Antibiotic versus cranberry in the treatment of uncomplicated urinary infection: a randomized controlled trial

SUMMARY OBJECTIVE: This study was designed to determine the effect of cranberry extract used in patients with single urinary tract infections. METHODS: Patients with simple-type urinary tract infections were divided into two groups. Treatment with fosfomycin or cranberry tablet was started. On days 1, 3, and 7 of the treatment, whether there was a decrease in the complaints was evaluated with a Likert-type scale. The recovery status of urinary tract infections and the well-being of patients were compared via antibiotic and cranberry groups. RESULTS: After the treatment, the leukocyte levels of the cranberry users were at the same level as those of the other group, and the rate of well-being and the portion of patients that reported to be "very well" on days 3 and 7 in the cranberry group was significantly higher compared with the fosfomycin group (p<0.05). CONCLUSION: Considering the results of this study, it was determined that the patient's complaints decreased from day 3 and their well-being increased with the use of cranberry only. Specifically, on day 7, the well-being of the cranberry group was higher than that of the fosfomycin group. For this reason, cranberry is a favorable alternative to antibiotics in uncomplicated and simple urinary tract infections.

Cranberry dosed extract: an effective therapy for recurrent Escherichia coli cystitis in elderly patients. The GerHogar Cysticlean® study / Extracto dosificado de arándano rojo: una terapia eficaz para la cistitis recurrente por Escherichia coli en pacientes de la tercera edad. El estudio GerHogar Cysticlean®

Abstract Introduction: Cystitis is the most prevalent urinary tract infection (UTI), and antibiotics are its conventional therapy. However, the prevalence rate of antibiotic resistance to uropathogens is significantly increased. Cranberry treatment has been associated with the inhibition of Escherichia coli (Ec) adherence to uroepithelial cells due to the anti-adhesive property related to its proanthocyanidins content, and cysticlean® (CYS) is a cranberry extract which contains 240 mg PACs per capsule. Since elderly people is one of the populations mostly exposed to cystitis and bacteria antibiotic resistance, it was decided to originally study the efficacy and safety of CYS, to treat cystitis instead of antibiotic, in elderly individuals. Material & Methods: Two groups were studied: Group 1 (G1): first cystitis episode was recorded within the last 3 months before the study initiation. Group 2 (G2): frequent cystitis recurrent episodes (1-2/month or more) within the last 3 months before the study initiation. G1 patients were treated with 1 capsule of CYS every 12 h for 1 month, while G2 patients were treated up to 12 months. Comparative evaluation was performed using Student test. Results: 160 elderly ambulatory and nursing home patients suffering from recurrent cystitis were treated with CYS. G1 and G2 had 38 and 122 subjects, respectively. Cranberry-based cystitis treatment was successful in 81.57 % and 81.96 % in G1 and G2 patients, respectively. Conclusion: CYS showed to be an effective alternative therapy to antibiotics to treat cystitis recurrences caused by Ec. Neither side effects nor adverse reactions have been reported.

Resumen Introducción: la cistitis es la infección del tracto urinario más común a nivel mundial y los antibióticos son su terapia convencional; sin embargo, la tasa de prevalencia de la resistencia de los uropatógenos a los antibióticos ha aumentado significativamente en los últimos tiempos. El tratamiento con arándano rojo se ha asociado con la inhibición de la adherencia de la Escherichia coli a las células uroepiteliales debido a la propiedad antiadherente relacionada con su contenido de proantocianidinas. La cysticlean® (CYS) es un extracto de arándano rojo que contiene 240 mg de PAC por cápsula. Objetivo: estudiar la eficacia y seguridad de la CYS en el tratamiento de la cistitis como reemplazo de los antibióticos en personas adultas mayores. Material y métodos: se estudiaron dos grupos, uno (G1) en el que el primer episodio de cistitis se registró dentro de los últimos 3 meses antes del inicio del estudio y otro (G2) en el que se registraron episodios recurrentes de cistitis frecuentes (≥1-2 al mes) en los últimos 3 meses antes del inicio del estudio. Los pacientes del G1 fueron tratados con 1 cápsula de CYS cada 12 horas durante 1 mes, mientras que los del G2 fueron tratados por 12 meses con el mismo esquema. La evaluación comparativa se realizó mediante la prueba de Student. Resultados: en el estudio participaron 160 pacientes ambulatorios de la tercera edad residentes de hogares de ancianos y con diagnóstico de cistitis recurrente. De estos, 38 se incluyeron en G1 y 122, en G2. El tratamiento de la cistitis a base de arándano rojo tuvo éxito en el 81,57 % y el 81,96 % de los pacientes de G1 y G2, respectivamente. Conclusión: la CYS demostró ser una terapia alternativa eficaz a los antibióticos para tratar las recurrencias de cistitis causadas por E. coli al no presentarse efectos secundarios ni reacciones adversas.

