Cranberry Extract Research Articles

Consumption of cranberry and probiotics as a natural remedy for urinary tract infections

Introduction and PurposeUrinary tract infections (UTIs) are a prevalent health issue caused primarily by uropathogenic Escherichia coli (UPEC) and other pathogens, affecting millions annually. These infections encompass lower (cystitis) and upper (pyelonephritis) tract manifestations, presenting with symptoms ranging from dysuria to severe complications like sepsis. Traditional antibiotic treatments, while effective, are increasingly challenged by resistance and adverse effects, necessitating exploration of alternative therapies. Cranberry-derived compounds, particularly proanthocyanidins (PACs), are known for their ability to inhibit bacterial adhesion to uroepithelial cells, a critical step in UTI pathogenesis. Clinical studies suggest that cranberry products may reduce UTI incidence, especially in vulnerable populations such as women and catheterized patients. Probiotics, specifically lactobacilli, contribute to urogenital health by competing with uropathogens for epithelial cell binding sites and producing antimicrobial substances. Emerging research highlights the potential synergistic benefits of combining cranberry extracts with probiotics in UTI prevention strategies. Material and MethodsThis review is based on articles from the PubMed database, covering the years 2004-2023, using keywords: urinary tract infections, cranberry, probiotics, E. Coli, antibiotics ConclusionsCranberry products and probiotics offer promising non-antibiotic approaches for UTI prevention, targeting fundamental aspects of bacterial pathogenesis. While preliminary studies indicate promising outcomes, rigorous clinical trials are essential to validate these combinations and optimize therapeutic protocols. Further research is warranted to identify specific bioactive compounds within cranberries, standardize probiotic formulations, and establish comprehensive guidelines for their clinical use in UTI management.

Potential of Cranberry to Stimulate Osteogenesis: An In Vitro Study

This study investigated the potential of Cranberry extract to stimulate osteogenesis in vitro. The total phenolic and monomeric anthocyanin contents in the Cranberry were determined. Liquid chromatography coupled with mass spectrometry was used to identify the Cranberry’s constituents. To assess the Cranberry’s cytotoxicity, a thiazolyl blue tetrazolium bromide assay was employed. Concerning the osteogenesis potential of Cranberry, alkaline phosphatase (ALP) activity, bone morphogenetic protein 2 (BMP-2) expression, and extracellular matrix mineralization were evaluated. The total phenolic content was 522.72 ± 9.80 mg GAE g-1 ES and 364.95 ± 12.49 mg GAE/g detected by the Fast Blue BB and Folin–Ciocalteu method, respectively. For monomeric anthocyanin, the content was 460 ± 30 mg ECG g-1 ES. Moreover, Cranberry concentrations ranged from 62.5 to 500 mg/mL and were found to be biocompatible with osteoblasts and mesenchymal stromal cells. Regarding osteogenesis, 20 mg/mL of Cranberry promoted 2-fold more ALP activity and almost 1.5-fold more BMP-2 than compared to the positive control group. Additionally, 200 mg/mL of Cranberry stimulated a 1.7-fold increase in extracellular matrix mineralization compared to the positive control group. In conclusion, Cranberry displayed potential in stimulating early and late markers of osteogenesis. Its ability to promote osteogenesis and its biocompatibility at higher concentrations hold promise for future application into biomaterials for bone regeneration.

Плацебо-контролируемое клиническое исследование эффективности D-маннозы Суперкомплекс в профилактике рецидивов ИМП.

