Prophylaxe von bakteriellen Infektionen mit Cranberrysaft - Wirkprinzip und Evidenz

Zusammenfassung

Forschungsergebnisse zur Wirksamkeit von Cranberry als Prophylaktikum bei rezidivierenden Harnwegsinfekten werden vorgestellt. Proanthocyanidine der Cranberries hemmen die bakterielle Andockung an Gewebe in vitro und nach oraler Aufnahme und Ausscheidung in den Urin bei Probanden. Durch randomisierte klinische Studien ist die Prophylaxe von Harnwegsinfekten durch Cranberrysaft bei Frauen evidenzbasiert. Die Antiadhäsionswirkung der Cranberry kann auch in der Therapie und Prophylaxe anderer bakterieller Erkrankungen wie Helicobacter pylori assoziierter Gastritis oder Karies eingesetzt werden. Die hohe antioxidative Kapazität von Cranberryprodukten ist zusätzlich eindrucksvoll belegt.

Abstract

Cranberry (Vaccinium macrocarpon) is a North-American folk remedy for treating and preventing infection. Research has identified an anti-adhesive mechanism of cranberry-proanthocyanidins that inhibit docking of bacteria on tissues in vitro. The efficacy of cranberry juice and extracts as a prophylactic agent against recurrent urinary infections is well documented in women. The anti-adhesion effect of cranberry-proanthocyandins can also be applied for treatment of other common diseases of bacterial pathogenesis, e.g. Helicobacter pylori-associated gastritis and dental caries/parodontal disease. Cranberries have an exceptionally high anti-oxidative capacity.

Schlüsselwörter

Cranberry - Proanthocyanidine - Harnwegsinfekte - Escherichia coli - Antiadhärenz - Fimbrien - Helicobacter pylori - Karies - Antioxidanzien

Keywords

Cranberry - proanthocyanidins - urinary tract infection - Escherichia coli - anti-adhesion - fimbriae - Helicobacter pylori - tooth decay - anti-oxidatives