The impact of cranberry (Vaccinium macrocarpon) and cranberry products on each component of the metabolic syndrome: a review

BACKGROUND: Some studies have shown that cranberry (Vaccinium macrocarpon) has beneficial effects on the components of the metabolic syndrome (MetS), a condition characterized by a cluster of cardiovascular risk factors suchas central obesity, hypertension, impaired glucose homeostasis, elevated triglycerides, and decreased HDL cholesterol levels. Cranberry is very rich in polyphenols, which may significantly reduce cardiovascular disease (CVD) risk. Main body of the ABSTRACT: Nutritional intervention studies have indicated that the intake of cranberries and cranberry products may have the following impact on metabolic health: (1) attenuate markers of obesity such as body weight, body mass index, and waist circumference; (2) reduce systolic and diastolic pressures; (3) decrease plasma concentrations of triglycerides and oxidized LDL-cholesterol, as well as increase HDL cholesterol; and (4) promote glucose homeostasis. In addition, nutritional intervention with cranberries could confer antioxidant and anti-inflammatory properties and the ability to reduce biomarkers of atherosclerosis associated with the MetS, such as homocysteine. Short CONCLUSION: Although there has been promising results, particularly related to lipid profile and blood pressure, further research is needed to support the recommendation of cranberry intake as a nutritional intervention for the treatment of MetS

Efficient hepatoprotective activity of cranberry extract against CCl

Objective To investigate the hepatoprotective efficacy of cranberry extract (CBE) against carbon tetrachloride (CCl

Efficient hepatoprotective activity of cranberry extract against CCl-induced hepatotoxicity in Wistar albino rat model: Down-regulation of liver enzymes and strong antioxidant activity

OBJECTIVE@#To investigate the hepatoprotective efficacy of cranberry extract (CBE) against carbon tetrachloride (CCl)-induced hepatic injury using in-vivo animal model.@*METHODS@#The hepatoprotective efficacy of CBE (200 and 400 mg/kg) was investigated against CCl (4 mL/kg)-induced hepatotoxicity, elevated liver enzymes [ALT (alanine aminotransferase), AST (aspartate aminotransferase), and alkaline phosphatase (ALP)], and total protein (TP) contents in the serum. Moreover, CBE-aided antioxidant defense against hepatotoxic insult of CCl was measured by evaluating a number of anti-oxidative biomarkers including reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) in the serum by using spectrophotometric analyses.@*RESULTS@#Results showed that the exposure of experimental animals to CCl did induce significant hepatotoxicity compared to the non-induced (untreated) group. The oral administration of CBE demonstrated a significant dose-dependent alleviation in the liver enzymes (AST, ALT, and ALP), increased antioxidant defense (GSH, SOD, and CAT), and reduced MDA levels in the serum of treated animals compared to the animals without treatment. The resulting data showed that the administration of CBE decreased the serum levels of ALT, AST, and ALP compared to the CCl-induced group.@*CONCLUSIONS@#The resulting data evidenced that CBE exhibits promising hepatoprotective potential against the chemical induced hepatotoxicity, maintains homeostasis in liver enzymes, and can provide significant antioxidant defense against free radicals-induced oxidative stress.

A study on the effect of whole cranberry powder on immune function of ICR mice in vivo / 预防医学

Objective Toevaluatetheeffectsofwholecranberrypowder(Pacranpowder)onimmunefunctionsofICR miceinvivo.Methods FemaleICRmice(18-22g)wererandomlydividedintocontrolgroupandlow,mediumandhigh dose groups of whole cranberry powder (83,1 66,and 332 mg/kgbw).Whole cranberry powder was treated with by gavage for 30 days continuously.Control mice were treated with distilled water only.Their immune functions were analyzed, including serum hemolysin analysis, antibody -producing cells (APCs ), conA -induced splenic lymphocyte transformation,SRBC-induced delayed type hypersensitivity,natural killer cell activity assay,peritoneal macrophages phagocytosed chicken red blood cells (CRBC),carbon clearance test and thymus or spleen /body weight ratio.Results Ascomparedwiththecontrols,wholecranberrypowdertreatmentincreasedthenumberofplagueformingcells(PFCs)at 83 mg/kgbw group(P<0.05 ).There were no statistical difference in the total production of antibodies,the activity of conA-induced splenic lymphocyte transformation,the left-hind voix pedis thickness,NK cytoactivity,the phagocytosis index and ratio of peritoneal macrophages, the carbon clearance ability between the groups treated with different concentrationsofwholecranberrypowderandthecontrolgroup(P>0.05).Conclusion Wholecranberrypowdercan enhance mouse the number of plague forming cells (PFCs).

Cranberry extract supplementation exerts preventive effects through alleviating Aβ toxicity in Caenorhabditis elegans model of Alzheimer's disease / 中国天然药物

Cranberry extract (CBE) rich in polyphenols are potent to delay paralysis induced by alleviating β-amyloid (Aβ) toxicity in C. elegans model of Alzheimer's disease (AD). In order to better apply CBE as an anti-AD agent efficiently, we sought to deterrmine whether preventive or therapeutic effect contributes more prominently toward CBE's anti-AD activity. As the level of Aβ toxicity and memory health are two major pathological parameters in AD, in the present study, we compared the effects of CBE on Aβ toxicity and memory health in the C. elegans AD model treated with preventive and therapeutic protocols. Our results revealed that CBE prominently showed the preventive efficacy, providing a basis for further investigation of these effects in mammals.

