments in Belgium. EMBO Rep 2015; 16:557-62. [PMID: 25851645 PMCID: PMC4428037 DOI: 10.15252/embr.201540070] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jean-Paul Pirnay
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussel, Belgium
| | - Etienne Baudoux
- Laboratory of Cellular and Gene Therapy, University Hospital Liège, Liège, Belgium
| | - Olivier Cornu
- Orthopaedic and Trauma Surgery Department, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussel, Belgium
| | - Alain Delforge
- Service d'Hématologie Expérimentale-Laboratoire de Thérapie Cellulaire Clinique, Université Libre de Bruxelles-Institut Jules Bordet, Bruxelles, Belgium
| | - Christian Delloye
- Orthopaedic and Trauma Surgery Department, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussel, Belgium
| | - Johan Guns
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Ernst Heinen
- Faculty of Medicine, Institute of Human Histology, Immunology Centre, University of Liège, Liège, Belgium
| | | | - Alain Vanderkelen
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussel, Belgium
| | | | - Ivan van Riet
- Division of Clinical Hematology, UZ Brussel, Brussel, Belgium
| | - Gilbert Verbeken
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussel, Belgium
| | - Petra De Sutter
- Centre for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | | | - Isabelle Huys
- Faculty of Pharmaceutical Sciences, KU Leuven, Leuven, Belgium Centre for Intellectual Property Rights, KU Leuven, Leuven, Belgium
| | | | - Christian Chabannon
- Centre de Thérapie Cellulaire, Département de Biologie du Cancer, Institut Paoli-Calmettes, Marseille Cedex, France Aix-Marseille Université (AMU), Marseille, France Inserm-Centre d'Investigations Cliniques en Biothérapie (CBT)-510, Marseille, France
| | - Kris Dierickx
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | - Paul Schotsmans
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | - Daniel De Vos
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussel, Belgium
| | - Thomas Rose
- Burn Wound Centre, Queen Astrid Military Hospital, Brussel, Belgium
| | - Serge Jennes
- Burn Wound Centre, Queen Astrid Military Hospital, Brussel, Belgium
| | - Sigrid Sterckx
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Gent, Belgium
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Pirnay JP, Blasdel BG, Bretaudeau L, Buckling A, Chanishvili N, Clark JR, Corte-Real S, Debarbieux L, Dublanchet A, De Vos D, Gabard J, Garcia M, Goderdzishvili M, Górski A, Hardcastle J, Huys I, Kutter E, Lavigne R, Merabishvili M, Olchawa E, Parikka KJ, Patey O, Pouilot F, Resch G, Rohde C, Scheres J, Skurnik M, Vaneechoutte M, Van Parys L, Verbeken G, Zizi M, Van den Eede G. Quality and safety requirements for sustainable phage therapy products. Pharm Res 2015; 32:2173-9. [PMID: 25585954 PMCID: PMC4452253 DOI: 10.1007/s11095-014-1617-7] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/30/2014] [Indexed: 12/11/2022]
Abstract
The worldwide antibiotic crisis has led to a renewed interest in phage therapy. Since time immemorial phages control bacterial populations on Earth. Potent lytic phages against bacterial pathogens can be isolated from the environment or selected from a collection in a matter of days. In addition, phages have the capacity to rapidly overcome bacterial resistances, which will inevitably emerge. To maximally exploit these advantage phages have over conventional drugs such as antibiotics, it is important that sustainable phage products are not submitted to the conventional long medicinal product development and licensing pathway. There is a need for an adapted framework, including realistic production and quality and safety requirements, that allowsa timely supplying of phage therapy products for ‘personalized therapy’ or for public health or medical emergencies. This paper enumerates all phage therapy product related quality and safety risks known to the authors, as well as the tests that can be performed to minimize these risks, only to the extent needed to protect the patients and to allow and advance responsible phage therapy and research.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussel, Belgium,
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25
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Rose T, Verbeken G, Vos DD, Merabishvili M, Vaneechoutte M, Lavigne R, Jennes S, Zizi M, Pirnay JP. Experimental phage therapy of burn wound infection: difficult first steps. Int J Burns Trauma 2014; 4:66-73. [PMID: 25356373 PMCID: PMC4212884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 09/08/2014] [Indexed: 06/04/2023]
Abstract
Antibiotic resistance has become a major public health problem and the antibiotics pipeline is running dry. Bacteriophages (phages) may offer an 'innovative' means of infection treatment, which can be combined or alternated with antibiotic therapy and may enhance our abilities to treat bacterial infections successfully. Today, in the Queen Astrid Military Hospital, phage therapy is increasingly considered as part of a salvage therapy for patients in therapeutic dead end, particularly those with multidrug resistant infections. We describe the application of a well-defined and quality controlled phage cocktail, active against Pseudomonas aeruginosa and Staphylococcus aureus, on colonized burn wounds within a modest clinical trial (nine patients, 10 applications), which was approved by a leading Belgian Medical Ethical Committee. No adverse events, clinical abnormalities or changes in laboratory test results that could be related to the application of phages were observed. Unfortunately, this very prudent 'clinical trial' did not allow for an adequate evaluation of the efficacy of the phage cocktail. Nevertheless, this first 'baby step' revealed several pitfalls and lessons for future experimental phage therapy and helped overcome the psychological hurdles that existed to the use of viruses in the treatment of patients in our burn unit.
