Role of bacteriophages in medicine

The topicality: the first mention of bacteriophages appeared about a century ago. Many researchers assessed opportunities of phage therapy as limitless, but the use of antibiotics prevented widespread use of bacteriophages. The threat of infections caused by multi-resistant bacteria is increasing, so phages are considered again as alternative methods of treatment [1, 2].

The purpose: to determine the value of bacteriophages in modern medicine, to evaluate the types of bacteriophage preparations used in therapeutic and prophylactic purposes.

Materials and methods: the analysis of foreign and domestic literature describing the mechanism of action of bacteriophages, aspects of the pharmacodynamics of the drug, nonspecific action of phages, as well as consideration of the fields of application of phages in modern medicine.

Results: at present, phage therapy is experiencing its renaissance in such branches of medicine as surgery, gynecology and urology, ophthalmology, traumatology [3, 4, 5, 6]. Bacteriophage preparations are a sterile filtrate of bacterial phagolysates used orally, topically for irrigating wounds and mucous membranes, injecting into the uterus, bladder, ear, paranasal sinuses, and also into the drained cavities - abdominal, pleural, and also in the cavity of abscesses after removal of exudate. The pharmaceutical industry offers a variety of drugs, their principle of action bases on the antimicrobial orientation of bacteriophages. For distinguishing of virulent and moderate phages uses the type of bacteriophage interaction with a bacterial cell. Virulent phages can only increase in quantity through the lytic cycle. There are several stages of process of interaction of a virulent bacteriophage with a cell: adsorption of a bacteriophage on a cell, penetration into a cell, biosynthesis of phage components and their assembly, release of bacteriophages from a cell as a result of cell wall lysis. After a certain critical amount of new viral particles (virions) accumulate inside the bacterial cell, the cell collapses, and the newly created viruses emerge and infect new bacterial cells, followed by repeating the cycle [2, 3].

Preparations based on bacteriophages have a narrow specificity of action and do not cause inhibition of normal microflora, in contrast to antibacterial drugs. The monitoring of the sensitivity of pathogens to bacteriophages contributes to the updating of phage compositions, which subsequently enter different regions. Adapted bacteriophages help to eliminate outbreaks of intrahospital infections caused by antibiotic-resistant strains [3].

It should be noted, that peroraly administered bacteriophages rapidly reach the focus of infection localization. In patients with purulent-inflammatory diseases, phages enter the blood an hour later, after 1-1.5 hours they are detected from bronchopulmonary exudate and from the surface of burn wounds, after 2 hours - from urine, as well as from the cerebrospinal fluid of patients with head injuries.

Proven stimulating effect of staphylococcal bacteriophage on bifidobacteria is the most important component of intestinal microbiocenosis.

The use of bacteriophages for the treatment of infectious diseases stimulates the factors of specific and nonspecific immunity, which is especially effective for the treatment of chronic inflammatory diseases in the background of immunosuppressive conditions, bacteriocarrier [7].

A great experience in the use of bacteriophages in the treatment of intestinal infections has been gained: high clinical efficacy of phagotherapy of acute and chronic dysentery, salmonellosis, accompanied by rehabilitation of carriers has been shown. Proved high epidemiological effectiveness of prophylactic use of dysenteric, typhoid and salmonella bacteriophages. The use of bacteriophages has shown good results in the treatment of diseases caused by opportunistic bacteria, dysbacteriosis, purulent lesions of the skin, ENT organs, musculoskeletal system, genitourinary system, circulatory organs and respiratory systems, including in newborns and children in the first year of life [8].

Conclusions: bacteriophages are unique microorganisms, their basis has been created a group of therapeutic and prophylactic drugs, which is special in its properties and characteristics. The main advantage of bacteriophage preparations is the absence of side effects and the destruction of normal microflora. The natural physiological mechanisms of interaction of phages and bacteria that underlie their action make it possible to predict the infinite variety of both bacteriophages themselves and possible methods for their use. As the bacteriophage collections expand, no doubt, new target pathogens will appear, the range of diseases in which phages can be used both in monotherapy and as part of complex treatment regimens will expand.

The list of references:

  1. Krasilnikov I. V., Lobastova A. K., Lyisko K. A. Kratkiy obzor sovremennogo sostoyaniya i perspektivnyih napravleniy razvitiya proizvodstva i primeneniya lechebnoprofilakticheskih preparatov bakteriofagov. Vestn. biotehnol. im. Yu.A .Ovchinnikova. — 2010. — 2: 2833.
  2. Bondarenko V. M. Klinicheskiy effekt i puti ratsionalno ispolzovaniya lechebnyih bakteriofagov v meditsinskoy praktike. Farmateka. 2011. 1 (214): 29 34.
  3. Aleshkin A.V., Karaulov A.V., Svetoch E.A. i dr. Bakteriofagi — probioticheskie sredstva regulyatsii mikrobiotsenozov i dekontaminatsii produktov pitaniya, zhivotnyih i rasteniy. Immunol. allergol.infektol. 2013. 3: 8089.
  4. Mohov E.M., Kadyikov V.A., Morozov A.M. Perspektivyi primeneniya bakteriofagov v hirurgii ostrogo appenditsita. Sovremennyie problemyi nauki i obrazovaniya. #2. 2017. 129
  5. Morozov A.M., Morozova A.D., Mohov E.M. Polivalentnyie preparatyi bakteriofagov v lechenii hirurgicheskih infektsiy. Materialyi Vserossiyskogo nauchnogo foruma studentov i molodyih uchenyih Studencheskaya nauka — 2017, Izdanie SPbGPMU g. SanktPeterburg, 2017. — 623 s.
  6. Morozov A.M., Mohov E.M. Otsenka effektivnosti primeneniya bakteriofagov v usloviyah obschehirurgicheskogo otdeleniya. VIII Konferentsiya molodyih uchenyih RMANPO s mezhdunarodnyim uchastiem «Gorizontyi meditsinskoy nauki»: sbornik materialov konferentsii; M.: FGBOU DPO RMANPO, 2017. T. II. 322 s.
  7. Bakteriofagi: biologiya i primenenie / Red.: E. Katter, A. Sulakvelidze. M.: Nauchnyiy mir. 2012.
  8. Bakteriofagi — istoriya voprosa i sovremennoe sostoyanie fagoterapii/ Lazareva E.B., Menshikov D.D. Meditsinskiy alfavit. 2014. T. 1. # 4. S. 4348.
Year: 2018
City: Shymkent
Category: Medicine