Phage Therapy for Helicobacter pylori

. The rise of antibiotic-resistant Helicobacter pylori necessitates the urgent development of novel therapeutic strategies. Bacteriophage (phage) therapy, which utilizes viruses that specifically infect and kill bacteria, represents a highly promising alternative. This chapter provides a critical review of the current state of phage therapy targeting H. pylori. We summarize the characteristics of the few isolated H. pylori phages, highlighting their promising in vitro lytic capabilities and, in some cases, notable stability in acidic conditions. However, the field is in its nascent stages, defined by a significant gap between in vitro success and the conspicuous absence of confirmatory in vivo efficacy data. The primary obstacles are dissected, with a special focus on the formidable physiological barriers of the human stomach: gastric acid, the proteolytic enzyme pepsin, and the protective mucus layer. Further challenges, including the difficulty in isolating lytic phages with broad host ranges, the inherent risks associated with the predominance of temperate phages, and the lack of standardized animal models for therapeutic evaluation, are critically discussed. Finally, we outline key future directions essential for clinical translation. These include intensifying phage discovery efforts, leveraging genetic engineering to create superior, obligately lytic phages, and developing intelligent oral delivery systems, such as nano-encapsulation, to overcome the gastric barriers. A concerted, multidisciplinary effort in these areas is essential to translate the theoretical promise of phage therapy into a clinical reality for treating H. pylori infections.