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Affiliation(s)
- Thomas Rose
- Burn Wound Center, Queen Astrid Military HospitalBruynstraat 1, B-1120 Brussel, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Burn Wound Center, Queen Astrid Military HospitalBruynstraat 1, B-1120 Brussel, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Burn Wound Center, Queen Astrid Military HospitalBruynstraat 1, B-1120 Brussel, Belgium
| | - Maya Merabishvili
- Laboratory for Molecular and Cellular Technology, Burn Wound Center, Queen Astrid Military HospitalBruynstraat 1, B-1120 Brussel, Belgium
- Eliava Institute of Bacteriophage, Microbiology and Virology3, Gotua street, Tbilisi 0160, Georgia
- Laboratory of Bacteriology Research, University of GhentDe Pintelaan 185, B-9000 Gent, Belgium
| | - Mario Vaneechoutte
- Laboratory of Bacteriology Research, University of GhentDe Pintelaan 185, B-9000 Gent, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, Katholieke Universiteit LeuvenKasteelpark Arenberg 21, B-3001 Leuven, Belgium
| | - Serge Jennes
- Burn Wound Center, Queen Astrid Military HospitalBruynstraat 1, B-1120 Brussel, Belgium
| | - Martin Zizi
- Department of Physiology, Vrije Universiteit BrusselLaerbeeklaan 101, B-1090 Brussel, Belgium
| | - Jean-Paul Pirnay
- Burn Wound Center, Queen Astrid Military HospitalBruynstraat 1, B-1120 Brussel, Belgium
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26
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Merabishvili M, Vandenheuvel D, Kropinski AM, Mast J, De Vos D, Verbeken G, Noben JP, Lavigne R, Vaneechoutte M, Pirnay JP. Characterization of newly isolated lytic bacteriophages active against Acinetobacter baumannii. PLoS One 2014; 9:e104853. [PMID: 25111143 PMCID: PMC4128745 DOI: 10.1371/journal.pone.0104853] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/18/2014] [Indexed: 12/24/2022] Open
Abstract
Based on genotyping and host range, two newly isolated lytic bacteriophages, myovirus vB_AbaM_Acibel004 and podovirus vB_AbaP_Acibel007, active against Acinetobacter baumannii clinical strains, were selected from a new phage library for further characterization. The complete genomes of the two phages were analyzed. Both phages are characterized by broad host range and essential features of potential therapeutic phages, such as short latent period (27 and 21 min, respectively), high burst size (125 and 145, respectively), stability of activity in liquid culture and low frequency of occurrence of phage-resistant mutant bacterial cells. Genomic analysis showed that while Acibel004 represents a novel bacteriophage with resemblance to some unclassified Pseudomonas aeruginosa phages, Acibel007 belongs to the well-characterized genus of the Phikmvlikevirus. The newly isolated phages can serve as potential candidates for phage cocktails to control A. baumannii infections.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
- Laboratory for Bacteriology Research (LBR), Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Dieter Vandenheuvel
- Laboratory of Gene Technology, Faculty of Bioscience Engineering, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Andrew M. Kropinski
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Guelph, Ontario, Canada
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada
| | - Jan Mast
- Electron Microscopy Unit, Veterinary and Agrochemical Research Centre, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Noben
- Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, Faculty of Bioscience Engineering, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Mario Vaneechoutte
- Laboratory for Bacteriology Research (LBR), Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
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Verbeken G, Pirnay JP, Lavigne R, Jennes S, De Vos D, Casteels M, Huys I. Call for a dedicated European legal framework for bacteriophage therapy. Arch Immunol Ther Exp (Warsz) 2014; 62:117-29. [PMID: 24500660 PMCID: PMC3950567 DOI: 10.1007/s00005-014-0269-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/06/2013] [Indexed: 01/21/2023]
Abstract
The worldwide emergence of antibiotic resistances and the drying up of the antibiotic pipeline have spurred a search for alternative or complementary antibacterial therapies. Bacteriophages are bacterial viruses that have been used for almost a century to combat bacterial infections, particularly in Poland and the former Soviet Union. The antibiotic crisis has triggered a renewed clinical and agricultural interest in bacteriophages. This, combined with new scientific insights, has pushed bacteriophages to the forefront of the search for new approaches to fighting bacterial infections. But before bacteriophage therapy can be introduced into clinical practice in the European Union, several challenges must be overcome. One of these is the conceptualization and classification of bacteriophage therapy itself and the extent to which it constitutes a human medicinal product regulated under the European Human Code for Medicines (Directive 2001/83/EC). Can therapeutic products containing natural bacteriophages be categorized under the current European regulatory framework, or should this framework be adapted? Various actors in the field have discussed the need for an adapted (or entirely new) regulatory framework for the reintroduction of bacteriophage therapy in Europe. This led to the identification of several characteristics specific to natural bacteriophages that should be taken into consideration by regulators when evaluating bacteriophage therapy. One important consideration is whether bacteriophage therapy development occurs on an industrial scale or a hospital-based, patient-specific scale. More suitable regulatory standards may create opportunities to improve insights into this promising therapeutic approach. In light of this, we argue for the creation of a new, dedicated European regulatory framework for bacteriophage therapy.
