PT  - JOURNAL ARTICLE
AU  - Shira Ben Porat
AU  - Daniel Gelman
AU  - Ortal Yerushalmy
AU  - Sivan Alkalay-Oren
AU  - Shunit Coppenhagen-Glazer
AU  - Malena Cohen-Cymberknoh
AU  - Eitan Kerem
AU  - Israel Amirav
AU  - Ran Nir-Paz
AU  - Ronen Hazan
TI  - Expanding clinical phage microbiology: simulating phage inhalation for respiratory tract infections
AID  - 10.1183/23120541.00367-2021
DP  - 2021 Oct 01
TA  - ERJ Open Research
PG  - 00367-2021
VI  - 7
IP  - 4
4099  - http://openres.ersjournals.com/content/7/4/00367-2021.short
4100  - http://openres.ersjournals.com/content/7/4/00367-2021.full
SO  - erjor2021 Oct 01; 7
AB  - 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 pathogens common in cystic fibrosis, were aerosolised by jet nebuliser and administered to a real-scale computed tomography-derived 3D airways model with a breathing simulator. Viable phage loads reaching the output of the nebuliser and the tracheal level of the model were determined and compared to the loaded amount. Phage inhalation resulted in a diverse range of titre reduction, primarily associated with the nebulisation 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.Phage therapy can be used against infectious diseases if personally tailored. Using a 3D airway model, this study shows that phage delivery to the respiratory tract by inhalation is unpredictable and requires precise evaluation. https://bit.ly/3ATdzr5