Literatur

• 01 Ahuja S, Kaack B, Roberts J. Loss of fimbrial adhesion with the addition of Vaccinium macrocarpon to the growth medium of p-fimbriated E. coli.  J Urol. 1998;  159 559-562
• 02 Arthur M. et al. . Molecular epidemiology of adhesion and hemolysin virulence factors among uropathogenic Escherichia coli.  Infect Immun. 1989;  57 303-313
• 03 Avorn J, Monane M, Gurwitz J H, Glynn R J, Choodnovsky I, Lipsitz L A. Reduction of Bacteriuria and Pyuria after Ingestion of Cranberry and Blueberry Juices.  Journal of the American Medical Association Voo. 1994;  (271) 10 751
• 04 Bailey D T, Dalton C, Joseph Daugherty F, Tempesta M S. Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study. Phytomedicine Feb.10.2007 Epub ahead of print
• 05 Bauer H W, Alloussi S, Egger G, Blümlein H M, Cozma G, Schulman C C. Multicenter UTI study group: a long-term, multicenter, double-blind study of an Escherichia coli extract (OM-89) in female patients with recurrent urinary tract infections.  Eur Urol. 2005;  47 (4) 542-548 329 (11) 753-756
• 06 Beerepoot M A, Stobberingh E E, Geerlings S E. A study of non-antibiotic versus antibiotic prophylaxis for recurrent urinary-tract infections in women (the NAPRUTI study).  Ned Tijdschr Geneeskd. 2006;  150 (10) 574-575
• 07 Blatherwick N R, Long M L. Studies on urinary acid II. The increased acidity produced by eating prunes and cranberries.  J Biol Chem. 1923;  57 815-818
• 08 Bodet C, Chandad F, Grenier D. Anti-inflammatory Activity of a High-molecular-weight Cranberry Fraction on Macrophages Stimulated by Lipopolysaccharides from Periodontopathogens.  J Dent Res. 2006;  85 (3) 235-239
• 09 Bodet C, Piche M, Chandad F, Grenier D. nhibition of periodontopathogen-derived proteolytic enzymes by a high-molecular-weight fraction isolated from cranberry.  J Antimicrob Chemother. 2006;  57 (4) 685-690
• 10 Burger O, Ofek I, Tabak M, Weiss E I, Sharon N, Neeman I. A high molecular mass constituent of cranberry juice inhibitis Helicobacter pylori adhesion to human gastric mucus. FEMS.  Immunol Med Microbiol. 2000;  29 295-301
• 11 Burger O, Weiss E, Sharon N, Tabak M, Neeman I, Ofek I. Inhibition of Helicobacter pylori adhesion to human gastric mucus by a high-molecular-weight constituent of cranberry juice.  Crit Rev Food Sci Nutr. 2002;  42 (S 3) 279-284
• 12 Chatterjee A, Yasmin T, Bagchi D, Stohs S J. Inhibition of Helicobacter pylori in vitro by various berry extracts, with enhanced susceptibility to clarithromycin.  Mol Cell Biochem. 2004;  265 (1-2) 19-26
• 13 Chu Y F, Liu R H. Cranberries inhibit LDL oxidation and induce LDL receptor expression in hepatocytes.  Life Sci. 2005;  77 (15) 1892-1901
• 14 Dartsch P C. Wissenschaftliches Gutachten im Auftrag der Fa. Töpfer-GmbH. 2006
• 15 Davies J K, Ahktar N, Ranasinge E. A juicy problem.  Lancet. 2002;  358 2126
• 16 DeCaprio A P. The toxicology of hydroquinone - relevance to occupational and environmental exposure.  Clin Rev Toxicol. 1999;  29 283-330
• 17 Di Martino P. et al. . Reduction of Escherichia coli adherence to uroepithelial bladder cells after consumption of cranberry juice: a double-blind randomized placebo-controlled cross-over trial.  World J Urol. 2006;  24 (1) 21-27
• 18 Duarte S. et al. . Inhibitory effects of cranberry polyphenols on formation and acidogenicity of Streptococcus mutans biofilms. FEMS.  Microbiol Lett. 2006;  257 (1) 50-56
• 19 Eck P. The American Cranberry. Rutgers University Press 1990
• 20 Foo L Y, Lu Y, Howell A B, Vorsa N. A-type proanthocyanidin trimers >from cranberry that inhibit adherence of uropathogenic p-fimbriated E. coli.  Journal of Natural Products. 2000; 
