Delivering phage therapy per os: benefits and barriers

ABSTRACT

Introduction: Multidrug-resistant bacterial infections of the gastrointestinal tract pose a serious public health concern. High levels of antibiotic drug resistance, along with the potential for antibiotics to precipitate disease or alter the gut microbiome has prompted research into alternative treatment methods. Evidence suggests that bacteriophage therapy delivered per os may be well-suited to target such infections.

Areas covered: Herein, we discuss the specific advantages and challenges of using orally administered phage therapy. Our literature review encompasses recent works using phages to target various clinically-relevant bacteria in vivo. We also provide insights into methods that aim to overcome the barriers to effective phage transit through the harsh gastrointestinal environment.

Expert commentary: Evidence from a number of in vivo animal studies suggests that targeting bacterial infections using phages delivered orally holds potential. Efficacious oral phage therapy depends on the delivery of sufficient phage titers to the infection site, which may be hindered by the host’s gastrointestinal tract and immune response.

KEYWORDS:

• Antibiotic resistance
• bacterial infection
• bacteriophages
• enteropathogenic
• gastrointestinal tract
• gastroenteritis
• gut microbiome
• phage therapy

Acknowledgments

Sincere thanks to Ms. Joanna Majewska for helpful discussions in the preparation of this review. We would also like to thank the Fulbright Program for supporting Ms. Susan Zelasko’s work.

Declaration of interest

S Zelasko U.S. has received support from the Fulbright Program Research Grant 2015-16. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was supported by the National Science Centre in Poland (grant no. UMO-2013/08/M/NZ6/01022 and UMO-2012/05/E/NZ6/03314), given to K Dabrowska.