Patient perspective: My life since learning of phage therapy one year ago

Issue 62 | January 30, 2020
12 min read
Capsid and Tail

Ella Balasa receiving phage therapy at Yale University. Photo credit: Dr. Benjamin Chan.

This week, Ella Balasa, a cystic fibrosis patient who received phage therapy from Yale researchers in 2019, tells her story.

Also in this issue: foods that induce prophages, understanding infant gut phages, an innovation showcase for phage companies, phage conferences and podcasts galore, and more!

Notice: We won’t publish Capsid & Tail next week; instead, we’ll be providing live coverage of Phage Futures Congress! Head to the Phage Directory homepage next Wednesday and Thursday to follow along!

Urgent January 29, 2020

Seeking Streptococcus anginosus phages for a patient

Phage Therapy

We are seeking Streptococcus anginosus phages for a patient.

Ways to help at this stage:

  • By sending your phages for testing on the patient’s strain
  • By receiving the strain and testing your phages
  • By receiving the strain and using it to search for new phages against the organism
  • By helping spread the word about this request
  • By providing us with names/email addresses of labs you think we should contact

Please email staff@phage.directory if you can help in any way, or if you would like further details/clarification.

Let’s make a difference,
Phage Directory

Urgent January 29, 2020

Seeking Achromobacter xylosoxidans phages for a patient

Phage Therapy

We are seeking Achromobacter xylosoxidans phages for a patient.

Ways to help at this stage:

  • By sending your phages for testing on the patient’s strain
  • By receiving the strain and testing your phages
  • By receiving the strain and using it to search for new phages against the organism
  • By helping spread the word about this request
  • By providing us with names/email addresses of labs you think we should contact

Please email staff@phage.directory if you can help in any way, or if you would like further details/clarification.

Let’s make a difference,
Phage Directory

What’s New

Aurélie Mathieu (Université Paris-Saclay) and colleagues have published an exciting new paper in Nature Communications: they isolated 150 E. coli phages from fecal samples from 1-year-old infants. Then they analyzed the host range of the phages on 75 E. coli strains. They saw that temperate phages outnumbered virulent ones, and that most E. coli strains were resistant to temperate phages but sensitive to virulent phages.

ResearchGut phages

Lance Boling (SDSU) and colleagues tested 117 consumable compounds (like toothpaste, Stevia, aspartame) for their ability to induce prophages from four bacterial species. They found that certain compounds induced prophages (some in a species-specific manner), suggesting that food could be used to “landscape” gut microbes through targeting prophages.

ResearchGut phagesProphages

A new article in STAT News by Eric Boodman (one of our favourite phage journalists!) talks about how a phage has been found that kills Mallory Smith’s infective Burkholderia cepacia isolate. In Mallory’s honour, the phage has been named BCMallory1. It was isolated by Ronen Hazan’s lab at the Hebrew University in Jerusalem.

Phage Therapy

Attention phage companies with interests in addressing animal health challenges! You can apply here to showcase your solution at the Animal Microbiome and Nutritional Health Congress in Chicago Mar 3-4, 2020. (Apparently most companies who’ve applied so far are phage companies!)

ConferencePitch Competition

PhageOption 2020 will take place at Universidad de los Andes, Cartagena, Colombia from November 4-6, 2020. The conference will focus on the role phages can play in controlling MDR bacteria in human and agriculture fields. Organizers: Researchers at Universidad de los Andes and SciPhage. Join the mailing list for more information.

Conference

Listen to Jeremy Barr of Monash University’s take on phage therapy and how close we are to bringing it to patients at scale. 16 min.

PodcastPhage Therapy

A new monthly podcast called Superbugs Unplugged covers antimicrobial resistance news (and even covers phages, in episode two!).

