Our Research

The Challenge: Urinary Tract Infections

  • Urinary tract infections (UTIs) are among the most common infections in the world. Upwards of 150 million cases are reported per year, primarily in women.
  • UTIs, also termed cystitis, have re-emerged as a serious issue in women’s health because many front-line antibiotics are no longer effective.
  • Consequently, recurrent UTIs (rUTI), defined as 3 or more  symptomatic UTIs within 12 months or 2 UTIs in a 6 month time period, has become one of the most challenging urological diseases to manage. This is especially true in postmenopausal women who are more than twice as likely to develop recurrent UTIs compared to women who have not gone through menopause yet.
  • In this postmenopausal population, recurrent UTIs can persist for years, significantly reducing quality of life and imposing a significant burden on the healthcare system.
  • Few treatment options exist for recurrent UTIs besides long-term antibiotic therapy. Development of antibiotic resistance and allergy leave the physician with fewer treatment options after each episode.
  • Alternate therapies that effectively resolve recurrent UTIs must be developed to improve the quality of life of postmenopausal women, an underserved and rapidly growing demographic group.

The Solution

  • Dr. Nicole De Nisco (UT Dallas) and urologist, Dr. Philippe Zimmern (UT Southwestern Medical Center) have established the Cure Recurrent Cystitis Initiative (CRCI) that aims to develop alternate therapies for recurrent UTIs through translational clinical research. Specifically, the CRCI seeks to investigate how the HOST environment, and in particular, inflammation and the urinary microbiome – the genetic material of all the bacteria, fungi, protozoa and viruses that live in the urinary tract, contribute to recurrent UTI pathology.
  • The long-term goal of the CRCI is to develop anti-inflammatory and probiotic therapies for recurrent UTIs.
  • The CRCI will perform IRB-approved studies to directly analyze the urinary microbiome and inflammation in patient samples.
    • High-resolution metagenome assemblies of the urinary microbiomes of women in different disease states will be generated by Next Generation and Oxford Nanopore sequencing technologies.
    • Biochemical methods, including proteomics and metabolomics, will be implemented to investigate inflammatory pathways associated with recurrent UTIs.
    • Data will be mined to identify functional aspects of the urinary microbiome and inflammation that may be leveraged to create novel therapies for recurrent UTIs.

The Team

The CRCI consists of four principal investigators and their research teams across North Texas. CCRI investigators include Dr. Nicole De Nisco (UT Dallas), Dr. Philippe Zimmern (UTSW), Dr. Kelli Palmer (UT Dallas), and Dr. Vladimir Shulaev (UNT). The diverse skillsets of the CRCI team include host-pathogen interactions, clinical urology, bacterial genomics, bioinformatics, and mass spectrometry. This complementary expertise positions the CRCI team to study rUTI in a way that bridges the gap between basic and clinical science and paves the way for clinical trials based on strong scientific premise.

Ongoing Clinical Studies

    For Interested Participants in Clinical Research Studies

    Genitourinary Microbiome Study in Women

    Philippe Zimmern, M.D.

    214-645-8787

     

    • Contrary to popular belief urine isn't actually sterile. 
    • In fact, there are good bacteria present. 
    • We are currently interested in seeing the changes in the urinary bacterial environment over time.
    • We are recruiting women age >55 years old with active UTIs or women who have never had any UTIs.
    • Compensation: $75 after first visit, $75 after second visit (10 days later), $100 after third visit (6 weeks later), and $125 after last visit (12 weeks later) for a total of $375 once the study is completed.
    • So, what is required of you? After today, you will need to come to clinic 3 more times, which we will schedule with you today. At each visit, we will obtain a urine sample, and some swabs around the vagina and anus. (These are done with Q-tips so it's painless). This will help us determine how the bacteria within these sites relate to each other.
    • Benefit to science and women's health: This work will show how the urinary bacterial environment changes over time. By comparing changes in women with or without UTI, we hope to identify beneficial bacteria that can be used as alternate therapy for UTIs.
    • If you are interested in more information, please let the clinic staff know.