In 2017, a 15-year-old girl with cystic fibrosis received a double lung transplant in London. Her recovery from the lifesaving operation was threatened when she developed an antibiotic-resistant infection. The deadly infection, triggered by immune-suppressing drugs she took to prepare her body prior to the transplant, was destroying her kidneys, liver, lungs and skin. According to the teen’s surgeon, her prognosis was grim.
Since traditional antibiotics weren’t working, her surgeon, Helen Spencer, a respiratory pediatrician and clinical lead for lung transplant services at London’s Great Ormond Street Hospital, and the teen’s parents took an extraordinary measure — they contacted the Hatfull Lab at Pitt.
Research assistants, undergraduate students and others who work with Graham Hatfull, the Eberly Family Professor of Biotechnology in the Department of Biological Sciences in the Kenneth P. Dietrich School of Arts and Sciences, study the molecular genetics of the mycobacteria and their mycobacteriophages. Phages are bacteria-killing viruses, and Hatfull’s lab has been working to identify phages that can be used to kill bacteria that resist antibiotic treatment. Hatfull led the team that identified and engineered three phages to create the cocktail that the girl eventually received.
The lifesaving research from his lab is the first known attempt to use phages to treat a mycobacterial infection in a human being, as well as the first therapeutic use of engineered phages. And in this case, it worked.
Hatfull and Spencer outlined the process in a paper published in Nature Medicine on May 8.
The discovery made by Hatfull, his lab and Spencer has gone viral: Media outlets including The Atlantic, Science magazine, NPR and The Wall Street Journal along with local outlets like the Pittsburgh Post-Gazette have covered the groundbreaking effort that’s being called a historic first – the use of engineered phages in a human patient.
While the patient is not technically cured, she has responded well without adverse reactions to the treatment and is living a normal life.
“This is a very exciting development,” said Hatfull. “These types of infections are common in CF patients and are extremely difficult to treat due to antibiotic resistance. Although phages may not yet be broadly applicable for such infections, this study shows that it may be a highly effective treatment.”