PodcastAntimicrobial resistancePhage Therapy

Latest Jobs

Professor Martha Clokie (University of Leicester) is hiring a full-time research associate to investigate phages against Salmonella strains associated with pigs and developing and testing phage products.
The Department of Food Science at Cornell University is seeking a Post-Doctoral Research Associate to carry out experiments and perform research on engineering phage: nanoparticle biocomposites for detection of pathogenic bacteria in a range of matrices (e.g. water, soil, food, serum).
Apply to work as a Research Associate I in Marina del Rey, California to identify new phages, characterize their microbiological and genomic features and help develop engineering pipelines.
Apply to work as a Process Engineer in Marina del Rey, California. You’ll support phage process development and manufacturing by identifying, procuring, and implementing manufacturing equipment required to produce bacteriophage drug products.

Community Board

Anyone can post a message to the phage community — and it could be anything from collaboration requests, post-doc searches, sequencing help — just ask!

Apply to host Viruses of Microbes 2022!

The Viruses of Microbes (VoM) conference is the official meeting of the International Society of Viruses of Microorganisms (ISVM). We are pleased to open the call for organizing the next VoM conference, to be held mid-2022.

Prospective organizers should first register by email to the ISVM secretary Tessa Quax. They will then receive an application form and a guidance to build the meeting budget. Complete application forms must be submitted by email by 30 April 2020.

Applications will be reviewed by the ISVM board and the selected organizers will be invited to present their application during the General Assembly of our Society on the upcoming VoM conference in July 2020 in Portugal. We welcome applications from researchers worldwide. Please note that we also welcome interest to organize the VoM meeting planned for mid-2024.

Best regards,
Corina Brussaard, President of ISVM (on behalf of the ISVM executive board)

Conference

In Memory of Jim Hu

Sadly, Dr Jim Hu, a founding member of the Center for Phage Technology at Texas A&M University, has passed away. He was great scientist, dedicated mentor, and valued member of CPT and TAMU. — Center for Phage Technology, Twitter

Jim was passionate about microbial genetics, the application of high throughput data and analysis tools to explore bacterial physiology, and the development of community-based resources. He also developed a two hybrid system for studying protein:protein interactions in E. coli, based on the phage lambda repressor. His warmth, wit, and friendship will be greatly missed.— Gail Christie, Phage Page, Facebook

In memory

Phage Methods Q&A: PEG precipitation

When doing a PEG precipitation of phages, some people (like me) use a PEG stock solution (20-30% w/v PEG in NaCl), whereas other people add the PEG powder directly to the sample.
What are the pros and cons? — @EvelienAdri

Check out the Twitter thread here for answers.

MethodsQ&A

Patient perspective: My life since learning of phage therapy one year ago

Profile Image
Lab Manager
Cystic Fibrosis Foundation
Virginia Commonwealth University, Richmond, VA, United States

I am a writer, a patient advocate, and a scientist. I received a degree in biology from Virginia Commonwealth University in 2014 and have worked in microbiology. I’ve studied the same bacteria that thrive in CF lungs, but in the environment. Over the past few years, I’ve become involved in the CF community by serving on various research committees through the CF Foundation, and as director for the US Adult CF Association. I also have a passion for writing, through which I provide a scientific voice about research experiences, like my recent phage therapy treatment, as well as writing about the hardship and triumph of living with CF.

I’ll take you on a journey of how phage therapy has had an impact on my life within the past year. The fall of 2018 was the first time I’d ever heard of this therapy as a possibility for treating the terrible lung infections that plague me.

I’ve had a bacteria called Pseudomonas aeruginosa festering in my lungs for as long as I can remember. I was born with a progressive genetic disease called cystic fibrosis. It is characterized by the buildup of thick sticky mucus primarily in the lungs but also affects the digestive tract and sinuses. The cycle of bacterial lung infections caused by this trapped mucus building up over time requires repeated antibiotics to treat them, mostly intravenously. The concurrent inflammation from the immune system trying to fight the infection leads to lung damage and eventually respiratory failure, shortening the life of a person with the disease, if a lung transplant does not occur to hopefully prolong life.

