Immune drugs could help GPs treat antibiotic-resistant UTI

Drugs that modulate the immune system could help beat increasingly antibiotic-resistant UTIs, US researchers say.

Urine test (Photo: iStock)

Up to one in 30 GP consultations relate to a UTI, with more than half of women thought to experience the condition during their lifetime.

Boosting the function of HIF-1α – a protein that helps stabilise the immune system – was shown to help combat uropathogenic E.coli in both in vivo mouse studies and in vitro tests on human bladder cells.

HIF-1α is known to play a significant role in modulating the innate immune response, the body’s first line of defence against pathogens. But it is relatively short-lived, which led University of California researchers to search for drugs that delayed its breakdown and extended its effects.

Drugs that stabilise HIF-1α were in development to treat anaemia, but the study suggests they could be used as an alternative or complement to antibiotic treatment for UTI.

Experiments, published in PLoS Pathology, showed that using these so-called HIF-1α-stabilisers could help protect the urinary tract against E.coli and substantially reduce the rate of colonisation in established UTI.

Drug to be developed

Uropathogenic E.coli is the most common root cause of UTI, followed by Straphylococcus saprophyticus and Proteus mirabilis.

The condition is thought to affect around 150m people worldwide and account for up to 3% of all UK GP consultations.

Due to the high prevalence of the disease and rapid emergence of antibiotic-resistant strains, ‘new effective strategies to prevent and treat UTI are urgently needed’, the researchers said.

As the drug must currently be administered directly into the bladder via catheter, the researchers said the next step was to develop a version of the drug that can be taken orally.

They said: ‘By depositing HIF-1α boosting agent directly into the bladder through a catheter, we could prevent infections and limit the risk of bladder and renal damage caused by acute inflammation.

‘Since there are no known effective prophylactic agents available – other than antibiotics – to prevent UTIs, this application could serve as a prophylaxis to benefit certain high-risk UTI patients.

‘A future goal of HIF-boosting drugs would be to develop oral formulations that could effectively distribute into the urinary tract to reach wider patient populations.’

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