The human microbiome is emerging as a target for treating a wide range of diseases, but it’s still a young field and there are lots of unknowns. Philip discussed with the CEO of BiomX whether phages may be the key to targeting specific bacterial strains in the microbiome.
In the last decade, scientists have found that the human microbiome plays a huge role in our health, as well as in a variety of diseases from diabetes to cancer and Alzheimer’s. As evidence linking the microbiome to our health continues to grow, so has the biotech industry’s interest in developing treatments that target the gut microbiome’s bacteria.
Still, the microbiome field is at an early stage and few companies worldwide have reached the clinical stage. One of the key challenges now is developing methods that can only target the specific microorganisms causing damage without harming those that are essential to our health.
One way of doing this is using bacteriophages, or phages for short, which are viruses that have evolved over millions of years to attack specific strains of bacteria. Phage therapy is actually quite an old concept developed in the early 20th century in Russia as an alternative to antibiotics. It’s only been in recent years that it has become of interest in Western countries.
Now, some biotechs are using phages to replace antibiotics or treat irritable bowel disease (IBD). However, selecting effective bacterial targets for phage therapies is no easy task. Nestlé, for example, has had difficulty developing a phage therapy for diarrhea.
“There is a lot of uncertainty [with phage treatments], but the modality is extremely potent in mouse models”, says Jonathan Solomon, co-founder of BiomX, an Israeli biotech developing phage therapy for IBD. “It’s not enough to understand specific species [of bacteria], you need to understand things on the strain level.”
Doing this requires the time to test and measure a treatment’s efficacy, a luxury not available in patients with acute, life-threatening conditions. But, “if it’s a chronic disease, we have time”, Solomon stated.
Backed by a $24M fundraising last year, BiomX uses an approach to treating IBD that mirrors cancer diagnostics, where tumors are identified and treated based on the presence of certain biomarkers. In order to deliver effective treatments, BiomX plans to screen patients for specific bacterial strains driving the disease and develop a personalized phage ‘cocktail’ that targets only harmful bacteria.
“In the microbiome, there is a lot of risk, and you don’t know what’s going to be the right indication that impacting a single microbe or group of microbes will have an effect,” explained Solomon. “We need to be diversified just in terms of the risk of the pipeline.”
A few emerging companies are helping this diversification in the field. Focusing on replacing antibiotics with phages are PhagoMed, in Austria, and Pherecydes Pharma in France.
Others are putting a twist on phage therapy by combining it with newer technologies. For example, Paris-based Eligo Bioscience is using CRISPR-Cas9 to only eliminate bacteria with certain DNA sequences, such as antibiotic resistance or virulence genes.
There’s also a wave of interest in using the microbiome as a target for cancer, though Solomon’s outlook in these areas is cautious, stating that the microbiome’s effects on these conditions might be hard to demonstrate in clinical trials.
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