Presentation by prof. Franco Vicariotto, M.D.

Dear doctor,
Down below you can find presentation by prof. Franca Vicariotto M.D. called „Ionic silver and vaginal diseases - New therapeutic perspective“.

TIAB Represents a new “era” for medical Silver It is an innovative complex molecular system developed by means of micro-technologies which incorporate. Silver ions Ag+ combined with Titanium Dioxide (TiO2).

Gynella Silver Caps

GYNELLA Silver Caps

GYNELLA Silver Caps (Soft gel capsules, 10 pcs), Composition: TIAB (microcrystalline titanium dioxide with covalently linked monovalent silver ions), Sodium Hyaluronate, Aloe Barbadensis Extract


Vaginal ecosystem: Vaginal discomforts (vaginitis and vaginosis), Bacterial Vaginosis, Yeast infection (candida), Aerobic Vaginitis;
Cervical Ectopium and Lesions: Physiologic - genetic alteration of epithelium that creates fissuring, Pathologic - as consequence of surgery, Post - coital bleeding

Gynella Silver Gel

GYNELLA Silver Foam

GYNELLA Silver Silver Foam (vulvovaginal foam, 50 ml), Composition: TIAB (microcrystalline titanium dioxide with covalently linked monovalent silver ions), Sodium Hyaluronate, Malva Sylvestris Extract, Benzalkonium Chloride


Vulvar dystrophy: age, hypoestrogenism, dermal lesions
Vulvar cracks: after sport, coitus, postpartum
Redness of the vulva: mechanical damage - sport, coitus

Before using the GYNELLA Silver Caps and GYNELLA Silver Gel, read carefully the package leaflet. Medical devices are available in a pharmacy and are not covered by public health insurance.

Czech from 00:00:00 - 00:23:45
English begins at 00:23:46

It's a pleasure to meet you, and to have you here, and it's your turn, and this microphone is functioning and this one is not,

This is for me?

This is for you

This one doesn't work

So I think it's better to stay here, I don't see all the colleagues, it's nice to be here with you, for you, I'm coming from Milano, from Italy. I'm working from more than 20 years about vulva vagina diseases and the founder of the Italian society of supplements in ob-gyn, you know this is very important in our specialisation and the new markets is not a nice world for a doctor, but there is market of supplements growing up much more and so I present my, my history with this very, very important product, the product name is TIAB, we have now TIAB in three parts of Europe, in Italy it's name is TIAGIN in Switzerland selling in Germany and in North Europe, it is Syltech. And her is Gynella, in Slovakia in your country and maybe in Romania.

I have been contacted from NMtech, this is company from London, but they are the office in in Milano and they ask me to develop, to us to develop this very very important new silver in our specialization in obstetrician gynaecology, in gynaecology because during pregnancy we can't use it, so in Italy this is a Sicilian company selling this product the name is IDIPHARMA and now it's very, very easy and very well because we have the gel situation and it is a much more easier this the dissolution and it the beginning we have the tablets the hard tablets it was many small problems from the dissolution now the compliance of the soft gel is much and much more and this is very easier to prescribe to our patients, and a we have the foam in Italy and in other parts of Europe, and here you have the gel, you say gel not gel like me, and this is so important the gel and the foam they are the same cradata and we use for vulva disease so for vagina disease we will see with the soft gel and for vulva problem we use the gel and I know from this company organising this very, very nice convention that in next year I think you will have the foam here too, the compliance of the foam is much more than that of the gel, the gel excuse me, haha, is very easy to use the foam and you will see later our, our trials, published trials, very important trials and with the this foam for vulva problems, what's happened in the beginning we didn't understand how important and how good was this product and then we published in the scientific roles we understand that this incredible, the antibacterial and the healing, warm healing possibility of our TIAB.

Gynella gel and Gynella silver caps, this is with your product a TIAB you now together we will see and study what is TIAB. Helping TIAB there is Hyaluronic acid and a very famous aloe that you know very well, from silver to TIAB, silver you know is one of the most common used compounds in the gynaecology discomforts, it's very old product you know that ancient Greek and Roman times but in the last years we forgot to use silver and we use too much antibiotics, so it's a again a new era of silver our TIAB, it's very normal TIAB, this complex, and this silver ions combine with titanium dioxide this is to repeat because I will repeat again in any future slides this words, silver ions Ag combine with titanium dioxide this is the TIAB.