Efeitos comparativos de diferentes géis à base de cranberry e proantocianidina sobre a dentina submetida à erosão: estudo in vitro / In vitro effect of Cranberry and proanthocyanidin on dentin erosion

Considerando que a Proantocianidina e outros componentes do Cranberry possam inibir as metaloproteinases da dentina quando esta é exposta a ação de agentes erosivos e tal fato pode minimizar o desgaste dentinário, o presente trabalho tem como objetivo avaliar o efeito protetor in vitro de géis à base de extrato de Cranberry e Proantocianidina em diferentes concentrações, aplicados sobre a dentina posteriormente submetida à erosão. Para tal, 150 espécimes de dentina bovina (4 x 4 mm) foram confeccionados e igualmente divididos em 10 grupos: G1- gel de clorexidina a 0,012%; G2- gel placebo; G3- gel a base de extrato de Cranberry a 0,05%; G4- gel a base de extrato de Cranberry a 1%; G5- gel a base de extrato de Cranberry a 5%; G6- gel a base de extrato de Cranberry a 10%; G7- gel a base de Proantocianidina 0,05%; G8- gel a base de Proantocianidina 1%, G9- gel a base de Proantocianidina 5%; G10- gel a base de Proantocianidina 10%. Os diferentes géis foram aplicados uma única vez sobre os espécimes antes do primeiro desafio erosivo durante 5 minutos. Em seguida, os espécimes foram submetidos a 3 ciclagens erosivas seguidas (imersão em bebida à base de Cola por 5 minutos seguido de imersão em saliva artificial por 3 horas) por dia, durante 5 dias. Após as 3 cilclagens erosivas diárias, os espécimes foram mantidos em saliva artificial por 15 horas. A perfilometria foi utilizada para quantificar o desgaste dentinário (μm). Os dados foram analisados pelo teste ANOVA seguido do teste de Fisher (p<0,05). Os resultados (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) mostraram que o gel de Cranberry a 0,05% (G3) e gel de Proantocianidina 10% (G10) apresentaram eficácia estatisticamente significante na redução da erosão dentinária em comparação aos outros grupos analisados...

Considering that Proanthocyanidin and other Cranberrys components might inhibit dentin metalloproteinases exposed to erosive agents and it can prevent dental wear, the aim of this in vitro study was to evaluate the effect of Cranberry and Proanthocyanidin gels used in different concentrations on dentin before an erosive challenge. For this purpose, 150 bovine root dentin blocks (4x4mm) were treated by different gels and randomly divided into 10 groups: G1- 0.012% Chlorhexidine Gel (positive control), G2- Placebo gel with no active principle (negative control), G3- 0.05% Cranberry gel, G4- 1% Cranberry gel, G5- 5% Cranberry gel, G6- 10% Cranberry gel, G7- 0.05% Proanthocyanidin gel, G8- 1% Proanthocyanidin gel, G9- 5% Proanthocyanidin gel and G10- 10% Proanthocyanidin gel. The gels were applied over specimens once before the first erosive challenge for 5 minutes. After that, the blocks were subjected to 3 sequential erosive cycles (cola drink for 5 minutes and artificial saliva for 3 hours, each) per day, during 5 days. After 3 daily erosive cycles, the blocks were maintained in artificial saliva for 15 h. Profilometry was used to quantify the dentin wear (μm). Data were analyzed by ANOVA and Fisher's test (p<0.05). Results (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) showed that 0.05% Cranberry gel (G3) and 10% Proanthocyanidin gel (G10) presented similar results when compared to positive control group (G1), and these three groups showed statistically lowest wear when compared to all other evaluated groups. The results of this study suggest a significant efficacy of Cranberry and Proanthocyanidin gels in preventing wear of dentin subjected to dental erosion in vitro...

Efeitos comparativos de diferentes géis à base de cranberry e proantocianidina sobre a dentina submetida à erosão: estudo in vitro / In vitro effect of Cranberry and proanthocyanidin on dentin erosion

Considerando que a Proantocianidina e outros componentes do Cranberry possam inibir as metaloproteinases da dentina quando esta é exposta a ação de agentes erosivos e tal fato pode minimizar o desgaste dentinário, o presente trabalho tem como objetivo avaliar o efeito protetor in vitro de géis à base de extrato de Cranberry e Proantocianidina em diferentes concentrações, aplicados sobre a dentina posteriormente submetida à erosão. Para tal, 150 espécimes de dentina bovina (4 x 4 mm) foram confeccionados e igualmente divididos em 10 grupos: G1- gel de clorexidina a 0,012%; G2- gel placebo; G3- gel a base de extrato de Cranberry a 0,05%; G4- gel a base de extrato de Cranberry a 1%; G5- gel a base de extrato de Cranberry a 5%; G6- gel a base de extrato de Cranberry a 10%; G7- gel a base de Proantocianidina 0,05%; G8- gel a base de Proantocianidina 1%, G9- gel a base de Proantocianidina 5%; G10- gel a base de Proantocianidina 10%. Os diferentes géis foram aplicados uma única vez sobre os espécimes antes do primeiro desafio erosivo durante 5 minutos. Em seguida, os espécimes foram submetidos a 3 ciclagens erosivas seguidas (imersão em bebida à base de Cola por 5 minutos seguido de imersão em saliva artificial por 3 horas) por dia, durante 5 dias. Após as 3 cilclagens erosivas diárias, os espécimes foram mantidos em saliva artificial por 15 horas. A perfilometria foi utilizada para quantificar o desgaste dentinário (μm). Os dados foram analisados pelo teste ANOVA seguido do teste de Fisher (p<0,05). Os resultados (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) mostraram que o gel de Cranberry a 0,05% (G3) e gel de Proantocianidina 10% (G10) apresentaram eficácia estatisticamente significante na redução da erosão dentinária em comparação aos outros grupos analisados.

