Introduction to Phage Therapy
Antibiotics have been the workhorses of modern medicine, but their success has fueled a dangerous rise in drug-resistant bacteria. Scientists at Baylor University and other research centers are launching a counterstrike using viruses and artificial intelligence.
Baylor announced this month that it and the other institutions have received a five-year award of up to $28 million from the Advanced Research Projects Agency for Health to test whether bacteriophages — viruses that attack and infect bacteria — can help rebalance the microbiome, or the community of bacteria, fungi and viruses that live in and on the body.
The project will be led by the University of Illinois Urbana-Champaign and other collaborators include Boston-based Ginkgo Bioworks, the University of Minnesota, Oregon State University and Oregon Health & Science University.
“Our long-term goal is to usher phage-based therapeutics into mainstream medicine as routine and widely accessible treatments,” said Asma Hatoum-Aslan, an associate professor of microbiology at the University of Illinois Urbana-Champaign who is leading the project, in a news release.
Potential Risks of Antibiotic Overuse
Antimicrobial resistance is a global public-health threat, driven in part by antibiotic overuse. Each year in the United States, there are more than 2.8 million drug-resistant infections and more than 35,000 deaths as a result, according to estimates from the Centers for Disease Control and Prevention. Worldwide, the number of deaths from these infections is predicted to rise dramatically and reach 39 million by 2050, according to a recent study.
A recent report from the World Health Organization found that in 2023, roughly 1 in 6 infections tested by labs worldwide were resistant to antibiotic treatment. The report also mentioned that 40% of drugs used to treat common urinary, gut, blood and sexually transmitted infections lost effectiveness from 2018 to 2023.
Antibiotics kill bacteria indiscriminately, even the beneficial ones, by targeting critical structures or jamming essential cellular machinery. But bacteria evolve workarounds, such as altering drug targets with mutations, swapping resistance genes, deploying enzymes or using chemical pumps that break down or spit out antibiotics.
How Phage Therapy Works
Bacteriophages only target specific bacteria, which makes phage therapy an attractive option for hard-to-treat infections, especially those caused by multidrug-resistant bugs. The first U.S. use of this therapy was in 2016 in a patient with a life-threatening, multidrug-resistant infection. Phage therapy is not federally approved or widely available and is currently employed under compassionate use, which lets a patient with a life-threatening condition get an experimental drug or device outside of a clinical trial.
Electron micrographs of bacterial viruses, also known as phages. Courtesy of Asma Hatoum-Aslan’s lab at the University of Illinois Urbana-Champaign.
University of Illinois Urbana-Champaign
Phage Therapy for Oral Care
Scientists believe viruses are 10 million times more numerous than all the stars in the visible universe. That’s partly why finding the right bacteriophages for specific bacteria is slow and tricky. Clinicians often start by testing phages from existing collections against bacteria taken from a patient to determine their effectiveness. A 2020 study found the timeline from requesting a phage therapy to administering it to a patient can stretch anywhere from 28 to 386 days.
The project aims to speed up that process by using artificial intelligence and machine learning to rapidly spot phage–bacteria pairings and assemble potent combinations. The first targets will be the oral microbes that cause tooth decay and gum disease — conditions linked to higher risks of cardiovascular disease, Type 2 diabetes and some cancers.
The photo shows the bacteria Streptococcus and a human white blood cell interacting.
Associated Press
Researchers Involved in the Project
Aaron Wright, a professor at Baylor University, will help zero in on promising viral candidates. His lab maps the proteins and small molecules that mark harmful shifts in the microbiome. Wright and scientists from New York received $5.6 million in 2024 from the National Institutes of Health to advance personalized fecal microbiome transplants for gut conditions such as irritable bowel syndrome, Crohn’s disease and ulcerative colitis.