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Affiliation(s)
- Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium,
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Pirnay JP, Vanderkelen A, De Vos D, Draye JP, Rose T, Ceulemans C, Ectors N, Huys I, Jennes S, Verbeken G. Business oriented EU human cell and tissue product legislation will adversely impact Member States' health care systems. Cell Tissue Bank 2013; 14:525-60. [PMID: 24052113 PMCID: PMC3838781 DOI: 10.1007/s10561-013-9397-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 09/02/2013] [Indexed: 01/14/2023]
Abstract
The transplantation of conventional human cell and tissue grafts, such as heart valve replacements and skin for severely burnt patients, has saved many lives over the last decades. The late eighties saw the emergence of tissue engineering with the focus on the development of biological substitutes that restore or improve tissue function. In the nineties, at the height of the tissue engineering hype, industry incited policymakers to create a European regulatory environment, which would facilitate the emergence of a strong single market for tissue engineered products and their starting materials (human cells and tissues). In this paper we analyze the elaboration process of this new European Union (EU) human cell and tissue product regulatory regime—i.e. the EU Cell and Tissue Directives (EUCTDs) and the Advanced Therapy Medicinal Product (ATMP) Regulation and evaluate its impact on Member States’ health care systems. We demonstrate that the successful lobbying on key areas of regulatory and policy processes by industry, in congruence with Europe’s risk aversion and urge to promote growth and jobs, led to excessively business oriented legislation. Expensive industry oriented requirements were introduced and contentious social and ethical issues were excluded. We found indications that this new EU safety and health legislation will adversely impact Member States’ health care systems; since 30 December 2012 (the end of the ATMP transitional period) there is a clear threat to the sustainability of some lifesaving and established ATMPs that were provided by public health institutions and small and medium-sized enterprises under the frame of the EUCTDs. In the light of the current economic crisis it is not clear how social security systems will cope with the inflation of costs associated with this new regulatory regime and how priorities will be set with regard to reimbursement decisions. We argue that the ATMP Regulation should urgently be revised to focus on delivering affordable therapies to all who are in need of them and this without necessarily going to the market. The most rapid and elegant way to achieve this would be for the European Commission to publish an interpretative document on “placing on the market of ATMPs,” which keeps tailor-made and niche ATMPs outside of the scope of the medicinal product regulation.
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Affiliation(s)
- Jean-Paul Pirnay
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Alain Vanderkelen
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Pierre Draye
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Thomas Rose
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Carl Ceulemans
- Department of Behavioural Sciences, Royal Military Academy, Brussels, Belgium
| | - Nadine Ectors
- Tissue Banks, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Isabelle Huys
- Department of Pharmaceutical and Pharmacological Sciences, Centre for Pharmaceutical Care and Pharmacoeconomics, KU Leuven, Leuven, Belgium
- Center for Intellectual Property Rights, KU Leuven, Leuven, Belgium
| | - Serge Jennes
- Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Human Cell and Tissue Banks, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
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Merabishvili M, Vervaet C, Pirnay JP, De Vos D, Verbeken G, Mast J, Chanishvili N, Vaneechoutte M. Stability of Staphylococcus aureus phage ISP after freeze-drying (lyophilization). PLoS One 2013; 8:e68797. [PMID: 23844241 PMCID: PMC3699554 DOI: 10.1371/journal.pone.0068797] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 06/03/2013] [Indexed: 11/24/2022] Open
Abstract
Staphylococcus aureus phage ISP was lyophilized, using an Amsco-Finn Aqua GT4 freeze dryer, in the presence of six different stabilizers at different concentrations. Stability of the lyophilized phage at 4°C was monitored up to 37 months and compared to stability in Luria Bertani broth and physiological saline at 4°C. Sucrose and trehalose were shown to be the best stabilizing additives, causing a decrease of only 1 log immediately after the lyophilization procedure and showing high stability during a 27 month storage period.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium.
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Huys I, Vaneechoutte M, Verbeken G, Debarbieux L. Key issues in phage therapy: a report of a dedicated workshop at the Viruses of Microbes II meeting. Res Microbiol 2013; 164:806-10. [PMID: 23583722 DOI: 10.1016/j.resmic.2013.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Isabelle Huys
- Centre for Pharmaceutical Care and Pharmaco-Economy, Faculty of Pharmaceutical Sciences, Univ. Leuven, Leuven, Belgium.
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Klykens J, Pirnay JP, Verbeken G, Giet O, Baudoux E, Jashari R, Vanderkelen A, Ectors N. Cleanrooms and tissue banking how happy I could be with either GMP or GTP? Cell Tissue Bank 2013; 14:571-8. [PMID: 23288450 DOI: 10.1007/s10561-012-9355-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 12/17/2012] [Indexed: 11/26/2022]
Abstract
The regulatory framework of tissue banking introduces a number of requirements for monitoring cleanrooms for processing tissue or cell grafts. Although a number of requirements were clearly defined, some requirements are open for interpretation. This study aims to contribute to the interpretation of GMP or GTP guidelines for tissue banking. Based on the experience of the participating centers, the results of the monitoring program were evaluated to determine the feasibility of a cleanroom in tissue banking and the monitoring program. Also the microbial efficacy of a laminar airflow cabinet and an incubator in a cleanroom environment was evaluated. This study indicated that a monitoring program of a cleanroom at rest in combination with (final) product testing is a feasible approach. Although no statistical significance (0.90 < p < 0.95) was found there is a strong indication that a Grade D environment is not the ideal background environment for a Grade A obtained through a laminar airflow cabinet. The microbial contamination of an incubator in a cleanroom is limited but requires closed containers for tissue and cell products.
