The Cold War on Phage Therapy
Colour-enhanced image of the bacteriophage T4
Emily Hufton looks at the history of bacteriophage research against the backdrop of the Cold War.
Much of the legacy of the Cold War is obvious today: it confirmed the US as a political powerhouse, dismantled communism across Eastern Europe, and claimed the lives of millions in proxy wars fought across the world. There were also huge benefits to science, especially in nuclear technology and space travel, as competing powers vied for supremacy. International political tension may also have prevented us from finding an alternative to antibiotics long before resistant infections began to claim 33,000 lives a year in the EU alone. One possible miracle cure that has been long overlooked by the West is the humble bacteriophage.
Bacteriophages are a type of virus that infects bacterial cells, where they may remain dormant or actively replicate. Following replication, the new phages are released, killing their hosts as the cells burst. The specificity of these phage-host interactions makes them a potentially potent agent in fighting off infections, and decreases the likelihood of resistance developing.
Even as scientists in the early 20th century debated the nature of bacteriophages - wondering whether they were viruses or bacterial enzymes - research into their potential therapeutic application was conducted. They were first used curatively in 1919 by the scientist instrumental in their discovery, Felix d’Herelle, enabling a 12 year old boy suffering from severe dysentery to make a remarkable recovery within a couple of days. Encouraged by similar results around the world, companies began to commercially manufacture these bacteriophages as treatments for bacterial infections.
Though biologists across the West were excited by the potential of phages, it was in Eastern Europe that research really took off. In 1923, the Eliava Institute of Bacteriophage, Microbiology and Virology was founded, devoted to the development of phage therapy. At its peak, the Institute employed 1,200 researchers and produced several tonnes of bacteriophage preparations against a whole range of bacterial infections. By the 1930s, these drugs were administered extensively to patients across the Soviet Union, treating everything from common complaints to potentially deadly infections.
Around this time, there were also great advances in Western antibiotic research, with Penicillin G made widely available in the US and Europe at the start of the 1940s. This seemed the final blow to interest in phage therapy in the West, where scientists had become dubious about its success. Not only were antibiotics considered a more promising avenue of research, researchers and doctors were more comfortable administering them to patients than the poorly understood bacteriophages. Whilst Russian scientists had isolated a distinct type of penicillin, (krustozin) this proved difficult to mass produce, and the West refused to grant the USSR production rights for the penicillin that had become vital to healthcare there. So Soviet biologists continued to channel their efforts into developing phage therapy, which became central to wartime treatments.
This rift between scientists in the West and East was fostered on both sides. In 1963, prominent American microbiologist Gunther Stent scathingly discussed the use of phage therapy in Japan, Germany, and other ‘out of the way places’. In a nation riddled with McCarthyism, antibiotic usage was fashionably patriotic. Interest in phage therapy declined even further, and none of the relevant Soviet literature was ever translated into English. Meanwhile, in the USSR, scientists were punished for expressing interest in Western scientific advances and methods, allowing Eastern Bloc researchers to continue developing phage therapy despite its dismissal elsewhere.
The fall of the Iron Curtain and the concerning rise in antibiotic resistance have now renewed Western interest in phage therapy. The early 2000s saw an immense increase in the number of companies interested in phages, from GangaGen in Bangalore to Itralytix in Baltimore and Phage Biotech in Rehovot. Despite a huge increase in clinical trials and several notable success cases, including the remarkable recovery of a patient given only a 1% chance of survival, has interest in this treatment come too late to prevent thousands of deaths from once treatable infections?