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November 2019
The liver

Phage therapy shows promise for treating alcoholic liver disease 

A team of researchers led by King’s College London and the University of California San Diego School of Medicine have for the first time successfully applied bacteriophage (phage) therapy in mice to alcohol-related liver disease. Phages are viruses that specifically destroy bacteria.
In a paper published 13th November in Nature, the team discovered that patients with severe alcoholic hepatitis had high numbers of a destructive gut bacterium and that they were able to use a precise cocktail of phages to target and kill the bacteria, eradicating the disease.
They found that with this disease, liver cells are injured by a toxin called cytolysin, secreted by Enterococcus faecalis, a type of bacteria typically found in low numbers in the healthy human gut. They found that people with alcoholic hepatitis have more cytolysin-producing E. faecalis in their guts than healthy people. The more E. faecalis present, the more severe their liver disease.
Using samples collected from patients, the researchers found that nearly 90 percent of cytolysin-positive patients with alcoholic hepatitis died within 180 days of hospital admission, compared to approximately 4 percent of cytolysin- negative patients.
To investigate the potential for phage therapy, the researchers isolated four different phages that specifically target cytolysin-producing E. faecalis. When they treated the mice with these, the bacteria were eradicated, and alcohol-induced liver disease was abolished. Control phages that target other bacteria or non-cytolytic E. faecalis had no effect.
Source: Bacteriophage targeting of gut bacterium attenuates alcoholic liver disease. Duan, Y., Llorente, C., Lang, S. et al. Nature (2019).
doi.org/10.1038/s41586-019-1742-x
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