{"id":31386,"date":"2026-06-18T15:36:36","date_gmt":"2026-06-18T14:36:36","guid":{"rendered":"https:\/\/ppr-antibioresistance.inserm.fr\/?p=31386"},"modified":"2026-06-18T16:20:20","modified_gmt":"2026-06-18T15:20:20","slug":"point-sur-la-phagotherapie-en-france","status":"publish","type":"post","link":"https:\/\/ppr-antibioresistance.inserm.fr\/en\/edito\/point-sur-la-phagotherapie-en-france\/","title":{"rendered":"Point sur la phagoth\u00e9rapie en France"},"content":{"rendered":"\n

Les Hospices Civils de Lyon (HCL)[1]<\/sup><\/a> obtiennent de l\u2019Agence nationale de s\u00e9curit\u00e9 du m\u00e9dicament et des produits de sant\u00e9 (ANSM)[2]<\/sup><\/a> l\u2019autorisation de fabrication d\u2019interm\u00e9diaires de production et de mati\u00e8res premi\u00e8res \u00e0 usage pharmaceutiques pour les phages anti-S.aureus<\/em>.<\/h4>\n\n\n\n
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\"\"<\/figure><\/div><\/div>\n\n\n\n
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On appelle phagoth\u00e9rapie l\u2019utilisation de bact\u00e9riophages pour s\u2019attaquer et d\u00e9truire sp\u00e9cifiquement des bact\u00e9ries pathog\u00e8nes sans effet nocif pour les autres cellules de l\u2019organisme h\u00f4te.<\/p>\n\n\n\n

Les bact\u00e9riophages, plus couramment appel\u00e9s \u00ab phages \u00bb sont des virus capables d\u2019infecter une bact\u00e9rie en utilisant celle-ci comme espace de r\u00e9plication et multiplication jusqu\u2019\u00e0 la lyse de la bact\u00e9rie h\u00f4te permettant la lib\u00e9ration des phages nouvellement cr\u00e9\u00e9s et pouvant s\u2019attaquer aux autres bact\u00e9ries-cibles environnantes jusqu\u2019\u00e0 leur disparition dans le milieu.<\/p>\n<\/div>\n<\/div>\n\n\n\n

D\u00e9couverts en 1915, la premi\u00e8re utilisation th\u00e9rapeutique de phages \u00e0 lieu en 1919 \u00e0 l\u2019H\u00f4pital Necker enfants malades. C\u2019est pour leur efficacit\u00e9 sp\u00e9cifique sur les pathog\u00e8nes que dans les ann\u00e9es 1920 les phages ont \u00e9t\u00e9 utilis\u00e9s en France jusqu\u2019\u00e0 l\u2019arriv\u00e9e des antibiotiques dans nos pharmacies. Les antibiotiques \u00e9tant bien plus faciles \u00e0 produire, stocker, et fonctionnant \u00e0 plus large spectre, leur d\u00e9ploiement s\u2019est fait \u00e0 tr\u00e8s grande \u00e9chelle face aux phages pr\u00e9sentant certains inconv\u00e9nients \u00e0 l\u2019exploitation industrielle.<\/p>\n\n\n\n

En effet, un phage est efficace contre une seule souche de bact\u00e9rie, si celle-ci n\u2019est pas correctement identifi\u00e9e, la phagoth\u00e9rapie n\u2019aura aucun effet sur l\u2019infection. Les phages \u00e9tant des virus, leur stabilit\u00e9, stockage et conservation \u00e9tait plus compliqu\u00e9e que celle des antibiotiques.<\/p>\n\n\n\n

Malgr\u00e9 son effacement face aux antibiotiques en France et dans le monde, la phagoth\u00e9rapie a continu\u00e9 de se d\u00e9velopper notamment dans les pays de l\u2019ancienne union sovi\u00e9tique (ex-URSS) et dans les pays de l\u2019Europe de l\u2019Est, notamment pour traiter les infections courantes comme le staphylocoque dor\u00e9[3]<\/sup><\/a>.<\/p>\n\n\n\n

