Regenerative
A UTI drug may work in a second way: helping bladder cells destroy hidden bacteria
By Life and Health Today Staff, . Life and Health Today.
Urinary tract infections recur in many people even after a full course of antibiotics, and one reason has been known for some time: Escherichia coli, the bacterium behind most cases, can slip inside the cells that line the bladder wall and shelter there, out of reach of both drugs and the immune system. A study published in PLOS Pathogens now reports that a drug already used to prevent recurrent urinary tract infections may work partly by reinforcing the bladder cells' own internal disposal system.
The drug is OM-89, sold under the brand name Uro-Vaxom. It has been prescribed for decades and was understood to work by stimulating the immune system. Researchers at the Laboratory of Microbiology and Microtechnology at the Swiss Federal Institute of Technology Lausanne, known as EPFL, now report a second mechanism: a direct effect on the cells lining the bladder, independent of immune signalling.
The team worked with organoid models, miniature tissue structures grown in the laboratory to mimic organ behaviour, and with differentiated cell cultures derived from both mouse and human bladder tissue, according to Genetic Engineering and Biotechnology News, which reported the findings. They treated the cells with OM-89, introduced several strains of E. coli, then added antibiotics and measured how many bacteria survived, how much antibiotic entered the cells, and what happened inside the cellular pathways responsible for breaking down unwanted material.
Lysosomes are the cell's internal disposal units: membrane-enclosed compartments that use acid and enzymes to break down debris and pathogens. The study found that OM-89 increased the acidity inside lysosomes and raised the activity of lysosomal enzymes. When the researchers chemically blocked lysosomal acidification, the drug's protective effect disappeared, which the authors say points to lysosomal activity as the mechanism rather than a coincidental association.
The drug also raised the concentration of antibiotics inside the bladder epithelial cells themselves. Genetic Engineering and Biotechnology News reported that this effect held across different antibiotic classes and across several bacterial strains, including samples taken from patients, though the patient samples were used in the cell models, not in a clinical trial.
"We found that OM-89 doesn't just stimulate the innate immune system as previously assumed," Kathrin Tomasek, project leader at the EPFL Laboratory of Microbiology and Microtechnology, said in the report. "It acts directly on bladder cells, strengthening their degradation pathways so they can destroy hidden bacteria more effectively while also helping antibiotics reach those bacteria, together reducing regrowth of the bacteria after treatment ends."
Christian Pasquali, senior scientific liaison director at OM Pharma, the company that makes Uro-Vaxom, was quoted in Genetic Engineering and Biotechnology News as saying that "the results come from preclinical models and do not change the approved indication or use of Uro-Vaxom." OM Pharma's involvement in the research is worth noting: the study's commercial context does not invalidate the findings, but readers should be aware that a company with a financial interest in the drug contributed to the work.
What this does not show is whether the same effects occur in people taking OM-89 as a pill. Cell cultures and organoids replicate some features of human tissue but not all of the complexity of a living bladder during an active infection. No clinical trial is described in the reports, and the study does not establish that OM-89 reduces recurrence rates through this mechanism in patients.
The open question is whether a clinical trial designed around this specific mechanism, measuring lysosomal activity and intracellular antibiotic levels in people with recurrent urinary tract infections, would confirm what the cell models suggest. That work has not been reported. Anyone weighing options for recurrent urinary tract infections should discuss them with a clinician who knows their history.