Summary
We have established that zinc prevents vulvovaginal candidiasis (VVC) by inhibiting the expression of an inflammatory fungal protein called Pra1. Our collaborators are performing a clinical trial with a zinc gel on women suffering from recurrent VVC and we will assess the effect of this treatment on PRA1 expression and inflammation.
What are we doing?
VVC affects three quarters of women, and a subset of women suffer from recurrent VVC. Together this accounts for half a billion infections per annum. Current antifungal drugs are not sustainable in women with recurrent VVC and may lead to the development of antifungal resistance so new treatment options are urgently needed. We have already shown that the application of zinc prevents Candida Pra1 expression and vaginal inflammation in experimental infection models of VVC and a small clinical pilot study indicates that a zinc gel prevents reinfections in women (PMID: 38055800). Here we aim to show that the application of the zinc gel prevents Candida Pra1 expression, vaginal inflammation and symptomatic immunopathology in women.
How are we doing it?
Our collaborators are carrying out a clinical trial using the zinc gel on women suffering from recurrent VVC. They will provide us with vaginal swabs. In each clinical sample we will use quantitative real time PCR to measure fungal PRA1 gene expression and ELISA to measure the selected inflammatory cytokines (IL‑1b and IL‑8).
What happens next?
We will write a larger grant application to characterise the VVC host-pathogen interaction in greater detail. Here, the clinical samples will be comprehensively assessed for pH, zinc levels, neutrophil count, S100A proteins, IL 1b, IL 8 (ELISA), host S100A, IL 1b, IL 8, CxCL 1, IL 6, and TNFa; fungal PRA1, ECE1, SAP6 and HWP1 mRNA (qRT-PCR).