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What Is Phage Therapy?
Bacteriophage therapy (phage therapy for short) is a means of fighting bacterial infections or dysbiosis using phages. Bacterial organisms can catch viral infections just as humans do, and the viruses which infect bacteria are called bacteriophages. These phages infect and can kill bacteria, but cannot infect humans or animals.
Bacteriophages have certain advantages over antibiotics, as each phage only kills the specific species of bacteria it targets. Such precision targeting can be useful in gut dysbiosis, as phages can selectively kill pathogenic bacteria, leaving the beneficial bacteria in the gut unharmed.
Using phage therapy to fight bacterial infections has a 100 year history, and is used today in places like Russia, Georgia, the Ukraine and Poland.
Where Can You Obtain Phage Therapy?
Phage therapy comes in two forms: you can buy inexpensive off-the-shelf phage products online, or you can get custom-selected phages that specifically target the bacterial species and strain of that species causing your health problems. Such custom-selected phages are obtained from clinics possessing a large library of thousands of different phages.
Off-the-shelf phages have the advantage of being inexpensive (as little as $30), but they are not guaranteed to work against the particular strain of bacteria that you may have, because phages are bacterial strain-specific.
You may be lucky, and the off-the-shelf product you buy contains a phage that targets your strain of bacteria. Or you may not be so lucky, and find your phage product does not work against the strain of bacteria you have. In which case, you could try a different off-the-shelf product, or you could opt for custom-selected phages which are guaranteed to target and kill your strain of bacteria.
Custom-selected phage therapy is offered at some clinics in the Republic of Georgia (the Phage Therapy Center, the Eliava Phage Therapy Center, and by the company Caucasus Healing).
Unfortunately the total cost of custom phage treatment in Georgia is expensive, in the ballpark of $3000 to $6000 (see here and here).
There is also a Phage Therapy Unit at the Ludwik Hirszfeld Institute, Poland.
These clinics possess a large library of many different phages, and they can usually find one in their library able to target your strain of bacteria. Treatment involves either visiting a clinic in Georgia or Poland, or becoming a remote patient of a clinic (sending your bacterial samples to the clinic, so that they can select and ship to you the appropriate phages in solution). At these clinics, the initial analysis to find a phage which can target your bacteria costs around $200.
Because of their low cost and ease of access, off-the-shelf phages may be a good place to start any experiments in phage therapy. Below we list many websites and pharmacies that have recently sprung up selling off-the-shelf phage products.
Only a few years ago, it was very hard to buy off-the-shelf phages from the countries which specialize in them (which includes the Republic of Georgia, Russia, the Ukraine and Poland). But now there are around a dozen websites/pharmacies selling off-the-shelf phages for the international market.
There is also increased interest in phages in the West, with a new phage therapy center at the University of California, San Diego, which is focusing on clinical trials of phage therapy.
Can Phage Therapy Treat ME/CFS?
The Phage Therapy Center in Georgia have a page on ME/CFS, and they say that phage therapy is sometimes effective for ME/CFS:
So the Phage Therapy Center in Georgia are saying in their experience, ME/CFS sometimes turns out to be caused by an overload of a bacterial toxin, produced by the pathogenic bacteria living in your body, and their phage therapy may then be able to address this bacterial infection, which may improve your ME/CFS.
This is very interesting, because Dr Igor Markov in the Ukraine also posits that ME/CFS is caused by an overload of bacterial toxins in the body. Dr Markov believes it is the kidneys which may harbor a low-level dysbiosis bacterial infection, which constantly secretes potent bacterial toxins into the systemic bloodstream, causing ME/CFS.
Dr Markov treats this this kidney bacteria dysbiosis with autovaccines (which stimulate the immune system to fight the pathogenic bacteria), and he claims a 93% success rate in curing ME/CFS.
