1
|
Droste LR, Ratliff CR. Characteristics of Urinary Tract Infections and the Use of Cranberry Products in Patients With Urinary Diversions: A Narrative Review. J Wound Ostomy Continence Nurs 2024; 51:206-211. [PMID: 38820218 DOI: 10.1097/won.0000000000001078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
PURPOSE The aim of this narrative literature review was to summarize evidence regarding bacteriuria and urinary tract infections (UTIs) in patients living with a urinary diversion and the use of cranberry products for the prevention of these infections. METHODS We searched for articles in the English language and available in full text to address the role of cranberry products in the management of UTIs in those with urinary diversions. We searched the electronic databases of MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials between January 2003 and December 2023. Thirty-two elements were read in full and 9 elements that evaluated UTIs and/or the role of cranberries in preventing UTIs are included in this narrative review. RESULTS Research indicates no significant difference in UTI rates, microbiology, or antibiotic sensitivity and resistance patterns between the different types of urinary diversions (orthoptic diversions, ileal conduit diversions, and continent cutaneous diversions). Similar to persons with an intact urinary tract, Escherichia coli (a prevalent coliform bacteria) was the most prevalent pathogen resulting in symptomatic UTIs. In addition, we found that E. coli strains persisted in urinary diversions involving reconstructed intestinal segments for prolonged periods of time despite antibiotic treatment. We found sparse evidence suggesting that cranberry products are effective for the prevention of UTIs after ileal conduit urinary diversion. CONCLUSIONS There are inconsistencies in the definition of bacteriuria in the literature making it difficult to compare findings among the studies. Clinical guidance discussing the optimal method for obtaining a urine specimen from a urinary diversion and its management is limited. Research studies on the use of cranberry products to treat UTIs in persons living with a urinary diversion are urgently needed.
Collapse
Affiliation(s)
- Linda R Droste
- Linda R. Droste, MSN, RN, CWOCN, CBIS, Retired
- Catherine R. Ratliff, PhD, GNP-BC, CWOCN, CFCN, FAAN, Department of Surgery, Division of Vascular & Endovascular Surgery, UVA Health, Charlottesville, Virginia
| | - Catherine R Ratliff
- Linda R. Droste, MSN, RN, CWOCN, CBIS, Retired
- Catherine R. Ratliff, PhD, GNP-BC, CWOCN, CFCN, FAAN, Department of Surgery, Division of Vascular & Endovascular Surgery, UVA Health, Charlottesville, Virginia
| |
Collapse
|
2
|
Rau M, Santelli A, Martí S, Díaz MI, Sabé N, Fiol M, Riera L, Etcheverry B, Codina S, Coloma A, Carreras-Salinas A, Ardanuy C, Cruzado JM, Melilli E. Randomized clinical trial of non-antibiotic prophylaxis with d-Mannose plus Proanthocyanidins vs. Proanthocyanidins alone for urinary tract infections and asymptomatic bacteriuria in de novo kidney transplant recipients: The Manotras study. Nefrologia 2024:S2013-2514(24)00053-1. [PMID: 38637262 DOI: 10.1016/j.nefroe.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/30/2023] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Studies analyzing non-antibiotic alternatives in kidney transplant UTI's are lacking. d-Mannose, a simple sugar, inhibits bacterial attachment to the urothelium, as does Proanthocyanidins; both could act as a synergic strategy preventing UTI; nonetheless their efficacy and safety have not been evaluated in kidney transplant population yet. METHODS This is a pilot prospective, double-blind randomized trial. Sixty de novo kidney transplant recipients were randomized (1:1) to receive a prophylactic strategy based on a 24-h prolonged release formulation of d-Mannose plus Proanthocyanidins vs. Proanthocyanidins (PAC) alone. The supplements were taken for the first 3 months after kidney transplant and then followed up for 3 months as well. The main objective of the study was to search if the addition of Mannose to PAC alone reduced the incidence of UTI and/or asymptomatic bacteriuria in the first 6 months post-transplantation. RESULTS 27% of patients experienced one UTI episode (cystitis or pyelonephritis) while asymptomatic bacteriuria was very common (57%). Incidences according UTI type or AB were: 7% vs. 4% for cystitis episode (p 0.3), 4% vs. 5% for pyelonephritis (p 0.5) and 17% vs. 14% for asymptomatic bacteriuria (p 0.4) for patients in the Mannose+PAC group vs. PAC group respectively. The most frequent bacteria isolated in both groups was Escherichia coli (28% of all episodes), UTI or AB due to E. coli was not different according to study group (30% vs. 23% for Mannose+PAC vs. PAC alone p 0.37). CONCLUSIONS Non-antibiotic therapy is an unmet need to prevent UTI after kidney transplantation; however, the use of d-Mannose plus PAC does not seem capable to prevent it.
Collapse
Affiliation(s)
- Melissa Rau
- Nephrology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain
| | - Adrian Santelli
- Nephrology Department, Clínicas Hospital, Montevideo, Uruguay
| | - Sara Martí
- Microbiology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Biomedical Research Institute (IDIBELL), Duran i Reynalds Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain
| | - María Isabel Díaz
- Nephrology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Sabé
- Infectology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain
| | - María Fiol
- Urology Department, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Luis Riera
- Urology Department, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Begoña Etcheverry
- Urology Department, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Sergi Codina
- Nephrology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Biomedical Research Institute (IDIBELL), Duran i Reynalds Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain
| | - Ana Coloma
- Nephrology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Biomedical Research Institute (IDIBELL), Duran i Reynalds Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Carreras-Salinas
- Microbiology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain
| | - Carmen Ardanuy
- Microbiology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Biomedical Research Institute (IDIBELL), Duran i Reynalds Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain
| | - Josep M Cruzado
- Nephrology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Biomedical Research Institute (IDIBELL), Duran i Reynalds Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Edoardo Melilli
- Nephrology Department, Bellvitge University Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain; Biomedical Research Institute (IDIBELL), Duran i Reynalds Hospital, 08907 Hospitalet de Llobregat, Barcelona, Spain.
| |
Collapse
|
3
|
Bolgarina Z, Gonzalez-Gonzalez LF, Rodroiguez GV, Camacho A. Cranberry Supplements for Urinary Tract Infection Prophylaxis in Pregnant Women: A Systematic Review of Clinical Trials and Observational Studies on Efficacy, Acceptability, Outcomes Measurement Methods, and Studies' Feasibility. Cureus 2023; 15:e46738. [PMID: 38022216 PMCID: PMC10631496 DOI: 10.7759/cureus.46738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Cranberry supplements are commonly used to prevent urinary tract infections (UTIs). However, their usefulness is uncertain in pregnant women. We aimed to comprehensively summarize the current knowledge on cranberry supplements' efficacy and acceptability during pregnancy in addition to the outcomes measurement methods and studies' feasibility. To achieve it, we searched PubMed, PMC, and Europe PMC databases plus screened citations followed by critical appraisal of included eligible English-written primary studies that (1) focused on pregnant women supplemented with any cranberry supplements; (2) provided data on cranberry supplements' efficacy, acceptability, outcomes measurement methods, and studies' feasibility; (3) included human subjects; and (4) published worldwide. Two randomized clinical trials (RCTs) and one nested cohort study, including 1156 pregnant women in total, contributed to our analysis. A tendency toward UTI reduction was demonstrated, although the results' validity was impacted by significant juice-induced gastrointestinal intolerance (23%; 44 of 188 subjects). Changing the form of supplementation from cranberry juice to capsules reduced the issue, causing side effects in one of 49 subjects (2%). Nevertheless, both RCTs still experienced significant recruitment and retention problems, which were at 33% and 59% on average, respectively. Newly acquired safety data on 919 more subjects suggests no increased risks of all malformations, vaginal bleeding, and neonatal complications. Investigating cranberry capsules' efficacy as a non-antibacterial option for UTI prevention in pregnant women has become a feasible and important direction with the current advancement in understanding cranberry supplements' actions, recommended doses plus regimens, and their safety in the population. We reviewed the challenges and discovered knowledge gaps and the implementation strategies for future studies.
Collapse
Affiliation(s)
- Zoryana Bolgarina
- Principles and Practice of Clinical Research, Harvard T.H. Chan School of Public Health, Boston, USA
- Obstetrics and Gynecology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | | | | | - Alejandro Camacho
- Principles and Practice of Clinical Research, Harvard T.H. Chan School of Public Health, Boston, USA
| |
Collapse
|
4
|
He C, Fan K, Hao Z, Tang N, Li G, Wang S. Prevalence, Risk Factors, Pathophysiology, Potential Biomarkers and Management of Feline Idiopathic Cystitis: An Update Review. Front Vet Sci 2022; 9:900847. [PMID: 35812890 PMCID: PMC9257190 DOI: 10.3389/fvets.2022.900847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Feline idiopathic cystitis is a widespread disease in small animal clinics, which mainly presents with urinary signs like dysuria, stranguria, hematuria, pollakiuria, and periuria. The etiopathogenesis of the disease may involve interactions between the environmental stressors, neuroendocrine system and bladder of affected cats. Diagnostic biomarkers have not been tested in clinical studies though they are theoretically feasible, and since the clinical signs of the disease assemble those of other feline lower urinary diseases, its diagnosis is a procedure of exclusion. The primary treatment of the disease is long-term multimodal environmental modification (or enrichment) while anti-anxiety drugs and nutritional supplements are recommended for chronic recurrent cases. Still, many medicines need to be evaluated for their efficacy and safety. This review aims to provide readers with a comprehensive understanding of feline idiopathic cystitis by summarizing and updating studies concerning the prevalence, risk factors, etiological hypotheses, diagnostic procedures, possible treatments, and prognosis of the disease.
Collapse
|
5
|
Cranberry: Chemical Composition, Antioxidant Activity and Impact on Human Health: Overview. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27051503. [PMID: 35268605 PMCID: PMC8911768 DOI: 10.3390/molecules27051503] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022]
Abstract
Cranberries are a rich source of bioactive compounds that comprise a healthy diet. Cranberry is abundant in nutritional components and many bioactive compounds that have antioxidant properties. Both American (Vaccinium macrocarpon) and European (Vaccinium oxycoccus) cranberry species are rich in polyphenols such as phenolic acids, anthocyanins and flavonoids, and is one of the few fruits that is high in proanthocyanidins, which is linked to many health benefits. The review systematizes information on the chemical composition of cranberry, its antioxidant effect, and the beneficial impact on human health and disease prevention after cranberry consumption, and in particular, its effect against urinary tract inflammation with both adults and children, cardiovascular, oncology diseases, type 2 diabetes, metabolic syndrome, obesity, tooth decay and periodontitis, Helicobacter pylori bacteria in the stomach and other diseases. Additional research needs to study cranberry proteomics profiling, polyphenols interaction and synergism with other biologically active compounds from natural ingredients and what is important in formulation of new functional foods and supplements.
