Expanding clinical phage microbiology: Simulating phage inhalation for respiratory tract infections

Shira Ben Porat, Daniel Gelman, Ortal Yerushalmy, Sivan Alkalay-Oren, Shunit Coppenhagen-Glazer, Malena Cohen-Cymberknoh, Eitan Kerem, Israel Amirav Ran Nir-Paz, Ronen Hazan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


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.

Original languageAmerican English
Article number00367-2021
JournalERJ Open Research
Issue number4
StatePublished - 1 Oct 2021

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© The authors 2021.


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