Considering that Proanthocyanidin and other Cranberrys components might inhibit dentin metalloproteinases exposed to erosive agents and it can prevent dental wear, the aim of this in vitro study was to evaluate the effect of Cranberry and Proanthocyanidin gels used in different concentrations on dentin before an erosive challenge. For this purpose, 150 bovine root dentin blocks (4x4mm) were treated by different gels and randomly divided into 10 groups: G1- 0.012% Chlorhexidine Gel (positive control), G2- Placebo gel with no active principle (negative control), G3- 0.05% Cranberry gel, G4- 1% Cranberry gel, G5- 5% Cranberry gel, G6- 10% Cranberry gel, G7- 0.05% Proanthocyanidin gel, G8- 1% Proanthocyanidin gel, G9- 5% Proanthocyanidin gel and G10- 10% Proanthocyanidin gel. The gels were applied over specimens once before the first erosive challenge for 5 minutes. After that, the blocks were subjected to 3 sequential erosive cycles (cola drink for 5 minutes and artificial saliva for 3 hours, each) per day, during 5 days. After 3 daily erosive cycles, the blocks were maintained in artificial saliva for 15 h. Profilometry was used to quantify the dentin wear (μm). Data were analyzed by ANOVA and Fisher's test (p<0.05). Results (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) showed that 0.05% Cranberry gel (G3) and 10% Proanthocyanidin gel (G10) presented similar results when compared to positive control group (G1), and these three groups showed statistically lowest wear when compared to all other evaluated groups. The results of this study suggest a significant efficacy of Cranberry and Proanthocyanidin gels in preventing wear of dentin subjected to dental erosion in vitro.

Attenuation of quorum sensing controlled virulence of Pseudomonas aeruginosa by cranberry.

Background & objectives: Emergence of antimicrobial resistance in Pseudomonas aeruginosa has led to the search for alternative agents for infections control. Natural products have been a good alternative to present antibiotics. The present study was undertaken to evaluate the effectiveness of cranberry in attenuation of virulence of P. aeruginosa in experimental urinary tract infection (UTI) in mouse model. Efforts were also directed to explore the action of cranberry towards virulence of P. aeruginosa through quorum sensing (QS) inhibition. Methods: Efficacy of cranberry was evaluated in an experimental UTI mouse model and on production of QS signals, alginate, pyochelin, haemolysin, phospholipase-C, cell-surface hydrophobicity, uroepithelial cell-adhesion assay and biofilm formation by already standardized methods. Results: Presence of cranberry showed significant decline in the production of QS signals, biofilm formation and virulence factors of P. aeruginosa in vitro (P<0.001). Further, cranberry was found to be useful in prevention of experimental UTI in mouse model as indicated by reduced renal bacterial colonization and kidney tissues destruction. Interpretation & conclusions: The findings of the present study indicated that cranberry inhibited QS and hence elaboration of virulence factors of P. aeruginosa. It also affected the adherence ability of this pathogen. This approach can lead to the discovery of new category of safe anti-bacterial drugs from dietary sources such as cranberry with reduced toxicity without the risk of antibiotic resistance.

Efeito antimicrobiano e modulador da resposta imune dos peptídeos hBD-3 e LL-37 e dos polifenóis do chá verde e do cranberry / Antimicrobial and immune regulatory activity of the peptides hBD-3, LL-37 and the polyphenols from cranberry and green tea