Collapse
|
6
|
Red Fruits Composition and Their Health Benefits-A Review. Foods 2022; 11:foods11050644. [PMID: 35267278 PMCID: PMC8909293 DOI: 10.3390/foods11050644] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/10/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
The probability that fruit ingestion may protect human health is an intriguing vision and has been studied around the world. Therefore, fruits are universally promoted as healthy. Over the past few decades, the number of studies proposing a relationship between fruit intake and reduced risk of major chronic diseases has continued to grow. Fruits supply dietary fiber, and fiber intake is linked to a lower incidence of cardiovascular disease and obesity. Fruits also supply vitamins and minerals to the diet and are sources of phytochemicals that function as phytoestrogens, antioxidant and anti-inflammatory agents, and other protective mechanisms. So, this review aims to summarize recent knowledge and describe the most recent research regarding the health benefits of some selected red fruits.
Collapse
|
7
|
Marouf R, Mbarga JM, Ermolaev A, Podoprigora I, Smirnova I, Yashina N, Zhigunova A, Martynenkova A. Antibacterial activity of medicinal plants against uropathogenic Escherichia coli. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:1-12. [PMID: 35784103 PMCID: PMC9245916 DOI: 10.4103/jpbs.jpbs_124_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/04/2022] Open
Abstract
Urinary tract infections (UTIs) are one of the most common bacterial infections with uropathogenic Escherichia coli (UPEC) being the most prevalent causative agent in both complicated and uncomplicated UTIs. Antibiotic resistance among UPEC has been already demonstrated against a wide variety of antibiotics and the situation is continuing to deteriorate increasing the rate of recurrence and the difficulty of treatment and prophylaxis. Recently, a big attention has been paid to non-antibiotic approaches as an alternative to conventional antibiotics. Among many strategies, phytotherapy has gained a special attention worldwide. Herbal remedies have been used in traditional medicine since ancient times and they are well known for their effectiveness in treating many health conditions including UTIs. Researches are conducted continuously to validate the use of many medicinal plants against UPEC, investigate their mechanisms of action, and determine their active constituents. Our extensive review of the recent literature revealed that many phytochemicals are shown to target and inhibit a wide variety of bioprocesses in UPEC, such as adhesion, motility, biofilm formation, and quorum sensing. Such natural approaches are very promising in confronting the antibiotic resistance of UPEC and can be further used to develop plant-based strategies and pharmaceutical products to treat and prevent UTIs caused by UPEC.
Collapse
|
8
|
Colombino E, Cavana P, Martello E, Devalle V, Miniscalco B, Ravera N, Zanatta R, Capucchio MT, Biasibetti E. A new diet supplement formulation containing cranberry extract for the treatment of feline idiopathic cystitis. Nat Prod Res 2021; 36:2884-2887. [PMID: 34039227 DOI: 10.1080/14786419.2021.1925273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to investigate whether cranberry extract could reduce lower urinary tract (LUT) and gastro-intestinal (GI) signs in feline idiopathic cystitis (FIC). Twenty-one client-owned cats were randomly allocated to two groups: a treated group (T, n = 10) receiving daily an oral nutritional supplement containing cranberry extract and a control group (C, n = 11). Owners were trained to recognise daily LUT and GI signs. Physical examination, urinalysis and bladder ultrasonography were performed at day 0 (T0), 15 (T15), 30 (T30), 60 (T60). Both groups showed an improvement for dysuria and periuria from T0 to T30 (p < 0.05), but only in cats of the T group, LUT signs disappeared at T60. A significant improvement in the T group was also observed for GI signs and bladder ultrasonography at T60 (p = 0.03). Urinalysis did not show any significant differences. This preliminary study suggests that cranberry could be effective in reducing LUT and GI signs in FIC.
Collapse
Affiliation(s)
- Elena Colombino
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Paola Cavana
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Elisa Martello
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Barbara Miniscalco
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | | | - Renato Zanatta
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Maria Teresa Capucchio
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy.,Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.,Clinica Veterinaria Borgo Po, Torino, Italy.,Institute of Sciences of Food Production, CNR, Grugliasco, Italy
| | - Elena Biasibetti
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| |
Collapse
|
9
|
Neto CC, Mortzfeld BM, Turbitt JR, Bhattarai SK, Yeliseyev V, DiBenedetto N, Bry L, Bucci V. Proanthocyanidin-enriched cranberry extract induces resilient bacterial community dynamics in a gnotobiotic mouse model. MICROBIAL CELL 2021; 8:131-142. [PMID: 34055966 PMCID: PMC8144911 DOI: 10.15698/mic2021.06.752] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cranberry consumption has numerous health benefits, with experimental reports showing its anti-inflammatory and anti-tumor properties. Importantly, microbiome research has demonstrated that the gastrointestinal bacterial community modulates host immunity, raising the question of whether the cranberry-derived effect may be related to its ability to modulate the microbiome. Only a few studies have investigated the effect of cranberry products on the microbiome to date. Especially because cranberries are rich in dietary fibers, the extent of microbiome modulation by polyphenols, particularly proanthocyanidins (PACs), remains to be shown. Since previous work has only focused on long-term effects of cranberry extracts, in this study we investigated the effect of a water-soluble, PAC-rich cranberry juice extract (CJE) on the short-term dynamics of a human-derived bacterial community in a gnotobiotic mouse model. CJE characterization revealed a high enrichment in PACs (57%), the highest ever utilized in a microbiome study. In a 37-day experiment with a ten-day CJE intervention and 14-day recovery phase, we profiled the microbiota via 16S rRNA sequencing and applied diverse time-series analytics methods to identify individual bacterial responses. We show that daily administration of CJE induces distinct dynamic patterns in bacterial abundances during and after treatment, before recovering resiliently to pre-treatment levels. Specifically, we observed an increase of Akkermansia muciniphila and Clostridium hiranonis at the expense of Bacteroides ovatus after the offset of the selection pressure imposed by the PAC-rich CJE. This demonstrates that termination of an intervention with a cranberry product can induce changes of a magnitude as high as the intervention itself.
Collapse
Affiliation(s)
- Catherine C Neto
- Department of Chemistry and Biochemistry University of Massachusetts Dartmouth, North Dartmouth, MA.,UMass Cranberry Health Research Center, University of Massachusetts Dartmouth, North Dartmouth, MA
| | - Benedikt M Mortzfeld
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA
| | - John R Turbitt
- Department of Chemistry and Biochemistry University of Massachusetts Dartmouth, North Dartmouth, MA.,UMass Cranberry Health Research Center, University of Massachusetts Dartmouth, North Dartmouth, MA
| | - Shakti K Bhattarai
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA
| | - Vladimir Yeliseyev
- Massachusetts Host-Microbiome Center, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston MA
| | - Nicholas DiBenedetto
- Massachusetts Host-Microbiome Center, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston MA
| | - Lynn Bry
- Massachusetts Host-Microbiome Center, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston MA
| | - Vanni Bucci
- UMass Cranberry Health Research Center, University of Massachusetts Dartmouth, North Dartmouth, MA.,Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA
| |
Collapse
|
10
|
Straub TJ, Chou WC, Manson AL, Schreiber HL, Walker BJ, Desjardins CA, Chapman SB, Kaspar KL, Kahsai OJ, Traylor E, Dodson KW, Hullar MAJ, Hultgren SJ, Khoo C, Earl AM. Limited effects of long-term daily cranberry consumption on the gut microbiome in a placebo-controlled study of women with recurrent urinary tract infections. BMC Microbiol 2021; 21:53. [PMID: 33596852 PMCID: PMC7890861 DOI: 10.1186/s12866-021-02106-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/28/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Urinary tract infections (UTIs) affect 15 million women each year in the United States, with > 20% experiencing frequent recurrent UTIs. A recent placebo-controlled clinical trial found a 39% reduction in UTI symptoms among recurrent UTI sufferers who consumed a daily cranberry beverage for 24 weeks. Using metagenomic sequencing of stool from a subset of these trial participants, we assessed the impact of cranberry consumption on the gut microbiota, a reservoir for UTI-causing pathogens such as Escherichia coli, which causes > 80% of UTIs. RESULTS The overall taxonomic composition, community diversity, carriage of functional pathways and gene families, and relative abundances of the vast majority of observed bacterial taxa, including E. coli, were not changed significantly by cranberry consumption. However, one unnamed Flavonifractor species (OTU41), which represented ≤1% of the overall metagenome, was significantly less abundant in cranberry consumers compared to placebo at trial completion. Given Flavonifractor's association with negative human health effects, we sought to determine OTU41 characteristic genes that may explain its differential abundance and/or relationship to key host functions. Using comparative genomic and metagenomic techniques, we identified genes in OTU41 related to transport and metabolism of various compounds, including tryptophan and cobalamin, which have been shown to play roles in host-microbe interactions. CONCLUSION While our results indicated that cranberry juice consumption had little impact on global measures of the microbiome, we found one unnamed Flavonifractor species differed significantly between study arms. This suggests further studies are needed to assess the role of cranberry consumption and Flavonifractor in health and wellbeing in the context of recurrent UTI. TRIAL REGISTRATION Clinical trial registration number: ClinicalTrials.gov NCT01776021 .
