Having observed that lysins were the phages' "active ingredients," Fischetti aims to harvest the lysins from them and turn them into stable antibacterial drugs. If successful, he could accomplish a double feat previously thought impossible: getting the bacteria-fighting benefits of phages to patients, while doing an end run around the regulatory Rube Goldberg machine that researchers like Wolcott face.
Whereas phages must evolve to keep up with bacterial evolution, lysins are like a blunt instrument that can kill entire families of bacteria, eliminating the need to isolate and test thousands of different compounds as phage scientists in Georgia do. But even if the FDA might perceive lysins more favorably than phages alone, Kutter says, the enzymes have drawbacks of their own. Lysins work only on Gram-positive bacteria, like strep and staph, not Gram-negative bacteria like E. coli and salmonella—the Gram-negative bacteria have an outside membrane that the lysins can't get through. Phages, on the other hand, can work against both kinds of bacteria. And unlike traditional phage therapy, lytic enzymes haven't made it to clinical trials yet, so although petri-dish evidence is promising, there's no telling whether it will translate into success in a hospital setting.
What Brillon really needs, Wolcott says, is a phage cocktail custom-mixed to target the particular bacteria colonizing his wounds. But it's back to the same old antibiotics for now. Sometimes, if the bacteria happen to be non-drug-resistant, the antibiotics work; sometimes they yield about the same results as a newt's-eye potion. Brillon keeps his legs wrapped in Ace bandages like a burn victim. "If you don't keep 'em tight," he says, "then the legs swell, and that's when the sores come out."
But he's not dwelling on the obstacles. Instead he imagines the day when he'll be able to put his infections behind him for good and spend more time fishing and playing with his four grandchildren who live nearby. He figures that if anyone can get him there, it will be Wolcott and his army of phages. "It really bothers him if he gets a hold of something he can't handle," Brillon says. "He tells me, 'I'm never going to give up on you.'"single page
Five amazing, clean technologies that will set us free, in this month's energy-focused issue. Also: how to build a better bomb detector, the robotic toys that are raising your children, a human catapult, the world's smallest arcade, and much more.