Os peptídeos antimicrobianos como por exemplo a catelicina (LL-37) e as defensinas humanas (hBD-1, hBD-2 e a hBD-3) são considerados antibióticos endógenos com importante papel na prevenção das doenças periodontais, devido a sua capacidade de regulação da resposta imune, sendo que os mesmos podem ser degradados pelos periodontopatógenos. Terapias que aumentem a produção destes peptídeos pelas próprias células do organismo, assim como a associação destes peptídeos com compostos naturais os quais possam agir em sinergismo na regulação da resposta imune, podem ser considerados novas estratégias para o melhor controle das doenças periodontais. Portanto os objetivos deste estudo in vitro foram: i) Avaliar a capacidade do extrato do chá verde (Camellia sinensis) e do seu polifenol, o EGCG, sobre a expressão gênica de hBD-1 e hBD-2 pelas células epiteliais gengivais (B11), sobre a degradação das mesmas frente ao P. gingivalis, ii) Através da utilização do modelo 3D de co-cultura celular, avaliar a capacidade antiinflamatória dos peptídeos hBD-3 e LL-37 quando em associação sobre a produção de citocinas, quimiocinas e fatores de crescimento, iii) Avaliar a capacidade anti-inflamatória da associação do EGCG e do polifenol proveniente do cranberry, o AC-PACs, com o peptídeo LL-37 sobre a produção de citocinas, quimiocinas e fatores de crescimento em modelo de co-cultura celular. As células epiteliais gengivais (B11) foram estimuladas com o extrato do chá verde e com o EGCG na presença e ausência de inibidores específicos. A produção e expressão gênica de hBD-1 e hBD-2 foram quantificados respectivamente pelas técnica de ELISA e qPCR. A capacidade do extrato do chá verde e do EGCG em proteger a degradação de hBDs pelo P. gingivalis foi mensurado através da técnica de ELISA. Foi desenvolvido um modelo em 3D de co-cultura de fibroblastos gengivais embebidos em uma matriz de colágeno com células epiteliais gengivais semeadas em sua superfície, no qual observou-se efeito sinérgico das células na secreção de IL-6 e IL-8 em resposta ao estímulo com LPS de A. actinomycetemcomitans (1 µg/ml) quando comparados as células individuais. Em seguida o modelo em 3D de co-cultura celular na presença no LPS de A. actinomycetemcomitans foi estimulado com: i) hBD-3 (10 and 20 µM) e LL-37 (0.1 and 0.2 µM), ii) EGCG (1 e 5 µg/ml) e LL-37 (0.1 and 0.2 µM) e iii) AC-PACs (25 e 50 µg/ml) e LL-37 (0.1 and 0.2 µM), individualmente e em associação. Foi utilizada a técnica de ELISA Multiplex para quantificar 41 diferentes citocinas, quimiocinas, fatores de crescimentos e 13 diferentes MMPs e TIMPs. Os resultados demonstraram que: i) o extrato do chá verde e o EGCG aumentaram a produção e a expressão gênica de hBD-1 e hBD-2 pelas células epiteliais de uma maneira dose-dependente, e foram capazes de prevenir a degradação das hBD-1 e hBD-2 recombinantes pelo sobrenadante de P. gingivalis, ii) o peptídeo hBD-3 em associação com o LL37 mostrou efeito sinérgico na diminuição da produção de GRO-α, G-CSF, IP-10, IL-6, e MCP1, entretanto teve apenas efeito aditivo na redução da produção de IL-8 em resposta ao estímulo com LPS de A. actinomycetemcomitans, iii) a associação do peptídeo LL-37 com o EGCG e com o AC-PACs mostraram efeito sinérgico na redução da produção de GRO-α, G-CSF e IL-6 em resposta ao estímulo com LPS de A. actinomycetemcomitans. Portanto os peptídeos antimicrobianos hBD-3 e LL-37, assim como o extrato do chá verde, o EGCG e o AC-PACs por demonstrarem capacidade de regular a produção de citocinas inflamatórias, induzir a produção de defensinas pelas próprias células e proteger as defensinas da degradação pelo P. gingivalis surgem como promissores alternativas para terapias adjuntas ao tratamento periodontal convencional. Entretanto estudos clínicos futuros são necessários para avaliar o papel dos peptídeos e dos compostos naturais na cavidade oral e na proteção dos tecidos periodontais frente à uma agressão

The antimicrobial peptides LL-37, hBD-1, hBD-2 and hBD-3 are considered an endogenous antibiotic, with important role in the prevention of periodontal diseases due to their ability to regulate the immune response. However those peptides could be degraded by periodontal pathogens. Therefore, therapies able to up regulate the secretion of those peptides by human cells, and the association of antimicrobial peptides with natural compounds, which may act in synergism to modulate the immune response, may be a novel approach for effectively controlling periodontal diseases. The aim of this in vitro study were: i) investigate the ability of green tea extract and EGCG to induce hBD-1 and hBD-2 secretion and gene expression by gingival epithelial cells (B11) and to protect hBDs from degradation by P. gingivalis, ii) A 3D co-culture model of gingival epithelial cells and fibroblasts stimulated with A. actinomycetemcomitans LPS (1 µg/ml) were used to investigated the anti-inflammatory properties of the hBD-3, LL-37, ACPACs and EGCG and to determine whether LL-37 acts in synergy with AC-PACs, EGCG and hBD-3. Gingival epithelial cells were stimulated with green tea extract or EGCG in the presence and absence of specific inhibitors. The secretion and gene expression of hBD-1 and hBD-2 was respectively measured by ELISA and qPCR. The ability of green tea extract and EGCG to prevent hBDs degradation by P. gingivalis present in a bacterial culture supernatant was evaluated by ELISA. A 3D co-culture model composed of gingival fibroblasts embedded in a collagen matrix overlaid with gingival epithelial cells had a synergistic effect with respect to the secretion of IL-6 and IL-8 in response to A. actinomycetemcomitans LPS stimulation compared to fibroblasts and epithelial cells individually. The 3D co-culture model was stimulated with noncytotoxic concentrations of: i) hBD-3 (10 and 20 µM) and LL -37 (0.1 and 0.2 µM), ii ) EGCG (1 and 5 µg/ml) and LL -37 (0.1 and 0.2 µM), iii) AC- PACs (25 and 50 µg/ml) and LL-37 (0.1 and 0.2 µM) alone and in association in the presence of A. actinomycetemcomitans LPS. A multiplex ELISA assay was used to quantify the secretion of 41 different cytokines, chemokines, growth factors and 13 different MMPs and TIMPs. Ours results showed that: i) the secretion and gene expression of hBD-1 and hBD-2 was up-regulated in a dose-dependent manner by green tea extract and EGCG. Green tea extract and EGCG were also able to prevent the degradation of recombinant hBD-1 and hBD-2 by a culture supernatant of P. gingivalis, ii) hBD-3 in association with LL-37 showed a synergistic effect to reduce the secretion of GRO- α, G-CSF, IP- 10, IL -6 and MCP -1, however had only additive effect on reducing the secretion of IL-8 in response to A. actinomycetemcomitans LPS stimulation, iii) the association of the peptide LL- 37 with EGCG and with AC- PACs showed a synergistic effect to reduce the secretion of GRO-α, G-CSF and IL-6 in response to A. actinomycetemcomitans LPS stimulation. Considering that the antimicrobial peptides hBD-3 and LL-37, as well as green tea extract, EGCG and AC- PACs, demonstrated the ability to regulate the secretion of inflammatory cytokines, up regulated the secretion of defensins by the cells and even to protect the defensins degradation by P. gingivalis, emerged as promising alternative adjunct therapy to conventional periodontal treatment. However future clinical studies are necessary to evaluate the role of peptides and natural compounds in the oral cavity and periodontal tissues

