@article {Ben Porat00367-2021, author = {Shira Ben Porat and Daniel Gelman and Ortal Yerushalmy and Sivan Alkalay-Oren and Shunit Coppenhagen-Glazer and Malena Cohen-Cymberknoh and Eitan Kerem and Israel Amirav and Ran Nir-Paz and Ronen Hazan}, title = {Expanding clinical phage microbiology: simulating phage inhalation for respiratory tract infections}, elocation-id = {00367-2021}, year = {2021}, doi = {10.1183/23120541.00367-2021}, publisher = {European Respiratory Society}, abstract = {Phage therapy is a promising antibacterial strategy for resistant respiratory tract infections. Phage inhalation may serve this goal; however, it requires a careful assessment of their delivery by this approach. Here we present an in-vitro model to evaluate phage inhalation. Eight phages, most of which target cystic fibrosis (CF)-common pathogens, were aerosolized by jet nebulizer and administered to a real-scale computed tomography (CT)-derived 3D airways model with a breathing simulator. Viable phage loads reaching the output of the nebulizer and the tracheal level of the model were determined and compared to the loaded amount. Phage inhalation resulted in a diverse range of titer reduction, primarily associated with the nebulization process. No correlation was found between phage delivery to the phage physical or genomic dimensions. These findings highlight the need for tailored simulations of phage delivery, ideally by a patient-specific model in addition to proper phage matching, to increase the potential of phage therapy success.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interests: The authors of "Simulating Phage Inhalation for Respiratory Tract Infections" by Ben Porat and Gelman et al. declare no conflict of interest.}, URL = {https://openres.ersjournals.com/content/early/2021/08/12/23120541.00367-2021}, eprint = {https://openres.ersjournals.com/content/early/2021/08/12/23120541.00367-2021.full.pdf}, journal = {ERJ Open Research} }