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Affiliation(s)
- J Klykens
- Cell and Tissue Banks, University Hospitals Leuven, UZ Gasthuisberg, Herestraat, 49, 3000, Leuven, Belgium,
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Merabishvili M, De Vos D, Verbeken G, Kropinski AM, Vandenheuvel D, Lavigne R, Wattiau P, Mast J, Ragimbeau C, Mossong J, Scheres J, Chanishvili N, Vaneechoutte M, Pirnay JP. Selection and characterization of a candidate therapeutic bacteriophage that lyses the Escherichia coli O104:H4 strain from the 2011 outbreak in Germany. PLoS One 2012; 7:e52709. [PMID: 23285164 PMCID: PMC3528706 DOI: 10.1371/journal.pone.0052709] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 11/20/2012] [Indexed: 11/18/2022] Open
Abstract
In 2011, a novel strain of O104:H4 Escherichia coli caused a serious outbreak of foodborne hemolytic uremic syndrome and bloody diarrhea in Germany. Antibiotics were of questionable use and 54 deaths occurred. Candidate therapeutic bacteriophages that efficiently lyse the E. coli O104:H4 outbreak strain could be selected rather easily from a phage bank or isolated from the environment. It is argued that phage therapy should be more considered as a potential armament against the growing threat of (resistant) bacterial infections.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
- Laboratory of Bacteriology Research, Ghent University, Ghent, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Andrew M. Kropinski
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Ontario, Canada
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada
| | | | - Rob Lavigne
- Laboratory of Gene Technology, KU Leuven, Heverlee, Belgium
| | - Pierre Wattiau
- Unit of Highly Pathogenic & Foodborne Zoonoses, Veterinary and Agrochemical Research Centre, Brussels, Belgium
| | - Jan Mast
- Electron Microscopy Unit, Veterinary and Agrochemical 8 Research Centre, Brussels, Belgium
| | - Catherine Ragimbeau
- Surveillance and Epidemiology of Infectious Diseases, Laboratoire National de Santé, Luxembourg, Luxembourg
| | - Joel Mossong
- Surveillance and Epidemiology of Infectious Diseases, Laboratoire National de Santé, Luxembourg, Luxembourg
| | - Jacques Scheres
- Maastricht University Medical Centre, Maastricht, The Netherlands
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Nina Chanishvili
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
| | | | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- * E-mail:
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De Vos D, Bilocq F, Verbeken G, Pieters T, Dijkshoorn L, Bogaerts P, Glupczynski Y, Deschaght P, Heuninckx W, Bosmans P, Vaneechoutte M, Rose T, Pot B, van der Reijden T, Pirnay JP, Jennes S, soentjens P. Thermally injured and Acinetobacter baumannii colonizations/infections during a five-year period at the Brussels Burn Wound Centre. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pirnay JP, Verbeken G, Rose T, Jennes S, Zizi M, Huys I, Lavigne R, Merabishvili M, Vaneechoutte M, Buckling A, De Vos D. Introducing yesterday’s phage therapy in today’s medicine. Future Virol 2012. [DOI: 10.2217/fvl.12.24] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The worldwide emergence of ‘superbugs’ and a dry antibiotic pipeline threaten modern society with a return to the preantibiotic era. Phages – the viruses of bacteria – could help fight antibiotic-resistant bacteria. Phage therapy was first attempted in 1919 by Felix d’Herelle and was commercially developed in the 1930s before being replaced by antibiotics in most of the western world. The current antibiotic crisis fueled a worldwide renaissance of phage therapy. The inherent potential of phages as natural biological bacterium controllers can only be put to use if the potential of the coevolutionary aspect of the couplet phage–bacterium is fully acknowledged and understood, including potential negative consequences. We must learn from past mistakes and set up credible studies to gather the urgently required data with regard to the efficacy of phage therapy and the evolutionary consequences of its (unlimited) use. Unfortunately, our current pharmaceutical economic model, implying costly and time-consuming medicinal product development and marketing, and requiring strong intellectual property protection, is not compatible with traditional sustainable phage therapy. A specific framework with realistic production and documentation requirements, which allows a timely (rapid) supply of safe, tailor-made, natural bacteriophages to patients, should be developed. Ultimately, economic models should be radically reshaped to cater for more sustainable approaches such as phage therapy. This is one of the biggest challenges faced by modern medicine and society as a whole.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thomas Rose
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Serge Jennes
- Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Martin Zizi
- Well Being Department, Queen Astrid Military Hospital, Brussels, Belgium
- Department of Physiology, Free University Brussels, Brussels, Belgium
| | - Isabelle Huys
- Department of Pharmaceutical & Pharmacological Sciences, Centre for Pharmaceutical Care & Pharmacoeconomics, KU Leuven, Leuven, Belgium
- Center for Intellectual Property Rights, KU Leuven, Leuven, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, KU Leuven, Leuven, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
- Laboratory of Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
- Eliava Institute of Bacteriophage, Microbiology, & Virology, Tbilisi, Georgia
| | - Mario Vaneechoutte
- Laboratory of Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Angus Buckling
- Biosciences, University of Exeter, Cornwall Campus, Penryn, UK
| | - Daniel De Vos
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
