Herbal medicine: "A viral cocktail saved the life of my daughter"

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Jo Carnell Holdaway

An experimental cocktail of viruses saved the life of a teenager with a life-threatening and seemingly incurable infection.

Isabelle's body was attacked by a bacterium and was given less than 1% chance of survival.

But doctors at Great Ormond Street Hospital have tried an untested "phage therapy," which uses viruses to infect and kill bacteria.

Isabelle is now learning to drive and is studying for her bachelor's degree.

Experts said the case was "extremely exciting" and showed the potential for treating other dangerous infections with phage.

What are phages?

They are the microbial incarnation of the adage: "The enemy of my enemy is my friend".

Phage, also called bacteriophages, are a type of natural virus that infects bacteria rather than the body's own cells.

Resembling sinister extraterrestrials, they land on the surface of a bacterium and inject their own genetic code.

This diverts the bacterial cell and turns it into a phage plant until the viruses eventually burst out of the cell.

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Why did Isabelle need it?

Isabelle Carnell-Holdaway was born with cystic fibrosis. This causes sticky mucus to form in the lungs, which can harbor dangerous infections.

A parent of TB – Mycobacterium Abcessus – infected her body and she needed powerful antibiotics to control it.

At the age of 16, she needed a double lung transplant, but the bacteria still hid in her body.

When she started taking immunosuppressive drugs to prevent her from rejecting the transplant, the infection came back.

Helen Spencer, her doctor, said: "For patients with growth regrowth mycobacterium after our experience, after the transplant, all died and died.

"For some patients, it's been less than a year despite aggressive treatment."

Isabelle had large black and purulent lesions forming on her skin, where the infection began.

And she found herself in intensive care when her liver started to deteriorate, with large colonies of bacteria forming in her body.

The doctors said that they could not do anything and that Isabelle had less than 1% chance of survival.

Her parents decided to take her home where she would be surrounded by her family.

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Where does the experimental treatment come from?

The idea of ​​attempting phage therapy came from Isabelle's mother, Jo, who had been looking for alternatives on the Internet.

The Great Ormond Street team contacted Professor Graham Hatfull of the Howard Hughes Medical Institute in the United States, who had the largest collection of phages in the world.

He had about 15,000 flasks of phage, but it took months to determine which combination of phages could act against Isabelle's infection.

The US team has opted for three phages, two of which are genetically modified to make them more effective.

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Nature Medicine

The therapy was injected into his blood twice a day and applied to the skin lesions, according to the journal Nature Medicine.

How were the results?

Isabelle's mom, Jo, noticed the difference in a few weeks. She does not doubt that her daughter's life has been saved by viruses.

Isabelle's lesions began to heal and some wounds opened for months began to close.

Jo told BBC News: "When we left the hospital, she literally looked like a skeleton with her skin, so poor she was.

"It was absolutely amazing the effect of the phage on her.

"She has found her life, that of a 17-year-old girl."

Isabelle returned to school in September, completed her GCSE mathematics course, and is now studying for her undergraduate degree.

She also learns to drive.

She told the BBC: "It's an amazing thing, it's still working slowly, it's great to be able to do all these things on my own without having problems."

Is she cured?

The deadly infection of Isabelle has not been completely cured, but she is under control.

She always receives two infusions of the viral cocktail every day.

And the family is waiting for a fourth phage to be added to the mix in order to get rid of the infection completely.

Dr. Spencer told BBC News: "It's really amazing, but also sad when I think of all the patients who did not survive, because the treatment was not available in time for them."

The story of Isabelle is remarkable, but it is only one case.

Technically, scientists can not be certain of the effectiveness of phage without performing clinical trials.

Dr. Spencer added, "We need to be very careful when extrapolating an individual case to other patients and what it might mean for them.

"But I think it encourages future research on phage therapy for some of these resistant bacteria that really concern us."

Is phage therapy new?

No, some doctors have been using phages for almost a century.

The field developed in Georgia and in other countries of the former USSR, but has never become a traditional medicine.

Phagotherapy has been overshadowed by the discovery of antibiotics, much easier to use.

An antibiotic can act on a wide range of bacterial infections, while phage therapy requires finding the precise phages that will attack each infection.

But now, phage therapy is resuming because of the proliferation of superbugs resistant to antibiotics.

What does this mean for other infections?

That's the big question and for now, there is no clear answer.

Professor Graham Hatfull, Howard Hughes Medical Institute, said: "We are in some unknown territory.

"The idea is to use bacteriophages as antibiotics, as a way that we could use to kill the bacteria that cause the infection."

But to use the phages more widely, the phages should be well adapted to the infection of the patient.

Professor Martha Clokie, phage researcher at the University of Leicester, told BBC News: "I think this work is extremely exciting.

"This shows how bacteriophages can be successfully developed as therapeutics even in very difficult circumstances where bacteria are resistant to many antibiotics and bacteria are difficult to treat.

"I think this will pave the way for other studies of the same kind and will facilitate the completion of the necessary tests on bacteriophages, so that they can be used more widely to treat humans."

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