The Phage Therapy Center also have a page on Lyme disease. The center have previously said there are no therapeutic phages for Lyme bacteria. However, they say that patients who are diagnosed with chronic Lyme disease (both those who have Lyme, as well as those with a false positive Lyme diagnosis) sometimes turn out to have a bacterial toxin overload caused by a phage-treatable species of bacteria.
So it sounds like phage therapy is not a treatment which will help all ME/CFS patients, but might have benefits for a small subset, possibly those patients who have had a stool analysis (like the Genova Diagnostics Stool Profiles) which indicates a gut dysbiosis involving a bacterial pathogen.
The Bacteria Targeted by Phages to Treat ME/CFS
There are off-the-shelf phage products available for many pathogenic bacterial species that are common inhabitants of the human gut and urinary tract microbiome, including: Staphylococcus aureus, Streptococcus pyogenes, Proteus mirabilis, Proteus vulgaris, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Klebsiella pneumoniae, Klebsiella oxytoca.
Some off-the-shelf phage product will target a specific bacterium, such as this Klebsiella phage product made by Microgen, and these products will contain a set of phages that are effective against the different species in the genus (like Klebsiella pneumoniae, Klebsiella ozaenae, Klebsiella rhinoscleromatis in this case), as well as contain phages which target different strains of these species.
Then there are other off-the-shelf phage products that contain phages which target a broad spectrum of different bacterial species, such as for example the Pyobacteriophage Complex product from Microgen, which targets many common gut pathogens, including Staphylococcus, Streptococcus, Enterococcus, Pseudomonas, Proteus, Klebsiella, Escherichia coli.
How Are Phages Administered?
Phages in solution are usually taken orally, but can also be administered as a rectal suppository, and in trials have been instilled intravesically into the bladder to treat urinary tract infections.
Tips for Successful Phage Treatment
Note that phage products which target a particular bacterium, but which are bought from different companies, will not usually contain exactly the same phages. Each company has its own phages.
So if you have a particular bacterial infection or dysbiosis, and an off-the-shelf phage product from one company did not have any efficacy against the bacterium, it is still possible that a phage product from another company might work for you.
Because phages are species-specific and strain-specific, the first product you bought might not contain a phage which targets your particular strain of bacterium. But a phage product from a second or third company may contain a phage that does the trick.
In the case of phage products from the Russian company Microgen, this company is actually a conglomerate which has 3 different phage-producing subsidiaries, and even when these subsidiaries make products which target the very same bacterium (and sold under the Microgen label), they contain different phages! So these three Microgen subsidiaries should be treated as different companies using different phages.
There is some concern about stomach or urinary tract acidity killing phages, but the information is somewhat contradictory:
This paper explains how many phages are sensitive to acid environments, but says that stomach acidity neutralizers like sodium bicarbonate have not shown to be helpful:
The above paper also notes that oral administration is not the best for getting phages into the systemic blood circulation:
Judging by figure 3 though, intranasal administration is effective for getting phages into the systemic circulation.
To address bacterial infections or dysbiosis in organs like the kidneys or prostate, one would imagine this will require phages to enter the systemic circulation.
Websites/Pharmacies Selling Off-The-Shelf Phage Products
The following websites sell off-the-shelf phage products:
Russian and Ukrainian Phages:
Georgian Phages:
Manufacturers of Phage Products
These are the main producers of off-the-self phage products:
Russian Phage Suppliers:
Georgian Phage Suppliers:
Manufacturer Logos
History of Phage Therapy
The first hint of the existence of phages came from English bacteriologist Ernest Hankin, who when in India observed that water from the river Ganges could kill cholera bacteria within hours. He hypothesized that some organism in the Ganges water was able to destroy cholera. We now know that the Ganges river has a particularly high level of phages.
Bacteriophages were later discovered by two scientists independently: by English bacteriologist Frederick Twort in 1915 (who did not pursue his discovery further), and by French microbiologist Felix D'Hérelle in 1917.
The idea of using phages to fight bacterial infection was first proposed by d'Hérelle, who suggested that the phages which were observed to kill bacteria in test tubes might be used to treat disease.
