Researchers have used a virus to fight a drug-resistant lung infection
Did you know that viruses can kill bacteria? It's true and the process holds much promise for medicine.
For the first time ever, researchers successfully used bacteriophages to treat an antibiotic-resistant mycobacterial lung infection. This process led the way for a young National Jewish Health patient with cystic fibrosis to receive a life-saving lung transplant, according to a press release by the institution published on Friday.
An antibiotic failure
“We had tried unsuccessfully for years to clear the mycobacterial infection with a variety of antibiotics,” said Jerry Nick, MD, lead author of the study and director of the Adult Cystic Fibrosis Program at National Jewish Health. “When we used the bacteria’s own natural enemies, we were able to clear the infection which resulted in a successful lung transplant.”
No one was happier with the results of the treatment than the patient himself.
“I am so grateful for the effort, persistence, and creativity of all the people who were involved in my treatment,” said Jarrod Johnson, recipient of the lung transplant. “I thought I was going to die. They have literally saved my life.”
Johnson is a 26-year-old cystic fibrosis patient who has been plagued with repeated lung infections starting from childhood and causing him to be admitted to various hospitals several times a year.
A rapid irreversible decline in lung function
In adulthood, he suffered from a rapid decline in his lung function due to a persistent Mycobacterium abscessus infection over a six-year period that caused doctors to believe he was likely to die in only a few years without a lung transplant. However, he had been refused transplants by three transplant centers because of his continuous mycobacterial infection.
That's when Nick and his team decided to treat him with phages (viruses that attack bacteria) for the first time ever. The treatment ran for 200 days but proved so successful that Johnson was ready to undergo a lung transplant.
“This research can serve as a roadmap for future use of phages to treat patients with severe Mycobacterium abscessus lung infection and to save lives,” concluded Nick.
Two mycobacteriophages were administered intravenously to a male with treatment-refractory Mycobacterium abscessus pulmonary infection and severe cystic fibrosis lung disease. The phages were engineered to enhance their capacity to lyse M. abscessus and were selected specifically as the most effective against the subject’s bacterial isolate. In the setting of compassionate use, the evidence of phage-induced lysis was observed using molecular and metabolic assays combined with clinical assessments. M. abscessus isolates pre and post-phage treatment demonstrated genetic stability, with a general decline in diversity and no increased resistance to phage or antibiotics. The anti-phage neutralizing antibody titers to one phage increased with time but did not prevent clinical improvement throughout the course of treatment. The subject received lung transplantation on day 379, and systematic culturing of the explanted lung did not detect M. abscessus. This study describes the course and associated markers of a successful phage treatment of M. abscessus in advanced lung disease.