Collapse
Affiliation(s)
- Timothy J Straub
- Infectious Disease & Microbiome Program, Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wen-Chi Chou
- Infectious Disease & Microbiome Program, Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA
| | - Abigail L Manson
- Infectious Disease & Microbiome Program, Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA
| | - Henry L Schreiber
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center for Women's Infectious Disease Research, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Division of Biology & Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Bruce J Walker
- Infectious Disease & Microbiome Program, Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA
| | - Christopher A Desjardins
- Infectious Disease & Microbiome Program, Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA
| | - Sinéad B Chapman
- Infectious Disease & Microbiome Program, Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA
| | | | - Orsalem J Kahsai
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Elizabeth Traylor
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karen W Dodson
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center for Women's Infectious Disease Research, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Meredith A J Hullar
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Scott J Hultgren
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center for Women's Infectious Disease Research, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - Ashlee M Earl
- Infectious Disease & Microbiome Program, Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA.
| |
Collapse
|
11
|
Hydrophilic Interaction Liquid Chromatography to Characterize Nutraceuticals and Food Supplements Based on Flavanols and Related Compounds. SEPARATIONS 2021. [DOI: 10.3390/separations8020017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purified extracts from different types of berries and medicinal plants are increasingly used as raw materials for the production of nutraceuticals and dietary supplements, mainly due to their high content in bioactive substances. This is, for instance, the case of phenolic compounds such as flavonoids, which exhibit a wide range of beneficial properties, including antioxidant, anti-inflammatory, antineoplastic and antimicrobial activities. This paper tackles the characterization of several kinds of nutraceuticals based on hydrophilic interaction liquid chromatography (HILIC) with fluorescence detection (FLD). The study focused on the determination of flavanols and related compounds such as condensed tannins. Analytes were recovered by solvent extraction using methanol:water:hydrochloric acid (70:29:1 v:v:v) as the extraction solvent under sonication for 30 min at 55 °C. Experimental design with response surface methodology was used to optimize the HILIC separation to achieve good resolution of the main components, using acetonitrile:acetic acid (99:1 v/v) (solvent A) and methanol:water:acetic acid, (95:3:2 v/v/v) (solvent B) as the components of the mobile phase. For the assessment of the elution gradient, factors under study were solvent B percentage and gradient time. The best conditions were achieved with 10% solvent B as the initial percentage and 30 min of linear gradient to reach 25% solvent B. Principal component analysis and partial least square-discriminant analysis were used to characterize and compare the compositional features of dietary supplements based on both targeted and non-targeted approaches. Results revealed that the sample distribution relied on the oligomeric nature of descriptors.
Collapse
|
12
|
Skąpska S, Marszałek K, Woźniak Ł, Szczepańska J, Danielczuk J, Zawada K. The Development and Consumer Acceptance of Functional Fruit-Herbal Beverages. Foods 2020; 9:foods9121819. [PMID: 33302360 PMCID: PMC7762522 DOI: 10.3390/foods9121819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/04/2020] [Accepted: 12/05/2020] [Indexed: 11/16/2022] Open
Abstract
The development of functional beverages often requires a compromise between the palatability and high content of bio-active compounds. The purpose of this study was to elaborate on the fruit-herbal beverages with defined pro-health functions and evaluate their consumer acceptance. The beverages contained 80% of juices obtained from the fruits of aronia, rugosa rose, acerola, sea buckthorn, and cranberry. Each beverage was supplemented with different plant extracts which enhanced the designed functions of the beverage. The beverages were sweetened with sugar or with steviol glycosides, and were preserved by thermal pasteurization. The main groups of bio-active compounds and antioxidant capacity using ABTS, DPPH, and ORAC methods were analysed before and after pasteurization. The sensory acceptance was tested by 60 adult consumers who assessed the desirability of taste, odour, colour, and overall quality. Each beverage contained substantial amounts of polyphenols, including anthocyanins; rosehip-acerola and sea buckthorn beverages were also sources of vitamin C and carotenoids. All these components were stable under thermal treatment. Rosehip-acerola beverages had the highest antioxidant capacity, which was measured using all three methods exhibited. The highest level of consumer acceptance and willingness to purchase went to aronia beverages, while the sea buckthorn gained the lowest. There was no significant difference between the acceptance of beverages sweetened with sugar and stevia. Women and the 25- to 34-year-old consumer group rated the overall acceptability of the beverages slightly higher, although this was not reflected in their inclination to buy them. Attitude toward proper body mass and health had no influence on overall acceptance and willingness to complete the purchases. The main motivation for purchasing the functional beverages was their sensory acceptance, even if the consumers were informed of their potential health benefits.
Collapse
Affiliation(s)
- Sylwia Skąpska
- Department of Fruit and Vegetable Product Technology, Prof. Wacław Dąbrowski Institute of Agricultural and Food Biotechnology, 36 Rakowiecka Str., 02-532 Warsaw, Poland; (K.M.); (Ł.W.); (J.S.); (J.D.)
- Correspondence:
| | - Krystian Marszałek
- Department of Fruit and Vegetable Product Technology, Prof. Wacław Dąbrowski Institute of Agricultural and Food Biotechnology, 36 Rakowiecka Str., 02-532 Warsaw, Poland; (K.M.); (Ł.W.); (J.S.); (J.D.)
| | - Łukasz Woźniak
- Department of Fruit and Vegetable Product Technology, Prof. Wacław Dąbrowski Institute of Agricultural and Food Biotechnology, 36 Rakowiecka Str., 02-532 Warsaw, Poland; (K.M.); (Ł.W.); (J.S.); (J.D.)
| | - Justyna Szczepańska
- Department of Fruit and Vegetable Product Technology, Prof. Wacław Dąbrowski Institute of Agricultural and Food Biotechnology, 36 Rakowiecka Str., 02-532 Warsaw, Poland; (K.M.); (Ł.W.); (J.S.); (J.D.)
| | - Joanna Danielczuk
- Department of Fruit and Vegetable Product Technology, Prof. Wacław Dąbrowski Institute of Agricultural and Food Biotechnology, 36 Rakowiecka Str., 02-532 Warsaw, Poland; (K.M.); (Ł.W.); (J.S.); (J.D.)
| | - Katarzyna Zawada
- Department of Physical Chemistry, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, 1 Banacha St., 02-091 Warsaw, Poland;
| |
Collapse
|
13
|
|
14
|
Cranberry for Bacteriuria in Individuals with Spinal Cord Injury: A Systematic Review and Meta-Analysis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:9869851. [PMID: 33194008 PMCID: PMC7648708 DOI: 10.1155/2020/9869851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/06/2020] [Accepted: 10/12/2020] [Indexed: 12/20/2022]
Abstract
Background Urinary tract infection (UTI) is common in individuals with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD) and in veterans with SCI who use antibiotics improperly for asymptomatic bacteriuria. Cranberry (CB) has been suggested for UTI prevention. Methods We performed a systematic search up to May 2020 in the following databases: AccessMedicine, BioMed Central, CINAHL, Cochrane Library, ProQuest, and PubMed. Quality assessment was performed using a specifically designed quality score. Risk ratio was calculated with both random effect model analysis (DerSimonian-Laird method) and quality effect model analysis (Doi Thalib method). Results Six studies on bacteriuria and SCI were reviewed. From the four studies available for meta-analysis, two of which with individuals taking both CB and control, 477 data from 415 participants were analysed (241 CB and 236 control). No significant differences were detected with meta-analysis. However, bias, limitations, and incompleteness were observed in the reviewed studies. Conclusion Although further studies are needed, we suggest an accurate monitoring of diet and fluid intake, the evaluation of risk for potential food or nutraceutical interactions with drugs, and the inclusion of inflammatory markers among the outcomes in addition to UTI.
Collapse
|
15
|
Plaza A, Cabezas R, Merlet G, Zurob E, Concha-Meyer A, Reyes A, Romero J. Dehydrated cranberry juice powder obtained by osmotic distillation combined with freeze-drying: Process intensification and energy reduction. Chem Eng Res Des 2020. [DOI: 10.1016/j.cherd.2020.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
16
|
González de Llano D, Moreno-Arribas MV, Bartolomé B. Cranberry Polyphenols and Prevention against Urinary Tract Infections: Relevant Considerations. Molecules 2020; 25:E3523. [PMID: 32752183 PMCID: PMC7436188 DOI: 10.3390/molecules25153523] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022] Open
Abstract
Cranberry (Vaccinium macrocarpon) is a distinctive source of polyphenols as flavonoids and phenolic acids that has been described to display beneficial effects against urinary tract infections (UTIs), the second most common type of infections worldwide. UTIs can lead to significant morbidity, especially in healthy females due to high rates of recurrence and antibiotic resistance. Strategies and therapeutic alternatives to antibiotics for prophylaxis and treatment against UTIs are continuously being sought after. Different to cranberry, which have been widely recommended in traditional medicine for UTIs prophylaxis, probiotics have emerged as a new alternative to the use of antibiotics against these infections and are the subject of new research in this area. Besides uropathogenic Escherichia coli (UPEC), the most common bacteria causing uncomplicated UTIs, other etiological agents, such as Klebsiellapneumoniae or Gram-positive bacteria of Enterococcus and Staphylococcus genera, seem to be more widespread than previously appreciated. Considerable current effort is also devoted to the still-unraveled mechanisms that are behind the UTI-protective effects of cranberry, probiotics and their new combined formulations. All these current topics in the understanding of the protective effects of cranberry against UTIs are reviewed in this paper. Further progresses expected in the coming years in these fields are also discussed.
Collapse
Affiliation(s)
- Dolores González de Llano
- Institute of Food Science Research (CIAL), CSIC-UAM, Nicolás Cabrera, 9, Campus de Cantoblanco, 28049 Madrid, Spain; (M.V.M.-A.); (B.B.)
| | | | | |
Collapse
|
17
|
Renaud V, Faucher M, Perreault V, Serre E, Dubé P, Boutin Y, Bazinet L. Evolution of cranberry juice compounds during in vitro digestion and identification of the organic acid responsible for the disruption of in vitro intestinal cell barrier integrity. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2020; 57:2329-2342. [PMID: 32431359 PMCID: PMC7230080 DOI: 10.1007/s13197-020-04271-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 01/14/2020] [Accepted: 01/21/2020] [Indexed: 01/02/2023]
Abstract
Cranberry juice is increasingly consumed for its richness in polyphenols having a positive impact on human health. Unfortunately, when regularly consumed, its high concentration in organic acids may cause some intestinal discomforts. In the present study, its organic acid content was reduced of 41% by electrodialysis with bipolar membrane (EDBM), and the resulted deacidified juice was divided in five different juices readjusted or not with different concentrations of citric and/or malic acid(s) corresponding to the concentration of this/these acid(s) recovered during EDBM or at the titratable acidity (TA) of the non-deacidified cranberry juice. The evolution of the cranberry juice main interesting compounds (organic acids and polyphenols), according to the concentration and nature of the organic acids present, was studied for the first time at each specific stages of the digestion. After digestion, Caco-2 cells were exposed to all digested juices to identify the organic acid(s) responsible for the loss of integrity of the epithelial barrier. It appeared that organic acid contents did not change during the different steps of the digestion while polyphenolic compounds decreased starting from the gastric phase. Whatever the organic acid concentration or nature, the concentration of PACs significantly decreased between the salivary and the gastric steps but was different according to their structure when the concentration of most of anthocyanins significantly decreased at the gastric step. Also, to the best of our knowledge, it was the first time that citric acid was demonstrated as the organic acid responsible for the loss of integrity of Caco-2 cell monolayers.
