"Somebody's father, friend, husband just passed away in the most developed country in the world... from a simple infection that probably could have been treated in Georgia."

In this episode, we sit down with Dr. Alexander (Sandro) Sulakvelidze to explore his journey in growing a phage therapy company from scratch, from food to human therapy. Growing up in the Republic of Georgia, phage therapy was a normal thing for Sandro; when he came to the US and saw people dying of preventable infections, he founded Intralytix. This was 26 years ago.

Takeaways:

- Starting with food safety applications proved crucial for Intralytix's survival and success as one of the few profitable phage companies

- The field has transformed from complete skepticism to active engagement, with hundreds attending phage conferences and multiple clinical trials underway

- Current regulatory concerns about transducing phages may be disproportionate given natural background levels in the human gut

- Personalized, customized phage cocktails consistently show better results than "mainstream" fixed cocktails

- Modern healthcare lacks the infrastructure for phage therapy - there's no equivalent to antibiotic susceptibility testing

- AI and machine learning are revolutionizing phage manufacturing, Intralytix is seeing 100% success in predicting optimal production conditions

- The next 5 years may see limited adoption through personalized medicine and nutraceuticals, while mainstream adoption could take 15+ years

- Phage therapy's future may extend beyond infectious disease to microbiome modulation for conditions like obesity and neurological disorders

- Proof of efficacy in rigorous clinical trials remains the critical barrier to widespread adoption and insurance coverage

- The field needs both mainstream products and the flexibility to customize treatments for individual patients

Chapters:

00:00 Introduction to Phage Therapy and Background

06:01 Evolution of Phage Therapy and Regulatory Changes

11:51 Skepticism and Acceptance of Phage Therapy in the West

20:11 Challenges in FDA Approval and Transduction Concerns

26:09 Personalized Medicine and Future of Phage Therapy

35:36 Navigating Regulatory Challenges in Phage Therapy

38:31 Research Gaps and Future Directions

41:45 Infrastructure and Logistical Hurdles

44:31 The Need for Standardization in Phage Testing

46:15 Cross-Pollination Between Food Safety and Human Health

50:38 Future Outlook: Phage Therapy in 5 to 15 Years

57:07 Challenges Ahead: Efficacy and Regulatory Concerns

Key Quotes:

"Deep in my heart, there is no doubt this works. There's just too many successful stories."

"My experience with FDA has been very good... The people we've dealt with have been reasonable."

"The variables you have to examine are mind boggling... We use artificial intelligence to learn what creates the best conditions to grow each phage."

"We are one of the very few phage companies today that actually has sales revenues... If you ignore the very long time, we're probably the only phage company that has some profit."

"The customized cocktail always worked better... scientifically and technically, it has a better chance of working."

Learn more about Intralytix: https://www.intralytix.com/