On this date: Treating disease with disease
(WHTM) – On May 8, 2019, the world learned a 17-year-old girl in Britain, on the brink of death due to a severe infection, had been saved by injecting her with a disease.
Isabelle Carnell-Holdaway suffered from cystic fibrosis, a genetic disease that causes sticky mucus to build up in the lungs. Not only does the mucus make it hard to breathe, it’s a breeding ground for infection.
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In Isabelle’s case, she was infected by mycobacterium abscessus, a bacterium which was not only very dangerous, but had developed a resistance to antibiotics. At the age of 16, Isabelle’s only chance for life was a double lung transplant. But, after the surgery, the disease came back, and no drugs could help. Doctors gave her a one percent chance of survival.
Meanwhile, Isabelle’s mother, Joanne, had been searching the internet for alternative treatments and learned about phages.
The idea of using phages – viruses that attack and destroy bacteria – has been around for over a century. Phage-therapy treatments were being studied and used in the early 20th century, but were left out of mainstream medicine with the development of antibiotics. However, in the 21st century, with more and more bacteria becoming resistant to antibiotics, something new was needed – or in this case, something old.
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At Joanne’s suggestion, Isabelle’s doctors contacted phage researchers at the University of California San Diego, and Graham Hatfull, a professor of biological sciences at the University of Pittsburgh. Hatfull had a massive collection of Bacteriophages – over 15,000 samples.
Now they were up against one of the main problems with phage therapy. Unlike antibiotics, which will work against many diseases, phages will only attack one species of bacteria. The scientific teams had to search through thousands of phages, hoping to find one that would work against the disease killing Isabelle.
They found three.
But it took three months.
The Pittsburgh team developed the phage cocktail; the San Diego team advised on the treatment protocol. In June 2018 Isabelle’s doctors started administering the cocktail to her twice a day with an intravenous drip. Slowly, she began to heal. By the time news of her near-miraculous recovery came out in 2019, she was living a near-normal life, learning to drive and going to school.
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That’s where the stories from 2019 end. Some even said Isabelle was completely cured.
But along with the promise of phage therapy, Isabelle’s case would also demonstrate its shortcomings. Eventually, her mycobacterium abscessus bacteria began to mutate, becoming resistant to the phages she was given. New and different phages were needed. But a new cocktail didn’t arrive in time. Isabelle died on February 1, 2022.
But the treatment gave Isabelle three years she would not have otherwise had. Efforts to advance bacteriophage therapy continue, from combing the earth for new phages (one of the viruses for Isabelle’s treatment was found in a rotting eggplant) to compiling ever larger phage databases, to developing ways to sort through the databases faster, to finding more efficient ways to manufacture large quantities of phages to bring down costs, to trying to devise broad spectrum phages which will attack more than one kind of bacterium. In essence, a whole new medical infrastructure must be brought online for phage therapy to be successful.
However, with drug-resistant “superbugs” making antibiotics less useful, phages may emerge as the next major step in medical technology.
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