About this Research Topic

Background

With the increasing threat of antibiotic resistance, the interest in phage therapy (PT) as a potential solution to this crisis has rapidly grown. Recently, several reports have been published describing successful treatment of patients with life-threatening antibiotic-resistant bacterial infections, including recipients of lung allografts and treatment using genetically modified phage. Moreover, the first PT center has been opened in the USA, following the establishment of a similar unit in Belgium. These developments give credence to our decision to establish, in 2005, the first such unit operating in accordance with EMA and national regulations, which helped pave the way for future progress in PT as an option to combat the antimicrobial resistance crisis. Ample evidence derived from observational studies indicates the safety of PT. Furthermore, several clinical trials have been completed (including one performed according to all required standards of good medical practice and evidence-based medicine) and are ongoing. However, these trials are yet to provide definitive proof of the effectiveness of PT.

As the struggle to register phage as a medicinal product and to introduce it onto the market continues, parallel data have been accumulating to indicate that phage may interact not only with bacteria but also with eukaryotic cells (including cells of the immune system). Therefore, it cannot be excluded that in the future, after phage discovery, research may shift towards phage–immune system interactions, whereas, to date, work on phage interactions with their natural target (bacteria) has prevailed. Hopefully, simultaneous advancements in both research fields can bring beneficial results for human health, both in terms of combating antibiotic-resistant bacterial infections and developing novel anti-inflammatory and immunomodulatory agents with minimal toxicity and satisfactory efficacy.

Evidently, there is an urgent need for relevant clinical trials to determine the true value of PT according to current standards of human research. The aim of this Research Topic is to facilitate the advancement of PT by publishing reports relevant for animal and human PT. In particular, the authors are welcome to submit Original Research, Review, Minireview, Hypothesis and Theory, Perspective, and Opinion papers on the following themes:

• phage therapy in animals and humans,
• selection of phages for therapy,
• phage pharmacokinetics,
• phage and antibiotics,
• phage therapy: beyond the antibacterial action,
• phage therapy and the immune system,
• ethical aspects of phage terapy,
• intellectual property and regulatory issues relevant for phage therapy.

This Research Topic is dedicated to Prof. Elisabeth Kutter on the occasion of her 80th
birthday. Dr. Kutter’s career as a phage scientist has extended nearly 60 years. She has been a
pioneer as a woman in science. She started to work with phage at the University of Rochester,
New York working with Dr. Wiberg on radioisotopes making excellent progress in the field –
progress which was even cited in Luria’s 1969 Nobel Prize talk. Betty first encountered phage
therapy during a visit to Georgia in 1990 which was part of a longer stay in the former Soviet
Union under a US-USSR research exchange program. Dr. Kutter was one of the first Americans
to advocate for phage therapy in the post antibiotic era.
Betty started hosting the Evergreen International Phage meetings in Olympia, Washington,
from 1975 onward, which helped to develop a strong phage community with participation
increasing over the years to 350 at the 23 rd biannual last year. Betty continues to be an active
member in the phage community, sharing her experience and working with all of us toward her
ultimate goal of making phage therapy available worldwide thus reducing the burden caused by
antibiotic resistant bacterial infections.

Keywords: phage therapy, bacteriophage, antibiotic-resistant infections, immunomodulation

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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