Urolog. pro Praxi, 2010; 11(2): 64-67
Role of immunotherapy in prophylaxis of reccurent urinary tract infection
- Klinika nefrologie, Institut klinické a experimentální medicíny, Praha
Recurrent urinary tract infections (UTIs) are a most frequent clinical problem affecting particularly women. Long-term use of antibiotic
prophylaxis, although effective, has its limitations making search for alterative treatments an option. Our recommendation for the prevention
of recurrent UTIs is to use herbal remedies containing cranberry products, D-mannose or nasturtium. Also effective is improvement of
microbial microflora using both oral and vaginal probiotics. However, the most important role in the prevention of these infections is played
by immunotherapy represented primarily by Uro-Vaxom. The efficacy of this product has been confirmed by a number of studies and metaanalyses.
A greater role in clinical practice could be possibly played by vaginal immunization using vaccines against a variety of pathogens
other than E. coli, particularly the vaccine against colonization by Proteus mirabilis currently under development. In conclusion, immunotherapy
can be recommended as a safe, effective and much needed alternative in the prevention of recurrent urinary tract infections.
Keywords: recurrent urinary tract infections, D-mannose, nasturtium, Uro-Vaxom, vaccination
Published: May 1, 2010 Show citation
References
- Foxman B, Somsel P, Tallman P. Urinary tract infection among women aged 40-65: behavioral and sexual risc factors. J Clin Epidemiol 2001; 54(7): 710-718.
Go to original source... 
Go to PubMed... - Stamm WE, Mc Kevitt M, Robersts PL, White NJ. Natural history of recurrent urinary tract infecions in women. Rev Infect Dis 1991; 13: 77-84. Go to original source... Go to PubMed...
- Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection on women. Can J Urol 2002; 9(3): 1558-1562.
- Miller JL, Krieger JN. Urinary tract infections cranberry juice, underwear, and probiotics in the 21st century. Urol Clin North Am 2002; 29(3): 695-699. Go to original source... Go to PubMed...
- Kleinwachter M, Schung E, Selmer D. Glucosinolate-Myrosinase System in Nasturtium (Tropaeolum majus L.): Variability of Biochemical Parameters and Screening for Clones Feasible for Pharmaceutical Utilization. J Agric Food Chem 2008; 56(23): 11165-11170. Go to original source... Go to PubMed...
- Albrecht U, Goos KH, Schneider B. A randomised, doubleblind, placebo-controlled trial of a herbal medicinal product containing Tropaeoli majoris herba (Nasturtium) and Armoraciae rusticanae radix (Horse radish) for the prophylactic treatment of patients with chronically recurrent lower urinary tract infections, Current Medical Research and Opinion 2007; 23(10): 2415-2422. Go to original source... Go to PubMed...
- Nevoral J. Probiotika a jejich klinické užití. Postgraduálni medicina 2009; 11: 14-23.
- Janda J. Infekce močových cest u dětí. In: Teplan V, a kol. Infekce ledvin a močových cest v dospělém a dětském věku. Praha: Grada Avicenum, 2004: 112 s.
- Huber M, Baier W, Serr A, Bessler WG. Immunogenicity of an E. coli extract after oral or intraperitoneal administration: induction of antibodies against pathogenic bacterial strains. Int J Immunopharmacol 2000; 22: 57-68. Go to original source... Go to PubMed...
- Lee SJ, Kim SW, Cho JH, Yoon MS. Anti-inflammatory effect of an Escherichia coli extract in a mouse model of lipopolysacharide induced cystitis. World J Urol 2006; 24: 33-38. Go to original source... Go to PubMed...
- Billips BK, Yaggie RE, Cashy JP, Schaeffer AJ, Klumpp DJ. A live-attenuated vaccine for treatment of urinary tract infection by uropathogenic Escherichia coli. J Infect Dis 2009; 200(2): 263-272. Go to original source... Go to PubMed...
- Frey C, Obolensky W, Wyss H. Treatment of recurrent urinary tract infections: efficacy of an orally administered biological response modifier. Urol Int 1986; 41: 444-446. Go to original source... Go to PubMed...
- Tammen H. Immunobiotherapy with Uro-Vaxom in recurrent urinary tract infection. The German Urinary Tract Infection Study Group. Br J Urol 1990; 65: 6-9. Go to original source... Go to PubMed...
- Schulman CC, Corbusier A, Michiels H, Taenzer HJ. Oral immunotherapy of recurrent urinary tract infections: a double-blind placebo-controlled multicenter study J Urol 1993; 150: 917-921. Go to original source... Go to PubMed...
- Magasi P, Panovics J, Illes A, Nagy M. Uro-Vaxom and the management of recurrent urinary tract infection in adults: a randomized multicenter double-blind trial. Eur Urol 1994; 26: 137-140. Go to original source... Go to PubMed...
- Bauer HW, Alonssi S, Egger G, Blumlein HM, Cozma G, Schulman CC. Multicenter UTI Study Group. A long-term, multicenter, double-blind study of an Escherichia coli extract (OM-89) in female patients with recurrent urinary tract infections. Eur Urol 2005; 47: 542-548. Go to original source... Go to PubMed...
- Krčméry S, Hromec J. Dlhodobá chemoprofylaxia a imunoterapia v prevencii recidivujících uroinfekcií u žien. Via pract 2006; 3(4): 190-193.
- Uehling DT, Hopkins WJ, Elkahwaji JE, Schmidt DM, Leverson GE. Phase 2 clinical trial of vaginal mucosal vaccine for urinary tract infections. J Urol 2003; 170(3): 867-869. Go to original source... Go to PubMed...
- Li X, Lockatell CV, Johnson DE, Laue MCh, Warren JW, Mobley HLT. Development of an Intranasal Vaccine To Prevent Urinary Tract Infection by Proteus Mirabilis Infection and Immunity, January 2004; 72(1): 66-75. Go to original source... Go to PubMed...
- Alamuri P, Eaton KA, Himpsl SD, Smith SN, Mobley HLT. Vaccination with Proteus Toxic Agglutinin, A Hemolysin-Independent Cytotoxin In Vivo, Protects against Proteus mirabilis Urinary Tract Infection. Infection and Immunity, February 2009; 77(2): 632-641. Go to original source... Go to PubMed...
- Koukalová D, Kročová Z, Vítek P, Macela A, Hájek V. Imunostimulační aktivita vakcíny pro léčbu recidivujících uroinfekcí. I. Bratislavské lékařské listy 1999; 100: 215-217. Go to PubMed...