Rates of bacterial sexually transmitted infections (STIs) are skyrocketing in the US These growing cases of chlamydia, gonorrhea and syphilis are treated with antibiotics, but at a cost: Antibiotics Push bacteria to increase resistance to drugs.
So it’s important to find new ways to prevent STIs while also reducing our dependence on antibiotics. However, we are currently stuck in a bind.
A good example of this is doxycycline post-exposure prophylaxis, or “doxy-PEP“, an antibiotic regimen aimed at preventing STIs. The Centers for Disease Control and Prevention (CDC) will soon recommend it that doctors prescribe the antibiotic doxycycline (doxy) to people at risk so they can take it after unprotected sex. The hope is that this pre-treatment can provide relief STI rates skyrocket in the US.
Evidence shows that doxy-PEP may reduce the risk of chlamydia, syphilis, and gonorrhea in people, although it is least effective against gonorrhea, which is often resistant to doxycycline. However, some experts worry that doxy-PEP could increase antibiotic resistance over time.
Could there be a better option for STI prevention? Experts say we may one day use methods that kill bacteria virus called bacteriophage or bacteriophage. Currently, the use of phages to prevent STIs remains hypothetical, but they may one day help reduce the amount of antibiotics needed to prevent and treat STIs and thereby reduce the burden of antibiotic resistance. born.
“Phages alone probably won’t be able to meet all the needs” for antibiotics, Mikael Skurnik, a phage researcher at the University of Helsinki in Finland, told Live Science. He added that, in general, combination therapy Phages along with antibiotics have proven synergistic in treating bacterial infections, so these combination therapies may one day also be useful in preventing STIs .
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Advantages of ‘phage-PEP’
CDC’s draft recommendations on prescribing doxy-PEP will be Open for public comment until November 16. Assuming these are officially announced, some experts worry about the consequences of antibiotic resistance.
“When I hear the words ‘prophylaxis’ and ‘antibiotics,’ it’s scary,” he said. Sabrina Green, a phage researcher at KU Leuven in Belgium. She told Live Science that doxy-PEP may cause concern if used repeatedly. Showing validity to this concern, two doxy-PEP trials found that participants took the drug father or four on average once a month.
With the threat of antibiotic resistance on the rise, some researchers are turning to bacteriophages. These are viruses that infect bacteria, multiply inside them and cause them to flare up. “Each infected bacterium releases, over the phage life cycle, about 100 to 200 new phage particles,” Skurnik said. This, he says, will add to the phage army until the bacterial population drops enough for the immune system to clear the infection.
Clinical applications for phage therapy are currently very limited. In America, there are very few clinical trials related to phages and viruses are usually only used when No other treatments have worked. But in some European countriesPhage therapy may be used for less serious infections.
If trials can confirm the safety and value of phage therapy seen so far with its limited use, it could one day provide a powerful alternative to antibiotics. And there are several reasons why phages might produce a better prophylactic effect than antibiotics like doxy-PEP.
One advantage is that phages can Kill non-resistant and drug-resistant bacteriawhile the tests showed doxy-PEP is not effective against drug-resistant gonorrhea strains. Additionally, because of the dual effects of bacteriophages and antibiotics in combination therapies, lower doses of antibiotics are needed to treat infections, Skurnik noted.
Another strength is that the phages will not pressure bacteria to evolve resistance to doxycycline or other antibiotics, as both Green and Skurnik worry might happen with doxy-PEP.
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Bacteria do mechanism of gene exchange with each other, allowing bacteria to share resistance to broad-spectrum antibiotics. Furthermore, bacteria tend to exchange antibiotic resistance gene cluster, so overuse of one antibiotic can lead to multi-drug resistance. However, phage resistance tends to involve genes that are specific to a bacterial species and are often not exchanged, making it impossible for bacteria to evolve or spread resistance against multiple phages.
That said, bacteria can evolve resistance to individual phages, therefore mixture of different phages may be necessary to prevent bacteria from escaping.
Compared to antibiotics, phages are also less likely to disturb the microbiome – the community of microorganisms that live inside us – because they often destroy a species or strain of bacteria. On the other hand, Doxycycline is one broad-spectrum antibiotics eliminates many beneficial bacteria and may allow opportunistic bacteria to proliferate unchecked.
“Sometimes yeast can dominate,” Skurnik notes. For example, Candida, a usually harmless fungus that can cause an infection called thrush after treatment with doxycycline. It’s difficult to draw firm conclusions about the safety of phages given their limited use, but by eliminating antibiotics, viruses could theoretically help avoid health concerns accompanied by disruption of the microflora.
Barriers to using phage-PEP
Several obstacles hinder the use of phage therapy for sexually transmitted diseases.
For example, chlamydia replicates only in the body’s cells. Inserting phages into human cells rather than free-floating bacteria is technically difficult, but some groups have experimented with encapsulating phages in human cells. Fat bubbles are called liposomes easily penetrates cells.
But the bigger problem is that, although researchers several phages have been found effective against bacterial STIs, but they haven’t found enough to make a phage cocktail. However, less than 0.0002% of phages worldwide have been sampled, suggesting that many samples with clinical value remain undiscovered. Phage research tends to favor well-studied, easy-to-grow model bacteria, rather than bacteria that cause STIs, Skurnik notes, and some phages are known to target to bacterial STIs has not been widely studied.
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If scientists can’t find the bacteriophage that infects the bacteria that cause STIs, phage technique can offer a solution. For example, a number of phages that target gonorrhea exist called prophecy, meaning they silently incorporate their genes into the bacteria for a period of time before replicating and separating from their host. Green said it is possible to create prophecies so that they destroy their hosts instantly.
“Using artificial intelligence and engineering, you can create in the laboratory a diverse range of phages, which can then cover most of these bacterial pathogens,” Skurnik said.
But again, phage therapies to prevent STIs are still a long way off, and the doxy-PEP sparks are causing concern at the moment.
“This concerns me as a microbiologist,” Green said, adding that people taking doxy-PEP should be closely monitored to monitor for resistance. “We haven’t perfected phage therapy for these types of infections, and if they become resistant, they really don’t have any other options,” she warns.
This article is for informational purposes only and is not intended to provide medical advice.
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