Sperm- And Germ-Fighting Contraceptive Enters Trials
07-Jan-2002
Scientists announced last week that a new type of contraceptive
gel that is also designed to protect against sexually transmitted
infections will be the first of its kind to begin clinical efficacy
trials at the National Institutes of Health's Contraceptive Clinical
Trials Network.
The gel, known by the brand name BufferGel (tm), was jointly developed
by researchers at The Johns Hopkins University and the private firm
ReProtect LLC. The new trial will test whether women using BufferGel
and a diaphragm can reduce the risk of pregnancy as effectively
as women using a conventional spermicidal detergent and a diaphragm.
BufferGel is applied vaginally before sex, like conventional spermicides.
Unlike these spermicides, which use detergents to kill sperm, BufferGel
contains no soaps. Developers avoided including soap or detergent
because they can irritate the vaginal lining after frequent use.
"BufferGel simply reinforces the mild acidity that occurs
in the vagina naturally," says developer Richard Cone, professor
of biophysics in Johns Hopkins' Krieger School of Arts and Sciences.
"The normal acidity levels in the vagina can readily kill sperm
and many of the germs that cause sexually transmitted infections,"
explains Cone, who is also managing director of ReProtect. "That's
why your stomach's contents are acidic. Most germs just don't survive
long in acidic environments."
Semen eliminates vaginal acidity for several hours to allow sperm
to leave the vagina and enter the uterus. Unfortunately, this also
can help make it possible for germs to infect the sexual partner.
Cone says BufferGel should block this effect, killing both sperm
and germs by rapidly acidifying semen.
While reinforcing the vagina's natural acidity seemed like a simple
enough approach for developing a contraceptive microbicide, several
practical considerations made developing a useful compound challenging,
according to Cone.
"Not only must the compound kill both sperm and germs, it
must do so without hurting the friendly bacteria in a healthy vagina,
like the lactobacilli," he explains. "Also, it mustn't
smell bad or taste bad or stain the sheets. And most importantly,
it mustn't irritate sensitive vaginal tissues." BufferGel has
met those standards both in animal trials and in extensive clinical
safety trials, according to Cone.
For the new contraceptive efficacy trial, researchers at 10 sites
in the United States are enrolling 1,000 women. Participants must
be in a sexually active and monogamous relationship and at low risk
for infection by sexually transmitted diseases. They must agree
not to use other forms of contraception beyond that supplied by
the study, and be willing to risk getting pregnant. Study participants
will use a diaphragm with either BufferGel or a conventional spermicide.
"In this trial, we want to achieve the highest possible level
of protection," says Thomas Moench, medical director for ReProtect
LLC. "We're including a diaphragm because it places a discrete
physical barrier over the cervix, significantly enhancing the protective
actions of contraceptive microbicides."
Moench, formerly an assistant professor of infectious diseases
at the Johns Hopkins Medical Institutions, originally created BufferGel
with Cone. Hopkins and ReProtect LLC are developing BufferGel through
a cooperative research agreement.
Researchers are also currently planning a larger trial to test
BufferGel's ability to block transmission of HIV and genital herpes.
The trial is scheduled to take place through NIH's HIV Prevention
Trials Network next year.
Cone is a part-owner of ReProtect. His financial interests in the
research are being managed by Johns Hopkins University in accordance
with its conflict-of-interest policies. NIH is funding the trials.
- By Michael Purdy
|