Collapse
Affiliation(s)
- Valentine Renaud
- Institute of Nutrition and Functional Foods (INAF), Department of Food Sciences, Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
- Laboratory of Food Processing and ElectroMembrane Processes (LTAPEM), Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
| | - Mélanie Faucher
- Institute of Nutrition and Functional Foods (INAF), Department of Food Sciences, Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
- Laboratory of Food Processing and ElectroMembrane Processes (LTAPEM), Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
| | - Véronique Perreault
- Institute of Nutrition and Functional Foods (INAF), Department of Food Sciences, Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
- Laboratory of Food Processing and ElectroMembrane Processes (LTAPEM), Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
| | - Elodie Serre
- Institute of Nutrition and Functional Foods (INAF), Department of Food Sciences, Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
- Laboratory of Food Processing and ElectroMembrane Processes (LTAPEM), Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
| | - Pascal Dubé
- Industrial Research Center of Quebec (CRIQ), Quebec, QC G1P 4C7 Canada
| | | | - Laurent Bazinet
- Institute of Nutrition and Functional Foods (INAF), Department of Food Sciences, Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
- Laboratory of Food Processing and ElectroMembrane Processes (LTAPEM), Paul Comtois Pavillion, Laval University, Quebec, QC G1V 0A6 Canada
| |
Collapse
|
18
|
Ankola AV, Kumar V, Thakur S, Singhal R, Smitha T, Sankeshwari R. Anticancer and antiproliferative efficacy of a standardized extract of Vaccinium macrocarpon on the highly differentiating oral cancer KB cell line athwart the cytotoxicity evaluation of the same on the normal fibroblast L929 cell line. J Oral Maxillofac Pathol 2020; 24:258-265. [PMID: 33456234 PMCID: PMC7802834 DOI: 10.4103/jomfp.jomfp_129_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/27/2020] [Accepted: 05/12/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The perpetual search is on to find botanical complementary adjuncts to the conventional therapies used that is not only cost-effective but also reduces side effects associated with conventional synthetic drugs that are available in the market. The aim of this study was to assess the in vitro anticancer efficacy of hydroalcoholic fruit extract of cranberry against oral cancer KB cell line by Di-Methyl Thiazoldiphenyl Tetrazolium bromide assay (MTT) assay and its cytotoxicity on normal fibroblast cells. MATERIALS AND METHODS Vaccinium macrocarpon extract was prepared using a hydroethanolic solvent (water - 30%:ethanol - 70%) using the standardized maceration protocol. Standard KB and normal fibroblast (L929) cell lines were used. The minimum lethal effect of the extract was calculated using the MTT cytotoxicity assay. RESULTS The extract shows a satisfactory antiproliferative effect on the KB cell line and a higher cell viability percentage of the normal fibroblast cell line. CONCLUSION V. macrocarpon can prove to be an adjunct to the existing anticancer drug therapy against oral cancer KB cell line.
Collapse
Affiliation(s)
- Anil V. Ankola
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Vaibhav Kumar
- Department of Public Health Dentistry, TPCT's Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Simran Thakur
- Intern, TPCT's Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Richa Singhal
- Department of Paediatrics, Safdarjung Hospital, New Delhi, India
| | - T Smitha
- Department of Oral Pathology, V.S. Dental College and Hospital, VV Puram, Bengaluru, Karnataka, India
| | - Roopali Sankeshwari
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| |
Collapse
|
19
|
Faucher M, Henaux L, Chaudron C, Mikhaylin S, Margni M, Bazinet L. Electromembrane approach to substantially improve the ecoefficiency of deacidified cranberry juice production: Physicochemical properties, life cycle assessment and ecoefficiency score. J FOOD ENG 2020. [DOI: 10.1016/j.jfoodeng.2019.109802] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
20
|
Baron G, Altomare A, Regazzoni L, Fumagalli L, Artasensi A, Borghi E, Ottaviano E, Del Bo C, Riso P, Allegrini P, Petrangolini G, Morazzoni P, Riva A, Arnoldi L, Carini M, Aldini G. Profiling Vaccinium macrocarpon components and metabolites in human urine and the urine ex-vivo effect on Candida albicans adhesion and biofilm-formation. Biochem Pharmacol 2020; 173:113726. [DOI: 10.1016/j.bcp.2019.113726] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/18/2019] [Indexed: 01/23/2023]
|
21
|
Sun J, Deering RW, Peng Z, Najia L, Khoo C, Cohen PS, Seeram NP, Rowley DC. Pectic Oligosaccharides from Cranberry Prevent Quiescence and Persistence in the Uropathogenic Escherichia coli CFT073. Sci Rep 2019; 9:19590. [PMID: 31862919 PMCID: PMC6925298 DOI: 10.1038/s41598-019-56005-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 12/04/2019] [Indexed: 11/26/2022] Open
Abstract
Urinary tract infections (UTIs) caused by Escherichia coli create a large burden on healthcare and frequently lead to recurrent infections. Part of the success of E. coli as an uropathogenic bacterium can be attributed to its ability to form quiescent intracellular reservoirs in bladder cells and its persistence after antibiotic treatment. Cranberry juice and related products have been used for the prevention of UTIs with varying degrees of success. In this study, a group of cranberry pectic oligosaccharides (cPOS) were found to both inhibit quiescence and reduce the population of persister cells formed by the uropathogenic strain, CFT073. This is the first report detailing constituents of cranberry with the ability to modulate these important physiological aspects of uropathogenic E. coli. Further studies investigating cranberry should be keen to include oligosaccharides as part of the ‘active’ cocktail of chemical compounds.
Collapse
Affiliation(s)
- Jiadong Sun
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA.,Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, 20814, USA
| | - Robert W Deering
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - Zhiyuan Peng
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - Laila Najia
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - Christina Khoo
- Ocean Spray Cranberries, Inc., One Ocean Spray Drive, Lakeville-Middleboro, MA, 02349, USA
| | - Paul S Cohen
- Department of Cell and Molecular Biology, University of Rhode Island, Kingston, RI, 02881, USA
| | - Navindra P Seeram
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - David C Rowley
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA.
| |
Collapse
|
22
|
Johnstone T. A clinical approach to multidrug-resistant urinary tract infection and subclinical bacteriuria in dogs and cats. N Z Vet J 2019; 68:69-83. [PMID: 31707934 DOI: 10.1080/00480169.2019.1689196] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Multidrug-resistant bacteria are increasingly isolated from the urinary tract of pets, particularly those that suffer from concurrent conditions, have been hospitalised, or were treated with antimicrobials in the recent past. Many of the multidrug-resistant bacteria encountered are resistant to all commonly used oral antibiotics. This poses both a therapeutic dilemma in the individual pet and a threat to public health. This article begins with an overview of multidrug resistance in organisms that are commonly isolated from the urinary tract of pets. This is followed by a proposed clinical approach to managing multidrug-resistant urinary bacteria, which summarises current knowledge regarding appropriate sampling and analysis, reviews the current guidelines regarding appropriate antimicrobial use and discusses treatment options that might be considered. The article highlights several shortcomings of the current knowledge to be considered when planning future clinical research and developing policies.
Collapse
Affiliation(s)
- T Johnstone
- Translational Research and Animal Clinical Trial Study Group, U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Australia
| |
Collapse
|
23
|
Tambunan MP, Rahardjo HE. Cranberries for women with recurrent urinary tract infection: a meta-analysis. MEDICAL JOURNAL OF INDONESIA 2019. [DOI: 10.13181/mji.v28i3.3299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Cranberries are the most widely used nonantibiotic prophylaxis for recurrent urinary tract infection (rUTI) in women; however, their efficacy still remains uncertain. Hence, this meta-analysis was aimed to assess the effectiveness, safety, and adherence of cranberry as a prophylactic drug for treating rUTI.
METHODS Literature search was conducted using PubMed, EBSCO, Science Direct, Scopus, Cochrane, and Google Scholar. Studies were screened for duplication, inclusion and exclusion criteria, and then reviewed by two authors independently. This included all randomized controlled trials of cranberry derivatives versus placebo and antibiotic prophylaxis. Cochrane risk-of-bias assessment tools were used to evaluate the quality of the study. Quantitative analysis was performed using the Review Manager 5.0 software.
RESULTS Nine studies were included. Among 1,542 participants, cranberry consumption reduced incidence of rUTI in women compared with placebo (p = 0.02). The subgroup analysis revealed that only cranberry capsules were superior to placebo (relative risk [RR] = 0.67, 95% confidence interval [CI] = 0.45–0.98), but not for cranberry juice (RR = 0.85, 95% CI: 0.7–1.04). Antibiotics had better outcome than cranberry for rUTI (RR = 0.83, 95% CI = 0.70–0.98). Most of the participants experienced minor adverse events such as rash and gastrointestinal symptoms. There was also a good adherence rate, ranging from 90.3–99% monthly dose.
CONCLUSIONS Cranberry, especially cranberry capsule consumption, had a significant effect in reducing the incidence of rUTI compared with placebo, with good adherence rates, and minor adverse events. In contrast, although antibiotic use had a greater efficacy, it was associated with a higher risk of severe adverse events.
Collapse
|
24
|
Ayyash M, Shehabi A, Mahmoud N, Al-Bakri A. Antibiofilm properties of triclosan with EDTA or cranberry as Foley Catheter lock solutions. J Appl Microbiol 2019; 127:1876-1888. [DOI: 10.1111/jam.14439] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 07/24/2019] [Accepted: 08/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
- M. Ayyash
- Department of Pharmaceutics and Pharmaceutical Technology School of Pharmacy The University of Jordan Amman Jordan
| | - A.A. Shehabi
- Department of Pathology‐Microbiology School of Medicine The University of Jordan Amman Jordan
| | - N.N. Mahmoud
- Department of Pharmacy Faculty of Pharmacy Al‐Zaytoonah University of Jordan Amman Jordan
| | - A.G. Al-Bakri
- Department of Pharmaceutics and Pharmaceutical Technology School of Pharmacy The University of Jordan Amman Jordan
| |
Collapse
|
25
|
Abstract
Urinary tract infections (UTIs) are highly prevalent, lead to considerable patient morbidity, incur large financial costs to health-care systems and are one of the most common reasons for antibiotic use worldwide. The growing problem of antimicrobial resistance means that the search for nonantibiotic alternatives for the treatment and prevention of UTI is of critical importance. Potential nonantibiotic measures and treatments for UTIs include behavioural changes, dietary supplementation (such as Chinese herbal medicines and cranberry products), NSAIDs, probiotics, D-mannose, methenamine hippurate, estrogens, intravesical glycosaminoglycans, immunostimulants, vaccines and inoculation with less-pathogenic bacteria. Some of the results of trials of these approaches are promising; however, high-level evidence is required before firm recommendations for their use can be made. A combination of these agents might provide the optimal treatment to reduce recurrent UTI, and trials in specific population groups are required.
