Abstract
Graft-versus-host disease, both acute and chronic (aGvHD, cGvHD) remains a major complication in patients undergoing hematopoietic cell transplantation (HCT) and a significant therapeutic challenge, as many patients do not respond adequately to presently available therapy. Increasing antimicrobial resistance has greatly revived interest in using bacterial viruses (phages) to combat antibiotic-resistant bacteria. In recent years, evidence has accumulated indicating that phages also have anti-inflammatory and immunomodulatory activities. This article suggests how these anti-bacterial and immunomodulatory activities of phages may be translated into a novel treatment of acute GvHD.
Highlights
AGvHD is recognized as the most common serious complication after hematopoietic cell transplantation (HCT)
A review of other available data on anti-inflammatory and immunomodulating effects of phages presented in this article suggests that PHAGE THERAPY (PT) could bring benefits to patients with cGvHD
To obtain some preliminary data, a clinical trial of PT in inflammatory bowel diseases (IBD) would be prudent before initiating such trials in immunosuppressed patients with aGvHD
Summary
AGvHD is recognized as the most common serious complication after hematopoietic cell transplantation (HCT). It results from immune attack of T cells contained in the graft which recognize foreign tissues of the recipient, activating the lymphocytes, which subsequently mount an immune response against the grafted cells. Immunobiology and therapy of aGvHD have been discussed in detail [1, 2]. While corticosteroids remain the mainstay of treatment, a substantial percentage of patients fail to respond (31% of standard risk patients and 57% of high-risk patients). Several second-line therapies are available, their value still remains uncertain, so the outcome of such steroid-resistant patients is poor [2, 3].
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