How it works, only this is very important it's the difference for difference silver this is a new silver it's is working for different situation only the monovalent ion silver Ag has antimicrobial activity the young form is usually unstable and then it's so important for strongly to have a strongly activity antibacterial activity to be stable, to be a stable complex, the ionic monovalent form is the only one active form of silver with antibacterial activity. In our TIAB system the monovalent ion silver is stabilised by the covalent bond to titanium dioxide, so this is so important because TIAB is innovative microsilver formulation

This is slide from Linnea, Linnea is the Switzerland company selling TIAB in Germany and Nord Europe, South America too, in South America too and this place is very nice because we can repeat that only the monovalent ion silver has antimicrobial activity and the colloidal silver form has only few Ag ions on the surface the anti-bacterial activity is then strongly reduced so colloidal is not good because only few ions, our monovalent ion silver is big antimicrobial activity this is the difference.

Another important question is the nanotechnology, what is the nanotechnology of our powder, nanotechnology doesn't mean it's very, very small, nano millimeters, they are nano, those material or devices. Ours is a devices in which there is at least one functional component with dimension between 2-200 nano millimeters, what does it mean, does it mean that you need only very small TIAB it a compare with the other silver preparation is thousand of times lower, and this is so important this turns to high tolerability and a great respect of the physiological environment around the lesion we will see the antimicrobial activities and the wound healing effect and this nanotechnology is very, very important for our product.

The safety of silver is not a problem, TIAB compound doesn't release Ag ions, there is an old, so how would we call it, uh, a Argyria is a condition caused by inappropriate exposure to chemical compounds with silver, it was, I say it was, because I think it's not more present Argyria in a Europe, it was a dramatic because the symptoms of Argyria is it a the skin turns blue and grey, so we don't have any problem using our MN product with silver, no risk Argyria because thermal stability and photochemical stability, so we I told you that there's a three very, very important effect of our product antimicrobial, film-barrier and healing effect the silver ions are linked with titanium dioxide we have this bridge on that is able to stabilise -this works very, very well in this case and this causes they natural, they naturing of microbial species. So we can say that they we have a antimicrobial effect, a barrier effect, in the barrier effect the isolation of the site of attack by microbial species the infection cannot spread over thanks to the protective film formed by the product, so we need to form with the with TIAB a protective film this is very, very important and then we discovered this incredible new effect, very important effect this is healing effect, promotes the natural repairing and rejuvenation of the tissues we will see later with the trials on the cervix how is a possible to use TIAB to repair the tissues, how does it is a possible physiological mechanism of immune response stimulates local grow factors aimed to repair local lesion have been observed so we have we demonstrated that we are works and later I will show you this fantastic effect of one healing of TIAB, this is another slide from Lennia show the same things that I told you before, the film isolates the area against microbial aggression so it's very important that you see, that you we are covered with this nice film with TIAB and we are protect from microbial aggression.

The antimicrobial effect, this is very important. We have three possibilities, breaking bacterial cellular wall, making it permeable, blocking the bacterial enzymatic system and touching directly to DNA and stopping the cell replication, you can see on the picture this very, very important effect of TIAB. Ag ions interact with the bacterial cellular membrane neutralising the bacteria before it can pass through the protective barrier and could affect understate tissue, this is a really very important antimicrobial effect from TIAB.

These two pictures they this mostly the same thing, in the first picture the Ag ions and the titanium dioxide creates the anti-bacterial film and the second picture you can see the three action antimicrobial action that I told you before.

