Interactions between Bacteriophage, Bacteria, and the Mammalian Immune System
Open accessAbstract
The human body is host to large numbers of bacteriophages (phages)–a diverse group of bacterial viruses that infect bacteria. Phage were previously regarded as bystanders that only impacted immunity indirectly via effects on the mammalian microbiome. However, it has become clear that phages also impact immunity directly, in ways that are typically anti-inflammatory. Phages can modulate innate immunity via phagocytosis and cytokine responses, but also impact adaptive immunity via effects on antibody production and effector polarization. Phages may thereby have profound effects on the outcome of bacterial infections by modulating the immune response. In this review we highlight the diverse ways in which phages interact with human cells. We present a computational model for predicting these complex and dynamic interactions. These models predict that the phageome may play important roles in shaping mammalian-bacterial interactions.
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Depending on microenvironmental cues and timing of exposure, phages can skew macrophages toward a proinflammatory, M1-like state, enhancing cytokine production, antimicrobial responses, and pathogen clearance.
“Depending on the microenvironmental cues and timing of exposure, phages can skew macrophages toward a proinflammatory, M1-like state, enhancing the production of cytokines, antimicrobial responses, and pathogen clearance”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 6 states that, although a pro-inflammatory interaction is theoretically possible, the literature it reviews says phages are not able to induce pro-inflammatory responses. Section 5.3 reports anti-inflammatory effects and only a very minor inflammatory cytokine increase in one mouse study; it does not describe M1-like macrophage polarization or enhanced antimicrobial responses through that mechanism. No page numbers were available in our copy. (LLM, conf=0.86)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredPhages alter microbial metabolites that regulate inflammation, genotoxic stress, and therapeutic response.
“Indirectly, phages reshape tumor-associated bacterial communities, depleting protumorigenic taxa and altering microbial metabolites that regulate inflammation, genotoxic stress, and therapeutic response [20–23]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 2, “The Human Phageome” (page unavailable), says phages can supply bacteria with genes involved in carbohydrate metabolism, while Section 5.3 reports anti-inflammatory responses to phages. Section 6 also models an effect of phage anti-inflammatory properties on bacterial-infection treatment outcomes. The paper does not establish that phages alter microbial metabolites regulating inflammation, genotoxic stress, or therapeutic response in tumors. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPhage DNA and structural proteins engage pattern recognition receptors within innate immune pathways, thereby enhancing antitumor immune responses.
“Additionally, phage DNA and structural proteins engage pattern recognition receptors within innate immune pathways, thereby enhancing antitumor immune responses [21,23–26]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 7 proposes that phage DNA might be recognized by the innate immune receptor TLR9; it does not establish that this engagement occurs. Section 5.3 reports that purified T4 capsid proteins did not induce inflammatory cytokines in mice, and the paper does not link DNA or structural-protein recognition to enhanced antitumor immunity. The tumor findings appear only in reference titles, not as support for the claimed mechanism; page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPhages deplete protumorigenic taxa.
“Indirectly, phages reshape tumor-associated bacterial communities, depleting protumorigenic taxa and altering microbial metabolites that regulate inflammation, genotoxic stress, and therapeutic response [20–23]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 6 (page unavailable) describes a model in which phages initially reduce bacterial counts, and Section 2 (page unavailable) discusses their potential to alter bacterial community composition. Neither passage identifies protumorigenic taxa or shows that phages deplete them in tumor-associated communities. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPhages reshape tumor-associated bacterial communities.
“Indirectly, phages reshape tumor-associated bacterial communities, depleting protumorigenic taxa and altering microbial metabolites that regulate inflammation, genotoxic stress, and therapeutic response [20–23]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 2, “The Human Phageome” (page unavailable), says phage interactions with commensal bacteria could alter community composition and affect immune function. It does not establish that phages reshape tumor-associated bacterial communities, deplete protumorigenic taxa, or alter metabolites affecting genotoxic stress or therapeutic response. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Phage particles and phage-derived nucleic acids can influence antigen-presenting cell function.
