Académie royale de Médecine de Belgique

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Vidéo et résumé Jean-Paul Pirnay


PHAGE THERAPY RESEARCH AT THE BRUSSELS MILITARY HOSPITAL  

par Jean-Paul PIRNAY (Laboratoire de technologie moléculaire et cellulaire de l’Hôpital militaire Reine Astrid de Bruxelles), invité.

In 2003, a first phage therapy related study proposal was submitted to the R&D department of Belgian Defense. It was dismissed as mere “science fiction” with a score of 8/20.

Fifteen years later, however, phage therapy has become commonplace in the Queen Astrid military hospital (QAMH). Phage therapy research in the QAMH encompasses diverse aspects :

i)    The isolation, selection, characterization and production (in cleanrooms) of therapeutic phages active against clinically important pathogens such as Acinetobacter baumannii (PMID: 25111143), Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli, including the O104:H4 strain from the 2011 foodborne EAHEC outbreak in Germany (PMID: 23285164).

ii)    Clinical trials:

    A small clinical safety study (PMID: 25356373): 10 applications of phage cocktail BFC 1 (PMID: 19300511), active against P. aeruginosa and S. aureus, in burn wound infections.

    PhagoBurn (www.phagoburn.eu), funded by the European Commission: Evaluating phage therapy for the treatment of burn wounds, infected with P. aeruginosa, through a randomized controlled trial (PMID: 30292481).

iii)  Study of the bacterium-phage (host-parasite) relationship, with an emphasis on bacterial phage resistance evolution and the development of adequate treatment protocols (PMID: 22660719, PMID: 26476097).

iv)  Under the umbrella of article 37 (unproven interventions) of World Medical Association’s “Declaration of Helsinki,” a number of patients with multidrug resistant infections were treated with phages in the Brussels military hospital (PMID: 28583189, PMID: 30884879).

v)   Elaboration of a dedicated regulatory framework for phage therapy, involving magistral phage preparations and including realistic production and QC/QA regimens (PMID: 21063753, PMID: 25585954, PMID: 29415431).

This presentation will give an overview of the evolution of phage therapy from "science fiction" to established therapy in the QAMH, and in Belgium in general.