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. 2014 Nov 18;5:618. doi: 10.3389/fmicb.2014.00618

Table 1.

Suggested principles in the choice of phages for therapy.

Principle Benefits Drawbacks Reference
1 Broad host range Reduces need to diagnose infecting strains; may simultaneously attack multiple strains of a single pathogen Broad host range may conflict with other optimal phage characteristics Balogh et al. (2010), Gill (2010)
2 Phage mixtures targeting different host receptors Development of resistance to phage less likely as mutants resistant to one phage remain sensitive to others in the mixture Greater development time, may limit the repertoire of phage available for some bacteria Balogh et al. (2010), Gill (2010), Chan and Abedon (2012), Chan et al. (2013)
3 Non-temperate Avoids lysogeny as an easy form of bacterial insensitivity; avoids pathogenicity genes commonly found in temperate phages Limits the repertoire of phage available for some bacteria Gill and Young (2011)
4 Ability to clear liquid cultures Simple in vitro assay Applicability to in vivo success unknown Smith and Huggins (1982), Henry et al. (2013)
5 Non-lysing phages Cells are killed without releasing toxins Phage do not amplify, so huge numbers of phage must be inoculated Matsuda et al. (2005)
6 Target surface virulence determinants or otherwise impose high cost of resistance Difficult bacterial escape; resistant cells become unfit/avirulent Limits the repertoire of phage available Capparelli et al. (2010a,b), Viertel et al. (2014), this paper
7 Tailspike de-polymerase Acapsular bacterial mutants are often avirulent (see item 6); unassembled tailspikes released at lysis as free enzyme, digest capsule of nearby cells and expose them to immune system Possibly limited host range of such phage, limits the repertoire of phage available for some bacteria Francis et al. (1934), Sutherland (1995), Mushtaq et al. (2004), Malnoy et al. (2005), Bull et al. (2010)
8 Non-transducing Will not mobilize pathogenicity or antibiotic resistance determinants Limits the repertoire of phage available for some bacteria Gill (2010)
9 Slow in vivo virion decay rate Increases phage longevity in the animal host, increasing probability of phage encountering bacteria None obvious, may allow for faster development of acquired immunity to phage Merril et al. (1996), Balogh et al. (2010)