[PDF][PDF] Targeted suppression of human IBD-associated gut microbiota commensals by phage consortia for treatment of intestinal inflammation

S Federici, S Kredo-Russo, R Valdés-Mas… - Cell, 2022 - cell.com
S Federici, S Kredo-Russo, R Valdés-Mas, D Kviatcovsky, E Weinstock, Y Matiuhin…
Cell, 2022cell.com
Human gut commensals are increasingly suggested to impact non-communicable diseases,
such as inflammatory bowel diseases (IBD), yet their targeted suppression remains a
daunting unmet challenge. In four geographically distinct IBD cohorts (n= 537), we identify a
clade of Klebsiella pneumoniae (Kp) strains, featuring a unique antibiotics resistance and
mobilome signature, to be strongly associated with disease exacerbation and severity.
Transfer of clinical IBD-associated Kp strains into colitis-prone, germ-free, and colonized …
Summary
Human gut commensals are increasingly suggested to impact non-communicable diseases, such as inflammatory bowel diseases (IBD), yet their targeted suppression remains a daunting unmet challenge. In four geographically distinct IBD cohorts (n = 537), we identify a clade of Klebsiella pneumoniae (Kp) strains, featuring a unique antibiotics resistance and mobilome signature, to be strongly associated with disease exacerbation and severity. Transfer of clinical IBD-associated Kp strains into colitis-prone, germ-free, and colonized mice enhances intestinal inflammation. Stepwise generation of a lytic five-phage combination, targeting sensitive and resistant IBD-associated Kp clade members through distinct mechanisms, enables effective Kp suppression in colitis-prone mice, driving an attenuated inflammation and disease severity. Proof-of-concept assessment of Kp-targeting phages in an artificial human gut and in healthy volunteers demonstrates gastric acid-dependent phage resilience, safety, and viability in the lower gut. Collectively, we demonstrate the feasibility of orally administered combination phage therapy in avoiding resistance, while effectively inhibiting non-communicable disease-contributing pathobionts.
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