Introduction. In recent years, the use of D-mannose as an alternative to antimicrobial agents has been widely discussed in the literature due to the fact that when applied topically, it reduces the ability of E. coli to bind to the urothelium. The aim of this study was to evaluate the change in the number of relapses during the observation period in patients who used «D-Mannose Supercomplex» as a metaphylaxis of cystitis in comparison with the control group, which received a placebo instead of this product. Materials and methods. A multicenter, randomized, double-blind, placebo-controlled, prospective clinical study was conducted to evaluate the efficacy and safety of a dietary supplement containing 2000 mg of D-mannose, 100 mg of cranberry extract, 80 mg of bearberry extract (8 mg of arbutin), and 30 mg of magnesium. Results. In animal models, the use of D-mannose led to a significant decrease in the bacterial load. The use of «D-Mannose Supercomplex» prolongs the relapse-free period in patients with RUTI after the end of antibacterial therapy. The duration of the relapse-free period correlates with the duration of D-mannose intake, which is consistent with modern concepts of the mechanism of action of the drug. The drug is well tolerated by patients. The number of adverse events (AE) in the «D-Mannose Supercomplex» and placebo groups was comparable. AE and allergic reactions associated, according to the researchers, with the use of the study drug, were not registered during the administration of the drug. Conclusions. The presented study data indicate that complex drugs containing D-mannose, cranberry extract, bearberry and magnesium (for example, «D-Mannose Supercomplex») can be considered from the standpoint of evidence-based medicine as a promising means of complex etiopathogenetic therapy for prolonging the relapse-free period in patients with exacerbation of recurrent urinary tract infection (RUTI).

Influence of fractionation of polyphenols by membrane chromatography on antioxidant, antimicrobial and proliferation-inhibiting effects of red fruit juices

Interest in fruit juice extracts as nutraceuticals is constantly increasing due to their health-beneficial properties, mainly caused by polyphenols. However, the correlation between the various effects of fruit juice extracts and their individual composition, including anthocyanins and copigments, is unknown. Therefore, in the present study, eight red fruit juice extracts were prepared using XAD-7 column chromatography, followed by fractionation and identification of the different compounds as well as characterization of their health-promoting effects. The fruit juice extract of pomegranate, chokeberry, and cranberry showed the highest antimicrobial potential against food-borne pathogens. The highest antioxidant and cell proliferation-inhibiting potential was also found in the pomegranate extract. It can be assumed that pomegranate extracts, which are rich in copigments, especially hydrolyzable tannins, are suitable natural antioxidants and antimicrobial agents. Pomegranate extracts could be used as nutraceuticals or natural preservatives.

Effect of UV Radiation and Temperature on Radical Scavenging Activity of Hippophaë rhamnoides L. and Vaccinium oxycoccos L. Fruit Extracts.

New active ingredients, including those of plant origin, which could protect the skin against various harmful factors, such as UV radiation and free radicals responsible for skin ageing, are still being sought. The present study was focused on the antioxidant activity of Hippophaë rhamnoides L. and Vaccinium oxycoccos L. fruit glycolic extracts. Investigations were also carried out to evaluate the effect of UVA radiation and the storage of the sea buckthorn and European cranberry extracts at an elevated temperature of 50 °C on their interactions with free radicals. The kinetics of the interactions of the extracts with DPPH were assessed using electron paramagnetic resonance (EPR) spectroscopy. The sea buckthorn and European cranberry extracts quench the EPR signal of DPPH free radicals, which indicates their antioxidant potential. The EPR method further showed that a mixture of sea buckthorn and cranberry extracts in a volume ratio of 2:1 was more potent in quenching free radicals compared to a mixture of these extracts in a ratio of 1:2. Our findings demonstrate that long-term UVA radiation exposure reduces the ability of sea buckthorn and cranberry extracts to interact with free radicals. Moreover, storage at elevated temperatures does not affect the interaction of sea buckthorn extract with free radicals, while it alters the ability of cranberry extract to interact with free radicals. This study has demonstrated that an important factor in maintaining the ability to scavenge radicals is the storage of raw materials under appropriate conditions. H. rhamnoides and V. oxycoccos extracts can be used as valuable raw materials with antioxidant properties in the pharmaceutical and cosmetic industries.

Comparative evaluation of cranberry extract and sodium fluoride as mouth rinses on S. mutans counts in children: a double-blind randomized controlled trial.

