Urinary tract infections represent one of the most common infections. For some they are a source of irritation or annoyance while for others they have severe physical and psychological effects.
But, for those struggling with recurrent urinary tract infections (rUTIs) there is a new development in the works – a sublingual vaccination that may prevent them altogether.
Uromune, a bacterial mucosal rUTI vaccine in the form of a sublingual spray, is currently pre-licensed in phase three development stage in 26 countries worldwide such as the U.K., New Zealand, and Spain. Health Canada has also authorized a test site in Kingston, Ont. in partnership with Queen’s Univesity.
The vaccine is made up of four common UTI-causing pathogens that prevents rUTIs.
Dr. Richard Baverstock, a Calgary urologist who has been practicing urology since 2004, says rUTIs are one of the most common referrals urologists get.
“This is an incredibly frustrating and common condition. I often say to people, ‘If you take away the most frustrating part of my practice, take away recurrent urinary tract infections’ because we haven’t made a tremendous improvement in this over my career or over the decade.”
See a full interview with Baverstock here.
But the Health Canada and Queen’s University early clinical practice experience study offers hope.
“That’s probably the single most exciting thing that’s coming down the pipeline, potential vaccines for UTIs,” says Baverstock. “We haven’t got Health Canada approval for the vaccines in Canada, but they’re coming.”
To investigate, Dr. J. Curtis Nickel with a Queen’s colleague and a Spanish researcher, reviewed 10 years of Uromune vaccine studies and concluded that the vaccine could be an alternative to antibiotic treatment for recurrent urinary tract infections.
However, further clinical trials would need to confirm the findings.
Nickel is a professor of urology, a practicing urologist and a Tier 1 Canada research chair in urologic pain and inflammation with over 600 papers published.
He has been conducting research to determine the viability of Uromune in Canada to gain Health Canada’s approval. The results of his research as released in June 2021.
Currently Nickel is the only physician in Canada who is able to administer Uromune under guidelines set out by Health Canada and describes this vaccine as a “groundbreaking phenomenon”.
“This is going to be a game changer. It is going to change medical practice when these results are able to be reported.”
Uromune was developed by Inmunotek, a vaccination company in Spain owned by an immunologist who developed vaccines for respiratory infections.
“These people have done all sorts of research, wonderful research to show that vaccinating inside the mouth, under the tongue stimulates the immune system in mucosal surfaces all over the body including the bladder and urethra and that’s what led to the development of this vaccine,” Nickel says.
“It causes an innate and adaptive immunity. What it really means is you can put it under the tongue and it immunizes the bladder.”
Currently, aside from antibiotics, there is no treatment for urinary tract infections. The vaccinations have also allowed Nickel and his team to make progress in their understanding of urinary tract infections.
“We really do know how these infections occur, but what we don’t know is why they occur in one woman and not in another or why they might occur in one woman in January but not in March.”
As of now, Uromune appears to be the only hope women may have to regain control of their rUTIs and it seems fairly simple.
“It comes in a little spray… You do two little puffs under your tongue, hold it for a minute and then swallow it. When it’s swallowed pretty well the vaccine is just dissipated in the stomach. All the activity occurs under the tongue and the immune system is stimulated not only under the tongue but down the respiratory tract, gastrointestinal tract, the vaginal tract, the urethra and the urinary tract. It’s quite amazing.”
According to Nickel, although Health Canada had only granted approval to his patients at Queen’s University to receive the vaccine under stringent guidelines, through word of mouth he said hundreds of rUTI sufferers in Canada and the U.S. have contacted him in hopes of obtaining the vaccine – proof of it’s need.
His review of previous trials shows positive results.
“You can glean that many of the women that took part in those trials and that paper, were in fact cured. In fact, they never had another UTI once they had the vaccine. The ones that weren’t cured had a significant reduction in the number of UTIs they had. Many going from one, five, ten a year to maybe one a year.”
Patients are vaccinated very slowly over a long period of time by sublingual placement of the vaccine under the tongue which causes little to no side effects.
Baverstock says a recent review article published in the Canadian Urology Association Journal by Nickel and others show major headway that can be made once the vaccine is approved.
“We’re talking game changer. Zero infections in six months. Not one, but zero,” says Baverstock.
Nickel presented an interim report of the local research and trials he’s been conducting at the Canadian Urological Association in June and at the American Urological Association in September.
For now, the pineapple-essenced Uromune vaccination is not available in Canada or the U.S. but there is hope in the future for North American rUTI sufferers.