The potential role for phage therapy for genetic modification of cutaneous diseases

Antimicrobial resistance has become increasingly common across the globe, claiming more than 33,000 lives annually in Europe and 35,000 lives in the United States alone. The problem lies in trying to find potential solutions capable of tackling resistance and being able to fight infections that may resist various antimicrobials. Since Alexander Fleming's discovery in 1928, every antimicrobial synthesized in the past 70 years has developed at least one or more strains of resistant bacteria. One particular alternative to antimicrobials has brought hope to many in the scientific community: the bacteriophage. Bacteriophages are viruses that can replicate within bacteria, triggering genetic alterations and changes in pathways of protein expression by encoding a few to hundreds of genes within their genomes. The bacteriophage can hijack the cell, using the cell's genetic apparatus to replicate within the bacterium until bacterial lysis occurs. This therapy has been used in the genodermatosis Netherton syndrome, which has been associated with the increased risk of Staphylococcus aureus infections. Emerging data support the potential role of bacteriophage therapy for Cutibacterium acnes in acne vulgaris, with a potential role in genetic disorders with severe acne vulgaris, including Apert syndrome. Bacteriophages hold benefits for genodermatoses associated with recurrent cutaneous infections, that is, the immunodeficiencies with distinctive cutaneous features as well as conditions such as atopic dermatitis, in which bacterial colonization plays a strong role.