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Comment by rvba | Hacker News Reader

Why nobody is investing serious money into bacteriophages?

It seems only russia shows some interest in them - ans mostly for military purposes

IIRC the most usage is romania and bulgaria(?), not russia.

As to why not, they dont “scale out” like other generalized pharmaceuticals or medicine. Phages need a bunch of patient specific diagnostics and revision to be effective against the specific target. Thats why you see people fly to romania for a month of treatment, and not order the bacteriophages from romania.

This isn't terribly different than the latest precision medicine in the US. For example, drugs like Keytruda can only be used in the presence or absence of certain genetic markers in the tumor. Most cutting edge immunotherapy is similar; they require patient specific diagnoses and sometimes revisions.

These therapies are the largest focus of cancer research in the US right now with enormous funding behind them, despite having the same weaknesses you point out as bacteriophages.

Do bacteriophages work against cancer?

Not in themselves. But they can apparently be used as a delivery mechanism in cancer related gene therapy.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9697857/

> Thats why you see people fly to romania for a month of treatment

I had no idea people did this!

What kind of diseases do people have who go for such treatments?

The cases I've heard of were all antibiotic-resistant infections.

"The Good Virus", by Tom Ireland, is an entertaining book about bacteriophage therapies, their history, and why they're difficult to scale up.

Now I wonder, how do you fly to Romania while infected with MRSA? Med evac only, or can you board a commercial flight?

Note that "MRSA is endemic in the United States, with the CDC estimating a 2% rate of carriage in the general population".

I'm not sure what questions get asked on entry to Romania...

Well in this case the bacterium is (accounting for mutations which might happen) more or less the same, not some antibiotic-resistant "super-bug". But I guess most phage research has gone into phages that attack bacteria which cause disease in humans, not in trees, so some further research would be needed? And such research seems to be indeed going on: https://pmc.ncbi.nlm.nih.gov/articles/PMC3911242/ "We report the isolation and characterization of the first virulent phages for X. fastidiosa, siphophages Sano and Salvo and podophages Prado and Paz, with a host range that includes Xanthomonas spp."

Plenty of companies research phages. They're just not that great for practical purposes because they are often strain-specific. Bacteria also evolve resistance to them easily.

The USSR's "research" was not great either. It mostly consisted of practical methods of evaluating environmental samples and concentrating/purifying phages.

>It seems only russia shows some interest in them

Used to show interest. Since the breakup of the Soviet Union, most of that's just been a dumpsterfire.

Because you need to fight the cause, not the effect.

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