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De Corte P, Verween G, Verbeken G, Rose T, Jennes S, De Coninck A, Roseeuw D, Vanderkelen A, Kets E, Haddow D, Pirnay JP. Feeder layer- and animal product-free culture of neonatal foreskin keratinocytes: improved performance, usability, quality and safety. Cell Tissue Bank 2012; 13:175-89. [PMID: 21394485 PMCID: PMC3286510 DOI: 10.1007/s10561-011-9247-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 12/23/2010] [Indexed: 10/25/2022]
Abstract
Since 1987, keratinocytes have been cultured at the Queen Astrid Military Hospital. These keratinocytes have been used routinely as auto and allografts on more than 1,000 patients, primarily to accelerate the healing of burns and chronic wounds. Initially the method of Rheinwald and Green was used to prepare cultured epithelial autografts, starting from skin samples from burn patients and using animal-derived feeder layers and media containing animal-derived products. More recently we systematically optimised our production system to accommodate scientific advances and legal changes. An important step was the removal of the mouse fibroblast feeder layer from the cell culture system. Thereafter we introduced neonatal foreskin keratinocytes (NFK) as source of cultured epithelial allografts, which significantly increased the consistency and the reliability of our cell production. NFK master and working cell banks were established, which were extensively screened and characterised. An ISO 9001 certified Quality Management System (QMS) governs all aspects of testing, validation and traceability. Finally, as far as possible, animal components were systematically removed from the cell culture environment. Today, quality controlled allograft production batches are routine and, due to efficient cryopreservation, stocks are created for off-the-shelf use. These optimisations have significantly increased the performance, usability, quality and safety of our allografts. This paper describes, in detail, our current cryopreserved allograft production process.
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Affiliation(s)
- Peter De Corte
- Skin- and Keratinocyte Bank, Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - Gunther Verween
- Skin- and Keratinocyte Bank, Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - Gilbert Verbeken
- Skin- and Keratinocyte Bank, Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - Thomas Rose
- Skin- and Keratinocyte Bank, Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - Serge Jennes
- Burn Wound Centre, Queen Astrid Military Hospital, 1120 Brussels, Belgium
| | - Arlette De Coninck
- Department of Dermatology, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Diane Roseeuw
- Department of Dermatology, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | | | - Eric Kets
- Queen Astrid Military Hospital, 1120 Brussels, Belgium
| | - David Haddow
- Altrika Ltd, 217 Portobello, Sheffield, S1 4DP UK
- University of Sheffield, Sheffield, UK
| | - Jean-Paul Pirnay
- Skin- and Keratinocyte Bank, Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
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Simoens S, Verbeken G, Huys I. Biosimilars and market access: a question of comparability and costs? Target Oncol 2012; 7:227-31. [DOI: 10.1007/s11523-011-0192-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 08/02/2011] [Indexed: 10/14/2022]
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Pirnay JP, Vanderkelen A, Zizi M, De Vos D, Rose T, Laire G, Ectors N, Verbeken G. Human cells and tissues: the need for a global ethical framework. Bull World Health Organ 2011; 88:870-2. [PMID: 21076570 DOI: 10.2471/blt.09.074542] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 04/22/2010] [Accepted: 04/29/2010] [Indexed: 11/27/2022] Open
Affiliation(s)
- Jean-Paul Pirnay
- Skin and Keratinocyte Bank, Burn Wound Centre, Queen Astrid Military Hospital, Bruynstraat 1, B-1120, Brussels, Belgium.
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Pirnay JP, De Vos D, Verbeken G, Merabishvili M, Chanishvili N, Vaneechoutte M, Zizi M, Laire G, Lavigne R, Huys I, Van den Mooter G, Buckling A, Debarbieux L, Pouillot F, Azeredo J, Kutter E, Dublanchet A, Górski A, Adamia R. The phage therapy paradigm: prêt-à-porter or sur-mesure? Pharm Res 2010; 28:934-7. [PMID: 21063753 DOI: 10.1007/s11095-010-0313-5] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 10/27/2010] [Indexed: 11/30/2022]
Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, 1120, Brussels, Belgium
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Verbeken G, Schoeters D, Verween G, De Vos D, Pascual B, De Corte P, Geukens K, De Coninck A, Roseeuw D, Rose T, Jennes S, Pirnay JP. Potential release of aluminum and other metals by food-grade aluminum foil used for skin allograft cryo preservation. Cell Tissue Bank 2010; 12:241-6. [PMID: 20146011 PMCID: PMC3135820 DOI: 10.1007/s10561-010-9171-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 01/22/2010] [Indexed: 10/26/2022]
Abstract
Since 1991, the skin bank of the Queen Astrid Military Hospital uses food-grade aluminum foil as a primary support for storing cryo preserved human donor skin (511 donors). The possible release of heavy metals into the cryo preservation media (30% (v/v) glycerol in physiological water) and the possible impact this release could have on the quality of the cryo preserved donor skin was evaluated. Aluminum was the principal detection target. Possible contaminants of the aluminum foil as such (arsenic, cadmium, chromium and lead) were also investigated. The evaluation was set up after a Belgian Competent Authority inspection remark. Aluminum was detected at a concentration of 1.4 mg/l, arsenic and lead were not detected, while cadmium and chromium were detected in trace element quantities. An histological analysis revealed no differences between cryo preserved and fresh donor skin. No adverse reactions in patients, related to the presence of aluminum or heavy metal traces, were reported since the introduction of the cryo preserved donor skin in our burn wound centre.