The first recorded case of human phage therapy occurred in 1919, when d'Hérelle and colleagues made a phage preparation for a 12-year-old boy with severe dysentery. After fully testing the preparation on himself for safety, he gave it to the boy, who fully recovered within days. D'Hérelle went on to set up phage therapy clinical trials around the world.
In 1933 D'Hérelle moved to Georgia to work at the Eliava Institute on phage research, with his Georgian microbiologist friend, George Eliava. This was done with Stalin's approval, who wanted phages to keep his army healthy, and welcomed D'Hérelle to the Soviet Union as a hero.
A few years later, George Eliava fell out with the Soviet authorities (unfortunately Eliava and the head of the secret police fell in love with the same woman) and was promptly executed. D'Hérelle then fled, but the Eliava Institute survived, and became the world's leading phage research center.
Further Info on Phages
An old BBC Horizon Documentary on Phage Therapy (Video) from 1997. The video is slow to load initially, but is fine once it gets going. Among other things, it details the phage therapy center in Georgia.
Recent BBC article on phage therapy
https://www.bacteriophage.news — informative site
http://europhages.com/en/ — informative site
https://bacteriophages.info/en/ — informative site
Bacteriophage therapy (phage therapy for short) is a means of fighting bacterial infections or dysbiosis using phages. Bacterial organisms can catch viral infections just as humans do, and the viruses which infect bacteria are called bacteriophages. These phages infect and can kill bacteria, but cannot infect humans or animals.
Bacteriophages have certain advantages over antibiotics, as each phage only kills the specific species of bacteria it targets. Such precision targeting can be useful in gut dysbiosis, as phages can selectively kill pathogenic bacteria, leaving the beneficial bacteria in the gut unharmed.
Using phage therapy to fight bacterial infections has a 100 year history, and is used today in places like Russia, Georgia, the Ukraine and Poland.
Where Can You Obtain Phage Therapy?
Phage therapy comes in two forms: you can buy inexpensive off-the-shelf phage products online, or you can get custom-selected phages that specifically target the bacterial species and strain of that species causing your health problems. Such custom-selected phages are obtained from clinics possessing a large library of thousands of different phages.
Off-the-shelf phages have the advantage of being inexpensive (as little as $30), but they are not guaranteed to work against the particular strain of bacteria that you may have, because phages are bacterial strain-specific.
You may be lucky, and the off-the-shelf product you buy contains a phage that targets your strain of bacteria. Or you may not be so lucky, and find your phage product does not work against the strain of bacteria you have. In which case, you could try a different off-the-shelf product, or you could opt for custom-selected phages which are guaranteed to target and kill your strain of bacteria.
Custom-selected phage therapy is offered at some clinics in the Republic of Georgia (the Phage Therapy Center, the Eliava Phage Therapy Center, and by the company Caucasus Healing).
Unfortunately the total cost of custom phage treatment in Georgia is expensive, in the ballpark of $3000 to $6000 (see here and here).
There is also a Phage Therapy Unit at the Ludwik Hirszfeld Institute, Poland.
These clinics possess a large library of many different phages, and they can usually find one in their library able to target your strain of bacteria. Treatment involves either visiting a clinic in Georgia or Poland, or becoming a remote patient of a clinic (sending your bacterial samples to the clinic, so that they can select and ship to you the appropriate phages in solution). At these clinics, the initial analysis to find a phage which can target your bacteria costs around $200.
Because of their low cost and ease of access, off-the-shelf phages may be a good place to start any experiments in phage therapy. Below we list many websites and pharmacies that have recently sprung up selling off-the-shelf phage products.
Only a few years ago, it was very hard to buy off-the-shelf phages from the countries which specialize in them (which includes the Republic of Georgia, Russia, the Ukraine and Poland). But now there are around a dozen websites/pharmacies selling off-the-shelf phages for the international market.
