Cited by 282Bacteriophages and microbial interactionsCRISPR and Genetic EngineeringVirus-based gene therapy research

Engineered phage with antibacterial CRISPR–Cas selectively reduce E. coli burden in mice

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Gencay, Yilmaz Emre, Jasinskytė, Džiuginta, Robert, Camille, Semsey, Szabolcs, Martínez, Virginia, Petersen, Anders Østergaard, Brunner, Katja, de Santiago Torio, Ana +28 more·2024·Nature Biotechnology

Abstract

Antibiotic treatments have detrimental effects on the microbiome and lead to antibiotic resistance. To develop a phage therapy against a diverse range of clinically relevant Escherichia coli , we screened a library of 162 wild-type (WT) phages, identifying eight phages with broad coverage of E. coli , complementary binding to bacterial surface receptors, and the capability to stably carry inserted cargo. Selected phages were engineered with tail fibers and CRISPR–Cas machinery to specifically target E. coli . We show that engineered phages target bacteria in biofilms, reduce the emergence of phage-tolerant E. coli and out-compete their ancestral WT phages in coculture experiments. A combination of the four most complementary bacteriophages, called SNIPR001, is well tolerated in both mouse models and minipigs and reduces E. coli load in the mouse gut better than its constituent components separately. SNIPR001 is in clinical development to selectively kill E. coli , which may cause fatal infections in hematological cancer patients.

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Crossref · 10.1038/s41587-023-01759-y

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  • Overall, these studies have established encouraging safety profiles and provided preliminary pharmacokinetic and immunogenicity data in immunocompromised populations.

    “Overall, these studies have established encouraging safety profiles and provided preliminary pharmacokinetic and immunogenicity data in immunocompromised populations, laying an important foundation for oncology-directed applications.”

    From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [129]

    The Results section, “Tolerability and recovery of SNIPR001 in minipigs” (page not provided), reports good tolerability and measurements of phage recovery in feces and plasma. It does not report immunogenicity data or establish a safety profile or pharmacokinetic findings in immunocompromised people. The Discussion says a clinical safety study was still ongoing. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • SNIPR001 demonstrates clinical proof of concept for targeted reduction of gut E. coli.

    “SNIPR001 was recovered from fecal samples in a dose-dependent manner and corresponded with a numerical reduction in gut E. coli levels, demonstrating clinical proof of concept for this targeted approach.”

    From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [129]

    The Results section, “Efficacy in a mouse colonization model” (page not provided), reports dose-related fecal recovery of SNIPR001 and a reduction in gut E. coli in mice. It does not establish clinical proof of concept: the Discussion says translation to humans requires investigation and that a clinical study was ongoing. (LLM, conf=0.90)

    Experimental — accuracy not yet measured
  • In a Phase 1 randomized, double-blind, placebo-controlled, multiple-dose, dose-escalation trial (NCT05277350) involving 36 healthy volunteers across three dose levels, 7-day oral administration of SNIPR001 was well tolerated, with only mild to moderate adverse events and no treatment-related discontinuations.

    “In a Phase 1 randomized, double-blind, placebo-controlled, multiple-dose, dose-escalation study trial (NCT05277350i) involving 36 healthy volunteers across three dose levels, 7-day oral administration of SNIPR001 was well tolerated, with only mild to moderate adverse events and no treatment-related discontinuations.”

    From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [129]

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  • SNIPR001 administration corresponded with a numerical reduction in gut E. coli levels.

    “SNIPR001 was recovered from fecal samples in a dose-dependent manner and corresponded with a numerical reduction in gut E. coli levels, demonstrating clinical proof of concept for this targeted approach.”
  • SNIPR001 is a next-generation, orally administered CRISPR-phage therapeutic designed to selectively reduce gut colonization by E. coli.

    “Building on this foundation, SNIPR001 represents a next-generation, orally administered CRISPR–phage therapeutic designed to selectively reduce gut colonization by E. coli, a major source of bloodstream infections in patients with hematological malignancies [129]”

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Research works printed but not linked: 2

  1. [22]Sabino, J, Hirten, R. P & Colombel, J. Alimentary Pharmacology & Therapeutics, Vol. 51 (Wiley Online Library, 2020). 31696976
  2. [29]Bikard D Development of sequence-specific antimicrobials based on programmable CRISPR–Cas nucleases Nat. Biotechnol 2014 32 1146 1150 25282355 PMC4317352

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Authors
Gencay, Y. E., Jasinskytė, D., Robert, C., Semsey, S., Martínez, V., Petersen, A. Ø., Brunner, K., de Santiago Torio, A., Salazar, A., Turcu, I. C., Eriksen, M. K., Koval, L., Takos, A., Pascal, R., Schou, T. S., Bayer, L., Bryde, T., Johansen, K. C., Bak, E. G., Smrekar, F., Doyle, T. B., Satlin, M. J., Gram, A., Carvalho, J., Jessen, L., Hallström, B., Hink, J., Damholt, B., Troy, A., Grove, M., Clube, J., Grøndahl, C., Haaber, J. K., van der Helm, E., Zdravkovic, M., & Sommer, M. O. A.
Affiliations
  • JMI Laboratories (US)
  • Weill Cornell Medicine (US)
  • Novo Nordisk Foundation (DK)
Corresponding author
Sommer, Morten Otto Alexander
Venue
Nature Biotechnology
Published
2023-05-04
Volume
42
Issue
2
Pages
265-274
ISSN
  • 0733-222X (ISSN-L)
  • 1087-0156
  • 1546-1696
OpenAlex
W4372330661
Cited by
282
References
63
Citations by year
2026: 92 · 2025: 114 · 2024: 59 · 2023: 17
FWCI
45.54
Type
journal article
Language
en
Open access
Locations
  • Nature Biotechnology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Technical University of Denmark, DTU Orbit (Technical University of Denmark, DTU) (submittedVersion, other-oa)
Funders
  • Wellcome Trust
  • Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (IDSEP160030)
  • Lundbeckfonden (R77-2010-6772, R140-2013-13496)
  • Novo Nordisk Fonden (NNF21OC0070455, NNF22OC0081058, NNF21OC0072832, NNF14OC0011335, NNF17OC0028232, NNF10CC1016517, NNF22OC0080975, NNF21OC0069281)
  • Biomedical Advanced Research and Development Authority (IDSEP160030)
Topics
  • Physical Sciences › Environmental Science › Ecology › Bacteriophages and microbial interactions
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › CRISPR and Genetic Engineering
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
Keywords
phage therapy, CRISPR-Cas, Escherichia coli, bacteriophages, phage engineering, biofilm, gut microbiota, antibiotic resistance, minipig model, phage cocktail
MeSH terms
Animals, Anti-Bacterial Agents, Bacteriophages, Escherichia coli, Humans, Swine, Swine, Miniature, Mice, CRISPR-Cas Systems

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