Over the past few years, these infections have become more frequent, so much so that it’s gotten to a point where I require oral antibiotics almost constantly, as well as higher doses of antibiotics delivered intravenously three or more times a year. Yet, the antibiotics’ ability to kill off the bacteria is waning.

Ella in the lab
Ella Balasa performing DNA extractions at Virginia Commonwealth University.

I am a microbiology lab technician and a freelance writer. In 2018, I was contacted by a company that was doing a documentary about a CF patient who was treated with phage by Yale University researchers. They asked me to write a synopsis of what living with CF is like to accompany the video. This was the first time I had heard of phage therapy and I was amazed. I knew I needed to contact the researchers to try this therapy for myself. That was how my journey began.

At the time, I was on the brink of the worse infection I’ve ever had, with my lung function reaching a mere 18% by the time I was treated in January 2019. To read details about my treatment from my perspective, click here.

In short, about a week after phage administration the Pseudomonas infection began to clear. The use of phage simultaneously with IV antibiotics changed the bacteria’s sensitivities and facilitated a synergistic attack on them — one they couldn’t repel. I stayed antibiotic free for about 6 months after that — a significant amount of time thus far in the trajectory of my lung disease.

In this time, I began advocating for phage therapy and serving as a voice to other patients. It was propelled by the Associated Press documentation of my treatment, and I also wanted to share my story personally to bring awareness to this potential treatment option for the CF community and beyond it.

With my science background, I’ve had an interest in learning about the fascinating way phage can be manipulated to provide the best outcomes with treatment. I’ve had many patients who are interested in accessing phage therapy reach out to me asking for advice and guidance. I share what I know about the biological aspects of phage, what I have learned about the process of obtaining treatment, the work there is still to be done with the FDA, beginning clinical trials, and just public awareness about the benefits of this treatment in general. In April, I connected with Diane and Mark Smith, who have supported IPATH and Yale researchers in memory of their daughter, Mallory, to advance phage research as quickly as possible.

Ella with Mark and Diane Shader Smith
A book tour at UVA for Salt in My Soul. Mallory Smith’s parents, Mark and Diane (left), Ella Balasa (center), Terri Quinan (CF Foundation), and assistant (right). Used with permission.

In the past few months I’ve attended conferences during which phage therapy was a top focus of sessions. At one of these conferences, not only did I see the Yale researchers who treated me, but I also met a researcher who knew of me only as patient “EB”, and seeing me in person, was awestruck. This was a researcher who had heard of my treatment case earlier this year when I was treated with the same phage he was presenting information about on his poster. I was also amazed by the connection between researcher and patient coming full circle, and the privilege to be contributing to research so directly.

Ella at ID Week
Ella Balasa attending Infectious Disease Week Conference in Washington DC, October 2019.

Another wonderful connection and opportunity happened at the very university where I work. Unbeknownst to me, there are phage researchers teaching the SEA-PHAGES program at Virginia Commonwealth University (VCU), and, learning of my case and my interest in phage research, asked me to speak to the class and offered to teach me how to isolate my own phage from water and soil samples. So far, we may have isolated a temperate phage.

Earlier in the year, I joined the CF Foundation (CFF)’s Infection Research Committee, and have advocated for phage therapy to be at the forefront of the research agenda in the future. I wrote a blog with the Director of Drug Discovery at the CFF detailing the science of phage to the CF patient population. More recently, I have spoken at the Milken Institute to raise awareness about the dire problem we face against antibiotic resistant bacteria and the need for development of novel therapies outside of traditional antibiotics to treat them.

Most recently, I have been asked to speak of my experience at the Phage Futures 2020 Conference. Advocating for phage therapy will continue to be a focus of my efforts until it is a standard of care treatment for all patients combating antibiotic resistant infections.

I also hope to be able to benefit from phage treatment again in the near future as I know Pseudomonas will get the upper hand over me once more.

Ella will be speaking about her experience receiving and advocating for phage therapy at the Phage Futures Congress in Washington, DC next week (Feb 5-6). For a 10% discount off your registration, enter code PHAGEDIRECTORY.

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