• 21 Foo L Y, Lu Y, Howell A B, Vorsa N. The structure of cranberry proanthocyanidins which inhibit adherance of uropathogenic P-fimbriated Escherichia coli in vitro.  Phytochemistry. 2000;  54 173-181
• 22 Fünfstück R, Straube E, Schildbach O, Tietz U. Prevention of reinfection by L-methionine in patients with recurrent urinary tract infection.  Med Klin (Munich). 1997;  92 (10) 574-581
• 23 Gettman M T, Ogan K, Brinkley L J, Adams-Huet B, Pak C Y, Pearle M S. Effect of cranberry juice consumption on urinary stone risk factors.  J Urol. 2005;  174 (2) 590-594
• 24 Grenier J, Fradette C, Morelli G, Merritt G J, Vranderick M, Ducharme M P. Pomelo juice, but not cranberry juice, affects the pharmacokinetics of cyclosporine in humans.  Clin Pharmacol Ther. 2006;  79 (3) 255-262
• 25 Howell A B. et al. . Inhibition of the adherance of p-fimbriated Escherichia coli to uroepithelial cell surfaces by proanthocyanidin extracts from cranberries.  N Engl J Med. 1998;  339 1085
• 26 Howell A B, Reed J D, Krueger C G, Winterbottom R, Cunningham D G, Leahy M. A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity.  Phytochemistry. 2005;  66 (18) 2281-2291
• 27 Howell A B, Leahy M, Kurowska E, Guthrie N. In vivo evidence that cranberry proanthocyanidines inhibit adherance of p-fimbriated E. coli bacteria to uroepithelial cells.  Fed Amer Soc Exp Biol J. 2001;  15 A284
• 28 http://www.siu.edu/~perspect/01_fall/endometritis.html
• 29 Jepson R G, Mihaljevic L, Craig J. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 2004 1 CD001321 Review
• 30 Johnson J R, Kaster N, Kuskowski M A, Ling G V. Identification of urovirulence traits in Escherichia coli by comparison of urinary and rectal E. coli isolates from dogs with urinary tract infection.  J Clin Microbiol. 2003;  41 (1) 337-345
• 31 Johnson-White B, Buquo L, Zainali M, Ligler F S. Prevention of nonspecific bacterial cell adhesion in immunoassays by use of cranberry juice.  Anal Chem. 2006;  78 (3) 853-857
• 32 Kontiokari T, Sundquist K, Nuutinen M, Pokka T, Koskela M, Uhari M. Randomised trial of cranberry-lingonberry juice und Lactobacillus GG drink for the prevention of urinary tract infections in women.  BMJ. 2001;  322 1571
• 33 Lee B B. et al. . Spinal-injured neuropathic bladder antisepsis (SINBA) trial.  Spinal Cord. 2006; 
• 34 Li Z, Seeram N P, Carpenter C L, Thames G, Minutti C, Bowerman S. Cranberry does not affect prothrombin time in male subjects on warfarin.  J Am Diet Assoc. 2006;  106 (12) 2057-2061
• 35 Liu Y, Black M A, Caron L, Camesano T A. Role of cranberry juice on molecular-scale surface characteristics and adhesion behavior of Escherichia coli. Biotechnol Bioeng.  2006;  93 (2) 297-305
• 36 McHarg T, Rodgers A, Charlton K. Influence of cranberry juice on the urinary risk factors for calcium oxalate kidney stone formation.  BJU Int. 2003;  92 (7) 765-768
• 37 Maatta-Riihinen K R, Kahkonen M P, Torronen A R, Heinonen I M. Catechins and procyanidins in berries of vaccinium species and their antioxidant activity.  J Agric Food Chem. 2005;  53 (22) 8485-8491
• 38 Morris N S, Stickler D J. Does drinking cranberry juice produce urine inhibitory to the development of crystalline, catheter-blocking Proteus mirabilis biofilms.  BJU Int. 2001;  88 (3) 192-197
• 39 Nowack R. Die amerikanische Cranberry (Vaccinium macrocarpon Aiton) - Portrait einer Arzneipflanze.  Zeitschrift für Phytotherapie. 2003;  24 40-46
• 40 Ofek I, Goldhar J, Zafriri D, Lis H, Adar R, Sharon N. Anti-Escherichia coli adhesin activity of cranberry and blueberry juices.  New Engl J Med. 1991;  324 1599
• 41 Ofek I, Goldhar J, Zafriri D, Lis H, Adar R, Sharon N. Anti-Escherichia adhesin activity of cranberry and blueberry juices.  Adv Exp Med Biol. 1996;  408 179-183