Collapse
|
26
|
Mantzorou M, Zarros A, Vasios G, Theocharis S, Pavlidou E, Giaginis C. Cranberry: A Promising Natural Source of Potential Nutraceuticals with Anticancer Activity. Anticancer Agents Med Chem 2019; 19:1672-1686. [PMID: 31272361 DOI: 10.2174/1871520619666190704163301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 05/23/2019] [Accepted: 05/27/2019] [Indexed: 12/12/2022]
Abstract
Studies have shown that cranberry and its components may exert anticancer properties. The present study aims to critically summarise the existing experimental studies evaluating the potential effects of cranberry on cancer prevention and treatment. PubMed database was searched to identify relevant studies. Current in vitro studies have indicated that cranberry and/or its components may act as chemopreventive agents, diminishing the risk for cancer by inhibiting cells oxidation and inflammatory-related processes, while they may also exert chemotherapeutic effects by inhibiting cell proliferation and angiogenesis, inducing cell apoptosis and attenuating the ability of tumour cells to invade and metastasis. Limited in vivo studies have further documented potential anticancer activity. Cranberry could be considered as a conglomeration of potential effective anticancer druglike compounds.
Collapse
Affiliation(s)
- Maria Mantzorou
- Department of Food Science and Nutrition, University of the Aegean, Lemnos, Greece
| | - Apostolos Zarros
- Institute of Cancer Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Georgios Vasios
- Department of Food Science and Nutrition, University of the Aegean, Lemnos, Greece
| | - Stamatios Theocharis
- First Department of Pathology, Medical School, University of Athens, Athens, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, University of the Aegean, Lemnos, Greece
| | | |
Collapse
|
27
|
Magnusson B, Kai-Larsen Y, Granlund P, Seiger Å, Lindbo L, Sanchez J, Johansson D. Long-term use of noble metal alloy coated urinary catheters reduces recurrent CAUTI and decreases proinflammatory markers. Ther Adv Urol 2019; 11:1756287219854915. [PMID: 31258625 PMCID: PMC6585253 DOI: 10.1177/1756287219854915] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/02/2019] [Indexed: 12/26/2022] Open
Abstract
Background: The objective of this study was to investigate a case of a permanently (suprapubic) catheterized woman with neurogenic bladder dysfunction. The patient had suffered from recurrent catheter-associated urinary tract infections (CAUTIs) since 2009, despite several prevention approaches and attempts. In 2013, the patient’s catheter was substituted for the BIP Foley Catheter, coated with a noble metal alloy (NMA) of gold, silver, and palladium. Method: This is a retrospective–prospective clinical case study covering 4 years history for the control catheters and up to 2.5 years for the anti-infective BIP Foley Catheter. CAUTI incidences, symptoms, antibiotics, catheter performance, and comfort were evaluated. Levels of proinflammatory cytokines were measured pre- and post-substitution to BIP Foley Catheter in urine of the case and of four other permanently catheterized patients. In addition, the levels of noble metals were assessed in urine of the case subject during use of the BIP Foley Catheter. Results: While using control catheters, the patient experienced symptomatic CAUTIs requiring antibiotics almost every month for 4 years. After 1 month with the BIP Foley Catheter, the symptoms disappeared, and the patient remained free of symptomatic CAUTIs and antibiotic treatment for the following 2.5 years, despite bacteriuria. The patient was satisfied with the comfort during insertion, use, and removal of the BIP Foley Catheter. Urinary levels of the proinflammatory cytokines interleukin (IL)-6, IL-8, and tumor necrosis factor alpha (TNFα) decreased towards normal levels post catheter type substitution. Traces of noble metals detected in a few urine samples were ⩽4% of the permitted daily exposure. The levels of the noble metals gold, silver, and palladium remaining on the BIP Foley Catheter after use were the same as for unused catheters. Conclusion: Long-term use of a NMA-coated catheter was associated with cessation of frequent CAUTIs. The catheter was experienced as comfortable and inflammatory markers were reduced with time. The coating was stable, with no significant metal release into urine and is therefore safe for patient use.
Collapse
Affiliation(s)
| | - Ylva Kai-Larsen
- Bactiguard AB, Alfred Nobels Allé 150, 146 48 Tullinge, Stockholm, Sweden
| | | | - Åke Seiger
- Rehab Station Stockholm, Spinalis, Stockholm, Sweden Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena Lindbo
- Rehab Station Stockholm, Spinalis, Stockholm, Sweden
| | - Javier Sanchez
- Bactiguard AB, Tullinge, Stockholm, Sweden Danderyd Hospital, Stockholm, Sweden
| | | |
Collapse
|
28
|
Shaheen G, Akram M, Jabeen F, Ali Shah SM, Munir N, Daniyal M, Riaz M, Tahir IM, Ghauri AO, Sultana S, Zainab R, Khan M. Therapeutic potential of medicinal plants for the management of urinary tract infection: A systematic review. Clin Exp Pharmacol Physiol 2019; 46:613-624. [PMID: 30932202 DOI: 10.1111/1440-1681.13092] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 01/21/2023]
Abstract
Urinary tract infection (UTI) is one of the most severe public health problem affecting both sexes but females are more susceptible due to the differences in urogenital and reproductive anatomy, physiology and lifestyle. As in UTI, different parts of the urinary tract are affected and morbidity due to UTI is more common in women of all ages and older men. Due to multi-drug resistant strains and high recurrence rate, UTI has become a major socioeconomic burden. The current review article was aimed to describe the natural therapeutic strategies to manage and cure the UTI. For this purpose, different databases including Google Scholar, Cochrane database, and PubMed etc. were explored. Inclusion criteria were any research article investigating the current therapy of UTI. It was found that microbial infections including Escherichia coli, Enterococcus faecalis and Klebsiella species are the major causes of UTI with different signs and symptoms including painful urination or dysuria, hematuria, urinary urgency, burning micturition, frequent urination, nausea, and vomiting. Antibiotics like trimethoprim, sulfamethoxazole, quinolone etc. as the first choice of the drug are used worldwide. However, due to microbial resistance, several life-threatening side effects, repeated high doses, high cost and low efficacy of these antibiotics motivated the researchers to explore natural remedies for the treatment of UTI. Herbal medicines are effective to combat bacterial resistance with high efficacy, and easy availability with minimal or no side effects. For these reasons it has attained the attention of researchers wanting to explore the herbal treatment of UTI. Vaccinium macrocarpon, Tribulus terrestris, Trachyspermum copticum, Cinnamomum verum and Hybanthusenn easpermus are some common medicinal plants reported to have therapeutic potential for the management and cure of the UTI. Although herbal medicines have more potential over conventional medicine but more discoveries are required to explore the phytoconstituents and their mechanism of action responsible for the management and cure of UTI.
Collapse
Affiliation(s)
- Ghazala Shaheen
- University College of Conventional Medicine, Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Directorate of Medical Sciences, Government College University-Faisalabad, Faisalabad, Pakistan
| | - Farhat Jabeen
- Department of Zoology, Government College University-Faisalabad, Faisalabad, Pakistan
| | - Syed Muhammad Ali Shah
- Department of Eastern Medicine, Directorate of Medical Sciences, Government College University-Faisalabad, Faisalabad, Pakistan
| | - Naveed Munir
- College of Allied Health Professional, Directorate of Medical Sciences, Government College University-Faisalabad, Faisalabad, Pakistan.,Department of Biochemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Daniyal
- TCM and Ethnomedicine Innovation & Development International Laboratory, Innovative Materia Medica Research Institute, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - Muhammad Riaz
- Department of Allied Health Sciences, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Imtiaz Mahmood Tahir
- College of Allied Health Professional, Directorate of Medical Sciences, Government College University-Faisalabad, Faisalabad, Pakistan
| | - Aymen Owais Ghauri
- Faculty of pharmacy, Rayaz College of Eastern Medicine, Jinnah University for Women, Karachi, Pakistan
| | - Sabira Sultana
- Department of Eastern Medicine, Directorate of Medical Sciences, Government College University-Faisalabad, Faisalabad, Pakistan
| | - Rida Zainab
- Department of Eastern Medicine, Directorate of Medical Sciences, Government College University-Faisalabad, Faisalabad, Pakistan
| | - Muslim Khan
- Department of Chemistry, Kohat University of Science and Technology, Kohat, Pakistan
| |
Collapse
|
29
|
Jurikova T, Skrovankova S, Mlcek J, Balla S, Snopek L. Bioactive Compounds, Antioxidant Activity, and Biological Effects of European Cranberry ( Vaccinium oxycoccos). Molecules 2018; 24:E24. [PMID: 30577610 PMCID: PMC6337168 DOI: 10.3390/molecules24010024] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 01/22/2023] Open
Abstract
Lesser known fruits or underutilized fruit species are recently of great research interest due to the presence of phytochemicals that manifest many biological effects. European cranberry, Vaccinium oxycoccos fruit, as an important representative of this group, is a valuable source of antioxidants and other biologically active substances, similar to American cranberry (V. macrocarpon) which is well known and studied. European cranberry fruit is rich especially in polyphenolic compounds anthocyanins (12.4⁻207.3 mg/100 g fw), proanthocyanins (1.5⁻5.3 mg/100 g fw), and flavonols, especially quercetin (0.52⁻15.4 mg/100 g fw), which mostly contribute to the antioxidant activity of the fruit. Small cranberry is also important due to its various biological effects such as urinary tract protection (proanthocyanidins), antibacterial and antifungal properties (quercetin, proanthocyanidins, anthocyanins), cardioprotective (proanthocyanidins) and anticancer activities (proanthocyanidins), and utilization in food (juice drinks, jams, jellies, sauces, additive to meat products) and pharmacological industries, and in folk medicine.
