噬菌体治疗细菌性感染的进展

噬菌体是自然界中广泛存在的细菌病毒,作为细菌的天然杀手,在细菌性感染尤其是多重耐药菌感染的治疗方面具有抗生素无法比拟的优势。综述了利用活噬菌体治疗细菌性感染的早期研究及近几年的初步临床试验结果、利用噬菌体裂解酶治疗细菌性感染的最新进展,指出了噬菌体治疗真正得以应用所面临的主要障碍并综述分析了一些具有一定可行性的解决方案,以期为噬菌体治疗的研究和应用提供参考,并推动噬菌体治疗研究的进一步发展。     

噬菌体治疗研究进展

噬菌体发现之初, 便被前苏联和东欧医学界用来治疗细菌感染。但是, 随着抗生素时代的到来, 人们慢慢忽略了对噬菌体的深入研究。近来, 由于全球耐药菌感染率不断攀升, 用抗生素治疗细菌感染面临了前所未有的挑战, 一些科学家和临床工作者开始重新把注意力集中到噬菌体研究上来, 并在这个领域取得了极大的进展, 尤其是通过大量的实验证明: 噬菌体可以有效地提高细菌感染的实验动物的存活率。本文就近几年国内外的科研工作者在噬菌体治疗领域所取得的进展做一综述。     

耐药菌感染的噬菌体治疗专利技术

耐药菌,尤其是多重耐药菌的出现和持续进化给人类健康带来了巨大的威胁。在抗生素逐渐失去特效作用的情况下,科学界和医药界又把眼光重新投向了抗菌的天然生物-噬菌体,并在一些研究中证明了噬菌体可以作为新的武器去替代抗生素治疗耐药菌感染。通过对噬菌体治疗及衍生的裂解酶治疗的世界专利申请进行统计及分析,获得了专利发展趋势、申请人分布特点及主要专利申请人等信息,详细分析了噬菌体及裂解酶治疗的主要专利技术路线和研发热点。     

耐药菌感染的噬菌体治疗专利技术

耐药菌,尤其是多重耐药菌的出现和持续进化给人类健康带来了巨大的威胁。在抗生素逐渐失去特效作用的情况下,科学界和医药界又把眼光重新投向了抗菌的天然生物-噬菌体,并在一些研究中证明了噬菌体可以作为新的武器去替代抗生素治疗耐药菌感染。通过对噬菌体治疗及衍生的裂解酶治疗的世界专利申请进行统计及分析,获得了专利发展趋势、申请人分布特点及主要专利申请人等信息,详细分析了噬菌体及裂解酶治疗的主要专利技术路线和研发热点。     

噬菌体治疗中细菌对噬菌体的抗性

抗生素治疗尽管有几十年有效治疗的历史,但随着越来越多耐/抗药性细菌的出现,细菌对抗生素的抗药性已成为一个大问题。噬菌体治疗是使用噬菌体作为抗菌剂来感染细菌株系,它一直是人们倡导的一个很有前途的常规抗生素治疗的替代方案。然而,由于细菌与噬菌体的协同进化中,细菌可以通过多种机制获得对噬菌体的抗性。因此,人们对噬菌体治疗抱有期望的同时,也关注噬菌体治疗长时间的使用之后,是否会与抗生素使用之后结果相类似,导致抗性细菌病原菌感染的治疗困难。综述了细菌-噬菌体协同进化中细菌病原菌对有感染能力的噬菌体是否会产生抗性,及其在噬菌体治疗中影响的争论,并展望了噬菌体治疗的潜在前景。     

噬菌体抗菌治疗安全性评估体系的建立

人类已经进入后抗生素时代,噬菌体治疗近年来重新备受重视,噬菌体制剂不同于传统抗菌药物,已有对传统抗菌药物的安全性评估体系不适合用于对噬菌体治疗制剂的评估,需要建立对噬菌体治疗安全性评估的体系。本文就噬菌体治疗所涉及的安全性问题进行系统分析研究,通过噬菌体本身的选择、噬菌体制剂制备、制剂形式、制剂给予途径、剂量和频次等,以及噬菌体治疗细菌感染性疾病患者选择等所涉及的安全性和噬菌体治疗对周围微环境的影响等进行全面分析。建立噬菌体治疗安全性评估体系,为噬菌体治疗尽早进入临床奠定基础。     

噬菌体疗法在疾病中的应用进展

随着耐药菌在世界范围内不断传播,应用噬菌体作为有效的抗生素替代疗法重新受到研究者的关注。另一方面,人体微生物群与宿主健康的相互作用研究不断深入,靶向调控微生物群来影响人体健康成为多项研究的关注焦点,利用噬菌体靶向降低与疾病发展正相关的特征性细菌的丰度,成为肿瘤、酒精性肝病及糖尿病等非感染性疾病更精准的预防或辅助治疗策略。本文对噬菌体疗法在感染性和非感染性疾病中的应用进展进行了综述。     