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Affiliation(s)
- Gilbert Verbeken
- LabMCT, Skin- and Keratinocyte Bank, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium.
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40
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Verbeken G, Verween G, Schoeters D, Geukens K, De Coninck A, Roseeuw D, Rose T, Jennes S, Pirnay J. Potential release of heavy metals by food grade aluminum foils used for skin allograft cryo preservation. Burns 2009. [DOI: 10.1016/j.burns.2009.06.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Verbeken G, Verween G, De Coninck A, Rose T, Roseeuw D, Jennes S, Pirnay J. Glycerol treatment as a bacteriological decontamination procedure for contaminated already cryo-preserved donor skin: Methodology and evaluation. Burns 2009. [DOI: 10.1016/j.burns.2009.06.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Merabishvili M, Pirnay JP, Verbeken G, Chanishvili N, Tediashvili M, Lashkhi N, Glonti T, Krylov V, Mast J, Van Parys L, Lavigne R, Volckaert G, Mattheus W, Verween G, De Corte P, Rose T, Jennes S, Zizi M, De Vos D, Vaneechoutte M. Quality-controlled small-scale production of a well-defined bacteriophage cocktail for use in human clinical trials. PLoS One 2009; 4:e4944. [PMID: 19300511 PMCID: PMC2654153 DOI: 10.1371/journal.pone.0004944] [Citation(s) in RCA: 314] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 02/13/2009] [Indexed: 12/16/2022] Open
Abstract
We describe the small-scale, laboratory-based, production and quality control of a cocktail, consisting of exclusively lytic bacteriophages, designed for the treatment of Pseudomonas aeruginosa and Staphylococcus aureus infections in burn wound patients. Based on succesive selection rounds three bacteriophages were retained from an initial pool of 82 P. aeruginosa and 8 S. aureus bacteriophages, specific for prevalent P. aeruginosa and S. aureus strains in the Burn Centre of the Queen Astrid Military Hospital in Brussels, Belgium. This cocktail, consisting of P. aeruginosa phages 14/1 (Myoviridae) and PNM (Podoviridae) and S. aureus phage ISP (Myoviridae) was produced and purified of endotoxin. Quality control included Stability (shelf life), determination of pyrogenicity, sterility and cytotoxicity, confirmation of the absence of temperate bacteriophages and transmission electron microscopy-based confirmation of the presence of the expected virion morphologic particles as well as of their specific interaction with the target bacteria. Bacteriophage genome and proteome analysis confirmed the lytic nature of the bacteriophages, the absence of toxin-coding genes and showed that the selected phages 14/1, PNM and ISP are close relatives of respectively F8, φKMV and phage G1. The bacteriophage cocktail is currently being evaluated in a pilot clinical study cleared by a leading Medical Ethical Committee.
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Affiliation(s)
- Maya Merabishvili
- Eliava Institute of Bacteriophage, Microbiology and Virology (EIBMV), Tbilisi, Georgia
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
- Laboratory of Bacteriology Research (LBR), Ghent University Hospital, Ghent, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
- * E-mail:
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
| | - Nina Chanishvili
- Eliava Institute of Bacteriophage, Microbiology and Virology (EIBMV), Tbilisi, Georgia
| | - Marina Tediashvili
- Eliava Institute of Bacteriophage, Microbiology and Virology (EIBMV), Tbilisi, Georgia
| | - Nino Lashkhi
- Eliava Institute of Bacteriophage, Microbiology and Virology (EIBMV), Tbilisi, Georgia
| | - Thea Glonti
- Eliava Institute of Bacteriophage, Microbiology and Virology (EIBMV), Tbilisi, Georgia
| | - Victor Krylov
- Laboratory of Bacteriophage Genetics, State Institute for Genetics and Selection of Industrial Microorganisms (SIGSIM), Moscow, Russia
| | - Jan Mast
- Unit Electron Microscopy, Veterinary and Agricultural Research Centre (VAR), Ukkel, Brussels, Belgium
| | - Luc Van Parys
- Section Health of the Division Well-Being (Belgian Defence Staff), Queen Astrid Military Hospital, Neder-over-Heembeek, Brussels, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology (LoGT), Katholieke Universiteit Leuven, Leuven, Belgium
| | - Guido Volckaert
- Laboratory of Gene Technology (LoGT), Katholieke Universiteit Leuven, Leuven, Belgium
| | - Wesley Mattheus
- Laboratory of Gene Technology (LoGT), Katholieke Universiteit Leuven, Leuven, Belgium
| | - Gunther Verween
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
| | - Peter De Corte
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
| | - Thomas Rose
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
| | - Serge Jennes
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
| | - Martin Zizi
- Section Health of the Division Well-Being (Belgian Defence Staff), Queen Astrid Military Hospital, Neder-over-Heembeek, Brussels, Belgium
- Department of Physiology (FYSP), Vrije Universiteit Brussel, Jette Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology (LabMCT), Burn Centre, Queen Astrid Military Hospital, Bruynstraat, Neder-over-Heembeek, Brussels, Belgium
| | - Mario Vaneechoutte
- Laboratory of Bacteriology Research (LBR), Ghent University Hospital, Ghent, Belgium
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Abstract
The treatment of infectious diseases with antibiotics is becoming increasingly challenging. Very few new antimicrobials are in the pharmaceutical industry pipeline. One of the potential alternatives for antibiotics is phage therapy. Major obstacles for the clinical application of bacteriophages are a false perception of viruses as 'enemies of life' and the lack of a specific frame for phage therapy in the current Medicinal Product Regulation. Short-term borderline solutions under the responsibility of a Medical Ethical Committee and/or under the umbrella of the Declaration of Helsinki are emerging. As a long-term solution, however, we suggest the creation of a specific section for phage therapy under the Advanced Therapy Medicinal Product Regulation.