There is also increased interest in phages in the West, with a new phage therapy center at the University of California, San Diego, which is focusing on clinical trials of phage therapy.
Can Phage Therapy Treat ME/CFS?
The Phage Therapy Center in Georgia have a page on ME/CFS, and they say that phage therapy is sometimes effective for ME/CFS:
So the Phage Therapy Center in Georgia are saying in their experience, ME/CFS sometimes turns out to be caused by an overload of a bacterial toxin, produced by the pathogenic bacteria living in your body, and their phage therapy may then be able to address this bacterial infection, which may improve your ME/CFS.
This is very interesting, because Dr Igor Markov in the Ukraine also posits that ME/CFS is caused by an overload of bacterial toxins in the body. Dr Markov believes it is the kidneys which may harbor a low-level dysbiosis bacterial infection, which constantly secretes potent bacterial toxins into the systemic bloodstream, causing ME/CFS.
Dr Markov treats this this kidney bacteria dysbiosis with autovaccines (which stimulate the immune system to fight the pathogenic bacteria), and he claims a 93% success rate in curing ME/CFS.
The Phage Therapy Center also have a page on Lyme disease. The center have previously said there are no therapeutic phages for Lyme bacteria. However, they say that patients who are diagnosed with chronic Lyme disease (both those who have Lyme, as well as those with a false positive Lyme diagnosis) sometimes turn out to have a bacterial toxin overload caused by a phage-treatable species of bacteria.
So it sounds like phage therapy is not a treatment which will help all ME/CFS patients, but might have benefits for a small subset, possibly those patients who have had a stool analysis (like the Genova Diagnostics Stool Profiles) which indicates a gut dysbiosis involving a bacterial pathogen.
The Bacteria Targeted by Phages to Treat ME/CFS
There are off-the-shelf phage products available for many pathogenic bacterial species that are common inhabitants of the human gut and urinary tract microbiome, including: Staphylococcus aureus, Streptococcus pyogenes, Proteus mirabilis, Proteus vulgaris, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Klebsiella pneumoniae, Klebsiella oxytoca.
Some off-the-shelf phage product will target a specific bacterium, such as this Klebsiella phage product made by Microgen, and these products will contain a set of phages that are effective against the different species in the genus (like Klebsiella pneumoniae, Klebsiella ozaenae, Klebsiella rhinoscleromatis in this case), as well as contain phages which target different strains of these species.
Then there are other off-the-shelf phage products that contain phages which target a broad spectrum of different bacterial species, such as for example the Pyobacteriophage Complex product from Microgen, which targets many common gut pathogens, including Staphylococcus, Streptococcus, Enterococcus, Pseudomonas, Proteus, Klebsiella, Escherichia coli.
How Are Phages Administered?
Phages in solution are usually taken orally, but can also be administered as a rectal suppository, and in trials have been instilled intravesically into the bladder to treat urinary tract infections.
Tips for Successful Phage Treatment
Note that phage products which target a particular bacterium, but which are bought from different companies, will not usually contain exactly the same phages. Each company has its own phages.
So if you have a particular bacterial infection or dysbiosis, and an off-the-shelf phage product from one company did not have any efficacy against the bacterium, it is still possible that a phage product from another company might work for you.
Because phages are species-specific and strain-specific, the first product you bought might not contain a phage which targets your particular strain of bacterium. But a phage product from a second or third company may contain a phage that does the trick.
In the case of phage products from the Russian company Microgen, this company is actually a conglomerate which has 3 different phage-producing subsidiaries, and even when these subsidiaries make products which target the very same bacterium (and sold under the Microgen label), they contain different phages! So these three Microgen subsidiaries should be treated as different companies using different phages.
Information about which of the 3 Microgen subsidiaries make which Microgen products is found here.
There is some concern about stomach or urinary tract acidity killing phages, but the information is somewhat contradictory:
Source: here.