Effects of cranberry powder on biomarkers of oxidative stress and glucose control in db/db mice

Increased oxidative stress in obese diabetes may have causal effects on diabetic complications, including dyslipidemia. Lipopolysccharides (LPS) along with an atherogenic diet have been found to increase oxidative stress and insulin resistance. Cranberry has been recognized as having beneficial effects on diseases related to oxidative stress. Therefore, we employed obese diabetic animals treated with an atherogenic diet and LPS, with the aim of examining the effects of cranberry powder (CP) on diabetic related metabolic conditions, including lipid profiles, serum insulin and glucose, and biomarkers of oxidative stress. Forty C57BL/KsJ-db/db mice were divided into the following five groups: normal diet + saline, atherogenic diet + saline, atherogenic diet + LPS, atherogenic diet + 5% CP + LPS, and atherogenic diet + 10% CP + LPS. Consumption of an atherogenic diet resulted in elevation of serum total cholesterol and atherogenic index (AI) and reduction of high density lipoprotein (HDL)-cholesterol. However, with 10% CP, the increase in mean HDL-cholesterol level was close to that of the group with a normal diet, whereas AI was maintained at a higher level than that of the group with a normal diet. LPS induced elevated serum insulin level was lowered by greater than 60% with CP (P 0.05). Mean activity of liver cytosolic glutathione peroxidase was significantly increased by LPS injection, however it was reduced back to the value without LPS when the diet was fortified with 10% CP (P 0.05). Overall results suggest that fortification of the atherogenic diet with CP may have potential health benefits for obese diabetes with high oxidative stress, by modulation of physical conditions, including some biomarkers of oxidative stress.

Valoración del uso de extracto de Arándano frente a la Profilaxis Antibiótica en la Prevención de infecciones urinarias recurrentes en mujeres mayores / Assessment of the use of Cranberry extract against Antibiotic Prophylaxis in the Prevention of recurrent urinary infections in older women

Conclusiones: El trimetoprim (TMP) tuvo una ventaja muy limitada sobre los arándanos en la prevención de infecciones urinarias (ITUs) recurrentes en mujeres adultas mayores; sin embargo, el TMP presentó más efectos adversos. Estos resultados permiten sopesar la atracción inherente de usar un producto natural, barato, que no aumenta las resistencias bacterianas, ni aumenta el riesgo de superinfección por Clostridium u hongos. Comentario: Las infecciones urinarias recurrentes son particularmente frecuentes en mujeres mayores. Este estudio compara la eficacia y tolerancia entre el trimetoprim y el Vaccinium macrocarpon (arándano) en la prevención de las ITUs recurrentes en mujeres adultas mayores. Se puede concluir que la profilaxis antibiótica tiene una eficacia moderada frente a los productos de arándano en la prevención de ITUs recurrentes en este grupo de edad, aunque la incidencia de eventos adversos es mayor con la profilaxis antibiótica.(AU)

Conclusions: Trimethoprim (TMP) had a very limited advantage over cranberry in the prevention of recurrent urinary tract infections (UTIs) in older women; however, TMP had more adverse effects than the cranberry extract. These findings allow a woman to weigh the inherent attraction of using a natural, cheap product, which does not increase bacterial resistance, nor increase the risk of superinfection with Clostridium or fungi. Comment: Recurrent urinary tract infections are particularly common in older women. This study compares the effectiveness and tolerance of trimethoprim compared with cranberries in preventing recurrent urinary tract infection. We can conclude that antibiotic prophylaxis has a major efficacy against cranberry products for the prevention of recurrent urinary tract infections in this age group, although higher incidence of adverse events. (AU)

Cranberries and lower urinary tract infection prevention

Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and clinical trials.

