Exploration of Digestive Diseases

From: The therapeutic potential of bacteriophage therapy in liver cirrhosis: a comprehensive review of current evidence

Table 1. Comparison between bacteriophage and antibiotics.

Features	Bacteriophage	Antibiotics
Specificity	Highly specific, target particular bacteria	Least specific, broad-spectrum action
Damage to the gut microbiome	Minimal damage, helps in the restoration of a healthier gut microbiome	Severe damage leads to gut dysbiosis
Efficacy in liver cirrhosis	Highly effective, targets infection without worsening liver condition	Less effective, causes resistance, and worsens liver condition
Resistance development	Decreased risk, due to its precision in targeting pathogenic bacteria	Increased risk, and may cause treatment failure
Mechanism of action	Lytic action kills specific bacteria without harming the gut microbiome	Bacteriostatic/bactericidal effect, harms gut microbiome

Return to article view

Declarations

Author contributions

SG: Conceptualization, Writing—original draft, Writing—review & editing. ISV: Data curation, Investigation, Writing—review & editing. DS: Methodology, Validation, Writing—review & editing. SSG: Resources, Visualization, Writing—review & editing. HNP: Supervision, Validation, Writing—review & editing. Srijamya: Conceptualization, Project administration, Supervision, Writing—review & editing. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that there are no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

Publisher’s note

Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

References

Owrangi S, Paik JM, Golabi P, de Avila L, Hashida R, Nader A, et al. Meta-Analysis: Global Prevalence and Mortality of Cirrhosis in Metabolic Dysfunction-Associated Steatotic Liver Disease. Aliment Pharmacol Ther. 2025;61:433–43. [DOI] [PubMed]

Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019;70:151–71. [DOI] [PubMed]

Marchesi JR, Adams DH, Fava F, Hermes GD, Hirschfield GM, Hold G, et al. The gut microbiota and host health: a new clinical frontier. Gut. 2016;65:330–9. [DOI] [PubMed] [PMC]

Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444:1027–31. [DOI] [PubMed]

Blaut M, Clavel T. Metabolic diversity of the intestinal microbiota: implications for health and disease. J Nutr. 2007;137:751S–5S. [DOI] [PubMed]

Shkoporov AN, Hill C. Bacteriophages of the Human Gut: The “Known Unknown” of the Microbiome. Cell Host Microbe. 2019;25:195–209. [DOI] [PubMed]

Henao-Mejia J, Elinav E, Thaiss CA, Flavell RA. The intestinal microbiota in chronic liver disease. Adv Immunol. 2013;117:73–97. [DOI] [PubMed]

Zhai Q, Wu H, Zheng S, Zhong T, Du C, Yuan J, et al. Association between gut microbiota and NAFLD/NASH: a bidirectional two-sample Mendelian randomization study. Front Cell Infect Microbiol. 2023;13:1294826. [DOI] [PubMed] [PMC]

Sarrazin C. Treatment failure with DAA therapy: Importance of resistance. J Hepatol. 2021;74:1472–82. [DOI] [PubMed]

10.

Tilg H, Adolph TE, Gerner RR, Moschen AR. The Intestinal Microbiota in Colorectal Cancer. Cancer Cell. 2018;33:954–64. [DOI] [PubMed]

11.

Ahmed B, Rasul A, Tareen KZ, Hamid Akash MS, Muhammad SA, Irfan M, et al. REVIEW—Contemporary evidence on the dynamic role of probiotics in liver diseases. Pak J Pharm Sci. 2019;32:2765–70. [PubMed]

12.

Bauer TM, Steinbrückner B, Brinkmann FE, Ditzen AK, Schwacha H, Aponte JJ, et al. Small intestinal bacterial overgrowth in patients with cirrhosis: prevalence and relation with spontaneous bacterial peritonitis. Am J Gastroenterol. 2001;96:2962–7. [DOI] [PubMed]

13.