“Once present in tissues or circulation, phage particles and phage-derived nucleic acids can be sensed by innate immune receptors, influence antigen-presenting cell function, and modulate adaptive immune responses [23,25]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 5.3 reports that purified phages changed inflammatory markers in human immune cells, and Section 5.1 reports phage uptake by phagocytes. Section 7 proposes that phage DNA might be recognized by TLR9, but the paper does not establish that phage particles or phage-derived nucleic acids influence antigen-presenting cell function specifically. Page numbers were not available in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredPhage particles, phage-derived nucleic acids, and phage-bacterial debris exert context-dependent effects on macrophage phenotypes.
“Phage particles, phage-derived nucleic acids, and phage–bacterial debris exert profound, context-dependent effects on macrophage phenotypes (Figure 2A).”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 5.2 (page not provided) reports that phages administered with bacteria increased bacterial phagocytosis by macrophages, supporting a context-dependent effect on macrophage function. Section 5.1 cautions that bacterial debris in phage preparations makes the responsible component difficult to identify. The paper does not establish that phage-derived nucleic acids or phage–bacterial debris exert effects on macrophage phenotypes, so the claim overstates its findings. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDepending on microenvironmental cues and timing of exposure, phages can skew macrophages toward an anti-inflammatory, M2-like state, promoting tissue repair, immune regulation, and homeostasis.
“or toward an anti-inflammatory, M2-like state, which promotes tissue repair, immune regulation, and homeostasis [23]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 5.3 (page unavailable) reports that certain phages induce anti-inflammatory markers, and Section 7 discusses possible dampening of immune responses. Neither section establishes that phages shift macrophages to an M2-like state or thereby promote tissue repair, immune regulation, and homeostasis. The cited paper also does not link such a shift to microenvironmental cues or exposure timing. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPhage particles and phage-derived nucleic acids can modulate adaptive immune responses.
“Once present in tissues or circulation, phage particles and phage-derived nucleic acids can be sensed by innate immune receptors, influence antigen-presenting cell function, and modulate adaptive immune responses [23,25]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Section 5.4 reports that phage exposure can induce antibodies and a long-lasting secondary immune response, supporting the claim for phage particles. Section 7 only postulates that phage DNA might be recognized by TLR9; it does not establish that phage-derived nucleic acids modulate adaptive immune responses. Page numbers are not available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredPhages can enhance antitumor immunity.
“Phages can eliminate cancer-associated bacteria, remodel the tumor microenvironment, enhance antitumor immunity, and deliver targeted therapeutic payloads.”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
Phage particles and phage-derived nucleic acids can be sensed by innate immune receptors.
“Once present in tissues or circulation, phage particles and phage-derived nucleic acids can be sensed by innate immune receptors, influence antigen-presenting cell function, and modulate adaptive immune responses [23,25]”
From Phage therapy in oncology: opportunities for cancer prevention and treatment (2026) · cites this paper as [23]
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- Authors
- Van Belleghem, J. D., Dąbrowska, K., Vaneechoutte, M., Barr, J. J., & Bollyky, P. L.
- Affiliations
- Laboratory Bacteriology Research, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy (PL)
- Ghent University (BE)
- Monash University (AU)
- Stanford Medicine (US)
- Venue
- Viruses
- Publisher
- MDPI AG
- Published
- 2018-12-25
- Volume
- 11
- Issue
- 1
- Pages
- 10
- ISSN
- 1999-4915 (ISSN-L)
- PMC
- PMC6356784
- OpenAlex
- W2905810822
- Cited by
- 408
- References
- 9
- Citations by year
- 2026: 56 · 2025: 61 · 2024: 47 · 2023: 53 · 2022: 52 · 2021: 65 · 2020: 42 · 2019: 30 · 2018: 1
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Viruses (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Falk Medical Research Trust (Transformative Award)
- Topics
- Physical Sciences › Environmental Science › Ecology › Bacteriophages and microbial interactions
- Life Sciences › Immunology and Microbiology › Immunology › Immune Response and Inflammation
- Life Sciences › Immunology and Microbiology › Immunology › Invertebrate Immune Response Mechanisms
- Keywords
- bacteriophages, phage-bacteria interactions, innate immunity, adaptive immunity, phagocytosis, cytokine response, antibody production, phageome, bacterial infection, host-microbe interactions
- MeSH terms
- Host Microbial Interactions, Animals, Antibodies, Viral, Bacteria, Bacterial Infections, Bacteriophages, Humans, Immunity, Innate, Phagocytosis, Cytokines, Mice, Adaptive Immunity, Microbiota
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