The indication of use this is very interesting for us and for our, for our work with our patients. When to use TIAB, vagina for the vaginitis I will show you our work against AV aerobic vaginitis and now we will have another future protocol against BV bacterial vaginosis and then in the on the cervix, in the ectropium, i was speaking with Vladimir before and he will help us during the discussion with this big big problem of ectropium, we, (I don't say where he was called here, I think they're order?), we treated the ectropium, it was a very bad situation. We have to treat or to help only a symptomatic ectropium. It is not a symptomatic ectropium. We don't need to do anything, but 20 years ago we were treating the ectropium and so we can use this incredible wound healing TIAB in post coital bleedings when we don't know what to do, we don't treat ectropium and sometimes these ectropium causes post coital bleedings, sometimes this ectropium is very very big and gaining infections is becoming much more because this ectropium is so big and so we can use our TIAB and then is very important in the future and now after after leap when we make any surgical things on the cervix, you know we have a lot of LEEP on our discussion here has a big big numbers of lipper and we will discuss together later and so in Italy in all the parts, not in all but quite in all the departments of colpo scopia and LEEP surgery for HPV treatment and CIN2 and CIN3 treatment we use, they use after treatment the TIAB system the TIAB soft gel.

Our clinical trials. This is, this was the first clinical style trial and I am a consultant, I work in a hospital, in a private hospital, before in a public hospital, now in a private hospital. I am the consultant too of the department on vulvo-vaginal disease of University of Milano, and we treat 58 patients every night for 7 nights, for 7 days, only to observational study to evaluation of tolerability and first efficacy. The very, very simple end points – burning, itching and discharge. And this was the first work that we published with TIAGIN. TIAGIN is the Italian name of your Gynella. And we have very, very good data against all this problem like burning, itching and discharge and this was the first nice trial that we did.

The second one is very important because we published this trial using TIAB against AV. My colleague before, he was speaking very well about aerobic vaginitis. This is a new, this is a new vaginitis, only 15 years old, we knew trichromoniesis, yeast infection, bacterial vaginosis and we say bacterial vaginitis, we don’t know what to do, what exactly the name, and Donders, you know Donders, Gilbert Donders from Belgium, very very famous. He invented this name – aerobic vaginitis. And this you know the difference from bacterial vaginosis and aerobic vaginitis. Bacterial Vaginosis, BV, is not an infection, it’s an imbalance. And the aerobic vaginitis is an infection.

And so we did and we published this very important demonstration for the antimicrobial effect of TIAB against bacteria. Not only, now we tried in BV but the first we published this against the the right bacteria because it was aerobic vaginitis, we have very good data we treat for 7 nights, for 7 days and we had 60% of women cured so this is, I think a very, very important data, I’m very proud of this, that we published this work for antimicrobial effect, sure antimicrobial effect of TIAB against bacteria.

And then we present you four clinical trials from 4 different universities of Italy. The first two, from Milan, Milan University and Naples University and it was using a TIAB TIAGIN after LEEP surgery and the objective was, the primary objective of this study to evaluate the efficacy of post-operative treatment with TIAB. The conclusions, there’s a rapid repair process with TIAGIN vagina capsules means that the uterine cervix is shortly exposed to chronic inflammation. So, we repeat. After surgery, for like LEEP, it was fantastic, good data to give TIAB, to repair, to helping repair the situation of the cervix. There are two different universities, the Milano University and in Napoli University they have a lot of numbers because there’s 327 patients with CIN2, this is very interesting for you, Vladimir, 300 patients with CIN2 who had undergone LEEP, were randomised in two groups and they used TIAB topical treatment with the TIAB system and hyaluronic acid that is inside TIAB permits rapid restoration of the ectocervix following LEEP treatment. So's a big data because 300 patients.

Different indication, other two different indications of other two different universities in in Italy. The Sicily University in Messina and the other is Roma University. In Roma University, they are studying to use TIAB formulation in a group with low-grade lesions. We were speaking before of this problem. Low-grade lesions positive for high-risk HPV with cervical ectropion, in clinical practice they give TIAB formulation and has shown itself to be a promising therapeutic aid, only aid, in the management of low-grade cervical lesions caused by HPV. So for prevention, not after-treatment but for prevention.