噬菌体疗法及其在美洲幼虫腐臭病中的研究进展

美洲幼虫腐臭病是西方蜜蜂中最严重的细菌病之一,给养蜂业带来了严重的损失。幼虫芽胞杆菌是幼蜂感染美洲幼虫腐臭病的病原菌。由于抗生素产生的耐药性越来越严重,并且抗生素的使用会破坏宿主肠道菌群,使蜂群处于高危的环境中,因此迫切需要抗生素治疗的替代技术,而噬菌体在预防和控制细菌耐药性方面已显示出显著的优势。主要综述了噬菌体疗法、安全性及其在蜜蜂美洲幼虫腐臭病中的研究现状,介绍了噬菌体疗法在各类细菌病中的研究与应用,对今后噬菌体治疗蜜蜂细菌病研究方向进行了展望。     

噬菌体：微小却不简单

噬菌体是专一感染细菌等微生物的病毒,是地球上多样性最高和最丰富的生物体,是生物学研究中重要的模式生物,同时是抗生素耐药菌的天然抗菌剂。噬菌体研究的相关成果极大地推动了生物学各个领域的发展。     

噬菌体展示技术在疫苗研究中的应用进展

噬菌体是一种以细菌为宿主的具有严格宿主特异性的病毒,近年来由于分子生物学和基因重组技术的长足发展,藉助噬菌体的基本特性创立和发展了噬菌体展示技术,此项技术将外源肽或蛋白与特定噬菌体衣壳蛋白融合并展示于噬菌体表面。利用这项技术制作的疫苗具有安全可靠、稳定性高、免疫效果好等优点,因此,在新型疫苗的研制上具有很大的应用价值。就噬菌体展示技术及其在疫苗研究中的优势、预防性疫苗与治疗性疫苗的研究进展予以综述。     

Phagotherapy in terms of bacteriophage genetics: hopes, perspectives, safety, limitations

The appearance and spreading of multidrug-resistant bacterial pathogens is a consequence of the large-scale use of antibiotics in medicine. In view of this, claims for the phage therapy were renewed: in recent studies, the natural phages and their products neutralizing various proteins, as well as the bacterial products often controlled by defective prophages (bacteriocins) were applied for treatment of bacterial infections. Constructs obtained by gene engineering are increasingly used to change some bacteriophage: properties to expand the spectrum of their lytic activity and to eliminate therapeutic drawbacks of some natural phages. In this review, the problem of phage therapy is discussed in general with respect to bacteriophage properties, their genetics, structure, evolution, taking into account long-term experience of the author in the field of bacteriophage genetics. Note that the general concept of phage therapy should be developed to ensure long-term, efficient and harmless phage therapy.     

Phage Therapy in Terms of Bacteriophage Genetics: Hopes, Prospects, Safety, Limitations

The appearance and spreading of multidrug-resistant bacterial pathogens is a consequence of the large-scale use of antibiotics in medicine. In view of this, claims for the phage therapy were renewed: in recent studies, the natural phages and their products neutralizing various proteins, as well as the bacterial products often controlled by defective prophages (bacteriocins) were applied for treatment of bacterial infections. Constructs obtained by gene engineering are increasingly used to change bacteriophage properties to expand the spectrum of their lytic activity and to eliminate therapeutic drawbacks of some natural phages. In this review, the problem of phage therapy is discussed in general with respect to bacteriophage properties, their genetics, structure, evolution, taking into account long-term experience of the author in the field of bacteriophage genetics. Note that the general concept of phage therapy should be developed to ensure long-term, efficient and harmless phage therapy.     

Amoxicillin and specific bacteriophage can be used together for eradication of biofilm of <Emphasis Type="Italic">Klebsiella pneumoniae</Emphasis> B5055

Despite the efficacy of antibiotics as well as bacteriophages in treatment of bacterial infections, their role in treatment of biofilm associated infections is still under consideration especially in case of older biofilms. Here, efficacy of bacteriophage alone or in combination with amoxicillin, for eradication of biofilm of Klebsiella pneumoniae B5055 has been assessed. Planktonic cells as well as biofilm of K. pneumoniae B5055 grown in 96-well microtiter plates were exposed to bacteriophage and amoxicillin at various Multiplicity of Infections (MoIs) as well as at three different antibiotic concentrations (512, 256 and 128 μg/ml), respectively. After exposure to 256 μg/ml (MIC) of amoxicillin, bacterial load of planktonic culture as well as 1-day-old biofilm was reduced by a log factor of 4.1 ± 0.31 (P = 0.008) and 1.24 ± 0.27 (P < 0.05), respectively but reduction in the bacterial load of mature biofilm (8-day-old) was insignificant (P = 0.23). When 8-day-old biofilm was exposed to higher antibiotic concentration (512 μg/ml) or phage alone (MoI = 0.01) a log reduction of 2.97 ± 0.11 (P = 0.182) and 3.51 ± 0.19 (P = 0.073), respectively was observed. While on exposing to a combination of both the amoxicillin and phage, a significant reduction (P < 0.01) in bacterial load of the biofilm was seen. Hence, when antibiotic was used in combination with specific bacteriophage a greater destruction of the biofilm structure suggested that the phages could be used successfully along with antibiotic therapy. An added advantage of the combination therapy would be its ability to check formation of resistant mutants that otherwise develop easily upon using phage or antibiotic alone.     