Recently, research in the field of caries prevention is emphasizing upon identification of edible non-toxic compounds that can interfere with the formation of cariogenic biofilm. This trial aimed to assess the effectiveness of non-dialyzable material (NDM) containing cranberry mouth rinse (C-MR) on the Streptococcus mutans (S. mutans) counts and compare with that of a sodium fluoride (F-MR) mouth rinse. 280 children (8-12years old) were enrolled in this double-blind single center, parallel, one-month, IRB/IEC approved non-inferiority trial. The participants fulfilling the inclusion criteria were randomly allocated into one of the two groups: C-MR and F-MR. All participants were given verbal and written instructions about at-home mouth-rinsing regimen under parental supervision for a month. Dental plaque samples were collected before and after a month of mouth-rinsing and subjected to culture techniques. S. mutans counts were assessed and compared in both groups. Primary outcome was the difference in the S. mutans counts between two interventions. Both intention-to-treat (ITT) and per-protocol analysis were carried out using two-sample t test with equal variance. The mean S. mutans counts (after log transformation) in C-MR group were: 14.66 (90% CI 14.4,14.9) at baseline and 12.85 (90% CI 12.5, 13.2) colony-forming units/ml (CFU/ml) at one-month post intervention (p = 0.001); while these counts were 14.69 (90% CI 14.5, 14.9) at baseline and 12.71 (90% CI 12.3, 13.1) at one-month intervention in F-MR groups (p = 0.001). ITT analysis showed an inter- group difference of 0.14CFU/ml (90% CI -0.32,0.59) in post-SM counts between groups (p = 0.629). The study demonstrated that the cranberry mouth rinse was non-inferior to the fluoride mouth rinse in terms of S. mutans levels change. Cranberry-based mouth rinse can be used effectively to reduce the S. mutans counts in children. Registration number in case of Clinical Trials-CTRI/2019/05/019395.

Evaluation of inhibitory activity of essential oils and natural extracts on foodborne viruses.

Enteric viruses are recognized as a major concern in health care and in the food sector in Canada. Novel clean-label strategies for controlling enteric viruses are sought in the food industry. In this study, we examined the antiviral potential of plant extracts and essential oils on murine norovirus 1 (MNV-1), hepatitis A virus (HAV), and herpes simplex virus 1 (HSV-1). Inactivation of the viruses by grape seed, blueberry, green tea, and cranberry extracts and by rosemary and thyme essential oils was measured using plaque formation assay. Concentrations ranging from 50 to 200 000ppm with a contact time of 90min were tested. Grape seed extract at 10 000ppm was the most effective (P<0.05) at reducing MNV-1 and HAV infectious titers, respectively, by 2.85±0.44 log10 and 1.94±0.17 log10. HSV-1 titer was reduced by 3.81±0.40 log10 at 1000ppm grape seed extract. Among the plant products tested, grape seed extract was found the most effective at reducing the infectious titers of MNV-1, HAV, and HSV.

Comparative evaluation of remineralizing potential of cranberry extract toothpaste with commercially available remineralization toothpaste on demineralized enamel: An in-vitro study

Comparative evaluation of remineralizing potential of cranberry extract toothpaste with commercially available remineralization toothpaste on demineralized enamel: An in-vitro study

Effect of tablets containing a paraprobiotic strain and the cranberry extract on caries incidence in preschool children: A randomized controlled trial.