Collapse
Affiliation(s)
- Tunde Jurikova
- Institute for teacher training, Faculty of Central European Studies, Constantine the Philosopher University in Nitra, SK-949 74 Nitra, Slovakia.
| | - Sona Skrovankova
- Department of Food Analysis and Chemistry, Faculty of Technology, Tomas Bata University in Zlín, CZ-760 01 Zlín, Czech Republic.
| | - Jiri Mlcek
- Department of Food Analysis and Chemistry, Faculty of Technology, Tomas Bata University in Zlín, CZ-760 01 Zlín, Czech Republic.
| | - Stefan Balla
- Institute for teacher training, Faculty of Central European Studies, Constantine the Philosopher University in Nitra, SK-949 74 Nitra, Slovakia.
| | - Lukas Snopek
- Department of Food Analysis and Chemistry, Faculty of Technology, Tomas Bata University in Zlín, CZ-760 01 Zlín, Czech Republic.
| |
Collapse
|
30
|
Drastic energy consumption reduction and ecoefficiency improvement of cranberry juice deacidification by electrodialysis with bipolar membranes at semi-industrial scale: Reuse of the recovery solution. J Memb Sci 2018. [DOI: 10.1016/j.memsci.2018.02.041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
31
|
Temiz Z, Cavdar I. The effects of training and the use of cranberry capsule in preventing urinary tract infections after urostomy. Complement Ther Clin Pract 2018; 31:111-117. [PMID: 29705442 DOI: 10.1016/j.ctcp.2018.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/08/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE The study was conducted to investigate the effects of training provided by researcher and the use of cranberry capsule in preventing late term UTIs after urostomy. METHODS The study included 60 patients who underwent ileal conduit diversion between June 2013 and November 2014. The participants were randomly divided into three groups. First group used cranberry capsule, second group received training about UTIs and the other control group. The patients were assessed for a UTI by laboratory analysis at 2, 3, and 4 months after discharge. RESULTS When the effect of cranberry capsule use and training on the prevention of urinary tract infections were compared, we found that there was a significant difference between the group that used and didn't use cranberry capsules, favoring the cranberry capsule (log-rank test; p < 0.05). CONCLUSION We found that the use of cranberry capsules is effective in the prevention of urinary tract infections.
Collapse
Affiliation(s)
- Zeynep Temiz
- Nursing Department, Faculty of Healthy Science, Artvin Coruh Universitesi, Artvin, Turkey
| | - Ikbal Cavdar
- Surgical Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey.
| |
Collapse
|
32
|
Fu Z, Liska D, Talan D, Chung M. Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis. J Nutr 2017; 147:2282-2288. [PMID: 29046404 DOI: 10.3945/jn.117.254961] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/03/2017] [Accepted: 09/25/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Cranberry (Vaccinium spp.) has been advocated for treatment of urinary tract infection (UTI); however, its efficacy is controversial. Women have a 50% risk of UTI over their lifetime, and ∼20-30% experience a subsequent UTI recurrence.Objective: We conducted this meta-analysis to assess the effect of cranberry on the risk of UTI recurrence in otherwise healthy women.Methods: Literature published before January 2011 was obtained from 2 published systematic reviews, and we conducted updated searches in EMBASE and MEDLINE (through July 2017). We included randomized controlled trials that were conducted in generally healthy nonpregnant women aged ≥18 y with a history of UTI, compared cranberry intervention to a placebo or control, and reported the outcome as the number of participants experiencing a UTI. Two researchers conducted abstract and full-text screenings, data extractions, and risk of bias assessments independently, and discrepancies were resolved by group consensus. Meta-analyses were performed by using Stata SE software (version 13). We employed a fixed-effect model using the Mantel-Haenszel method to estimate the summary risk if the heterogeneity was low to moderate (I2 < 50%). Otherwise, we applied a random-effects model using the DerSimonian-Laird method.Results: We identified 7 randomized controlled trials conducted in healthy women at risk of UTI (n = 1498 participants). Results of the meta-analysis showed that cranberry reduced the risk of UTI by 26% (pooled risk ratio: 0.74; 95% CI: 0.55, 0.98; I2 = 54%). Risk of bias indicated that 2 studies had high loss to follow-up or selective outcome reporting. Overall, the studies were relatively small, with only 2 having >300 participants.Conclusion: These results suggest that cranberry may be effective in preventing UTI recurrence in generally healthy women; however, larger high-quality studies are needed to confirm these findings. This trial was registered at crd.york.ac.uk/prospero as CRD42015024439.
Collapse
Affiliation(s)
- Zhuxuan Fu
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
| | - DeAnn Liska
- Nutrition Science and Biostatistics, Biofortis Research, Addison, IL; and
| | - David Talan
- University of California, Los Angeles School of Medicine, UCLA-Olive View Medical Center, Sylmar, CA
| | - Mei Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA;
| |
Collapse
|
33
|
Food derived anti-adhesive components against bacterial adhesion: Current progresses and future perspectives. Trends Food Sci Technol 2017. [DOI: 10.1016/j.tifs.2017.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
34
|
Peron G, Sut S, Pellizzaro A, Brun P, Voinovich D, Castagliuolo I, Dall'Acqua S. The antiadhesive activity of cranberry phytocomplex studied by metabolomics: Intestinal PAC-A metabolites but not intact PAC-A are identified as markers in active urines against uropathogenic Escherichia coli. Fitoterapia 2017; 122:67-75. [DOI: 10.1016/j.fitote.2017.08.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 12/22/2022]
|
35
|
Optimization of cranberry juice deacidification by electrodialysis with bipolar membrane: Impact of pulsed electric field conditions. Sep Purif Technol 2017. [DOI: 10.1016/j.seppur.2017.04.054] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
36
|
Physico-chemical parameters and proanthocyanidin profiles of cranberries cultivated in New Zealand. J Food Compost Anal 2017. [DOI: 10.1016/j.jfca.2017.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
37
|
Jensen HD, Struve C, Christensen SB, Krogfelt KA. Cranberry Juice and Combinations of Its Organic Acids Are Effective against Experimental Urinary Tract Infection. Front Microbiol 2017; 8:542. [PMID: 28421045 PMCID: PMC5378705 DOI: 10.3389/fmicb.2017.00542] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
The antibacterial effect of cranberry juice and the organic acids therein on infection by uropathogenic Escherichia coli was studied in an experimental mouse model of urinary tract infection (UTI). Reduced bacterial counts were found in the bladder (P < 0.01) of mice drinking fresh cranberry juice. Commercially available cranberry juice cocktail also significantly reduced (P < 0.01) bacterial populations in the bladder, as did the hydrophilic fraction of cranberry juice (P < 0.05). Quinic, malic, shikimic, and citric acid, the preponderant organic acids in cranberry juice, were tested in combination and individually. The four organic acids also decreased bacterial levels in the bladder when administered together (P < 0.001), and so did the combination of malic plus citric acid (P < 0.01) and malic plus quinic acid (P < 0.05). The other tested combinations of the organic acids, and the acids administered singly, did not have any effect in the UTI model. Apparently, the antibacterial effect of the organic acids from cranberry juice on UTI can be obtained by administering a combination of malic acid and either citric or quinic acid. This study show for the first time that cranberry juice reduce E. coli colonization of the bladder in an experimental mouse model of urinary tract infection and that the organic acids are active agents.
Collapse
Affiliation(s)
- Heidi D Jensen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark.,Natural Products and Peptides, University of CopenhagenCopenhagen, Denmark
| | - Carsten Struve
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | | | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| |
Collapse
|
38
|
Bałan BJ, Lewicki S, Siwicki AK, Stelmasiak M, Skopiński P, Skopińska-Różewska E, Wasiutyński A, Zdanowski R. Morphometric abnormalities in spleen and kidney of the progeny of mice fed American cranberry extract (Vaccinium macrocarpon) during pregnancy and lactation. Pol J Vet Sci 2017; 20:57-65. [PMID: 28525344 DOI: 10.1515/pjvs-2017-0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cranberries and cranberry-derived diet supplements are often recommended for the treatment of urinary tract infections, also during pregnancy. These products contain strongly anti-angiogenic chemical compounds which could not be indifferent to the developing fetus. In the present work we evaluated the effect of feeding pregnant and lactating mice American cranberry extract (daily dose 0.88 mg) on the morphology and some parameters of spleen and kidney function of their adult progeny. Six weeks after delivery the morphometry of spleen and kidney, cytometric analysis of spleen lymphocytes, evaluation of humoral response to SRBC (Sheep Red Blood Cells), and examination of serum creatinine/urea concentration, were performed in the offspring. Spleens of progeny from experimental (E) group differed from the spleens of progeny of control mice in the lower number of lymphatic nodules and their larger diameter. Cytometry of spleen cells from progeny of E mothers revealed more CD19+ and CD8+ lymphocytes than in the control group. No difference was seen in the response to immunization by red blood cells of sheep (SRBC) between control and E offspring. An increase in the diameter of glomeruli was observed in the kidneys of the experimental group in comparison with the control group. No abnormalities in creatinine and urea serum level were observed. A higher concentration of VEGF and bFGF in E offspring sera in comparison to the controls was seen. CONCLUSION Although the observed differences between the control and experimental group were not large, caution is recommended in using cranberries and their extracts during pregnancy until more research will be done on this topic.
Collapse
|
39
|
Fraile B, Alcover J, Royuela M, Rodríguez D, Chaves C, Palacios R, Piqué N. Xyloglucan, hibiscus and propolis for the prevention of urinary tract infections: results of in vitro studies. Future Microbiol 2017; 12:721-731. [PMID: 28345957 DOI: 10.2217/fmb-2017-0015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To assess the properties of a medical device containing xyloglucan, propolis and hibiscus to create a bioprotective barrier to avoid the contact of uropathogenic Escherichia coli strains on cell walls in models of intestinal (CacoGoblet) and uroepithelial (RWPE-1) cells (derived from normal human prostate epithelium). MATERIALS & METHODS Two uropathogenic E. coli strains (expressing type 1 fimbriae and P fimbriae) were used to assess, by electronic microscopy and ELISA, the barrier properties of the medical device. The antimicrobial activity was assessed in broth dilution assays. RESULTS The three components (xyloglucan, propolis and hibiscus) did not alter E. coli cell integrity in intestinal and uroepithelial cell models and were devoid of antibacterial activity. The three components avoided bacterial contact in both cell monolayers. CONCLUSION The nonpharmacological barrier properties of xyloglucan, propolis and hibiscus confirm the role of the medical device for the management of urinary tract infections.
