The UTI vaccine can be taken as a disintegrating tablet | Tech Reddy

If the promising results in mice and rabbits are replicated in clinical trials, it may one day be possible to prevent recurrent AIDS with a vaccine instead of antibiotics.

By Alice Klein

A sublingual vaccine tablet protects against urinary tract infections (UTIs) in mice and rabbits. If it is found to work in humans, it could reduce the need to treat infections with antibiotics.

More than half of all women will get a UTI at least once in their lifetime, and about 5 to 10 percent will have it three or more times a year.

These recurring infections are often managed with daily antibiotics to prevent overgrowth Escherichia coli (E. coli) most bacteria cause UTIs. However, long-term use of antibiotics can cause bacteria to become resistant to antibiotics and disrupt the healthy population of gut bacteria, leading to gastrointestinal disease.

As an alternative to antibiotics, Shawn Kelly and Joel Collier of Duke University in North Carolina and their colleagues have developed a vaccine to prevent UTIs.

It trains the immune system to recognize and fight UTI-causing bacteria by exposing it to three peptide molecules found on the surface of these microbes.

It is formulated as a tablet that dissolves under the tongue. This mode of vaccine delivery may induce immune responses in the urinary tract due to similarities between the oral mucosa and the urinary tract.

The tablet is self-contained and stable at room temperature, making it easy to store, transport and use. “Eliminating the cold chain requirement will reduce the costs of vaccine delivery,” says Kelly.

In mice, the vaccine worked as well as high-dose antibiotics to prevent UTIs, and a follow-up experiment in rabbits also showed protective effects.

Because the vaccine targets UTI-causing bacteria, not healthy bacteria, it doesn’t disrupt the animals’ normal mix of gut bacteria.

The team hopes these promising results will lead to clinical trials in humans, Collier said. “We need to conduct biodistribution and safety studies before clinical trials, and we are actively looking for partners to do this,” he says.

Another sublingual vaccine for UTI prevention, called MV140, is being developed by the Spanish company Inmunotek. In a recent clinical trial of 240 women with recurrent UTIs, nearly 60 percent of those who received the vaccine had no UTI episodes during a nine-month follow-up period, compared with 25 percent of those who received a placebo.

The MV140 vaccine comes as a liquid that should be sprayed under the tongue twice a day for three to six months. It’s unclear how long protection from the new soluble pill will last in humans and whether booster pills will be needed, but “even with boosters, it’s going to be a less disruptive paradigm than using an antibiotic,” Kelly says.

Link to Journal: Science AdvancesDOI: 10.1126/sciadv.abq4120

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