Hraiech Sami, Brégeon Fabienne, Rolain Jean-Marc
Institut Hospitalo-Universitaire Méditerranée Infection, URMITE CNRS IRD INSERM UMR 7278, Marseille, France ; Réanimation Médicale - Détresses Respiratoires et Infections Sévères, APHM, CHU Nord, Marseille, France.
Institut Hospitalo-Universitaire Méditerranée Infection, URMITE CNRS IRD INSERM UMR 7278, Marseille, France ; Service d'Explorations Fonctionnelles Respiratoires, APHM, CHU Nord, Marseille, France.
Drug Des Devel Ther. 2015 Jul 16;9:3653-63. doi: 10.2147/DDDT.S53123. eCollection 2015.
Pulmonary infections involving Pseudomonas aeruginosa are among the leading causes of the deterioration of the respiratory status of cystic fibrosis (CF) patients. The emergence of multidrug-resistant strains in such populations, favored by iterative antibiotic cures, has led to the urgent need for new therapies. Among them, bacteriophage-based therapies deserve a focus. One century of empiric use in the ex-USSR countries suggests that bacteriophages may have beneficial effects against a large range of bacterial infections. Interest in bacteriophages has recently renewed in Western countries, and the in vitro data available suggest that bacteriophage-based therapy may be of significant interest for the treatment of pulmonary infections in CF patients. Although the clinical data concerning this specific population are relatively scarce, the beginning of the first large randomized study evaluating bacteriophage-based therapy in burn infections suggests that the time has come to assess the effectiveness of this new therapy in CF P. aeruginosa pneumonia. Consequently, the aim of this review is, after a brief history, to summarize the evidence concerning bacteriophage efficacy against P. aeruginosa and, more specifically, the in vitro studies, animal models, and clinical trials targeting CF.
涉及铜绿假单胞菌的肺部感染是囊性纤维化(CF)患者呼吸状况恶化的主要原因之一。在这类人群中,反复使用抗生素治疗促使多重耐药菌株的出现,这使得迫切需要新的治疗方法。其中,基于噬菌体的疗法值得关注。在前苏联国家一个世纪的经验性使用表明,噬菌体可能对多种细菌感染具有有益作用。西方国家最近对噬菌体的兴趣再度兴起,现有体外数据表明,基于噬菌体的疗法可能对治疗CF患者的肺部感染具有重要意义。尽管关于这一特定人群的临床数据相对较少,但评估基于噬菌体疗法治疗烧伤感染的首个大型随机研究的启动表明,评估这种新疗法对CF铜绿假单胞菌肺炎有效性的时机已经到来。因此,本综述的目的是在简要介绍历史之后,总结有关噬菌体对铜绿假单胞菌疗效的证据,更具体地说,是针对CF的体外研究、动物模型和临床试验。