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Affiliation(s)
- Gilbert Verbeken
- Hospital Center of the Base-Queen Astrid, Laboratory for Molecular & Cellular Technology, Burn Unit, Bruynstraat 1, B-1120 Neder-over-Heembeek, Belgium.
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Somers T, Duinslaeger L, Delaey B, Verbeken G, Van Halle S, Boedts D, Govaerts P, Offeciers E. Stimulation of epithelial healing in chronic postoperative otorrhea using lyophilized cultured keratinocyte lysates. Am J Otol 1997; 18:702-6. [PMID: 9391664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE After tympanoplasty, despite a closed tympanic graft, some patients continue to have persistent otorrhea due to insufficient epithelial healing and granulation tissue formation in the depths of the outer ear canal. When all medical therapies fail, many otologists undertake revision surgery, usually with free skin grafting. To avoid surgery, the authors sought to improve this condition with a lysate of lyophilized cultured allogeneic keratinocytes. STUDY DESIGN AND PATIENTS In this prospective pilot study, lyophilized cultured allogeneic keratinocyte lysates have been administered in 27 patients. These patients had uncontrollable otorrhea that resisted medical (topical) therapy for at least 6 months. MAIN OUTCOME MEASURE The criterion of success was a complete epithelialization and cessation of otorrhea. RESULTS After an average of 2 applications, cessation of otorrhea was achieved in 20 cases (74%). Three patients (11%) relapsed after 3 months. The other ears (63%) still were dry at the 1-year final evaluation. CONCLUSIONS These results are similar to those obtained after application of sheets of viable cultured keratinocytes of autologous as well as of allogeneic origin. Because the soluble lysate can be incorporated into ototopical drops, the lysate technique is more "user-friendly" and can be applicable in any outpatient clinic. Because keratinocytes contain many growth factors (e.g., epidermal growth factor, basic fibroblast growth factor, platelet-derived growth factor, transforming growth factor), the authors speculate that the release of those intracellular growth factors is responsible for the observed therapeutic effect. This form of therapy by its combination of several growth factors might be considered a more physiologic method than the, also still experimental, growth factor therapy in which high doses of only single growth factor are used.
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Affiliation(s)
- T Somers
- University Department of Oto-Rhino-Laryngology, Medical Institute Sint Augustinus, Antwerp, Belgium
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Duinslaeger LA, Verbeken G, Vanhalle S, Vanderkelen A. Cultured allogeneic keratinocyte sheets accelerate healing compared to Op-site treatment of donor sites in burns. J Burn Care Rehabil 1997; 18:545-51. [PMID: 9404990 DOI: 10.1097/00004630-199711000-00013] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Donor site treatment is a crucial issue in the treatment of extensive burns. In this single-blind, randomized study treatment of donor sites with a polyurethane dressing, Op-Site (Smith & Nephew, York, U.K.) is compared to treatment with allogeneic cultured keratinocyte sheets. Results show a mean healing time of 6.7 days with use of cultured keratinocyte sheets compared to mean healing time of 13.6 days with Op-Site treatment. Also, improvement in the comfort of patients as the result of less exudate formation and pain attenuation was noted.
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Somers T, Verbeken G, Vanhalle S, Delaey B, Duinslaeger L, Govaerts P, Offeciers E. Treatment of chronic postoperative otorrhea with cultured keratinocyte sheets. Ann Otol Rhinol Laryngol 1997; 106:15-21. [PMID: 9006355 DOI: 10.1177/000348949710600103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cultured allogeneic ear keratinocyte sheets were used to treat 26 ears presenting with long-standing (average 37 months) chronic otorrhea, resistant to regular treatment, long after surgery for atresia (n = 8), cholesteatoma (n = 10), and chronic otitis media (n = 8). Complete epithelial healing and cessation of otorrhea were obtained in 18 cases (69%), following an average of 2.2 weekly applications. Temporary epithelial healing lasting at least 3 months was observed in 3 patients (12%) subsequently needing repeated applications. Lack of complete epithelialization was documented in 5 cases (19%). In 3 of those 5 cases, a reason could be determined. The authors speculate that the allocultured keratinocytes are able to promote migration and proliferation of resident cells at the wound edges, despite their short survival time, by release of keratinocyte-stimulating factors.