Preand probiotics may help restore a dysbiotic oral ecosystem. The first years of life provide a window of opportunity to modulate the composition of the oral microbiota and prevent disease. The aim of the present study was to investigate the effect of a tablet containing inactivated Ligilactobacillus salivarius CECT 5317 and the cranberry extract on the development of caries in cariesactive preschool children. The study employed a randomized, placebo-controlled, double-blind design. Preschool children (N = 73) with at least one active carious lesion were enrolled and randomly assigned to the test group or the placebo group. The intervention period was 3 months. Caries was assessed according to the International Caries Detection and Assessment System (ICDAS) II criteria at baseline and after 9 months, and oral hygiene was evaluated with the simplified oral hygiene index (OHI-S). The salivary counts of Streptococcus mutans and Lactobacillus spp. were determined at baseline, and then after 3 and 9 months through the conventional cultivation on TYCSB and MRS agar, respectively. Sixty children completed the trial (a dropout rate of 19%). The baseline caries prevalence was high in both groups (~71%) and there were no major differences between the groups with regard to background variables. The 9-month incidence of initial carious lesions (ICDAS 1+2) was significantly lower in the test group as compared to the placebo group (p < 0.05). The plaque levels, and the salivary counts of S. mutans and Lactobacillus spp. remained unchanged in both groups throughout the study. A daily intake of a tablet containing a paraprobiotic and the cranberry extract reduced the 9-month incidence of initial non-cavitated carious lesions in caries-active preschool children. The present study is one of the first to show the impact of synbiotics on the development of caries in children.

Antibacterial, Antioxidant, and Healing Potential of Wound Dressings Utilizing Cranberry Extract in Combination with Methacrylated Polyvinyl Alcohol and Methacrylated Sericin

Antibacterial, Antioxidant, and Healing Potential of Wound Dressings Utilizing Cranberry Extract in Combination with Methacrylated Polyvinyl Alcohol and Methacrylated Sericin

Supplementation with Highly Standardized Cranberry Extract Phytosome Achieved the Modulation of Urinary Tract Infection Episodes in Diabetic Postmenopausal Women Taking SGLT-2 Inhibitors: A RCT Study.

Urinary tract infections (UTIs) are the most common bacterial infections in postmenopausal women, and women with diabetes are possibly at a higher risk. The aim of this study is to evaluate the potential benefit on the prevention of UTI episodes, assessed by urinalysis and urine culture (primary outcome) after two, four and six months, of daily oral dietary supplement (120 mg highly standardized cranberry extract phytosome), compared to placebo, in diabetic postmenopausal women taking SGLT-2 inhibitors. Forty-six subjects (mean age 72.45 ± 1.76) completed the study (23 placebo/23 supplement). Considering UTI episodes, during the six-month supplementation period, an increase of 1.321 (95% CI: -0.322; 2.9650) was observed in the placebo group, while it remained at a steady value of 0.393 (95% CI: -4.230; 5.016) in the supplemented group. Regarding UTI episodes, in both groups, interaction between times for supplementation was statistically significant (p = 0.001). In particular, at follow-up 4, 9% of the placebo group showed infection versus only 3% with cranberry supplementation. Glycaemia and glycated hemoglobin values (secondary outcomes) were not modified at the end of six months with respect to the basal values in both groups, as expected. While in terms of quality of life per the SF-12 health questionnaire, there were no differences between the two groups, an improvement in SF-12 quality of life was observed in both groups (six months vs. basal). In conclusion, highly standardized cranberry extract phytosome supplementation reduced UTI recurrence.

A Cranberry Extract Stimulates Procollagen I Release and Expression After UV Radiation in a 3D Skin Model

A Cranberry Extract Stimulates Procollagen I Release and Expression After UV Radiation in a 3D Skin Model

Evaluation of flexural strength and microhardness in Vaccinium macrocarpon (cranberry)-added self-cure polymethyl methacrylate dental resin: An in vitro study.

