Bacteriophage Therapies for Lung Diseases

Technology Overview

Dr. Rhea Coler

Bacterial resistance to standard antibiotics is growing worldwide. In 2023, one in six laboratory-confirmed bacterial infections were antibiotic-resistant. In the United States, an estimated 2.8 million people contract an antibiotic-resistant infection annually, leading to 35,000 deaths every year. The bacterium that causes tuberculosis regularly evolves resistance to antibiotic treatment and many nontuberculous mycobacteria (NTM) have natural resistance.

Infectious disease specialist Rhea Coler, PhD, develops innovative strategies to prevent and treat tuberculosis, NTM infections, and other bacterial lung diseases. Her lab is advancing the use of bacteriophages, which are viruses that attack bacterial cells, as highly specific antibacterial agents. Bacteriophages have the potential to efficiently eliminate pathogenic bacteria, including bacteria that cause severe disease in people with cystic fibrosis. This approach, known as phage therapy, has roots in early 20th-century medicine with interest re-emerging as antibiotic resistance becomes an increasing problem globally. 

As a natural predator of bacteria, bacteriophages have multiple therapeutic advantages. Each bacteriophage type is highly specific for a particular bacterial host. This specificity reduces the risk of overt side effects to the patient—including their healthy human microbiome. In contrast, treatment with broad spectrum antibiotics is known to disrupt the microbiome. Bacteriophages have evolved to efficiently target and kill their bacterial hosts, and thus the potential for resistance against bacteriophages is low. Another advantage is that bacteriophages can be freeze-dried for long-term storage with rapid on-demand access. They can be delivered intravenously, topically or through inhaled, aerosolized formulations.

Clinical applications

In medical settings, bacteriophages have successfully treated infections in patients with cystic fibrosis who have NTM disease caused by Mycobacterium abscessus. Bacteriophage use is limited to emergency-medical use for life-threatening situations, often for cystic fibrosis patients whose frequent need for antibiotic therapy increased their susceptibility to resistant bacteria. Case studies demonstrate that tailored therapy with a cocktail of bacteriophages selected to eliminate only the bacteria causing the infection is safe and can be effective.

The specificity of bacteriophages reduces the possibility of side effects but means that bacteriophages that attack one bacterial type might be ineffective against others. Fighting the full range of bacterial diseases requires the largest possible arsenal of therapeutic options. Similar to other viruses, bacteriophages likely evolved under environmental pressure, so creating a repository of bacteriophages with samples from regions with diverse ecologies and human populations will expand the bacteriophage pharmacy.

Dr. Coler’s lab, led by Senior Research Scientist Sasha Larsen Akins, PhD, develops bacteriophage therapies in collaboration with Graham Hatfull, PhD, at the University of Pittsburgh in work supported by the Gates Foundation. The Hatfull Lab has a substantial collection of phages from around the world, but one region that is lacking in samples is the Pacific Northwest. To expand and diversify the selection of therapeutic bacteriophages, the Coler Lab conducts Pacific Northwest “phage hunts” with academic collaborators, students and citizen scientists who collect samples from any place that bacteria, and therefore bacteriophages, are plentiful.

Bacteriophages in the samples are isolated, sequenced and tested at the Coler Lab by researchers who are trained in Good Clinical Laboratory Practice (GCLP). Advanced equipment including robotics allow simultaneous runs of multiple high-throughput assays. Novel phages undergo a battery of tests against important bacterial pathogens, under physiologically relevant conditions (e.g., oxygenation, presence of antibiotics) and over time. Additionally, the Coler Lab developed a mouse model for testing the effectiveness of candidate therapeutic bacteriophages delivered directly to the lungs as an aerosol.

Dr. Coler has experience leading and collaborating with pharmaceutical and biotechnology companies. Her research has led to patents, start-up companies, and clinical products. Her lab is interested in building a bacteriophage research center to translate bacteriophages from discovery to clinical use.

Stage of Development

• Preclinical in vitro
• Preclinical in vivo

Partnering Opportunities

• Sponsored research agreement
• Collaborative research opportunity
• Consultation agreement
• Licensing agreement
• High-throughput screening
• Contracted services or research agreement

Learn More

• Rhea Coler, PhD
• Coler Lab
• Coler Lab page on bacteriophage research
• Coler Lab research on gold nanoparticles for delivering therapeutics

Publications

1. Rubino I, Guerrero-Bustamante CA, Harrison M … Coler RN. Comparative study on the virulence of mycobacteriophages. J Virol. 2025;99(6):e0192024.
2. Smytheman T, Pecor T, Miller DE … Coler RN, et al. Evaluation of host immune responses to Mycobacteriophage Fionnbharth by route of delivery. Virol J. 2025;22(1):14.
3. Janssen S, Larsen S, Morrow C … Coler RN, et al. Preclinical evidence for phage therapy to treat mycobacterial infections: A narrative review. Phage. 2025;6(3):140-153.
4. Carrigy NB, Larsen SE, Reese V … Coler RN, et al. Prophylaxis of Mycobacterium tuberculosis H37Rv infection in a preclinical mouse model via inhalation of nebulized bacteriophage D29. Antimicrob Agents Chemother. 2019;63(12):e00871-19.

Last updated March 2026