Viruses That Consume Bacteria Heal Diabetic Foot Ulcers

Not Just Cold Feet

There is quite a long list of potential health complications for those people living with diabetes – especially long-term patients. One of the most concerning is diabetic neuropathy, usually described as numbness or a loss of sensation in the feet. It is caused by decreased blood flow to the feet and nerve damage. In later stages, some patients with neuropathy experience extreme pain and sensitivity that has been described as “walking on broken glass that is on fire.” It is estimated that between 15%-25% of people with diabetes experience foot ulcers; of them, 40% – 80% become infected and ultimately contribute to the cause of death. (1)

Diabetes can make even minor problems like blisters and infections very dangerous. People who have diabetes can lose a foot or even die if they don’t get treatment quickly enough.

A Viral Solution

Finding effective treatments for neuropathy and diabetic foot ulcers that can occur has been an ongoing challenge for scientists. Traditionally, antibiotics have been used, but bacterial resistance to the treatment has become an issue. It is where a new kind of treatment using viral therapy is showing great promise. There is a group of viruses called bacteriophages (or just phages), which prey on bacteria. It was discovered in the early 1900s by Frederick Twort and Felix d’Herelle, who used phage therapy to treat dysentery. The success of this study led to a wider exploration of uses for phage therapy. In fact, for many parts of the world (including the former Soviet Republic of Georgia and Poland), phage therapy is often the standard of care for bacterial infections. In the U.S. and other western medical communities, the discovery of antibacterial therapy would set the standard for treatment. (2)

There are many benefits to using phage therapy. One is that it is more specific in terms of the bacterial targets. Another is how diverse it is in terms of its application across various infections. Phage therapy has also been shown to heal wounds faster and has lower side effects. (3) 

This past year, a group of researchers with Australia’s Flinders University used phages to treat diabetic foot ulcers. “The phages effectively decreased the bacterial load and significantly improved wound healing in multi-drug resistant infections – similar or superior to the currently prescribed antibiotic treatment.” Given the prevalence of antibiotic resistance, this study presents a new way of approaching a dangerous infection that kills many patients worldwide each year. There is no way to truly measure how much this treatment can help a patient’s mental and physical health and how much money it will save them in the long run. (4) 

Phages in the Future

Phage therapy has a long history that has been ignored by much of the Western medical community. Like the one from Australia mentioned above, most studies have used animal models to evaluate the effectiveness of phage treatment and show great promise. More research has to be done, specifically on humans, but the results, so far, are promising. (4)

There are already studies looking at applying this technology to treat pneumonia, foodborne bugs, or even food poisoning symptoms. Much of the research so far has been limited to animals. So the next step is to begin safely studying how phage therapy can be used with humans. Specifically, the different phage strains should be studied for their effectiveness and to identify which phages, in combination, can treat specific diseases and infections. (5)

References:

1. Dunya-Remy, C., et al. Staphylococcus aureus toxins and diabetic foot ulcers: role in pathogenesis and interest in diagnosis. Toxins 2016 Jul: 8(7): 209. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963842/
2. Abedon, S. T., Kuhl, S.J., Blasdel, B.G., Kutter, E.M. Phage treatment of human infections. Bacteriophage. 2011 Mar-Apr; 1(2): 66-85. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278644/
3. Chan, Benjamin, K., Abedon, Stephan, T., Loc-Carillo, Catherine. Phage cocktails and the future of phage therapy. Future Microbiology. May 23, 2013. Vol. 8, No. 6. https://www.futuremedicine.com/doi/full/10.2217/fmb.13.47
4. Moghadam, M.G., Khoshbayan, A., Changing, Z., Farahani, I., Shariati, A. Bacteriophages, a new therapeutic solution for inhibiting multidrug-resistant bacteria causing wound infection: a lesson from animal models and clinical trials. Drug Design, Development and Therapy. 2020 May 15; 14: 1867-1883. https://pubmed.ncbi.nlm.nih.gov/32523333/
5. Kifelew, L. G. et al. Efficacy of phage cocktail AB-SA01 therapy in diabetic mouse wound infections caused by multidrug-resistant staphylococcus aureus. BMC Microbiology. 2020; 20: 204. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346408/