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I thought one issue is that our immune system might adapt and kill the phages, making them more of a one-time use per person. Is this true?



They don't infect human cells at all so none of the "I am being attacked" signalling will be coming out of human cells (nor out of the various symbiotic bacteria we live with in and around our body), thus its unlikely it will elicit much of a response. Phages just sit around and do nothing if the right host isn't available and they are so highly specific to the bacteria they infect.

So I don't think so but not much research has been done in the west on phages since the invention of antibiotics.


To my understanding you’re right (ie they don’t affect human cells) but there’s absolutely a chance the human immune system picks them up, but only really if they get in the blood stream. And really this is a secondary concern if that is the goal of treatment, because not doing it means the person probably dies. And due to the extreme sensitivity of a phage to a specific pathogen even having concerns about immune reactions in the future is likely to be a very minor concern given the alternative.

Most phage therapy I have seen/heard of is related to wound care and bacteria that is causing intractable antibiotic resistant infections (either superficial or potentially respiratory). In these environments immune cells cant really effectively do their immune actions (because of the debris, and because a necessary function of effective immunity is effective circulation).

A good going blood borne infection being attacked by bacteriophages would be scary to treat someone through… intravascular bacteria being lysed causes a generalised inflammatory response that amongst other things is hyper coagulable


Your immune system attacks plenty of things that are not attacking your cells.

There are multiple different detection mechanisms.


it looks like our immune system does attack them sometimes and a lot of the successes have been with people on immunosuppressants https://arstechnica.com/science/2021/07/maybe-not-so-fast-wi...


>none of the "I am being attacked" signalling will be coming out of human cells

There's more than enough "I'm being attacked" signalling from the cells attacked by the actual bacteria the phage was meant to address - which is generally about where we also want the phage to be.




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