Progress of bacteriophage as therapeutic agent against Helicobacter pylori, especially in India

Helicobacter pylori (H. pylori), the major causative agent for gastrointestinal disorders, including peptic ulcer, gastritis, and gastric cancer, infects approximately 50% global and 75–80% of Indian population. The standard triple therapy is increasingly compromised by rising antimicrobial resistance (AMR) and development of Multidrug resistant strains. The crisis with the AMR even amplifies in India, it being the world’s highest populated developing country. An alternative to antibiotics could be relayed to that of bacteriophages, which are by nature the bacterial predators. This review explores prevalence and challenges of H. pylori infection in India, evaluates potential of bacteriophage mediated therapy in terms of factors influencing its efficacy, such as phage resistance, host specificity, and treatment regimen. We also examine the progress made in isolating bacteriophages, probable sources of isolation and methods of screening, current research and clinical advancements of phage therapy against H. pylori infection despite challenges such as the scarcity of naturally occurring H. pylori phages and the bacterium’s protective niche within the gastric mucosa. Lastly, we discuss techniques that suggest strategies to engineer bacteriophages, like CRISPR-cas, retron and in vitro based methods enhancing the effectiveness and specificity against bacterial pathogens. This article will help guiding and directing the future prospects in phage therapy, against H. pylori in Indian set up, which would ultimately address the issue of AMR, that happens to be a persisting threat to mankind. This approach leverages bacteriophages’ ability to precisely target bacterial cells while leaving human cells and beneficial microbiota unaffected.