People with recurrent urinary tract infections (UTIs) may soon have access to a safer treatment or prevention aid. This is as scientists in the U.S. recently reported that a vaccine tablet they developed could work as well as antibiotics.
Bladder
The sublingual vaccine tablet dissolves rapidly and gets into action after being placed below the tongue. In animal models, researchers found it to be as effective as high-dose oral antibiotics without producing unpleasant side effects.
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Antibiotics are currently the standard treatment for people with recurrent UTIs. With this new vaccine, patients could soon have a safer yet more convenient alternative.
This promising vaccine was reported in a study that appeared in the journal Science Advances.
A big challenge
UTIs are a leading public health issue that affects millions of people globally every year. They result when bacteria invade the urethra, ureter, bladder, or kidney.
Researchers say roughly 1 in 2 women will experience a UTI in their lifetime. Some of these women – about 27 percent – have a recurrent infection within six months of an earlier one. People with recurrent UTIs can have infections more than three times in a year, experts say.
Physicians typically rely on long-term antibiotics to help patients manage their recurrent UTIs. However, these treatments can disrupt the gut microbiota and bring about awful side effects.
Worse still, uropathogenic Escherichia coli (UPEC) is getting more and more resistant to antibiotics that are commonly used. This pathogen is responsible for about 80 percent of uncomplicated UTI cases.
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A major challenge in the fight against UTIs is the lack of potent drug delivery. Thus, immunomodulating therapies that are being explored at this time are often prolonged and repeated, while extended use comes with its negative effects as well.
A better way to tackle recurrent UTIs
To address the challenges of drug delivery and adverse side effects, biomedical engineering researchers created a vaccine that can be dissolved and absorbed under the tongue. This pill triggers key immune cells to target and destroy bacteria that cause UTIs.
The sublingual nanofiber vaccine includes three peptides that are present almost solely on the UPEC bacteria’s surface. This helps to lessen the risk of “off-target” side effects.
When tested in animal models, the immunization produced a level of efficacy akin to that of high-dose oral antibiotics. It achieved this with fewer effects on the gut microbiome.
The vaccine improved antibody responses in mice, and the antibodies generated clearly attached to infection-causing UPEC. There were even greater urinary antibodies when the vaccine was combined with an adjuvant, researchers said.
By studying fecal samples obtained from vaccinated mice, the research team also found that the microbiome was not altered by the treatment. Vaccination also alleviated the symptoms of a type of sepsis known as urosepsis in mice while also improving their survival chances.
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Cost-effective treatment
Prolonged and repeated antibiotic use in recurrent UTI cases can make treatment costly. These researchers were, therefore, also interested in cost reduction.
The vaccine was at first droplet-based. As a step to reduce costs and promote ease of access, the team also made it in tablet form. The efficacy of the tablet-based vaccines was found to be similar to that of droplet-based variants.
The team went further to test the potency of the vaccine by exposing mice to a more lethal bacterial dose. The animals that were treated showed an 80 percent survival rate, while the rate was just 20 percent among those that were not immunized.
Going even further, the researchers tested the immunization in rabbits. The oral cavity of these small mammals has a greater similarity to humans. Higher antibody levels were observed in the rabbits, as earlier seen in mice.
The sublingual nanofiber vaccine tablets are rapid-dissolving. As per the researchers, they dissolved in human saliva in under 20 seconds, at body temperature, to highlight their potential viability for use in humans.
This study does have its limitations, according to experts. A major limitation is that the vaccine is only effective against 80 percent of pathogenic bacteria, a specialist told Medical News Today. It will not help much in fighting some others, including Staphylococcus, Klebsiella, and Pseudomonas.
The findings in the research are remarkable nonetheless. Also, the vaccine is a big leap forward with its promise of a more efficient delivery. This study can both improve the treatment of UTIs and aid vaccine research on the whole.
References
Kelly, S. H., et al. (2022). A sublingual nanofiber vaccine to prevent urinary tract infections. Science Advances, 8(40), eabq4120. https://doi.org/10.1126/sciadv.abq4120