Le staphylocoque dor\u00e9 (Staphylococcus aureus<\/em>) est l\u2019agent pathog\u00e8ne le plus fr\u00e9quent en m\u00e9decine humaine et v\u00e9t\u00e9rinaire, dans la majorit\u00e9 des cas il est inoffensif. Pourtant S.aureus<\/em> peut s\u2019av\u00e9rer tr\u00e8s dangereux lorsqu\u2019il infecte les tissus profonds d\u2019un patient. La plupart du temps la bact\u00e9rie y acc\u00e8de par une l\u00e9sion cutan\u00e9e. En 2019, il est la cause de plus de 1millions de d\u00e9c\u00e8s dans le monde et plus de 16 000 en France[4]<\/sup><\/a>. Ces infections ont largement \u00e9t\u00e9 soign\u00e9es via l\u2019utilisation massive d\u2019antibiotiques depuis leur d\u00e9couverte, engendrant une s\u00e9lection fortuite des souches S.aureus<\/em> multir\u00e9sistantes. Menant aujourd\u2019hui S.aureus<\/em> \u00e0 la premi\u00e8re place des agents pathog\u00e8nes responsables des infections nosocomiales dans les h\u00f4pitaux ex-aequo avec Escherichia coli (E.coli<\/em>).<\/p>\n\n\n\n

Aujourd\u2019hui en France et dans le monde le sujet de la r\u00e9sistance aux antibiotiques (et plus largement \u00e0 l\u2019ensemble des antimicrobiens) s\u2019impose comme une priorit\u00e9 pour toutes les sant\u00e9s (One Health)[5]<\/sup><\/a>, le d\u00e9veloppement d\u2019alternatives aux antibiotiques notamment avec la phagoth\u00e9rapie est encourag\u00e9.<\/p>\n\n\n\n

Un point d\u2019alerte important subsiste, les bact\u00e9ries peuvent d\u00e9velopper une r\u00e9sistance aux phages via diff\u00e9rents m\u00e9canismes comme les mutations spontan\u00e9es et l\u2019immunit\u00e9 adaptative CRISPR-Cas.[6]<\/sup><\/a> Par exemple, lorsque la mutation a lieu sur le r\u00e9cepteur auquel le phage s\u00e9lectionn\u00e9 doit se lier pour infecter la bact\u00e9rie, alors celle-ci ne sera pas lys\u00e9e et pourra se multiplier malgr\u00e9 la phagoth\u00e9rapie et donc une souche r\u00e9sistante \u00e9mergera.<\/p>\n\n\n\n

Sans oublier les biofilms, qui sont un obstacle \u00e0 ne pas n\u00e9gliger sur l\u2019efficacit\u00e9 de la phagoth\u00e9rapie. Un biofilm est un agr\u00e9gat de cellules bact\u00e9riennes attach\u00e9 \u00e0 une surface et enrob\u00e9 d\u2019une matrice polym\u00e9rique[7]<\/sup><\/a>. Cette conformation permet aux bact\u00e9ries de se prot\u00e9ger des divers biocides qui peuvent se trouver dans son environnement (dont les phages), et contre le syst\u00e8me immunitaire de son h\u00f4te. On retrouve des biofilms dans l\u2019environnement, dans les industries mais aussi en milieu hospitalier.<\/p>\n\n\n\n

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C\u2019est pour cette raison que la phagoth\u00e9rapie n\u2019est envisag\u00e9e qu\u2019en compl\u00e9ment d\u2019une antibioth\u00e9rapie, il faut aussi s\u2019assurer que l\u2019on ma\u00eetrise bien la technique et son utilisation pour limiter et \u00e9viter l\u2019arriv\u00e9e de nouvelles r\u00e9sistances. <\/p>\n\n\n\n

C\u2019est dans ce contexte que le projet PHAG-ONE[8]<\/sup><\/a> a vu le jour. La recherche d\u2019alternatives th\u00e9rapeutiques dans le domaine des antibact\u00e9riens constitue un enjeu majeur de sant\u00e9 publique<\/strong> et a \u00e9t\u00e9 identifi\u00e9e comme une priorit\u00e9, aussi bien au niveau national, qu\u2019international. L\u2019objectif principal du projet est de d\u00e9velopper des banques de phages sp\u00e9cialis\u00e9s.<\/p>\n<\/div>\n\n\n\n

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\"\"<\/figure><\/div><\/div>\n<\/div>\n\n\n\n

