Forgotten Cure Part Two

1. How did having a state health system influence the treatment of infectious disease in 1940s-50s Russia?

The state health system was underfunded, so while it tried to provide health care for all, it was often short on resources (like money and antibiotics). This was an embarrassment to the Soviet Union, so it relied on propaganda to discourage the use of antibiotics to treat infectious disease. This propaganda encouraged citizens to rely on alternative medicines like herbs, and because phage therapy was also considered alternative medicine, it became more popular as a treatment for infectious disease during that time.

2. The Hirszfeld Institute is also intertwined with Russian history. A tragic quote is given on page 66 by Hirszfeld about the death of his daughter. Even so, the outcome of these 2 centers has been very different. Discuss why you think this is so. Contrast the Phage Therapy Center in Wroclaw with the Eliava Institute in Tbilisis.

The Phage Therapy Center might have succeeded where the Eliava Institute did not because of the differences in their founding, focus, and support. The Phage Therapy Center was supported by the Polish government after the end of World War 2 and became better established afterward. The Eliava Institute, by contrast, lost funding towards the end of world war 2 and focused more on phage. The two different political climates surrounding these institutions can account for the differences in what happened to them.

3. Research in the USA often differs from other countries because of regulations by the FDA and private investments. Describe the experimental design that Merril used to determine how to select for phages that were not removed by the liver and spleen. Review the Merril, Carlton, and Adhya PNAS paper, focusing on interpreting their figures.

For his experimental design, Merril injected lambda phage into mice and tested for the presence of phage in the blood after 7 hours. He then selected the remaining phage from the parent testing and used serial-passage techniques to select the phages Argo 1 and Argo 2 that survived longer than the original parent lambda phage (around 18 hours). This was done by selecting the remaining phage and reinjecting the mice 8 times. As can be seen in the figures below, Argo 1 and Argo 2 persisted in the blood longer that the wild type at high concentrations.

These passaged phages were then used in another experiment to demonstrate their effectiveness against E. coli. Four groups of mice were infected with a lethal dose of the bacteria and three were treated with phage (Argo 1, Argo 2, or wild-type phage) and one was left as a control. The ones treated with phage were more likely to survive, and Argo 1 and Argo 2 phage treatments seemed to lessen the disease severity.

4. The most convincing argument for using phage is tied to the increasing problem of antibiotic resistance. Even so, many still consider phage therapy an alternative therapy. Chapter 8 describes several start-up companies: Phage Therapy, Phage Biotics, GangaGen, Exponential Biotherapies. Research these companies and discuss the potential for phage therapy in modern Western medicine. What experiments need to be done?

Personally, I think that for phage therapy to lose the label of alternative medicine and be fully embraced by Western Medicine science alone will not be sufficient. I think that Phage Therapy in the west has been hurt by associations with eastern medicine and the soviet union. I think that double-blind experiments do need to be done and continued, but I also think prominent western scientists will need to lend their support to phage therapy. In addition to a bit of a PR campaign, more experimental data showing the use of phage and antibiotics together to combat antibiotic resistance would be beneficial. Finally, what I found to be most intriguing was mention in the book, the author said that many bacteria that developed a resistance to phage seemed to mutate into a harmless, avirulent form of the bacteria. If there could be experiments done that showed that bacteria tended to become avirulent when becoming resistant to phage not only would that revolutionize how we treat disease, but it would also help phage therapy.