Recurrent urinary tract infections (UTIs) pose significant challenges, causing persistent discomfort, frequent treatments, and increasing antibiotic resistance concerns.
Sequoia Vaccines, a US-based biopharmaceutical company, has developed a novel approach to preventing recurrent UTIs with its FimCH vaccine, targeting key bacterial components to enhance immunity and reduce infection recurrence.
The FimCH vaccine stimulates the immune system to produce antibodies against the FimCH pili, a crucial protein structure on the surface of E. coli bacteria, which is the most common pathogen responsible for urinary tract infections (UTIs). These pili allow the bacteria to attach to the mucosal tissue in the bladder wall, a key step in initiating infection.
When the FimCH vaccine is administered, it triggers an immune response that generates specific antibodies against the FimCH protein. These antibodies bind to the pili, preventing the bacteria from adhering to the bladder lining. By blocking this attachment, the vaccine helps reduce bacterial colonisation and lowers the likelihood of recurrent infections, offering a proactive defence against UTIs.
FimCH vaccine clinical testing
In Phase 1 trials, Sequoia Vaccines’ FimCH vaccine demonstrated promising results in healthy volunteers and in patients with a history of recurrent UTI. The vaccine successfully induced a robust immune response, producing antibodies targeting the FimCH pili in the majority of trial participants.
The trial showed the vaccine was well-tolerated, with no serious adverse effects reported. Participants with a history of recurrent UTI experienced a reduction in UTI frequency, suggesting that the vaccine effectively interferes with bacterial adhesion to the bladder wall. These early findings suggest the FimCH vaccine has the potential to effectively prevent recurrent urinary tract infections by blocking bacterial adherence to mucosal tissue in the bladder, laying the foundation for further clinical development and larger-scale studies.
Expanded access in high-risk patients
In a compassionate use setting, Sequoia Vaccines’ FimCH vaccine was administered to patients at high risk for antibiotic-resistant infection requiring treatment with intravenous carbapenem. The findings showed that the vaccine helped to reduce the frequency of recurrent urinary tract UTIs in these high-risk patients, who often face limited treatment options due to antibiotic resistance. These results suggest that the FimCH vaccine could complement existing therapies, particularly in managing infections resistant to traditional antibiotics.
Future Directions
A FimCH vaccine targeting the FimH adhesin on E. coli holds significant promise for preventing a range of infections beyond UTIs, including the prevention of sepsis and pneumonia. Additionally, E. coli is known to be the cause of infection in patients with indwelling catheters or in patients with chronic conditions such as diabetes or cancer. A vaccine in these populations could help reduce the need for prolonged antibiotic use, which is crucial for combating antimicrobial resistance.
References
- Eldridge et al. 2020 Dec 16;17(5):1262–1270.
https://doi.org/10.1080/21645515.2020.1834807 - Perer et al. 2024: https://doi.org/10.3389/fimmu.2024.1359738
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