Cranberry in children: prevention of recurrent urinary tract infections and review of the literature

Urinary tract infections (UTI) are common in childhood. In 30-50 percent of children with UTI the infections occur recurrently, especially in those with vesicoureteral reflux (VUR), neurogenic bladder (NB), previous cystitis or pyelonephritis and malformative uropathies. To reduce the likelihood of UTI, antibiotic prophylaxis has been regarded as the therapeutic standard for many years. However, the disadvantage of long-term antibiotic therapy is the potential for development of collateral effects and resistant organisms in the host. Such reasons have induced scientists to search for alternative modalities of UTI prevention and have contributed to determining the increasing desire for "naturalness" of the population and preventing excessive medication. The use of cranberry fulfils these needs by potentially replacing or enhancing traditional procedures. The purpose of this study was to assess the effectiveness of cranberry in preventing UTI in pediatric populations. We searched Pubmed, the Cochrane Central Register of Controlled Trials and Internet. Cranberry in patients with previous UTI was evaluated in three studies, cranberry in patients with VUR in three studies and four studies analyzed the efficacy of cranberry in children with NB. In seven of nine studies cranberry had a significant effect in preventing UTI.

Effects of freeze-dried cranberry powder on serum lipids and inflammatory markers in lipopolysaccharide treated rats fed an atherogenic diet

This study investigated the effects of freeze-dried cranberry powder on anti-inflammation and lipid profiles of lipopolysaccharide (LPS)-treated rats fed an atherogenic diet for 6 weeks. Forty Sprague-Dawley male rats (6-weeks-old) were equally divided into the following five groups: 1) normal diet group + saline (NC); 2) atherogenic diet + saline (HFC); 3) atherogenic diet + LPS (HL); 4) atherogenic diet with 5% cranberry power + LPS (C5); 5) atherogenic diet with 10% cranberry power + LPS (C10). LPS (0.5 mg/kg) was injected into the abdominal cavities of rats 18 hours prior to sacrifice. At the end of the experimental period, we measured serum lipid profiles as well as levels of serum C-reactive protein (CRP), nitric oxide (NO), and pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, IL-6, and IL-10 as an anti-inflammatory cytokine. The mean serum high density lipoprotein (HDL)-cholesterol level in C5 rats was significantly higher than that in NC and HL rats (P < 0.05). The mean serum levels of CRP and IL-1beta were significantly lower (P < 0.05) in the cranberry powder groups compared to those in HL rats. Additionally, mean serum IL-6 levels tended to be lower in the cranberry groups than that in the HL group, whereas serum IL-10 and NO showed 29% and 88% higher mean values in the C5 group and 49% and 24% higher in the C10 group than those in the HL group, respectively. These results suggest that freeze-dried cranberry powder may have beneficial effects on cardiovascular diseases by modifying serum lipids and the early inflammatory response.

Effects of cranberry powder on serum lipid profiles and biomarkers of oxidative stress in rats fed an atherogenic diet

This study investigated that the antioxidative effect of freeze-dried cranberry powder against protein and lipid oxidation and ameliorative effect of serum lipid profile in rat fed atherogenic diet. Six weeks old male Sprague-Dawley rats were divided into the following four groups: normal diet group with 5% corn oil (control), atherogenic diet group with 5% corn oil, 10% lard, 1% cholesterol, and 0.5% sodium cholate (HFC), atherogenic plus 2% cranberry powder diet group (HFC + C2), and atherogenic plus 5% cranberry powder diet group (HFC + C5), and respective diet and water were fed daily for 6 weeks. After the experimental period, the serum lipid profile, such as total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride, ferric reducing ability of plasma (FRAP), plasma phenolics content, superoxide dismutase (SOD) activity, serum protein carbonyl and thiobarbituric acid reactive substances (TBARS) levels were examined. Total phenolic compound and total flavonoid levels in freeze-dried cranberry powder were 9.94 mg/g and 8.12 mg/g, respectively. Serum total cholesterol and LDL-cholesterol levels were not significantly different for cranberry powder treatment, but serum HDL-cholesterol level was significantly increased in HFC + C5 group compared with HFC group. Plasma FRAP value tended to be increased by cranberry powder treatment though there was no significant difference. Plasma total phenol concentrations and SOD activities were not significantly different among all groups. Serum protein carbonyl and TBARS levels were significantly decreased in HFC + C5 group compared with HFC group. Overall results suggested that freeze-dried cranberry powder might have the serum lipid improving effect, as well as antioxidative effect demonstrated by its protective effect against protein and lipid oxidation.

