Armed Phages: A New Weapon in the Battle Against Antimicrobial Resistance

The increasing prevalence of multidrug-resistant (MDR) bacterial infections necessitates the exploration of alternative antimicrobial strategies, with phage therapy emerging as a viable option. However, the effectiveness of naturally occurring phages can be significantly limited by bacterial defense...

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Main Authors: Cleo Anastassopoulou, Deny Tsakri, Antonios-Periklis Panagiotopoulos, Chrysa Saldari, Antonia P. Sagona, Athanasios Tsakris
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/17/7/911
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author Cleo Anastassopoulou
Deny Tsakri
Antonios-Periklis Panagiotopoulos
Chrysa Saldari
Antonia P. Sagona
Athanasios Tsakris
author_facet Cleo Anastassopoulou
Deny Tsakri
Antonios-Periklis Panagiotopoulos
Chrysa Saldari
Antonia P. Sagona
Athanasios Tsakris
author_sort Cleo Anastassopoulou
collection DOAJ
description The increasing prevalence of multidrug-resistant (MDR) bacterial infections necessitates the exploration of alternative antimicrobial strategies, with phage therapy emerging as a viable option. However, the effectiveness of naturally occurring phages can be significantly limited by bacterial defense systems that include adsorption blocking, restriction–modification, CRISPR-Cas immunity, abortive infection, and NAD+ depletion defense systems. This review examines these bacterial defenses and their implications for phage therapy, while highlighting the potential of phages’ bioengineering to overcome these barriers. By leveraging synthetic biology, genetically engineered phages can be tailored to evade bacterial immunity through such modifications as receptor-binding protein engineering, anti-CRISPR gene incorporation, methylation pattern alterations, and enzymatic degradation of bacterial protective barriers. “Armed phages”, enhanced with antimicrobial peptides, CRISPR-based genome-editing tools, or immune-modulating factors, offer a novel therapeutic avenue. Clinical trials of bioengineered phages, currently SNIPR001 and LBP-EC01, showcase their potential to safely and effectively combat MDR infections. SNIPR001 has completed a Phase I clinical trial evaluating safety in healthy volunteers, while LBP-EC01 is in Phase II trials assessing its performance in the treatment of <i>Escherichia coli</i>-induced urinary tract infections in patients with a history of drug-resistant infections. As “armed phages” progress toward clinical application, they hold great promise for precision-targeted antimicrobial therapies and represent a critical innovation in addressing the global antibiotic resistance crisis.
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spelling doaj-art-8505dc4655764eebb5dd55bb60de5adc2025-08-20T03:13:58ZengMDPI AGViruses1999-49152025-06-0117791110.3390/v17070911Armed Phages: A New Weapon in the Battle Against Antimicrobial ResistanceCleo Anastassopoulou0Deny Tsakri1Antonios-Periklis Panagiotopoulos2Chrysa Saldari3Antonia P. Sagona4Athanasios Tsakris5Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceSchool of Life Sciences, University of Warwick, Coventry CV4 7AL, UKDepartment of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceThe increasing prevalence of multidrug-resistant (MDR) bacterial infections necessitates the exploration of alternative antimicrobial strategies, with phage therapy emerging as a viable option. However, the effectiveness of naturally occurring phages can be significantly limited by bacterial defense systems that include adsorption blocking, restriction–modification, CRISPR-Cas immunity, abortive infection, and NAD+ depletion defense systems. This review examines these bacterial defenses and their implications for phage therapy, while highlighting the potential of phages’ bioengineering to overcome these barriers. By leveraging synthetic biology, genetically engineered phages can be tailored to evade bacterial immunity through such modifications as receptor-binding protein engineering, anti-CRISPR gene incorporation, methylation pattern alterations, and enzymatic degradation of bacterial protective barriers. “Armed phages”, enhanced with antimicrobial peptides, CRISPR-based genome-editing tools, or immune-modulating factors, offer a novel therapeutic avenue. Clinical trials of bioengineered phages, currently SNIPR001 and LBP-EC01, showcase their potential to safely and effectively combat MDR infections. SNIPR001 has completed a Phase I clinical trial evaluating safety in healthy volunteers, while LBP-EC01 is in Phase II trials assessing its performance in the treatment of <i>Escherichia coli</i>-induced urinary tract infections in patients with a history of drug-resistant infections. As “armed phages” progress toward clinical application, they hold great promise for precision-targeted antimicrobial therapies and represent a critical innovation in addressing the global antibiotic resistance crisis.https://www.mdpi.com/1999-4915/17/7/911bacteriophagesphage therapyantimicrobial resistancebacterial defensesgenetically engineered phagesCRISPR-Cas
spellingShingle Cleo Anastassopoulou
Deny Tsakri
Antonios-Periklis Panagiotopoulos
Chrysa Saldari
Antonia P. Sagona
Athanasios Tsakris
Armed Phages: A New Weapon in the Battle Against Antimicrobial Resistance
Viruses
bacteriophages
phage therapy
antimicrobial resistance
bacterial defenses
genetically engineered phages
CRISPR-Cas
title Armed Phages: A New Weapon in the Battle Against Antimicrobial Resistance
title_full Armed Phages: A New Weapon in the Battle Against Antimicrobial Resistance
title_fullStr Armed Phages: A New Weapon in the Battle Against Antimicrobial Resistance
title_full_unstemmed Armed Phages: A New Weapon in the Battle Against Antimicrobial Resistance
title_short Armed Phages: A New Weapon in the Battle Against Antimicrobial Resistance
title_sort armed phages a new weapon in the battle against antimicrobial resistance
topic bacteriophages
phage therapy
antimicrobial resistance
bacterial defenses
genetically engineered phages
CRISPR-Cas
url https://www.mdpi.com/1999-4915/17/7/911
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