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Phage Therapy: What Have We Learned?
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Viruses 2018, 10(6), 323;

Phage Therapy Faces Evolutionary Challenges

University of Reunion Island, UMR Plant populations and bio-agressors in tropical environment (PVBMT), Saint-Pierre 97410, Reunion, France
Received: 18 May 2018 / Revised: 9 June 2018 / Accepted: 12 June 2018 / Published: 12 June 2018
(This article belongs to the Special Issue Hurdles for Phage Therapy (PT) to Become a Reality)
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Antibiotic resistance evolution in bacteria indicates that one of the challenges faced by phage therapy is that, sooner or later, bacteria will evolve resistance to phages. Evidently, this is the case of every known antimicrobial therapy, but here this is also part of a ubiquitous natural process of co-evolution between phages and bacteria. Fundamental evolutionary studies hold some clues that are crucial to limit the problematic process of bacterial resistance during phage applications. First, I discuss here the importance of defining evolutionary and ecological factors influencing bacterial resistance and phage counter-defense mechanisms. Then, I comment on the interest of determining the co-evolutionary dynamics between phages and bacteria that may allow for selecting the conditions that will increase the probability of therapeutic success. I go on to suggest the varied strategies that may ensure the long-term success of phage therapy, including analysis of internal phage parameters and personalized treatments. In practical terms, these types of approaches will define evolutionary criteria regarding how to develop, and when to apply, therapeutic phage cocktails. Integrating this perspective in antimicrobial treatments, such as phage therapy, is among the necessary steps to expand its use in the near future, and to ensure its durability and success. View Full-Text
Keywords: phage therapy; evolution; bacterial resistance; virulence phage therapy; evolution; bacterial resistance; virulence

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Torres-Barceló, C. Phage Therapy Faces Evolutionary Challenges. Viruses 2018, 10, 323.

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