Health
Oral spray vaccine for urinary tract infections shows potential to prevent 'warrior disease'
“Urinary tract infections aren't going away, so I'm losing a lonely battle with the medical community.”
“I could see this impacting every aspect of my life.”
these are, real woman People who suffer from frequent urinary tract infections (UTIs).
It is one of the most common bacterial infections, with more than half of women and one in five men experiencing a urinary tract infection at some point in their lives.
In addition, people who have repeated infections (two or more in six months, three times in a year) may have a significantly reduced quality of life.
Ongoing pain often means a lack of work or social activities, lack of sleep, sexual anxiety, and increased levels of depression.
Antibiotics have been the only weapon in our arsenal for decades, but with the alarming increase in antibiotics, Global antimicrobial resistance Researchers are working to develop new treatments.
“We're scared because there are no new antibiotics coming in,” said Bob Yang, a urologist in the UK.
“Because the mainstay of treatment is once-a-day, low-dose antibiotics, we are breeding the next generation of treatment-resistant bacteria virtually every day.”
But a pineapple-flavored vaccine, which has not yet been approved for use in Australia, could mark a new chapter in this story.
It's called MV140, and it contains heat-inactivated bacteria from the four main species that cause urinary tract infections: Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis and Proteus vulgaris.
But this is a needleless vaccine.
The vaccine is stored in the refrigerator and sprayed under the tongue daily for three months to prevent UTIs from occurring.
Why under the tongue? Yang, who has worked as a researcher at a vaccine development company, says this is because stimulating the oropharyngeal system (the base of the tongue, tonsils, and roof of the mouth) causes a strong immune response in the bladder.
Early evidence of safety and efficacy
Until now, we have only seen short-term studies on MV140.
2022 trial Women who received the vaccine experienced an average of zero to one urinary tract infection over a nine-month period, while women who received a placebo experienced an average of three infections over the same period.
However, the first long-term observational study has been completed by clinicians at the Royal Berkshire Hospital in Reading, England.
The results of this small study were: Presented at the European Urological Association Congress in Paris It was published on April 6th, but has not yet been peer-reviewed.
Of the 72 women and 17 men who participated in the MV140 trial, 54 percent did not develop a urinary tract infection nine years after taking the drug., the research team said.
The remaining 46% reported having urinary tract infections less frequently and less severely, with some reporting that they could get rid of the infections simply by drinking more water. But some needed antibiotics because of their “breakthrough illness.”' infection.
About 40% of participants received repeated doses of MV140 one to two years after initial treatment, some for breakthrough infections and some simply as a preventative measure.
“But importantly, we wanted to test the safety of this vaccine, and we showed that there were no long-term side effects over nine years,” said Dr. Yang, who co-led the study..
A study by the same team published last month They also found that after receiving MV140, patients reported increased energy levels, the ability to perform more daily activities, and improved mental well-being.
state of being overlooked
Monash University immunologist Malcolm Starkey, who is developing immunotherapy for urinary tract infections, said the results were promising.
He said targeting the immune response rather than the specific bacteria that cause urinary tract infections could take some of the guesswork out.
“We don't necessarily know which antibiotic to use in a particular case because it's not always clear what specific infection is causing the symptoms,” Starkey said.
“The idea of developing a vaccine with such long-term effects is truly game-changing.”
There is strong international interest in developing a UTI vaccine, and other types of vaccines are also being tested in the United States.
fast-dissolving tablets It is a vaccine that does not require refrigeration; Administered directly to cells in the bladder When tested in mice, it provided protection against recurrent urinary tract infections.
Both of these treatments are the work of researchers at Duke University, but neither has reached the stage of human clinical trials.
Starkey said researchers now need to test MV140's effectiveness in more complex groups, such as immunocompromised people, children, and patients with chronic urinary tract infections.
Urinary tract infections can become chronic when bacteria in the urine become embedded in the bladder lining and effectively hide from antibiotics.
This is a largely unrecognized condition and many people do not receive an accurate diagnosis.
“Unfortunately, urinary tract infections don't get enough attention, and I think one of the reasons for that is because they primarily occur in women,” Dr. Starkey said.
“It's also a bit of a warrior's disease, people can suffer from this for a very long time, and it's also a bit of a taboo topic.
“When you go to family barbecues, people talk about melanoma and breast cancer tests, but they don't really talk about urine.”
Dr Starkey said trying to diagnose a urinary tract infection was currently “confused” as doctors relied on bacterial culture techniques developed 50 to 60 years ago. .
Additionally, we are only beginning to understand the bladder microbiome.
He said patients can also be a bit confused by the system and, unlike in the UK and US, Australia does not have specialist urinary tract infection clinics staffed by urologists, gynecologists and microbiologists. Ta.
“these A multidisciplinary clinic is really needed to manage complex cases. ”
What's next?
MV140 is not approved in most countries, including Australia, the United Kingdom, and the United States.
However, Australian doctors can apply to prescribe it to specific patients by: special access scheme or apply to become Certified prescriber for multiple patients.
But this means it cannot be widely available Three months of treatment costs $320.
There are currently no applications to the Medicines Control Agency for approval of MV140.
Patient advocacy group Chronic UTI Australia said it had heard mixed reactions about the effectiveness of MV140 for patients with chronic buried urinary tract infections.
“There are some anecdotal reports from patients with one or more courses of chronic urinary tract infections. [MV140] “We found that those who were treated with a full dose of antibiotics over a long period of time had fewer urinary tract infection flare-ups while on treatment,” the research group said.
Dr. Yang and his colleagues are now expanding the trial to patients with spinal cord injuries, who commonly suffer from bladder dysfunction and recurrent infections.
“This is very interesting to us. If this is effective, we could eliminate one of the biggest causes of death for spinal cord injury patients in the world.”
And finally, why is it pineapple flavored?
“It’s just that it’s delicious.
“But I'm sorry if you don't like pineapple.”
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Sources 2/ https://www.abc.net.au/news/health/2024-04-11/vaccine-treatments-for-urinary-tract-infections-uti-antibiotic/103684972 The mention sources can contact us to remove/changing this article |
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