Turning of (Ph)age: Expanding the therapeutic potential of our viral allies

Novel strategies for treating bacterial infections are needed to combat the growing threat of antibiotic resistance. Here we sought to engineer and produce phage-like particles to either harness the microbiome to secrete therapeutics or to hijack pathogenic bacteria for treatment and prevention of disease. For this, we used the P2/P4 system to design, produce and test P4 phage-mediated single- and dual-action antimicrobial prototypes. Upon successful completion of the in vitro proof of concept experiments, we focused on optimizing early-stage bioprocessing for in vivo studies, leading to 10^11 plaque forming units (PFU) per mL and 0.25 endotoxin units (EU) per 10^9 PFU. We also challenged the P4 viral vector packaging limit by deleting the sid gene to package the payload into P2-sized capsids (~25.8 kb cargo capacity). Importantly, repressing the therapeutic payload during the production of particles improved viral titers about 2 logs, maintained viral payload sequence integrity and improved post-transduction functional activity. Altogether, this study demonstrates the potential of novel phage-based antimicrobials to go beyond elimination of bacteria. The in vitro optimized P2/P4 system constitutes a promising platform technology for in vivo evaluations of targeted antimicrobial candidates paving the way for future antimicrobial research in animal models of infection.