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用于治疗尿路感染的噬菌体疗法:进展与未来挑战

Phage Therapy for Urinary Tract Infections: Progress and Challenges Ahead.

作者信息

Morgan Chase J, Atkins Haley, Wolfe Alan J, Brubaker Linda, Aslam Saima, Putonti Catherine, Doud Michael B, Burnett Lindsey A

机构信息

School of Biological Sciences, Division of Molecular Biology, University of California San Diego, La Jolla, CA, 92093, USA.

Bioinformatics Program, Loyola University Chicago, Chicago, IL, USA.

出版信息

Int Urogynecol J. 2025 May 13. doi: 10.1007/s00192-025-06136-8.


DOI:10.1007/s00192-025-06136-8
PMID:40358692
Abstract

INTRODUCTION AND HYPOTHESIS: Urinary tract infection (UTI) treatment is a growing public health concern owing to increasing antimicrobial resistance. Phage therapy, an alternative or adjunctive treatment to antibiotics, has the potential to address this challenge. However, clinical use of phage therapy is hindered by knowledge gaps and inconsistent reporting. The objective was to review the current state of phage therapy for UTIs and highlight research priorities that can optimize phage clinical efficacy. METHODS: Current literature on UTI phage therapy was examined, focusing on the lack of standardized phage susceptibility testing, phage characterization, and microbiological assessments during and after treatment. RESULTS: Critical areas requiring further investigation include appropriate phage dosing, optimal routes of administration, and the dynamics of phage-host and phage-patient interactions. The influence of the urinary microbiome, including endogenous phages, on treatment outcomes also needs to be better understood. Suggested data collection and reporting standards should be developed and implemented to improve clinical impact of studies examining phage therapy for UTI. Randomized clinical trials are needed to establish efficacy and determine the best practices for clinical use. CONCLUSION: Phage therapy is a promising alternative to antibiotics for managing UTIs, especially in the face of rising antimicrobial resistance. To fully realize its potential, however, future research must focus on standardized protocols, dosing strategies, and the role of the urinary microbiome, with an emphasis on rigorously conducted clinical trials. These steps are essential for integrating phage therapy into mainstream UTI treatment regimens.

摘要

引言与假设:由于抗菌药物耐药性不断增加,尿路感染(UTI)的治疗成为日益受到关注的公共卫生问题。噬菌体疗法作为抗生素的替代或辅助治疗方法,有潜力应对这一挑战。然而,噬菌体疗法的临床应用受到知识空白和报告不一致的阻碍。目的是回顾目前UTI噬菌体疗法的现状,并强调可优化噬菌体临床疗效的研究重点。 方法:研究了关于UTI噬菌体疗法的现有文献,重点关注缺乏标准化的噬菌体敏感性测试、噬菌体特性鉴定以及治疗期间和治疗后的微生物学评估。 结果:需要进一步研究的关键领域包括合适的噬菌体剂量、最佳给药途径以及噬菌体 - 宿主和噬菌体 - 患者相互作用的动态变化。还需要更好地了解泌尿微生物组(包括内源性噬菌体)对治疗结果的影响。应制定并实施建议的数据收集和报告标准,以提高研究噬菌体疗法治疗UTI的临床影响力。需要进行随机临床试验以确定疗效并确定临床使用的最佳实践。 结论:噬菌体疗法是治疗UTI的一种有前景的抗生素替代方法,尤其是在抗菌药物耐药性不断上升的情况下。然而,为了充分发挥其潜力,未来的研究必须专注于标准化方案、给药策略以及泌尿微生物组的作用,重点是严格开展的临床试验。这些步骤对于将噬菌体疗法纳入主流UTI治疗方案至关重要。

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[1]
Phage Therapy for Urinary Tract Infections: Progress and Challenges Ahead.

Int Urogynecol J. 2025-5-13

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本文引用的文献

[1]
Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050.

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[2]
Safety, pharmacokinetics, and pharmacodynamics of LBP-EC01, a CRISPR-Cas3-enhanced bacteriophage cocktail, in uncomplicated urinary tract infections due to Escherichia coli (ELIMINATE): the randomised, open-label, first part of a two-part phase 2 trial.

Lancet Infect Dis. 2024-12

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The antibiotic resistance crisis and the development of new antibiotics.

Microb Biotechnol. 2024-7

[4]
An intron endonuclease facilitates interference competition between coinfecting viruses.

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Longitudinal alterations in the urinary virome of kidney transplant recipients are influenced by BK viremia and patient sex.

Microbiol Spectr. 2024-8-6

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Nat Microbiol. 2024-6

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Nat Commun. 2024-5-10

[8]
Lytic bacteriophages induce the secretion of antiviral and proinflammatory cytokines from human respiratory epithelial cells.

PLoS Biol. 2024-4-23

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Bacterial Vaccines for the Management of Recurrent Urinary Tract Infections: A Systematic Review and Meta-analysis.

Eur Urol Focus. 2024-9

[10]
DNA-targeting short Argonautes complex with effector proteins for collateral nuclease activity and bacterial population immunity.

Nat Microbiol. 2024-5

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