Bacteriophages in the treatment and prevention of atopic dermatitis and dermatoses complicated by secondary bacterial infection

Abstract

Bacteriophages are a large group of viruses that can selectively affect bacteria. Bacteriophages and their ability to regulate the growth and activity of pathogenic microorganisms were discovered by scientists at the beginning of the 20th century. Further studies of the properties of bacteriophages led to the construction of the modern concept of virus activity and formed the ground of molecular genetics and biology. To date, more than 6 000 phage species are known to be ubiquitous, but a prerequisite for their existence is the presence of a bacterial host cell, proteins and energy resources serve as the basis for further viral replication. The ability of bacteriophages to selectively destroy bacterial host cells is of particular importance for the therapy and prevention of dermatoses with a potential risk of bacterial infection or pathogenetically aggravated by the activity of the bacterial flora. Such dermatoses include atopic dermatitis, acne, eczema, psoriasis, pyoderma. The article highlights the main advantages and features of bacteriophages, presents data from some of the currently available studies on the use of phages in dermatovenereology. To illustrate the possibility of using bacteriophages in dermatology, a clinical case of successful relief of exacerbation of IgE- independent atopic dermatitis with a high risk of secondary infection in an 8-year-old child is presented. In this case, as an additional to the recommended standard external anti-inflammatory therapy, a gel for external use was prescribed based on a complex of more than 70 virulent bacteriophages capable of inhibiting the growth of actual bacterial strains, among them Staphylococcus spp. (including S. aureus), Streptococcus spp. (including S. pyogenes), Cutibacterium acnes, etc. The range of bacteriophages in dermatovenereology can be expanded due to the constant growth of antibiotic resistance. The use of bacteriophages in routine dermatological practice requires further clinical trials.