Collapse
Affiliation(s)
- Benito Fraile
- Department of Biomedicine & Biotechnology, University of Alcalá, 28871, Alcalá de Henares, Madrid, Spain
| | - Javier Alcover
- Laboratorios DIATER, SA. Avenida Gregorio Peces Barba, no. 2. Parque Tecnológico de Leganés. 208918 Leganés, Madrid, Spain
| | - Mar Royuela
- Department of Biomedicine & Biotechnology, University of Alcalá, 28871, Alcalá de Henares, Madrid, Spain
| | - David Rodríguez
- Laboratorios DIATER, SA. Avenida Gregorio Peces Barba, no. 2. Parque Tecnológico de Leganés. 208918 Leganés, Madrid, Spain
| | - Concepción Chaves
- Department of Biomedicine & Biotechnology, University of Alcalá, 28871, Alcalá de Henares, Madrid, Spain
| | - Ricardo Palacios
- Laboratorios DIATER, SA. Avenida Gregorio Peces Barba, no. 2. Parque Tecnológico de Leganés. 208918 Leganés, Madrid, Spain
| | - Núria Piqué
- Department of Microbiology & Parasitology, Pharmacy Faculty, Universitat de Barcelona (UB), Diagonal Sud, Facultat de Farmàcia, Edifici A, Av Joan XXIII, 08028 Barcelona, Spain
| |
Collapse
|
40
|
Ticinesi A, Nouvenne A, Borghi L, Meschi T. Water and other fluids in nephrolithiasis: State of the art and future challenges. Crit Rev Food Sci Nutr 2017; 57:963-974. [PMID: 25975220 DOI: 10.1080/10408398.2014.964355] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Adequate hydration, as to maintain urinary volume over 2 L/day, has long been considered as the cornerstone medical prescription for preventing nephrolithiasis. However, scientific evidence about what kind of water stone formers should drink and about the effects of other beverages on urinary stone risk factors is sometimes unclear. Moreover, the recommendation that water therapy prevents kidney stone recurrence relies on only one randomized controlled trial, even if more epidemiologic and basic science studies seem to support this assumption. Therefore, in this review we analyze current evidence that support water therapy in nephrolithiasis and we highlight the possible effects of different types of water and other beverages on lithogenic risk, giving some practical recommendations for what stone formers should be advised to prevent recurrence.
Collapse
Affiliation(s)
- Andrea Ticinesi
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - Antonio Nouvenne
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - Loris Borghi
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - Tiziana Meschi
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| |
Collapse
|
41
|
Mohanty S, Kamolvit W, Zambrana S, Sandström C, Gonzales E, Östenson CG, Brauner A. Extract of Clinopodium bolivianum protects against E. coli invasion of uroepithelial cells. JOURNAL OF ETHNOPHARMACOLOGY 2017; 198:214-220. [PMID: 28087472 DOI: 10.1016/j.jep.2017.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/19/2016] [Accepted: 01/09/2017] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Clinopodium bolivianum is a South American plant with anti-inflammatory and anti-infective activities. The increasing antibiotic resistance urges for alternative therapy. Based on its use in traditional medicine, we investigated the effect of C. bolivianum on the ability to defend bladder epithelial cells from E. coli infection. MATERIALS AND METHODS The extract was analyzed by LC-MS. Bladder epithelial cell lines T24 and 5637 and uropathogenic E. coli No. 12, its isogenic mutant WE16 csgBA bscA::Cm and CFT073 were used to investigate the effect of C. bolivianum on uroepithelial infection. Bacterial adherence and invasion to cells treated with C. bolivianum were analyzed. Expression of uroplakin 1a, β1 integrin, caveolin-1, IL-8 and antimicrobial peptides in response to C. bolivianum treatment was assessed using RT-PCR. Protein expression was confirmed by Western blot analysis or ELISA. The antimicrobial effects of C. bolivianum on bacteria and fungus were investigated using minimum inhibitory concentration. Furthermore, the formation of biofilm was investigated with crystal violet assay. RESULTS C. bolivianum extract consisted of more than 70 different types of phytochemicals including sugars and phenolic compounds. The extract decreased the uroplakin 1a expression and E. coli adhesion and invasion of uroepithelial cells while up-regulated caveolin-1. In uninfected C. bolivianum treated cells, IL-8 was lower than in non-treated cells. In infected cells, however, no difference was observed between treated and non-treated cells. Further, C. bolivianum treatment reduced uropathogenic E. coli (UPEC) biofilms but did not inhibit bacterial growth. CONCLUSIONS Our results show that C. bolivianum has a protective role on bladder epithelial cells against UPEC infection by decreasing the bacterial adhesion, invasion and biofilm formation.
Collapse
Affiliation(s)
- Soumitra Mohanty
- Department of Microbiology, Tumour and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Witchuda Kamolvit
- Department of Microbiology, Tumour and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Silvia Zambrana
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden; Area de Farmacologia, Instituto de Investigaciones Farmaco Bioquimicas, Facultad de Ciencias Farmacéuticas y Bioquimicas, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Corine Sandström
- Department of Chemistry and Biotechnology, Uppsala BioCenter, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - Eduardo Gonzales
- Area de Farmacologia, Instituto de Investigaciones Farmaco Bioquimicas, Facultad de Ciencias Farmacéuticas y Bioquimicas, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Annelie Brauner
- Department of Microbiology, Tumour and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, 17176 Stockholm, Sweden.
| |
Collapse
|
42
|
Schneider M, Esposito D, Lila MA, Foegeding EA. Formation of whey protein-polyphenol meso-structures as a natural means of creating functional particles. Food Funct 2016; 7:1306-18. [PMID: 26857696 DOI: 10.1039/c5fo01499a] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Whey proteins provide structure and nutritional properties in food, while berry juices are thought to have biological activity that can impart anti-inflammatory health effects. In combination, the two could be an excellent source of necessary and supplemental nutrients as well as expand the functionality of whey proteins in food structures. The objectives of this investigation were to (1) develop an approach for particle formation between whey protein and cranberry, blackcurrant, or muscadine grape juices, (2) determine resulting particle composition and physical characteristics, and (3) evaluate properties related to food structure stability and maintenance of phytochemical bioactivity. Particles were formed by combining 20% w/w whey protein with juice containing 50, 250, or 500 μg g(-1) total phenolics, adjusting pH to 4.5, and centrifuging to collect aggregated particles. Particles had an approximate molar ratio of 9-50 proteins per polyphenol, and the ratio increased with increasing phenolic content of the juice used to create the particles. Particle size ranged from 1-100 μm at pH 4.5, compared to 10 μm particles that formed when whey protein isolate alone was precipitated at pH 4.5. Polyphenols and other juice components, such as acids and sugars appeared to be involved in particle formation. Particles improved foam stability, and the anti-inflammatory properties of entrapped polyphenols were maintained in the particles. Highly functional protein-polyphenol particles can be designed to stabilize food structures and simultaneously deliver polyphenols associated with health benefits.
Collapse
Affiliation(s)
- Margaret Schneider
- North Carolina State University, Department of Food, Bioprocessing and Nutrition Sciences, 400 Dan Allen Dr., Raleigh, NC 27695, USA
| | - Debora Esposito
- Plants for Human Health Institute, Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, 600 Laureate Way, Kannapolis, NC 28081, USA.
| | - Mary Ann Lila
- Plants for Human Health Institute, Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, 600 Laureate Way, Kannapolis, NC 28081, USA.
| | - E Allen Foegeding
- North Carolina State University, Department of Food, Bioprocessing and Nutrition Sciences, 400 Dan Allen Dr., Raleigh, NC 27695, USA
| |
Collapse
|
43
|
Montorsi F, Gandaglia G, Salonia A, Briganti A, Mirone V. Effectiveness of a Combination of Cranberries, Lactobacillus rhamnosus , and Vitamin C for the Management of Recurrent Urinary Tract Infections in Women: Results of a Pilot Study. Eur Urol 2016; 70:912-915. [DOI: 10.1016/j.eururo.2016.05.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/29/2016] [Indexed: 10/21/2022]
|
44
|
Dietz BM, Hajirahimkhan A, Dunlap TL, Bolton JL. Botanicals and Their Bioactive Phytochemicals for Women's Health. Pharmacol Rev 2016; 68:1026-1073. [PMID: 27677719 PMCID: PMC5050441 DOI: 10.1124/pr.115.010843] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Botanical dietary supplements are increasingly popular for women's health, particularly for older women. The specific botanicals women take vary as a function of age. Younger women will use botanicals for urinary tract infections, especially Vaccinium macrocarpon (cranberry), where there is evidence for efficacy. Botanical dietary supplements for premenstrual syndrome (PMS) are less commonly used, and rigorous clinical trials have not been done. Some examples include Vitex agnus-castus (chasteberry), Angelica sinensis (dong quai), Viburnum opulus/prunifolium (cramp bark and black haw), and Zingiber officinale (ginger). Pregnant women have also used ginger for relief from nausea. Natural galactagogues for lactating women include Trigonella foenum-graecum (fenugreek) and Silybum marianum (milk thistle); however, rigorous safety and efficacy studies are lacking. Older women suffering menopausal symptoms are increasingly likely to use botanicals, especially since the Women's Health Initiative showed an increased risk for breast cancer associated with traditional hormone therapy. Serotonergic mechanisms similar to antidepressants have been proposed for Actaea/Cimicifuga racemosa (black cohosh) and Valeriana officinalis (valerian). Plant extracts with estrogenic activities for menopausal symptom relief include Glycine max (soy), Trifolium pratense (red clover), Pueraria lobata (kudzu), Humulus lupulus (hops), Glycyrrhiza species (licorice), Rheum rhaponticum (rhubarb), Vitex agnus-castus (chasteberry), Linum usitatissimum (flaxseed), Epimedium species (herba Epimedii, horny goat weed), and Medicago sativa (alfalfa). Some of the estrogenic botanicals have also been shown to have protective effects against osteoporosis. Several of these botanicals could have additional breast cancer preventive effects linked to hormonal, chemical, inflammatory, and/or epigenetic pathways. Finally, although botanicals are perceived as natural safe remedies, it is important for women and their healthcare providers to realize that they have not been rigorously tested for potential toxic effects and/or drug/botanical interactions. Understanding the mechanism of action of these supplements used for women's health will ultimately lead to standardized botanical products with higher efficacy, safety, and chemopreventive properties.