Occurrence of denture stomatitis and prosthesis breakage are common problems faced by elderly people wearing removable dentures. To overcome this, several attempts are made to improve the denture material by addition of antimicrobials without compromising original properties. The aim of the study was to evaluate flexural strength and microhardness of self-cured polymethyl methacrylate (PMMA) denture base resin after addition of Vaccinium macrocarpon (commonly called as cranberry), extract as antimicrobial, at varying proportions. Experimental in vitro study. Frozen cranberry fruits were subjected to extraction process in the presence of aqueous solvents. Lyophilized extract was added in proportions of 0, 0.5, 1.0, 1.5, and 2.0 dry wt/wt % into polymer of self-cure PMMA denture base resin. Based on cranberry inclusion, the study comprised one control (0%) and four test groups (0.5%-2%) with total of 100 samples. A three-point bending test for flexural strength was done for fifty study samples (n = 10). Surface of fractured samples was analyzed using a scanning electron microscope (SEM). Microhardness was determined using Vickers hardness test. One-way statistical ANOVA test was done to find the difference between groups, followed by Tukey's post hoc test for multiple pairwise comparison. Flexural strength ranged from 66.80 to 69.28 MPa, and a statistically insignificant difference was observed between groups (P > 0.05). SEM evaluation showed uniformly dispersed strands of cranberry extract in PMMA matrix. With higher concentration, less voids were seen. Vickers microhardness value significantly decreased from 15.96 in the control group to 14.57 with 2% cranberry addition (P < 0.05). Incorporation of cranberry extract into self-cure PMMA denture base resin, up to 2 dry wt %, did not decline the flexural strength. However, there was a significant decrease in Vickers microhardness values when compared against the control group (0% cranberry inclusion).

Evaluation of potential Synergistic effect of Cranberry extract and Amoxicillin-Clavulanic acid using Checkerboard method

This study investigates the potential synergistic effect of Cranberry (Vaccinium oxycoccos) extract and Amoxicillin-Clavulanic acid in enhancing antibacterial effectiveness and combating resistance. The main objectives of this study are do determine the MIC and FIC values for Amoxicillin-Clavulanic Acid and Vaccinium oxycoccos extract on different bacterial strains, and therefore to evaluate the synergistic effect of compounds combined. Vaccinium oxycoccos extract is rich in proanthocyanidins, phenolic acids, anthocyanins, vitamin C, and triterpene compounds, and has demonstrated antibacterial, antifungal, and anti-inflammatory properties. This study specifically evaluates its potential to inhibit biofilm formation by gram-negative bacteria. Amoxicillin, a semi-synthetic penicillin, is combined with Clavulanic acid, a β-lactamase inhibitor, to treat various bacterial infections. However, the rising antimicrobial resistance challenges the efficacy of this antibiotic combination. The effectiveness of combining antibiotics and natural substances in inhibiting bacterial growth can vary among different bacteria. This research emphasizes the importance of personalized treatment for each bacterial strain to effectively combat antibiotic-resistant infections.

Ficus carica L. (Fig) promotes nerve regeneration in a mouse model of sciatic nerve crush.

Peripheral nerve injuries result in significant loss of motor and sensory function, and the slow rate of nerve regeneration can prolong recovery time. Thus, approaches that promote axonal regeneration are critical to improve the outcomes for patients with peripheral nerve injuries. In this study, we investigated the effects of Ficus carica L. (fig) and Vaccinium macrocarpon Ait. (cranberry), which are rich in phytochemicals with demonstrable and diverse medicinal properties, on nerve regeneration in a mouse model of sciatic nerve crush. Our investigation revealed that fig extract, but not cranberry extract, prevented the decline in muscle weight and nerve conduction velocity induced by nerve crush. The fig extract also mitigated motor function impairment, myelin thinning, and axon diameter reduction, indicating its potential to promote nerve regeneration. Furthermore, the fig extract enhanced macrophage infiltration into the nerve tissue, suggesting that it could ameliorate nerve injury by promoting tissue repair via increased macrophage infiltration. The study provides valuable insights into the potential of the fig extract as a novel agent promoting nerve regeneration. Further investigation into the mechanisms underlying the action of fig extracts is needed to translate these findings into clinical applications for patients with peripheral nerve injuries.

