Department of Microbiology and Immunology, Stanford University, Stanford, California, USA.
Clinic of Urology, Pediatric Urology and Andrology, Justus-Liebig University, Giessen, Germany.
Urol Int. 2023;107(8):778-784. doi: 10.1159/000531206. Epub 2023 Aug 4.
Acute lower uncomplicated urinary tract infection (uUTI) affects a large proportion of women. Increased antimicrobial resistance has created an urgent need for novel therapeutics and the phytotherapeutic drug BNO 1045 (Canephron® N) has previously been shown to be noninferior to standard antimicrobial stewardship. This sub-analysis from a randomized, double-blind, controlled phase III noninferiority clinical trial using BNO 1045 versus fosfomycin to treat uUTI aimed to determine how urine cytokine levels are altered by the two different treatments.
Urine samples from a predefined subset of women diagnosed with uUTI (18-70 years) and treated with BNO 1045 (n = 58) or fosfomycin (n = 69) were analyzed for urine levels of IL-6 and IL-8, using analyte-to-creatinine ratios.
BNO 1045 treatment showed similar effects to fosfomycin treatment in reducing both urine IL-6 and IL-8 levels. Mean IL-6 and IL-8 levels were markedly reduced in all patients regardless of treatment. BNO 1045 treatment decreased urine IL-8 significantly (p = 0.0142) and showed a trend toward reduction of urine IL-6 (p = 0.0551). Fosfomycin treatment reduced both IL-6 and IL-8 levels significantly (p = 0.0038, <0.0001 respectively).
BNO 1045 is, in addition to reducing symptoms, comparable to fosfomycin treatment in reducing the local inflammatory response associated with uUTI.
急性单纯下尿路感染(uUTI)影响了很大一部分女性。抗菌药物耐药性的增加迫切需要新的治疗方法,植物药 BNO 1045(Canephron® N)此前已被证明与标准抗菌药物管理不劣效。这项来自一项随机、双盲、对照 III 期非劣效性临床试验的亚分析,使用 BNO 1045 与磷霉素治疗 uUTI,旨在确定两种不同治疗方法如何改变尿液细胞因子水平。
从诊断为 uUTI(18-70 岁)的女性中选择一个预先定义的亚组,用 BNO 1045(n=58)或磷霉素(n=69)治疗,用分析物与肌酐的比值分析尿液中 IL-6 和 IL-8 的水平。
BNO 1045 治疗与磷霉素治疗在降低尿液 IL-6 和 IL-8 水平方面具有相似的效果。所有患者的尿液 IL-6 和 IL-8 水平均明显降低,无论治疗如何。BNO 1045 治疗显著降低尿液 IL-8(p=0.0142),并显示降低尿液 IL-6 的趋势(p=0.0551)。磷霉素治疗显著降低了尿液 IL-6 和 IL-8 水平(p=0.0038,<0.0001)。
除了缓解症状外,BNO 1045 还可降低与 uUTI 相关的局部炎症反应,与磷霉素治疗相当。