Collapse
Affiliation(s)
- Birgit M Dietz
- University of Illinois at Chicago/National Institutes of Health Center for Botanical Dietary Supplements, Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois
| | - Atieh Hajirahimkhan
- University of Illinois at Chicago/National Institutes of Health Center for Botanical Dietary Supplements, Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois
| | - Tareisha L Dunlap
- University of Illinois at Chicago/National Institutes of Health Center for Botanical Dietary Supplements, Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois
| | - Judy L Bolton
- University of Illinois at Chicago/National Institutes of Health Center for Botanical Dietary Supplements, Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois
| |
Collapse
|
45
|
Serre E, Boutin Y, Langevin ME, Lutin F, Pedneault K, Lacour S, Bazinet L. Deacidification of cranberry juice protects against disruption of in-vitro intestinal cell barrier integrity. J Funct Foods 2016. [DOI: 10.1016/j.jff.2016.06.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
46
|
Singh I, Gautam LK, Kaur IR. Effect of oral cranberry extract (standardized proanthocyanidin-A) in patients with recurrent UTI by pathogenic E. coli: a randomized placebo-controlled clinical research study. Int Urol Nephrol 2016; 48:1379-86. [PMID: 27314247 DOI: 10.1007/s11255-016-1342-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the effect of cranberry extract (PAC-A ~ proanthocyanidin-A) on the in vitro bacterial properties of uropathogenic (E. coli) and its efficacy/tolerability in patients with subclinical or uncomplicated recurrent UTI (r-UTI). MATERIALS AND METHODS After obtaining clearance from the ethics committee and administering a written informed consent, 72 patients with r-UTI were enrolled as per protocol (November 2011 to March 2013) in this prospective study, to randomly receive (PAC-A: group I, 36) or (placebo: group II, 36), for 12 weeks. Any change/reduction in the incidence of r-UTI at 12 weeks was construed to be the primary endpoint of this study. RESULTS After 12 weeks, bacterial adhesion scoring decreased (0.28)/(2.14) in group I/II (p < 0.001); 32/36 (88.8 %) and 2/36 (5.5 %) in groups I and II, respectively, turned MRHA negative (p < 0.001); biofilm (p < 0.01) and bacterial growth (p < 0.001) decreased in group I; microscopic pyuria score was 0.36/2.0 in group I/II (p < 0.001); r-UTI decreased to 33.33 versus 88.89 % in group I/II (p < 0.001); mean subjective dysuria score was 0.19 versus 1.47 in group I/II (p < 0.001), while mean urine pH was 5.88 versus 6.30 in group I/II (p < 0.001). No in vitro antibacterial activity of cranberry could be demonstrated, and no adverse events were noted. CONCLUSIONS The overall efficacy and tolerability of standardized cranberry extract containing (PAC-A) as a food supplement were superior to placebo in terms of reduced bacterial adhesion; bacterial MRHA negativity; urine pH reduction; and in preventing r-UTI (dysuria, bacteriuria and pyuria). Larger randomized controlled trials are needed to elucidate the precise role, exact dose and optimal duration of PAC-A therapy in patients at risk of r-UTI.
Collapse
Affiliation(s)
- Iqbal Singh
- Departments of Surgery (Urology), University College of Medical Sciences (University of Delhi) & GTB Hospital, Shahdara, Dilshad Garden, New Delhi, 110095, Delhi, India.
| | - Lokesh Kumar Gautam
- Departments of Surgery (Urology), University College of Medical Sciences (University of Delhi) & GTB Hospital, Shahdara, Dilshad Garden, New Delhi, 110095, Delhi, India
| | - Iqbal R Kaur
- Departments of Microbiology, University College of Medical Sciences (University of Delhi) & GTB Hospital, New Delhi, 95, India
| |
Collapse
|
47
|
Maki KC, Kaspar KL, Khoo C, Derrig LH, Schild AL, Gupta K. Consumption of a cranberry juice beverage lowered the number of clinical urinary tract infection episodes in women with a recent history of urinary tract infection. Am J Clin Nutr 2016; 103:1434-42. [PMID: 27251185 DOI: 10.3945/ajcn.116.130542] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/17/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Urinary tract infections (UTIs) are among the most common bacterial infections and are often treated with antibiotics. Concerns about multidrug-resistant uropathogens have pointed to the need for safe and effective UTI-prevention strategies such as cranberry consumption. OBJECTIVE We assessed the effects of the consumption of a cranberry beverage on episodes of clinical UTIs. DESIGN In this randomized, double-blind, placebo-controlled, multicenter clinical trial, women with a history of a recent UTI were assigned to consume one 240-mL serving of cranberry beverage/d (n = 185) or a placebo (n = 188) beverage for 24 wk. The primary outcome was the clinical UTI incidence density, which was defined as the total number of clinical UTI events (including multiple events per subject when applicable) per unit of observation time. RESULTS The dates of the random assignment of the first subject and the last subject's final visit were February 2013 and March 2015, respectively. The mean age was 40.9 y, and characteristics were similar in both groups. Compliance with study product consumption was 98%, and 86% of subjects completed the treatment period in both groups. There were 39 investigator-diagnosed episodes of clinical UTI in the cranberry group compared with 67 episodes in the placebo group (antibiotic use-adjusted incidence rate ratio: 0.61; 95% CI: 0.41, 0.91; P = 0.016). Clinical UTI with pyuria was also significantly reduced (incidence rate ratio: 0.63; 95% CI: 0.40, 0.97; P = 0.037). One clinical UTI event was prevented for every 3.2 woman-years (95% CI: 2.0, 13.1 woman-years) of the cranberry intervention. The time to UTI with culture positivity did not differ significantly between groups (HR: 0.97; 95% CI: 0.56, 1.67; P = 0.914). CONCLUSION The consumption of a cranberry juice beverage lowered the number of clinical UTI episodes in women with a recent history of UTI. This study was registered at clinicaltrials.gov as NCT01776021.
Collapse
Affiliation(s)
- Kevin C Maki
- Biofortis Clinical Research, Addison, IL; MB Clinical Research, Glen Ellyn, IL;
| | | | | | | | | | - Kalpana Gupta
- Department of Medicine, Boston University School of Medicine, Boston, MA; and VA Boston Healthcare System, Boston, MA
| |
Collapse
|
48
|
Liska DJ, Kern HJ, Maki KC. Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice? Adv Nutr 2016; 7:498-506. [PMID: 27184277 PMCID: PMC4863270 DOI: 10.3945/an.115.011197] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Cranberry has been used traditionally to prevent urinary tract infections (UTIs), primarily among generally healthy women prone to recurrent UTIs. Results from a number of published clinical studies have supported this benefit; however, meta-analyses on cranberry and UTI prevention have reported conflicting conclusions. This article explores the methodological differences that contributed to these disparate findings. Despite similar research questions, the meta-analyses varied in the studies that were included, as well as the data that were extracted. In the 2 most comprehensive systematic reviews, heterogeneity was handled differently, leading to an I(2) of 65% in one and 43% in the other. Most notably, the populations influencing the conclusions varied. In one analysis, populations with pathological/physiological conditions contributed 75.6% of the total weight to the summary risk estimate (RR: 0.86; 95% CI: 0.71, 1.04); another weighted the evidence relatively equally across UTI populations (RR: 0.62; 95% CI: 0.49, 0.80); and a third included only women with recurrent UTIs (RR: 0.53; 95% CI: 0.33, 0.83). Because women with recurrent UTIs are the group to whom most recommendations regarding cranberry consumption is directed, inclusion of other groups in the efficacy assessment could influence clinical practice quality. Therefore, conclusions on cranberry and UTIs should consider differences in results across various populations studied when interpreting results from meta-analyses.
Collapse
Affiliation(s)
| | - Hua J Kern
- Biofortis Innovation Services, Addison, IL; and
| | - Kevin C Maki
- Midwest Center for Metabolic & Cardiovascular Research, Chicago, IL
| |
Collapse
|
49
|
Serre E, Rozoy E, Pedneault K, Lacour S, Bazinet L. Deacidification of cranberry juice by electrodialysis: Impact of membrane types and configurations on acid migration and juice physicochemical characteristics. Sep Purif Technol 2016. [DOI: 10.1016/j.seppur.2016.02.044] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
50
|
Thomas LV, Jenkins G, Belton J, Clements S, Jacob C, Johnson N, Joy D, Low J, Munson E, Sheppard J. Nutritional advice for community patients: insights from a panel discussion. Br J Community Nurs 2016; 21:130-7. [PMID: 26940615 DOI: 10.12968/bjcn.2016.21.3.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article describes the conclusions of an expert panel that discussed four case studies; these were examples of patients typically encountered by nurses working in the community. The panel considered the nutritional and lifestyle advice that could be given by nurses relating to conditions such as irritable bowel syndrome (IBS), depression, chronic fatigue syndrome, vulnerability to common infections, elderly care, recurrent urinary tract infection, antibiotic use, and risk of type 2 diabetes. A general conclusion was the importance of motivational interviewing techniques in achieving full understanding of patients' concerns and to determine the best health strategy. As well as specific guidance appropriate for each disorder, a range of information sources for both health professionals and patients are listed in the paper. The panel noted that, although general nutritional advice can be given by nurses working at GP surgeries and in the community, patients should always be referred to registered dietitians or nutritionists if significant dietary changes are considered.
Collapse
Affiliation(s)
| | | | - Julie Belton
- Operational & Strategic Director, Cuckoo Lane Surgery, Hanwell, UK
| | - Suzie Clements
- Education Lead & Associate Trainer, Hertfordshire Community NHS Trust, Welwyn Garden City, UK
| | - Ciara Jacob
- Practice Nurse in Centric Health and vice-Chair Irish Practice Nurse Association, Newbridge, Republic of Ireland
| | - Naomi Johnson
- Assistant Science Manager, Yakult UK Limited, South Ruislip, UK
| | - Deirdre Joy
- Senior Science Officer, Yakult Ireland, Dublin, Republic of Ireland
| | - Jennifer Low
- Consultant Registered Dietitian, JL Nutrition Clinic, Sevenoaks, Kent, UK
| | - Eileen Munson
- Senior Lecturer, University of South Wales, Pontypridd, Wales, UK
| | | |
Collapse
|