Anti-Microbial Effects of Vaccinium Macrocarpon (Cranberry) Extract on Serotypes 26 and 45 of Escherichia Coli as a Prophylaxis of Recurrent Urinary Tract Infection (UTI)

Background: Urinary tract infection (UTI) is the second most common type of bacterial infection globally, affecting people of different age groups. Cranberry is renowned for its antibacterial properties and has been used to treat UTIs in recent years. Objective: This study aimed to assess the antimicrobial effects of cranberry extract on the prophylaxis of recurrent UTI caused by different serotypes of Escherichia coli (E. coli). Methods: This quasi-experimental study recruited 60 recurrent UTI patients from the Urology department of King Edward Medical University, Lahore, Pakistan. Patients with a history of recurrent UTIs caused by E. coli were included. Urine microscopy and culture tests were performed, and only E. coli-positive cases were serotyped. Patients received Vaccinium macrocarpon (cranberry) extract at a dose of 500 mg/day for four weeks along with their standard treatment. Follow-up evaluations were conducted after one and three months to assess UTI symptoms and the presence of E. coli in urine samples. Statistical analysis was performed using SPSS version 25, with quantitative variables expressed as mean ± standard deviation and qualitative variables as frequencies and percentages. Results: Of the 60 patients, 15 (25%) were positive for E. coli. Serotyping revealed 8 patients (53%) with serotype 26 and 7 patients (47%) with serotype 45. After three months of treatment, cranberry extract eradicated E. coli in 12 patients (80%); specifically, it eradicated 100% of serotype 45 and 62% of serotype 26 cases. Conclusion: Cranberry extract (500 mg/day) for three months demonstrated significant antimicrobial effects on E. coli serotypes 26 and 45, with greater efficacy observed in serotype 45. These findings suggest cranberry extract as a potential prophylactic treatment for recurrent UTIs. Keywords: Cranberry extract, recurrent UTI, E. coli serotypes, antimicrobial effects, prophylactic treatment, Vaccinium macrocarpon, urinary tract infection, Escherichia coli

Effect of flavonoids from grape seed and cranberry extracts on the microbiological activity of Streptococcus mutans: a systematic review of in vitro studies

ObjectiveTo provide an overview of the available scientific evidence from in vitro studies regarding the effect induced by the flavonoids contained in grape seed extracts (GSE) and cranberry on the microbiological activity of Streptococcus mutans (S. mutans).MethodsThis systematic review was performed following the parameters of the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). Electronic and manual searches were conducted using PubMed, ScienceDirect, Web of Science, EBSCO, and Cochrane databases. Reference lists of selected articles were reviewed to identify relevant studies. The search was not limited by year and was conducted solely in English. Eligible studies comprised publications describing in vitro studies that evaluated the effect of flavonoids derived from GSE and cranberry extracts on the microbiological activity of S. mutans. Common variables were identified to consolidate the data. Authors of this review independently screened search results, extracted data, and assessed the risk of bias.ResultsOf the 420 studies identified from the different databases, 22 publications were finally selected for review. The risk of bias was low in 13 articles and moderate in 9. The studies analyzed in this review revealed that cranberry extract has an inhibitory effect on the bacterial growth of S. mutans in ranges from 0.5 mg/mL to 25 mg/mL, and GSE exerts a similar effect from 0.5 mg/mL to 250 mg/mL. Additionally, the extracts or their fractions showed reduced biofilm formation capacity, decreased polymicrobial biofilm biomass, deregulation of glycosyltransferases (Gtf) B and C expression, and buffering of pH drop. In addition to adequate antioxidant activity related to polyphenol content.ConclusionsThe overall results showed that the extracts of cranberry and grape seed were effective in reducing the virulence factors of the oral pathogen. According to the data, proanthocyanidins are the active components in cranberry and grape seed that effectively resist S. mutans. They can inhibit the formation of insoluble polysaccharides in the extracellular matrix and prevent glycan-mediated adhesion, cohesion, and aggregation of the proteins in S. mutans. This suggests that these natural extracts could play an important role in the prevention of cariogenic bacterial colonization, as well as induce a decrease in their microbiological activity.

