Bacteriophages: perspectives in the personalised therapy of the diseases caused by bacterial agents

Abstract

Introduction . In recent years, much attention has been paid to the development of antibacterial agents based on viruses of bacteria – bacteriophages. The effectiveness of such preparations was demonstrated in the treatment of a wide range of diseases caused by bacterial pathogens. However, the wide introduction of phage therapy is hindered by a number of objective limitations. Objective . To describe the main study directions in the field of therapeutic phage preparations and the problems of their implementation in practical medicine. Materials and methods . This mini-review is based on experimental studies published in 2016-2026 and scientific reviews for 2020–2026 presented in the Web of Science, PubMed, Scopus, E-Library databases based on the keywords “phage therapy”, “bacteriophage/phage”, etc. Results. Currently, both phage “cocktails” of fixed composition and personalized phages and their cocktails are used as therapeutic preparations. New phage therapy centers have been established in several countries in addition to the centers in Georgia and Poland. In the Russian Federation, NPO Microgen has been industrially producing more than a dozen phage-based medicines for several decades; a number of organizations are developing new phage preparations. However despite the high potential of phage therapy, it is necessary to overcome a number of problems. It is necessary to develop new regulations for obtaining small batches of various phage preparations that are personalized for a particular patient. A new approach is required for the patenting and registration of such medicines. Such mechanism has been developed abroad that makes it possible to use phages as pharmaceutical “backbone” drugs for therapy. Conclusion . Phage therapy is a promising area of personalized medicine. However, its effectiveness depends on the exact selection of the bacteriophage to a specific pathogen. The development of methods for creating synthetic phages with specified properties and cell-free technologies can expand the possibilities of phage therapy. Further accumulation of clinical data, development of regulatory documents and regulatory support during clinical application are necessary for the introduction of this technology into clinical practice.