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Affiliation(s)
- T Somers
- University Department of Otolaryngology, Sint Augustinus Hospital, University of Antwerp, Belgium
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De Coninck A, Draye JP, Van Strubarq A, Vanpée E, Kaufman L, Delaey B, Verbeken G, Roseeuw D. Healing of full-thickness wounds in pigs: effects of occlusive and non-occlusive dressings associated with a gel vehicle. J Dermatol Sci 1996; 13:202-11. [PMID: 9023702 DOI: 10.1016/s0923-1811(96)00536-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study, based upon a pig model, was conducted to investigate the effects of moist and dry healing conditions on wound closure (epithelialization, granulation tissue, contraction) of full-thickness wounds. Thirty-two full-thickness square wounds (3 cm x 3 cm) covered with either an occlusive polyurethane dressing (Tegaderm) or a non-occlusive dressing (Melolin) were evaluated. The effect of the presence or the absence of a gel (3% Idroramnosan) was also investigated with both dressings. The dressings were renewed twice a week. The time required for wound closure was 19.2 +/- 1.6 days for Tegaderm and 26.6 +/- 3.0 days (means +/- SD) for Melolin, respectively. The healing time of the full-thickness porcine wounds was significantly (P < 0.001) reduced by the occlusive dressing. Equivalent results were found with the 3% gel, indicating that the gel can be used as a neutral vehicle. The healing rate, calculated according to Gilman's method, was also significantly (P < 0.001) enhanced by the occlusive dressing. This progression was 0.073 +/- 0.004 cm/day and 0.050 +/- 0.009 cm/day (means +/- SD) for Tegaderm and Melolin, respectively. The contribution of contraction to wound closure was similar in all wounds, indicating that the occlusive dressing did not have an effect on wound contraction. Histological evaluation was performed on full-thickness skin biopsies of whole wound harvested from the time of wound closure to 3 months after. At any time point, no significant histological variations were observed between the different treated wounds. This study demonstrates in a porcine model that for full-thickness wounds, as for split-thickness wounds, occlusive dressing enhances healing rate and shortens the time for wound repair. The shortened healing time is a function primarily of the effect of occlusive dressing on epithelialization, especially the third phase of wound resurfacing.
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Affiliation(s)
- A De Coninck
- Department of Dermatology, Vrije Universiteit Brussel, Belgium
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Duinslaeger L, Verbeken G, Reper P, Delaey B, Vanhalle S, Vanderkelen A. Lyophilized keratinocyte cell lysates contain multiple mitogenic activities and stimulate closure of meshed skin autograft-covered burn wounds with efficiency similar to that of fresh allogeneic keratinocyte cultures. Plast Reconstr Surg 1996; 98:110-7. [PMID: 8657762 DOI: 10.1097/00006534-199607000-00018] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
For several years, grafting with allogeneic keratinocyte cultures has been used successfully as a wound-healing therapy both by us and by many other groups. Since their postgrafting survival time is limited, the effect of these cultures is generally explained by the production of wound repair-stimulating factors that promote proliferation and migration of resident cells. In this study we show that lysates of cultured keratinocytes contain mitogenic activity for keratinocytes, endothelial cells, and fibroblasts. In addition, the lysates inhibit the contraction of collagen gels by human skin fibroblasts. On the basis of these observations and of in vivo data obtained by ourselves and others, we have evaluated the effect of total keratinocyte lysates on the healing of meshed skin autograft-covered burn wounds. Twenty burn wounds were tangentially excised and autografted with one to three meshed conventional skin transplants. An area treated with a gel containing lysated keratinocyte cultures was compared with an area treated with placebo-gel in terms of epithelialization on day 5. In six patients an additional fresh keratinocyte alloculture was applied as a positive control. Results indicate that the newly formed epithelium (difference between percentage of epithelialization on day 5 and on day 0) was 31.1 percent in the treated area compared with 16.5 percent in the placebo area. This result is comparable with the value obtained by treatment with fresh keratinocyte allocultures, namely, 33.8 percent. These figures show a twofold stimulation of epithelialization.
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Affiliation(s)
- L Duinslaeger
- Burn Center of Brussels and Innogenetics, Ghent, Belgium
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49
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Somers T, Verbeken G, Vanhalle S, Delaey B, Duinslaeger L, Govaerts P, Offeciers E. Lysates from cultured allogeneic keratinocytes stimulate wound healing after tympanoplasty. Acta Otolaryngol 1996; 116:589-93. [PMID: 8831847 DOI: 10.3109/00016489609137894] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In the past, cultured keratinocyte allografts have been used with benefit in the treatment of burn wounds and leg ulcers. Since in burn wounds autologous and allogeneic fresh keratinocyte cultures were found to give similar favorable results as lysates of allogeneic cultured cells, the authors investigated whether this lysate mixed in an antibiotic suspension would also accelerate the epithelial healing after routine tympanoplasty. In a double blind setting the healing process in 50 consecutive tympanoplasty ears was studied: an acceleration of healing of 8 days was observed in the lysate-treated group (39.25 days) as compared with the control group (47.23 days). The percentage of ears which healed within 6 weeks (after 5 weekly applications of 200 microliters suspension in both groups) was significantly higher in the treated group (61%) than in the control population (36%). Although the therapeutical effect of the keratinocyte lysate in this study is believed to be due primarily to its mitogenic activity through growth factors or cytokines, at present it is still unclear which growth factors are involved and which combinations of these factors have to be present to modulate the different stages of the complex healing processes.
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Affiliation(s)
- T Somers
- University Department of Otolaryngology, Sint Augustinus Hospital, University of Antwerp, Belgium
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