Assessing the treatment effect of cranberry type A proanthocyanidins on vulvovaginal candidiasis: a randomised controlled clinical interventional study

ObjectiveThis study aimed to evaluate the efficacy and safety of cranberry extracts: A-type proanthocyanidins (A-PACs) in the treatment and prevention of vulvovaginal candidiasis (VVC).MethodAn open, randomised, parallel-design study was conducted....

Helicobacter pylori Growth and Urease Inhibition by Cranberry (Vaccinium macrocarpon) Extract: a Pilot Study

The aim of the study was to evaluate the activity of three cranberry (Vaccinium macrocarpon) ethanol solutions on Helicobacter pylori growth and urease activity. We included numerous clinical Helicobacter pylori isolates and three methods: agar well diffusion method (AWDM), disk diffusion method (DDM) and urease inhibition test (UIT). The results were expressed as differences in inhibitory zone diameters (AWDM and DDM) or urease inhibition duration (UIT) by cranberry solutions compared to the ethanol control. AWDM showed that 400, 40 and 4 mg/l cranberry extracts inhibited the growth of 82.1, 57.1 and 42.8% of the isolates, respectively, while DDM at the highest cranberry concentration suppressed only 39.3% of the isolates. At 400, 40 and 4 mg/l, cranberry extracts also inhibited urease activity of 63.6, 54.5 and 40.9% isolates within 10 min, but of fewer isolates (18.2, 13.6 and 9.1%, respectively) at the 45th min. Although cranberry activity was dose- and strain-dependent, it affected more than half of the isolates at the two highest concentrations. DDM was less effective in detecting this activity. The cranberry extracts also inhibited the urease activity of H. pylori; however, in most cases, the inhibition was only temporary. Briefly, the high cranberry activity against H. pylori, together with its anti-adhesive, antioxidant, anti-biofilm and anti-cancer properties, justifies its use for prophylaxis or adjunctive treatment of chronic H. pylori infection. Importantly, UIT results suggest the benefit of regular cranberry intake over random intake.

Differences in P-Type and Type 1 Uropathogenic Escherichia coli Urinary Anti-Adhesion Activity of Cranberry Fruit Juice Dry Extract Product and D-Mannose Dietary Supplement

Background Urinary tract infection (UTI) prevention benefits of cranberry intake are clinically validated, especially for women and children. To ensure the benefits of cranberry dietary supplement products, the anti-adhesion activity (AAA) against uropathogenic bacteria is routinely used in in vitro bioassays to determine the activity in whole product formulations, isolated compounds, and ex vivo bioassays to assess urinary activity following intake. D-mannose is another dietary supplement taken for UTI prevention, based on the anti-adhesion mechanism. Objective Compare the relative AAA of cranberry and D-mannose dietary supplements against the most important bacterial types contributing to the pathogenesis of UTI, and consider how certain components potentially induce in vivo activity. Methods The current study used a crossover design to determine ex vivo AAA against both P- and Type 1-fimbriated uropathogenic Escherichia coli of either D-mannose or a cranberry fruit juice dry extract product containing 36 mg of soluble proanthocyanidins (PACs), using bioassays that measure urinary activity following consumption. AAA of extracted cranberry compound fractions and D-mannose were compared in vitro and potential induction mechanisms of urinary AAA explored. Results The cranberry dietary supplement exhibited both P-type and Type 1 in vitro and ex vivo AAA, while D-mannose only prevented Type 1 adhesion. Cranberry also demonstrated more robust and consistent ex vivo urinary AAA than D-mannose over each 1-week study period at different urine collection time points. The means by which the compounds with in vitro activity in each supplement product could potentially induce the AAA in urines was discussed relative to the data. Conclusions Results of the current study provide consumers and healthcare professionals with additional details on the compounds and mechanisms involved in the positive, broad-spectrum AAA of cranberry against both E. coli bacterial types most important in UTIs and uncovers limitations on AAA and effectiveness of D-mannose compared to cranberry.