Zinc shows long-term potential in addressing recurrent thrush, study suggests

The research aims to provide a long-term solution to the condition. Current treatment involves a six-month maintenance regimen with antifungals such as fluconazole. However, following discontinuation, more than half of women suffer reinfections within six months, with reports of treatment resistance of thrush to these antifungals.

“Recurring thrush can be deeply distressing and problematic, and we urgently need new treatments,” said lead researcher Dr Duncan Wilson, a Wellcome Trust Senior Fellow who is based at the University of Exeter’s MRC Centre for Medical Mycology.

“Our new finding on zinc is very exciting, because it suggests that simple provision of zinc could block the production of the inflammatory Pra1 molecule, but we’re not in the position to make treatment recommendations at this stage.”

Zinc may block molecule that triggers inflammatory responses

The investigation, which was published in the journal Science Translational Medicine, revealed that the 20 µM zinc sulphate found in Juviagel, a vaginal hydrogel, was enough to prevent the reinfection of thrush in five out of six women who completed the study.

In addition, the UK-based team found that applying zinc in mice blocked the production of Pra1, the molecule that triggers an inflammatory response, which they believe is responsible for many cases of thrush.

“These findings are very encouraging, although the number of participants is small,” said Wilson. “We are now carrying out a larger clinical trial to confirm that zinc treatments are effective.”

He said the researchers hoped that in the longer term, this could be a promising strategy for managing thrush.

“We’d been studying this Pra1 molecule for more than ten years to understand its role in zinc scavenging,” he added. “This research shows the fundamental importance of basic research of this nature, which can help shed light on how our bodies work and sometimes provide surprising routes to new treatments.”

Fempharma’s clinical trial looking into effectiveness of Juviagel

Juviagel’s makers, Hungarian-based Fempharma, revealed that the company was conducting its own investigations into the water-based gel and its role in resolving signs and symptoms of thrush.

Also defined as a study primary outcome is the condition’s reoccurrence during the follow-up period.

“We are now carrying out a large clinical trial to confirm that Juviagel zinc treatments are effective,” said Fempharma’s CEO, Dr Peter Bartal.

“We believe that we can develop our product to help avoid the recurrence of vaginal yeast infections.”

Fempharma’s randomised controlled trial will be conducted on 76 women with vulvovaginal candidiasis (VVC), or thrush, with participants allocated either into a control group or a treatment group.

The control group will receive a single dose of oral fluconazole (150 mg), while the treatment group will receive a single oral dose of fluconazole (150 mg) followed by treatment with a zinc-containing vaginal gel (daily for two weeks and twice per week thereafter).

Vaginal samples (vaginal swab and cervicovaginal lavage) will be collected at baseline and at four, eight, and 12 weeks after starting treatment. Clinical signs and symptoms will be assessed before the intervention and follow-ups.

Methodology includes use of zinc-containing vaginal hydrogel

Wilson’s retrospective cohort study enrolled ten women in total, all of whom had a history of recurrent vaginal infections.

They were asked to place 2 ml of gel into the vagina nightly for two consecutive weeks and, after that, twice per week.

Women were asked to return to the clinic for evaluation if any symptoms of vaginal infection were present. Patients underwent a detailed gynaecological exam at enrolment and the follow-up visit.

For the research assessing Pra1’s role in vaginal inflammation, a pilot study of mice was conducted to reduce the number of animals used, estimate variability among animals, and evaluate procedures and their effects.

All animals were acclimatised for at least one week before starting experiments and were randomly assigned to experimental groups.

Mouse experiments were not blinded until sample collection. All in vitro and ex vivo experiments and sample measurements were blinded.