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AIMS AND BACTERIOPHAGES
Based on a scientific collaboration agreement with the EPTC (Eliava Phage Therapy Center), AIMS is involved in promoting the use of bacteriophages in patients affected by infectious diseases that do not respond to antibiotic treatments and for whom no reasonable therapeutic alternatives are available. In the absence of approval from European drug regulatory agencies, the therapy can be administered to patients who need it, based on the criteria defined in the Declaration of Helsinki.
The AIMS doctors, together with their EPTC colleagues, assess the eligibility of patients for phage therapy based on clinical and microbiological findings. They coordinate the treatment with the patients' attending physicians, whom they do not replace but rather integrate with, so that patients can continue their conventional therapies (in particular antibiotic therapy), with which phages do not interfere, but in many cases actually increase the susceptibility of the infection to pharmacological treatment. They follow patients throughout their therapeutic journey, ensuring that they adhere to current guidelines in the treatment of their specific condition.
The EPTC (Phage Therapy Clinical Center of the Eliava Institute)
The Eliava Institute was founded in 1923 by the Georgian microbiologist George Eliava and the Franco-Canadian scientist Félix d'Herelle. The friendship and scientific interest that united these two people was the essential glue that allowed them to dedicate themselves to the development of a new Institute of Microbiology, which the two researchers aspired to transform into the world center for phage research. In fact, during the period of the former Soviet Union, the Eliava Institute housed one of the most important collections of bacteria and bacteriophages. In its scientific laboratories, numerous and effective phage-based preparations were developed, produced for commercial purposes by production units within the Institute itself. The products of what is still today the Eliava Institute of Bacteriophage, Microbiology and Virology (IBMV) were used for the prophylaxis and treatment of infectious diseases in humans throughout the former Soviet Union, both in the public health network and by the armed forces. The Institute survived a series of serious challenges and difficulties following the dissolution of the USSR in 1991, but it has always maintained its focus on research and clinical applications of bacteriophages.
The Eliava Phage Therapy Clinical Center (EPTC) is affiliated with the Eliava IBMV and is one of the few centers of its kind in the world dedicated to phage therapy. EPTC has specialists in the fields of Internal Medicine, Pediatrics, Urology, Gynecology, Dermatology, and Surgery who work using therapeutic strategies that integrate the conventional approach with the unique characteristics of bacteriophages for the treatment of complex cases in which a bacterial infection is recognized as the etiological and pathogenetic factor.
Information about the Eliava phage therapy center
After their discovery in the 1940s, antibiotics supplanted phage therapy in the healthcare community's war against bacterial infections. However, an increasing number of bacteria have become ever more resistant to antibiotics, creating one of the most significant global health threats. Today, patients visit EPTC from all over the world to fight their antibiotic-resistant bacterial infections with Eliava's therapeutic phages. Phage preparations for prophylactic and therapeutic use are prepared by selecting bacteriophages that target a wide range of pathogenic bacteria. The selection of which phage or phage cocktail to use on a patient is decided after performing bacteriological analysis on the patient's clinical samples, based on 100 years of clinical experience.
Therefore, phage therapy is the use of "good" viruses (antibacterial viruses) to treat infections caused by antibiotic-resistant germs or chronic infections in which antibiotics fail to eradicate the pathogen. The bacteriophage, or antibacterial virus, acts directly and exclusively on the target bacteria to destroy them through a process called "lysis," leaving human cells intact. The specific bacteriophage seeks out the host bacteria on which it is active, attaching to the outside of the bacterial cell wall and injecting its DNA into the bacterium. This phage DNA disrupts the cell's reproductive mechanism, which is reprogrammed to produce phage particles. During this active infection process, and after the phage has sufficiently multiplied and assembled its progeny inside the cell, enzymes are released by the phages that "lyse" the outer wall of the bacteria, killing the bacteria and releasing new bacteriophages into the environment to find and attack other bacteria of that type. Since phages multiply exponentially, a bacterial infection can be eradicated in a very short period of time.
Phage therapy is an alternative or synergistic treatment to antibiotic therapy for the treatment of bacterial infections in cases where an infection is chronic or where antibiotics have not worked. It can be a last-resort tool for infections caused by multi-resistant bacteria. In particular, in the case of MRSA, ESBL, CRE, and VRE bacteria, the superbugs responsible for the frightening reality of today's world. Phages can target antibiotic-resistant infections, but they can also prove advantageous in treating infections that cannot be effectively treated with antibiotics due to poor tissue perfusion or the presence of bacterial biofilms. This is due to their different pharmacokinetics (the ability to be delivered within wounds and in the body). Phages are also a useful solution for treating infections in people with antibiotic allergies and protect the bacterial ecology in the gut (microbiome) because of their specificity. Broad-spectrum antibiotics, on the other hand, destroy many good bacteria in the digestive tract.
THE THERAPEUTIC PATHWAY AT EPTC
Each clinical case, especially when it comes to chronic infections in patients who have undergone numerous treatments and/or surgeries, has its own peculiarities, and therefore the treatment plan must be established on a case-by-case basis. Generally speaking, there are two possible treatment options:
The first option requires the patient to go directly to Tbilisi to receive treatment directly from the local team.
The second is to be followed remotely by EPTC doctors with the support of AIMS doctors, taking the medications at home.
The choice of the best course of action must be discussed each time with the patient, based on clinical and logistical needs, and not least, financial possibilities.
The treatment process at EPTC always follows a general guideline, which unfolds over approximately 10 working days during which:
DAY 1 – 2
• Diagnostic tests (If outside the clinic, you will be accompanied by clinic staff)
• Medical and specialist consultations, if necessary: internal medicine, surgery, dermatology, endocrinology, gynecology, infectious disease, pulmonology, neurology, etc.
• Support services: therapeutic massage, physiotherapy, IV fluids
Not included in the package (and if necessary)
• Customized phage preparation (if standard phages are not sensitive) for bacterial strain
• Hospital surgery (if necessary and approved by the patient)
• Emergency Department
• Hospitalizations
• Translation services (other than English, which is included)
THE FIRST WEEK
• Results from bacterial cultures, modification of treatment if necessary
• Repeat the bacteriological analysis to monitor progress (reduction of infection)
• Ongoing phagic procedures (e.g. urology, gynecology, otorhinolaryngology, inhalations)
BEANS TO TAKE HOME (HOME THERAPY)
• The necessary home therapy will be provided to complete the first treatment cycle and to repeat an additional treatment cycle.
FURTHER INFORMATION:
Upon request, the Eliava Phage Therapy Center can refer you to logistics companies that support the patient. They can assist you in organizing your trip to Georgia, finding affordable accommodation, translation services, and transportation from the airport and around the area.
AFTER RETURNING HOME
After returning home, you will be followed by AIMS doctors, who are always in direct contact with EPTC specialists.
© Academy for innovation in medical sciences