Melatonin and Cranberry Attenuate Infection-induced Apoptotic Renal Damage in a Vesicoureteral Reflux Rabbit Model / 대한비뇨기과학회지

PURPOSE: We evaluated the protective effects of melatonin and cranberry on infection-induced renal damage in a rabbit model of vesicoureteral reflux(VUR). MATERIALS AND METHODS: Thirty-six New Zealand male rabbits were divided into the following 5 groups: 1) control, 2) VUR, 3) E. coli, 4) cranberry, and 5) melatonin. After creating unilateral VUR, infection was induced by intravesical instillation of an E. coli suspension. Cranberry powder was supplied with the feed. Melatonin was injected into the peritoneal cavity. Three weeks after surgery, the rabbits were sacrificed, and the kidneys were extirpated and examined histopathologically to evaluate inflammation, fibrosis, and tubular changes. Apoptosis in the renal tissue was assessed with a terminal deoxynucleotidyl transferase(TdT)-mediated deoxyuridine triphosphate(dUTP) in situ nick-end labeling(TUNEL) study. RESULTS: Grossly, the refluxing kidney was larger than the contralateral normal kidney, and the refluxing ureter was dilated and tortuous. Microscopic examination of the kidneys from the E. coli group showed an apparent periglomerular mononuclear cell infiltration, tubular dilatation and atrophy, and interstitial fibrosis. The kidneys from the reflux, cranberry, and melatonin groups showed mild mononuclear cell infiltration without interstitial fibrosis. The mean number of apoptotic cells in the kidneys of the E. coli group was significantly higher than that in the control, cranberry, and melatonin groups(p<0.05), but there was no significant difference between the cranberry and the melatonin groups. CONCLUSIONS: This study demonstrates that the balance of apoptotic activity may play a key role in the development of reflux nephropathy. Melatonin and cranberry may prevent infection-induced renal damage by attenuating apoptosis.

Protective Effects of Cranberry on Infection-induced Oxidative Renal Damage in a Vesicoureteral Reflux Rabbit Model / 대한비뇨기과학회지

PURPOSE: We evaluated the protective effects of cranberry, which is known as a fruit with anti-oxidative effects, on infection-induced oxidative renal damage with using a rabbit vesico-ureteral reflux (VUR) model. MATERIALS AND METHODS: New Zealand male rabbits were divided into 5 groups (the control group, VUR group, E. coli group, cranberry group and melatonin group). VUR was created and confirmed at 2 weeks after the operation. Infection was induced by intravesical instillation of an E. coli suspension. Cranberry powder was supplied with the feed. Melatonin was injected into the peritoneal cavity. The rabbit kidneys were obtained 3 weeks after the operation. Histopathologic examination was performed to evaluate for inflammation, fibrosis and the tubular change. The oxidative renal damage was evaluated by measuring malondialdehyde (MDA) in the renal tissue. RESULTS: Grossly, the refluxing kidney was larger than the contralateral normal kidney and the refluxing ureter was dilated and tortuous. The microscopic observation of the kidneys from the E. coli group showed apparent periglomerular mononuclear cell infiltration, tubular dilatation and atrophy, and interstitial fibrosis. The kidneys from the reflux group, cranberry group and melatonin group showed mild mononuclear cell infiltration without interstitial fibrosis. The MDA level in the kidneys of the E. coli group was significantly higher than that in the control, cranberry and melatonin groups (p<0.05). The MDA level in the cranberry and melatonin groups didn't significantly differ from that in the sterile group. CONCLUSIONS: This study demonstrates that cranberry has an anti-inflammatory effect due to an anti-oxidative function and it may prevent infection-induced oxidative renal damage. But application of cranberry in children with VUR needs more clinical studies.

Prevention of Relapse with the Cranberry Juice in Chronic Pelvic Pain Syndrome / 대한비뇨기과학회지

PURPOSE: The treatment of chronic pelvic pain syndrome (CPPS) is based on antibiotic therapy, but many patients experience a relapse after treatment. Cranberry juice is known for its roles in both the treatment and prevention of urinary tract infections. This study was performed to evaluate the effectiveness of cranberry juice in the prevention of a relapse after the treatment of CPPS. MATERIALS AND METHODS: Fifty patients, diagnosed as CPPS (National Institutes of Health; NIH-catagory IIIa), were included in this study. All the patients had initially been treated with levofloxacin and supportive treatment for 8-12 weeks. After completion of the initial treatment, 26 volunteer patients were recommended to drink 150ml of cranberry juice twice a day, 24 patients, as a control group, received no cranberry juice and all the patients re-evaluated after 3 months. RESULTS: On initial diagnosis, the white blood cell (WBC) count in the high power field (HFP) of expressed prostatic secretions (EPS) and the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) in cranberry group were 18.2 3.4 and 23.1 4.4 and those of the control group 16.4 4.8 and 22.4 3.7, respectively. When the medical treatment was ended, the WBC of the EPS and NIH-CPSI in the cranberry group were 2.5 2.1 and 14.1 4.1, and those of the control group were 2.7 1.9 and 13.7 2.1, respectively. After the three month follow-up, the cranberry group showed a WBC of 2.2 2.5 in the EPS and a NIH-CPSI of 12.7 3.9, a slight decrease or similar result compared to the treatment completion period. No patient showed aggravation of symptoms after drinking cranberry juice, whereas five from the control group did. CONCLUSIONS: Cranberry juice showed an effect in the prevention of a relapse in CPPS patients, with no adverse effects.