The last one is incredible, this is in Sicily University, this is a sexual demonstration. They use FSFI, you know this is a brief questionnaire measuring the sexual functioning in women. Sexual arousal, orgasm, satisfaction and pain and the conclusion is incredible. They observed a significant improvement in both FSFI and VHIS, that is another score, they are two important scores in sexual behaviour which can considered direct and indirect signs of increased vaginal epithalisation following vaginal treatment with TIAB What does it mean? When is any little problem, sexual problems, after using TIAB it was much, much better. And then, we change now and we go outside, and we go on the vulva. This is another important work, as my work, a work of my friend. My friend is the chief of department, yes and you can see, my name is always the second name because he is the director, the chief of this important department in Milano of vulvar disease. You know that sometimes dermatologists when then have problems and difficulties, they send to this department their patient to know how something to do. And so we publish this against vulvar dermatosis, you know, the vulvar dermatosis is a very, very important situation.

With our TIAB, TIAB Foam, this is we have a very, very good data for in the treatment helping cortisone therapy, and so the background was that vulvar contact dermatitis or dermatosis is inflammatory disorders of genital skin causing itch, burning and plaques with overlying excoriation and linear fissures. And our objective, to assess the effectiveness of our foam, TIAB foam, complex of titanium and to be sure that this treatment is helping the other treatment. The other treatment, you know, is cortisone treatment. So, 36 women older than 18 years, affected by vulvar contact dermatitis were recruited, and the conclusion was very, very good because TIAB represent an appropriate agents for the reduction of symptoms and sign of vulvar contact dermatitis. And so this is very, very important that you know, that your gel and our foam in the future you will have this foam, is enough to cure a lot of vulvar diseases.

This here again from Linnea. They, they have the foam and they use the foam, they sell the foam in Europe and South America for vulvar redness, coitum problems, sport problems, mechanical stress, you know, sometime in bicycle or if you are making too much sport, it, you can have a very simple redness of the vulva, you can use this foam for fissuring, sport fissuring, coitum fissuring, post-partum, we try to use post-partum fissuring and vulvar dystrophy, aging, is very important aging because we try to use TIAB foam in menopause, in all, in post menopause. Old women with problem, with vulvar problem in old women with vulvar problem we use the foam with the good, with good data.

So here are the new protocols. One protocol is starting with again bacterial vaginosis, this is the most difficult because bacterial vaginosis is not an infection, it’s only an imbalance, so we had to work with TIAB and to look at if it’s enough to reduce the relapses because the big problem of BV is not to have a BV one time, but the problem, the recurrences, relapses of BV. And then we have to, we want to do another protocol, other clinical trial on cervical ectropion, symptomatic ectropion, and so this too, new trials now start.

At the end, the take home messages. So our titanium dioxide forms the platform to which Silver Ag ions are anchored through strong covalent bonds. This is the basis, this is the focus of our TIAB. The monovalent silver Ag ions in our TIAB represent a unique characteristic, they are active at very low concentration and are stable and active also in light condition. The TIAB ions possess proven antimicrobial characteristics, where the exposed part of Ag binds to functional group of proteins, resulting in protein denaturation and ultimately bacteria cell death. So, strong antimicrobial possibility. The TIAB creates a barrier that doesn’t alter the physiological characteristic of epithelium and grants an effective protection against external attacks favouring the best micro-environment for natural reparation of the epithelium, wound healing.

NMTECH is the company selling TIAB in all the world, it’s a patent and I say thank you to all of you.



Titanium dioxide with monovalent silver ions covalently linked (TIAB) and its application in gynekology

Prof. Franco Vicariotto: „Ionic silver and vaginal diseases - New therapeutic perspective“


Prof. Franco Vicariotto M.D.

Prof. Franco Vicariotto M.D.
  • specialist consultant of HUMANITAS-S.PIO X Hospital of Milan and of Lower Genital Tract Disease Unit at the V. Buzzi Hospital - University of Milan
  • graduated in Medicine and Surgery at University of Milan (specialization in Obstetrics and Gynecology)
  • in the Board of several scientific societies:
    • Italian Society of Menopause (SIM)
    • European Society for Infectious Diseases in Ob-Gyn
    • Italian society of supplements in Obstetrician and Gynecology
  • clinical advisor for IMS Health
  • clinical advisor on women’s health for several Italian and International companies
  • author of many publications and moderator-spokesman in scientifc meeting and conferences in Italy and international (over 40 in the last two years)

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