RT Journal Article SR Electronic T1 Expanding clinical phage microbiology: simulating phage inhalation for respiratory tract infections JF ERJ Open Research JO erjor FD European Respiratory Society SP 00367-2021 DO 10.1183/23120541.00367-2021 VO 7 IS 4 A1 Shira Ben Porat A1 Daniel Gelman A1 Ortal Yerushalmy A1 Sivan Alkalay-Oren A1 Shunit Coppenhagen-Glazer A1 Malena Cohen-Cymberknoh A1 Eitan Kerem A1 Israel Amirav A1 Ran Nir-Paz A1 Ronen Hazan YR 2021 UL http://openres.ersjournals.com/content/7/4/00367-2021.abstract 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