This paper explains how many phages are sensitive to acid environments, but says that stomach acidity neutralizers like sodium bicarbonate have not shown to be helpful:
The above paper also notes that oral administration is not the best for getting phages into the systemic blood circulation:
Judging by figure 3 though, intranasal administration is effective for getting phages into the systemic circulation.
To address bacterial infections or dysbiosis in organs like the kidneys or prostate, one would imagine this will require phages to enter the systemic circulation.
Websites/Pharmacies Selling Off-The-Shelf Phage Products
The following websites sell off-the-shelf phage products:
Russian and Ukrainian Phages:
- OTC Online Store — Search Bacteriophages — Microgen
- Kalinka Store — Search Bacteriophages — Microgen and Phagex
- Phage24 — Search Bacteriophages — SniPha 360, made by Pharmex
- Pharmacy House — Search Bacteriophages — Microgen; only a few products
- WM Medical Supply — Search Bacteriophages — Microgen
- AptekaPro — Search Bacteriophages — Microgen and Mikromir
- Phagex — fill out this form to purchase Phagex phages directly from Phagex
Georgian Phages:
• MyBacteriophage — Search Bacteriophages — Eliava and BioChimPharm.
• MyPhages — Search Bacteriophages — BioChimPharm — Eliava and Biopharm L.
• Phage Mart — Search Bacteriophage — Eliava and BioChimPharm.
Manufacturers of Phage Products
These are the main producers of off-the-self phage products:
Russian Phage Suppliers:
- Microgen (Микроген) — Russian pharmaceutical company that makes immuno-biological products. Phage products they make detailed ➤ here.
- Mikromir — Russian company which researches and makes phages.
Georgian Phage Suppliers:
- Eliava (ელიავა) — Georgian company linked to the Eliava Institute. Their phages are used at the Eliava Phage Therapy Center. Phage products they make detailed ➤ here.
- BioChimPharm — Georgian company, an off-shoot of the Eliava Institute. Phage products they make detailed ➤ here.
- Biopharm L — Georgian phage company.
- Bohemia Pharm — Czech pharmaceutical company.
- Aziya — Uzbekistani company. Phage products they make detailed ➤ here.
Manufacturer Logos
History of Phage Therapy
The first hint of the existence of phages came from English bacteriologist Ernest Hankin, who when in India observed that water from the river Ganges could kill cholera bacteria within hours. He hypothesized that some organism in the Ganges water was able to destroy cholera. We now know that the Ganges river has a particularly high level of phages.
Bacteriophages were later discovered by two scientists independently: by English bacteriologist Frederick Twort in 1915 (who did not pursue his discovery further), and by French microbiologist Felix D'Hérelle in 1917.
The idea of using phages to fight bacterial infection was first proposed by d'Hérelle, who suggested that the phages which were observed to kill bacteria in test tubes might be used to treat disease.
The first recorded case of human phage therapy occurred in 1919, when d'Hérelle and colleagues made a phage preparation for a 12-year-old boy with severe dysentery. After fully testing the preparation on himself for safety, he gave it to the boy, who fully recovered within days. D'Hérelle went on to set up phage therapy clinical trials around the world.
In 1933 D'Hérelle moved to Georgia to work at the Eliava Institute on phage research, with his Georgian microbiologist friend, George Eliava. This was done with Stalin's approval, who wanted phages to keep his army healthy, and welcomed D'Hérelle to the Soviet Union as a hero.
A few years later, George Eliava fell out with the Soviet authorities (unfortunately Eliava and the head of the secret police fell in love with the same woman) and was promptly executed. D'Hérelle then fled, but the Eliava Institute survived, and became the world's leading phage research center.
Further Info on Phages
An old BBC Horizon Documentary on Phage Therapy (Video) from 1997. The video is slow to load initially, but is fine once it gets going. Among other things, it details the phage therapy center in Georgia.
Recent BBC article on phage therapy
https://www.bacteriophage.news — informative site
http://europhages.com/en/ — informative site
https://bacteriophages.info/en/ — informative site
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