噬菌体治疗肺炎克雷伯菌感染的研究进展

随着细菌的进化以及部分抗生素的滥用，耐药细菌的感染已成为21世纪主要的公共卫生挑战之一。其中，耐药肺炎克雷伯菌(Klebsiella pneumoniae)问题尤为突出。噬菌体在治疗耐药细菌感染引起的疾病方面展现出一定的潜力及独特优势，但目前噬菌体治疗尚缺乏统一的临床指导规范。虽然临床上有少数将噬菌体用于治疗肺炎克雷伯菌感染的成功案例，但多数情况下是采用噬菌体配合抗生素疗法，噬菌体在其中的作用仍不明确。本文综合评述国内外研究数据，回顾与噬菌体治疗肺炎克雷伯菌感染相关的数个重点问题，包括噬菌体的特性以及影响其疗效的因素，旨在为肺炎克雷伯菌和其他耐药细菌的噬菌体治疗提供参考。     

Therapeutic bacteriophages as a rescue treatment for drug-resistant infections – an in vivo studies overview

Bacteriophages, highly prevalent in all environments, have found their use in medicine as an alternative or complement to antibiotics. The therapeutic use of bacteriophages was particularly popular in the 1920s and 1930s, until the discovery and introduction of antibiotics. Due to the dynamic growth of antibiotic resistance among bacterial strains, numerous international institutions (such as the FDA) have declared the search for novel treatment modalities to be of the highest priority. To date, bacteriophage therapy has not been registered for general use in Western countries. The regulation of biological medicinal products (within medicinal product regulation) does not contain a specific documentation frame for bacteriophages (only for vaccines, blood derived products, etc.) which, as active substances, need to meet specific requirements. Recently, the FDA allowed bacteriophage therapy to be used in the United States, via the Emergency Investigational New Drug scheme; clinical trials to compare the safety and efficacy of bacteriophage therapy are also permitted. To date, several therapeutic products of this type have made it to phase I or II; some clinical programmes have also been completed. This article cites numerous animal model studies and registered clinical trials, showing the safety and effectiveness of bacteriophage therapy, including infections caused by bacterial strains resistant to antibiotic treatment.     

Development of a novel method of lytic phage delivery by use of a bacteriophage P22 site-specific recombination system

Bacteriophage therapy represents a potential alternative to the use of antibiotics to control proliferation of pathogenic bacteria. As an alternative to the strategy where a limited number of doses of large numbers of lytic bacteriophages are administered, a novel method delivery system was developed so that phages are continually released into the culture. Specifically, a non-pathogenic Escherichia coli strain was constructed that was lysogenic for a lytic mutant of bacteriophage lambda. This lysogen was shown to be effective at decreasing the number of lambda-sensitive E. coli in vitro. Construction of this E. coli strain was accomplished by development of a plasmid-based system utilizing the site-specific recombination machinery of bacteriophage P22 to integrate DNA constructs into the host chromosome. This recombination system is useful for strain construction and other genetic manipulations in both E. coli and Salmonella enterica serovars.     

噬菌体裂解酶——现状与未来

噬菌体裂解酶是一种由DNA噬菌体基因编码的高特异性酶, 可高效消化细菌细胞壁。革兰氏阳性菌噬菌体裂解酶的结构域相似, 裂解效率高, 与抗生素具协同抗菌作用, 且不易产生耐受性菌株, 抗体等体液因子对裂解酶的裂解活性影响小, 裂解酶作为一种潜在抗感染药物具有重要的研究价值。目前已建立了多种病原菌裂解酶应用的动物模型, 在防控耐药性病原菌感染上取得重要进展。本文就噬菌体裂解酶的抗菌作用进行综述。     

Isolation and partial characterization of Salmonella Gallinarum bacteriophage

Infections caused by Salmonella remain a major public health problem worldwide. Animal food products, including poultry meat and eggs, are considered essential components in the individual’s daily nutrition. However, chicken continues to be the main reservoir for Salmonella spp.Poultry farmers use several types of antibiotics to treat pathogens. This can pose a health risk as pathogens can build antibiotic resistance in addition to the possibility of accumulation of these antibiotics in food products. The use of phages in treating poultry pathogens is increasing worldwide due to its potential use as an effective alternative to antibiotics. Phages have several advantages over antibiotics; phages are very specific to target bacteria, less chances of developing secondary infections, and they only replicate at the site of infection.Here we report the isolation of a bacteriophage from chicken feces. The isolated bacteriophage hosts on Salmonella Gallinarum, a common zoonotic infection that causes fowl typhoid, known to cause major losses to poultry sector. The isolated bacteriophage was partially characterized as a DNA virus resistant to RNase digestion with approximately 20 Kb genome. SDS-PAGE analysis of total viral proteins showed at least five major bands (21, 28, 42, 55 and 68 kDa), indicating that this virus is relatively small compared to other known poultry phages. The isolated bacteriophage has the potential to be an alternative to antibiotics and possibly reducing antibiotic resistance in poultry farms.