Suggests that a preventive treatment might still be

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suggests that a preventive treatment might still be efficacious if bacteriophages are given 48 or 72 h before the start of in- fection, or if the amount of bacteriophages is decreased when given 24 h before infection. Such possibilities will expand the applications of bacteriophages to prevent infections from oc-
Phage Therapy for Lung Infections JID 2010:201 (1 April) 1103 curring. On the basis of the low level of cytokines induced by the bacteriophage solution, it is tempting to consider that the preventive effect is only due to bacteriophages rather than due to an inflammatory reaction. However, we cannot exclude the possibility that bacteriophages could induce phagocytic activity of cells such as macrophages toward bacteria (which may not necessarily require cytokine production). Infection of bacteria by in-site bacteriophages decreases rapidly the amount of path- ogenic bacteria, reducing chances for the bacteria to start an active infection process and provoke lung damage. Recently, Golshahi et al [32] provided evidence that bacteriophages giv- en by means of nebulization should be efficiently distributed in the lungs, which accords with the preventive effect we de- scribed. Taken together, these results clearly open the possibility of using bacteriophages in the prevention of bacterial lung in- fections. For example, one possibility is pretreatment of pop- ulations at risk for such infections (immunocompromised pa- tients or patients with cystic fibrosis) to decrease the probability of infection in places where patients are more likely to be in- fected by bacteria (eg, care centers or hospitals). This is par- ticularly relevant in situations in which an epidemic strain has been identified and for which preventive treatment with specific bacteriophages could be used to limit its spread. Such epidemic strains have been reported previously for P. aeruginosa in cen- ters for treatment of cystic fibrosis [33]. Another situation in which a preventive treatment could be proposed is an influenza pandemic. According to recent studies, a predominant cause of death during the 1918 influenza pandemic was pneumonia rather than influenza itself [34]. A preventive bacteriophage treatment against pneumonia using a bacteriophage cocktail that targets the most prevalent lung pathogens could be en- visaged in the case of a new influenza pandemic and could probably substantially decrease the number of deaths. For obvious reasons, the genome sequence of a natural bac- teriophage that could be considered for therapeutic use should be determined. However, complete annotation of a bacterio- phage genome requires in-depth bioinformatics analysis, be- cause gene-coding sequences found in bacteriophages are highly variable; moreover, few bacteriophage genomes have been an- alyzed in depth. Instead, here we propose a brief analysis aimed at confirming the virulent nature of the bacteriophage. Taking advantage of the ACLAME database, we determined that among all potential ORFs in the 6 reading frames, no significant match

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