Financ\u00e9 par le programme prioritaire de recherche (PPR) sur l\u2019Antibior\u00e9sistance[9]<\/sup><\/a> port\u00e9 par l\u2019Inserm \u00e0 la suite d\u2019un appel \u00e0 projets op\u00e9r\u00e9 par l\u2019ANR, ce projet a dans ses objectifs d\u2019isoler et s\u00e9lectionner des phages d\u2019int\u00e9r\u00eat th\u00e9rapeutique<\/strong> tout en analysant l’\u00e9mergence de la r\u00e9sistance bact\u00e9rienne aux phages<\/strong>. Les agents pathog\u00e8nes cibles sont notamment Staphylococcus aureus, Staphylococcus epidermidis <\/em>et Escherichia coli.<\/em><\/p>\n\n\n\n

Derni\u00e8re avanc\u00e9e majeure du projet PHAG-ONE : les HCL ont obtenu officiellement les autorisations de l\u2019ANSM pour la fabrication d\u2019interm\u00e9diaires de production et de mati\u00e8res premi\u00e8res \u00e0 usage pharmaceutiques (MPUP) pour les phages anti-S.aureus<\/em>. Cette autorisation est une premi\u00e8re dans le monde pour une structure publique et permet aux HCL de pouvoir r\u00e9aliser des pr\u00e9parations hospitali\u00e8res (\u00e0 partir de ces MPUP) sous forme de lots de plusieurs centaines de flacons.<\/h4>\n\n\n\n

Cette annonce est un premier pas vers une potentielle exploitation de la phagoth\u00e9rapie comme alternative \u00e0 l\u2019antibioth\u00e9rapie dans les cas de r\u00e9sistance, permettant de soigner un grand nombre de patients ainsi que de pr\u00e9venir des risques de r\u00e9\u00e9mergence de pathologies caus\u00e9es par des agents pathog\u00e8nes auparavant trait\u00e9s par antibiotiques.<\/p>\n\n\n\n

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Lire le communiqu\u00e9 de presse des Hospices Civils de Lyon<\/a><\/div>\n<\/div>\n\n\n\n
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[1]<\/a> https:\/\/www.chu-lyon.fr\/<\/a><\/p>\n\n\n\n

[2]<\/a> https:\/\/ansm.sante.fr\/<\/a><\/p>\n\n\n\n

[3]<\/a> https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC90351\/<\/a><\/p>\n\n\n\n

[4]<\/a> https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(21)02724-0\/fulltext<\/a><\/p>\n\n\n\n

[5]<\/a> https:\/\/oneplanetsummit.fr\/index%2ephp\/les-evenements-16\/one-health-summit-305<\/a><\/p>\n\n\n\n

[6]<\/a> https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6070868\/<\/a><\/p>\n\n\n\n

[7]<\/a> https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3962273\/<\/a><\/p>\n\n\n\n

[8]<\/a> https:\/\/www.phag-one.fr\/<\/a><\/p>\n\n\n\n

[9]<\/a> https:\/\/ppr-antibioresistance.inserm.fr\/fr\/<\/a><\/p>\n\n\n\n

Autrices<\/h2>\n\n\n\n

Direction du PPR Antibior\u00e9sistance :<\/p>\n\n\n\n

    \n
  • Evelyne Jouvin-Marche, directrice du programme<\/li>\n\n\n\n
  • Marine Lem\u00e9e, cheffe de programme<\/li>\n\n\n\n
  • Aurore Brunet, charg\u00e9e de communication du programme<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

    Les Hospices Civils de Lyon (HCL)[1] obtiennent de l\u2019Agence nationale de s\u00e9curit\u00e9 du m\u00e9dicament et des produits de sant\u00e9 (ANSM)[2] l\u2019autorisation de fabrication d\u2019interm\u00e9diaires de production et de mati\u00e8res premi\u00e8res \u00e0 usage pharmaceutiques pour les phages anti-S.aureus. On appelle phagoth\u00e9rapie l\u2019utilisation de bact\u00e9riophages pour s\u2019attaquer et d\u00e9truire sp\u00e9cifiquement des bact\u00e9ries pathog\u00e8nes sans effet nocif pour […]<\/p>\n","protected":false},"author":285,"featured_media":31387,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"categories":[3341],"tags":[],"acf":[],"yoast_head":"\nPoint sur la phagoth\u00e9rapie en France - French\u00a0National ANTIBIOTIC RESISTANCE Portal<\/title>\n<meta name=\"description\" content=\"Informations, \u00e9v\u00e8nements et actualit\u00e9s autour de l'Antibior\u00e9sistance en France et \u00e0 l'international.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ppr-antibioresistance.inserm.fr\/en\/edito\/point-sur-la-phagotherapie-en-france\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Point sur la phagoth\u00e9rapie en France - 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