Hrncir T, Hrncirova L, Kverka M, Hromadka R, Machova V, Trckova E, et al. Gut Microbiota and NAFLD: Pathogenetic Mechanisms, Microbiota Signatures, and Therapeutic Interventions. Microorganisms. 2021;9:957. [DOI] [PubMed] [PMC]

14.

Arivarasan VK, Consul C. Bacteriophage as cargo and its application in nanomedicine. Prog Mol Biol Transl Sci. 2023;201:173–89. [DOI] [PubMed]

15.

Hasan M, Ahn J. Evolutionary Dynamics between Phages and Bacteria as a Possible Approach for Designing Effective Phage Therapies against Antibiotic-Resistant Bacteria. Antibiotics (Basel). 2022;11:915. [DOI] [PubMed] [PMC]

16.

Gan L, Feng Y, Du B, Fu H, Tian Z, Xue G, et al. Bacteriophage targeting microbiota alleviates non-alcoholic fatty liver disease induced by high alcohol-producing Klebsiella pneumoniae. Nat Commun. 2023;14:3215. [DOI] [PubMed] [PMC]

17.

Fujiki J, Schnabl B. Phage therapy: Targeting intestinal bacterial microbiota for the treatment of liver diseases. JHEP Rep. 2023;5:100909. [DOI] [PubMed] [PMC]

18.

Naseri M, Palizban F, Yadegar A, Khodarahmi M, Aghdaei HA, Houri H, et al. Investigation and characterization of human gut phageome in advanced liver cirrhosis of defined etiologies. Gut Pathog. 2022;14:9. [DOI] [PubMed] [PMC]

19.

Chen L, Hou X, Chu H. The Novel Role of Phage Particles in Chronic Liver Diseases. Microorganisms. 2023;11:1181. [DOI] [PubMed] [PMC]

20.

Ichikawa M, Nakamoto N, Kredo-Russo S, Weinstock E, Weiner IN, Khabra E, et al. Bacteriophage therapy against pathological Klebsiella pneumoniae ameliorates the course of primary sclerosing cholangitis. Nat Commun. 2023;14:3261. [DOI] [PubMed] [PMC]

21.

Hung CH, Kuo CF, Wang CH, Wu CM, Tsao N. Experimental phage therapy in treating Klebsiella pneumoniae-mediated liver abscesses and bacteremia in mice. Antimicrob Agents Chemother. 2011;55:1358–65. [DOI] [PubMed] [PMC]

22.

Phage therapy shows promise for treating Alcoholic Liver Disease [Internet]. King’s College London; [cited 2025 Oct 10]. Available from: https://www.kcl.ac.uk/news/phage-therapy-shows-promise-for-treating-alcoholic-liver-disease

23.

Strathdee SA, Hatfull GF, Mutalik VK, Schooley RT. Phage therapy: From biological mechanisms to future directions. Cell. 2023;186:17–31. [DOI] [PubMed] [PMC]

24.

Chen X, Mendes BG, Alves BS, Duan Y. Phage therapy in gut microbiome. Prog Mol Biol Transl Sci. 2023;201:93–118. [DOI] [PubMed]

25.

Emencheta SC, Olovo CV, Eze OC, Kalu CF, Berebon DP, Onuigbo EB, et al. The Role of Bacteriophages in the Gut Microbiota: Implications for Human Health. Pharmaceutics. 2023;15:2416. [DOI] [PubMed] [PMC]

26.

Schooley RT. Exploring bacteriophage therapy for drug-resistant bacterial infections. Top Antivir Med. 2023;31:23–30. [PubMed] [PMC]

27.

Çolakoğlu M, Xue J, Trajkovski M. Bacteriophage Prevents Alcoholic Liver Disease. Cell. 2020;180:218–20. [DOI] [PubMed]

28.

Mendes BG, Duan Y, Schnabl B. Immune Response of an Oral Enterococcus faecalis Phage Cocktail in a Mouse Model of Ethanol-Induced Liver Disease. Viruses. 2022;14:490. [DOI] [PubMed] [PMC]