Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives

Antimicrobial peptides (AMPs) and bacteriophages, though long recognised, have gained significant attention in recent antimicrobial research due to the rapid evolution of microbial resistance to existing antibiotics. This publication comprehensively examines the current literature on the potential o...

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Main Authors: Chibuzo Vincent Alisigwe, Chibuzor Stanley Ikpa, Uchenna Joseph Otuonye
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:The Microbe
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950194625000226
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author Chibuzo Vincent Alisigwe
Chibuzor Stanley Ikpa
Uchenna Joseph Otuonye
author_facet Chibuzo Vincent Alisigwe
Chibuzor Stanley Ikpa
Uchenna Joseph Otuonye
author_sort Chibuzo Vincent Alisigwe
collection DOAJ
description Antimicrobial peptides (AMPs) and bacteriophages, though long recognised, have gained significant attention in recent antimicrobial research due to the rapid evolution of microbial resistance to existing antibiotics. This publication comprehensively examines the current literature on the potential of AMPs and bacteriophages to treat infections caused by antimicrobial-resistant bacteria, either as monotherapies, in combination with existing antibiotics, or in synergy with each other. Bacteriophages kill bacteria by injecting their genomes (DNA or RNA), leading to bacterial cell lysis, while AMPs can either disrupt bacterial cell membranes or interfere with their intracellular targets after penetrating the cell, causing cell death. Our review highlights that both AMPs and bacteriophages have been successfully employed in vitro, in clinical trials, and in patient treatments to eliminate bacterial isolates. Notably, studies combining AMPs and bacteriophages, though not yet widespread, have demonstrated remarkable efficacy. For example, one study investigated the combined use of Lys11, an endolysin derived from phage ϕ11, and the AMP R8K against Staphylococcus aureus. The results indicated that pre-treatment with R8K significantly increased the susceptibility of S. aureus to Lys11-mediated lysis, even at low concentrations. While the precise mechanisms underlying the synergistic action of AMPs and bacteriophages remain unclear, our findings underscore the need for further research in this promising domain. Regarding safety, numerous studies affirm the general safety of bacteriophages due to their specificity for bacterial cells. However, concerns about phage evolution potentially eliciting human immune responses necessitate additional investigation to enhance phage therapy. The issue of safety also extends to the recommended purification of AMPs when used in conjunction with bacteriophages to prevent adverse immune reactions in patients. In conclusion, this review advocates for intensified research into the combined use of AMPs and bacteriophages, emphasising their potential to revolutionise the treatment of antimicrobial-resistant infections.
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spelling doaj-art-133c2d70cf424a92a236a92a00940f322025-02-06T05:13:09ZengElsevierThe Microbe2950-19462025-03-016100254Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternativesChibuzo Vincent Alisigwe0Chibuzor Stanley Ikpa1Uchenna Joseph Otuonye2Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Correspondence to: Department of Microbiology, Michael Okpara University of Agriculture, Umudike, Umuahia, Abia State 7267, Nigeria.Department of Microbiology, Michael Okpara University of Agriculture Umudike, Umuahia 7267, NigeriaDepartment of Microbiology, Michael Okpara University of Agriculture Umudike, Umuahia 7267, NigeriaAntimicrobial peptides (AMPs) and bacteriophages, though long recognised, have gained significant attention in recent antimicrobial research due to the rapid evolution of microbial resistance to existing antibiotics. This publication comprehensively examines the current literature on the potential of AMPs and bacteriophages to treat infections caused by antimicrobial-resistant bacteria, either as monotherapies, in combination with existing antibiotics, or in synergy with each other. Bacteriophages kill bacteria by injecting their genomes (DNA or RNA), leading to bacterial cell lysis, while AMPs can either disrupt bacterial cell membranes or interfere with their intracellular targets after penetrating the cell, causing cell death. Our review highlights that both AMPs and bacteriophages have been successfully employed in vitro, in clinical trials, and in patient treatments to eliminate bacterial isolates. Notably, studies combining AMPs and bacteriophages, though not yet widespread, have demonstrated remarkable efficacy. For example, one study investigated the combined use of Lys11, an endolysin derived from phage ϕ11, and the AMP R8K against Staphylococcus aureus. The results indicated that pre-treatment with R8K significantly increased the susceptibility of S. aureus to Lys11-mediated lysis, even at low concentrations. While the precise mechanisms underlying the synergistic action of AMPs and bacteriophages remain unclear, our findings underscore the need for further research in this promising domain. Regarding safety, numerous studies affirm the general safety of bacteriophages due to their specificity for bacterial cells. However, concerns about phage evolution potentially eliciting human immune responses necessitate additional investigation to enhance phage therapy. The issue of safety also extends to the recommended purification of AMPs when used in conjunction with bacteriophages to prevent adverse immune reactions in patients. In conclusion, this review advocates for intensified research into the combined use of AMPs and bacteriophages, emphasising their potential to revolutionise the treatment of antimicrobial-resistant infections.http://www.sciencedirect.com/science/article/pii/S2950194625000226Antimicrobial peptidesBacteriophagesAntimicrobial resistanceAntibioticsAMRAMPs
spellingShingle Chibuzo Vincent Alisigwe
Chibuzor Stanley Ikpa
Uchenna Joseph Otuonye
Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives
The Microbe
Antimicrobial peptides
Bacteriophages
Antimicrobial resistance
Antibiotics
AMR
AMPs
title Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives
title_full Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives
title_fullStr Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives
title_full_unstemmed Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives
title_short Examining alternative approaches to antibiotic utilisation: A critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives
title_sort examining alternative approaches to antibiotic utilisation a critical evaluation of phage therapy and antimicrobial peptides combination as potential alternatives
topic Antimicrobial peptides
Bacteriophages
Antimicrobial resistance
Antibiotics
AMR
AMPs
url http://www.sciencedirect.com/science/article/pii/S2950194625000226
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