Hopefully you know by now that the bladder and urine is NOT sterile but houses a community of microbes, collectively known as the bladder microbiota. Until now, we have mostly spoken about bacteria and fungi in the bladder. But a recent study has shed light on another never-before-seen member of the microbiota: tiny viruses called phages.

What are Phages?

Phages are also called bacteriophages and are basically viruses that can infect and replicate within bacteria and other organisms similar to bacteria called archaea.

They basically consist of a protein that contains DNA or RNA.

In humans, viruses cause an infection by entering cells and where they replicate. Phages do the same thing to bacteria: they penetrate the bacterial wall, injecting their genetic data and are then able to replicate.

There are two types of phages: lytic or lysogenic. Lytic phages infect bacteria and then burst the cell wall once they have replicated to infect more bacteria, essentially killing the bacteria in the process.

Lysogenic bacteria hide their genetic data in bacterial genes, which the bacteria passes on to future generations. When a bacteria containing the viral genetic data is weakened, the phages can replicate again and become lytic phages. This can actually be helpful for the bacteria, as phages may take some of the bacterial genetic data and pass it around.

In the gut, for example, phages are thought to play an important role in driving the biodiversity of the gut ecosystem (the gut microbiota). One phage is usually specific for one bacteria.

Phages are actually widely distributed across the planet and can be found anywhere bacteria are present.

We already knew they were present in the gut but now, for the first time, they have also been identified in the bladder.

Phages in the Bladder

Over 200 different species of phages have so far been identified in the bladder, outnumbering bacterial species.

A change in phage populations was observed in females suffering from urinary symptoms, suggesting that phages play a role in bladder health.

Unfortunately, we do not know yet what role phages play exactly or which phage infects which bacteria. Research is ongoing and will hopefully bring more answers and possible therapeutic interventions.

Phage Therapy

Phages have actually been used as a therapy for killing pathogenic bacteria for over 90 years.

Because phages can kill bacteria, specific phages can be beneficially used to kill specific bacteria.

Although phages have been discovered as a therapeutic agent a long time ago, they have mainly only been used in France, Poland, Georgia and Russia.

Although more studies still need to be done on the subject, so far phage therapy seems to be a safe and effective way of killing specific pathogenic bacteria and may be especially useful in cases of antibiotic resistance or for people who cannot take antibiotics for other reasons.

Because phages are targeted, they most likely also do not negatively affect the microbiome like antibiotics do.

Phages can also be used the other way around: to boost specific beneficial bacteria. They achieve this by selectively attaching to only harmful bacteria, allowing the beneficial strains to outperform the harmful bacteria. Some phage supplements are already available (for example Floraphage and Probiophage). These may or may not be helpful for addressing dysbiosis in the bladder.

For bladder health, we can hope that more research into the phages of the bladder opens up new therapeutic options for chronic infections.

Have you heard of phages or had any experiences with them? What do you think of phages? Let me know in the comments!




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Sources

Wikipedia Bacteriophage accessed Feb 2018 https://en.wikipedia.org/wiki/Bacteriophage#Phage_therapy

Advanced Supplements Floraphage Accessed Feb 2018 https://www.advanced-supplements.co.uk/product/floraphage/

Abedon, Stephen T et al. “Phage Treatment of Human Infections.” Bacteriophage 1.2 (2011): 66–85. PMC. Web. 18 Feb. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278644/

Ventura, Marco et al. “The Impact of Bacteriophages on Probiotic Bacteria and Gut Microbiota Diversity.” Genes & Nutrition 6.3 (2011): 205–207. PMC. Web. 18 Feb. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145054/

Miller-Ensminger, T. et al BACTERIOPHAGES OF THE URINARY MICROBIOME JB March 2018, Volume 200, Issue 5 http://jb.asm.org/content/early/2018/01/10/JB.00738-17

Mole, Beth Never-before-seen viruses that can kill bacteria stream from women’s bladders Ars Technica Feb 2018 https://arstechnica.com/science/2018/02/streaming-viral-content-womens-bladders-gush-with-cryptic-killer-viruses