Abstract

Numerous pre-clinical and clinical studies have recently demonstrated the significant role of phage therapy in treating multidrug-resistant bacterial infections. However, only a few researchers have focused on monitoring the phage-mediated adverse reactions during phage therapy. Besides adverse reactions, immunological response after short- and long-term oral administration of bacteriophages is also lacking. In this study, we administered the bacteriophages orally against Klebsiella pneumoniae XDR strain in dosages of 1015 PFU/ml and a 1020 PFU/ml (still higher) to Charles Foster rats as a single dose (in acute toxicity study) and daily dosage for 28 days (in sub-acute toxicity study). One milliliter suspension of bacteriophages was administered through the oral gavage feeding tube. No adverse effect was observed in any of the experimental as well as in the control animals.Further, an insignificant change in food and water intake and body weight was observed throughout the study period compared with the control group rats. On the 28th day of phage administration, blood was collected to estimate hematological, biochemical, and cytokines parameters. The data suggested no difference in the hematological, biochemical, and cytokine profile compared to the control group. No significant change in any of the treatment groups could be observed on the gross and histopathological examinations. The cytokines estimated, interleukin-1 beta (IL-1β), IL-4, IL-6, and INF-gamma, were found within the normal range during the experiment. The results suggested no adverse effect, including the severe detrimental impact on oral administration of high (1015 PFU/ml) and very high dose (1020 PFU/ml) of the bacteriophages cocktail. The high and long-term oral administration of bacteriophages did not induce noticeable immunological response as well.

Highlights

  • The emergence of multi-drug resistant bacteria has forced humankind to look for alternatives to antibiotics

  • G: Group; G1: Normal control (TMG); G2: Medium oral dose of bacteriophage (1015/ml), and G3: High oral dose of bacteriophage (1020/ml); All the values are presented as mean ± standard error of the mean (SEM) (n 6)

  • Majority of the isolates showed resistant to multiple drugs, and these were selected for bacteriophage isolation

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Summary

Introduction

The emergence of multi-drug resistant bacteria has forced humankind to look for alternatives to antibiotics. In the recent time alternative approaches have focused on the development of different biologicals that includes 1) passive immunization with pathogen-specific immunoglobulin preparations, 2) induction of a pathogen-specific memory response through vaccination, 3) immune-stimulatory agents leading to potentiation of host immune response facilitating clearance of the extracellular and intracellular infecting microbe, and 4) elimination of pathogenic bacteria by using lytic bacteriophages (Zumla et al, 2016; Luepke et al, 2017). These bacteriophages (or phages) infect and promote bacterial lysis via a multi-step process of replication. Avian influenza A (H5N1) causing severe respiratory disease in humans reported with immune response by increasing inflammatory cytokine and chemokine production (de Jong et al, 2006; Lam et al, 2011)

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