• 42 Raz R, Stamm W E. A controlled trial of intravaginal estriol in postmenopausal women.  N Engl J Med. 1993; 
• 43 Reid G, Bruce A W. Low vaginal pH and urinary tract infection.  Lancet. 1995;  346 8991-8992
• 44 Reid G. et al. . Cranberry juice consumption may reduce biofilms on uroepithelial cells: pilot study in spinal cord injured patients.  Spinal Cord. 2001;  39 26-30
• 45 Rice J C. et al. . Pyelonephritic Escherichia coli expressing p-fimbriae decrease immune response of the mouse kidney.  JASN. 2005;  16 3583-3591
• 46 Säemann M D, Weichhart T. Ursachen der rezidivierenden Harnwegsinfektionen: neue Erkenntnisse.  DMW. 2005;  130 2031-2034
• 47 Schmidt D R, Sobota A E. An examination of the anti-adherance activity of cranberry juice on urinary and non-urinary bacterial isolates.  Microsbios. 1988;  55 173-181
• 48 Schulz, Hänsel, Tyler. Rational Phytotherapy - A physicianŽs guide to Herbal Medicine. Berlin, Heidelberg, New York; Springer 1999
• 49 Seeram N P, Adams L S, Hardy M L, Heber D. Total cranberry extract versus its phytochemical constituents: antiproliferative and synergistic effects against human tumor cell lines.  J Agric Food Chem. 2004;  52 (9) 2512-2517
• 50 Shmuely H. et al. . Susceptibility of Helicobacter pylori isolates to the antiadhesion activity of a high-molecular-weight constituent of cranberry.  Diagn Microbiol Infect Dis. 2004;  50 (4) 231-235
• 51 Sobota A E. Inhibition of bacterial adherance by cranberry juice: Potential use for the treatment of urinary tract infections.  The Journal of Urology. 1984;  131 1013
• 52 Steinberg D, Feldman M, Ofek I, Weiss E I. Effect of a high-molecular-weight component of cranberry on constituents of dental biofilm.  JAC. 2004;  54 86-89
• 53 Steinberg D, Feldman M, Ofek I, Weiss E I. Cranberry high molecular weight constituents promote Streptococcus sobrinus desorption from artificial biofilm.  Int J Antimicrob Agents. 2005;  25 (3) 247-251
• 54 Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women.  Can J Urol. 2002;  9 (3) 1558-1562
• 55 Sun J, Chu Y F, Wu X, Liu R H. Antioxidant and anti-proliferative activities of common fruits.  J Agric Food Chem. 2002;  50 7449-7454
• 56 Sun D, Abraham S N, Beachey E H. Influence of berberine sulfate on synthesis and expression of Pap fimbrial adhesin in uropathogenic Escherichia coli.  Antimicrob Agents Chemother. 1988;  32 (8) 1274-1277
• 57 Terris M K, Issa M M, Tacker J R. Dietary supplementation with cranberry concentrate tablets may increase the risk of nephrolithiasis.  Urology. 2001;  57 (1) 26-29
• 58 Waites K B, Canupp K C, Armstrong S, De Vivo M J. Effect of cranberry extract on bacteriuria and pyuria in persons with neurogenic bladder secondary to spinal cord injury.  J Spinal Cord Med. 2004;  27 (1) 35-40
• 59 Wang L, Del Priori L V. BullŽs eye maculopathy secondary to herbal toxicity frum uva-ursi.  Am J Ophthalmol. 2004;  137 (6) 1135-1137
• 60 Weiss E I, Lev-Dor R, Kashamn Y, Goldhar J, Sharon N, Ofek I. Inhibiting interspecies coaggregation of plaque bacteria with a cranberry juice constituent.  J Am Dent Assoc. 1998;  129 1719-1723
• 61 Weiss E I. et al. . A high molecular mass cranberry constituent reduces mutans streptococci level in saliva and inhibits in vitro adhesion to hydroxyapatite.  FEMS Microbiol Lett. 2004;  232 (1) 89-92
• 62 Yamanaka A, Kimizuka R, Kato T, Okuda K. Inhibitory effects of cranberry juice on attachment of oral streptococci and biofilm formation.  Oral Microbiol Immunol. 2004;  19 (3) 150-154
• 63 Zafriri D, Ofek I, Adar R, Pocino M, Sharon N. Inhibitory activity of cranberry juice on adherance of type 1 and P fimbriated Escherichia coli to eucaryotic cells.  Antimicrob Agents Chemother. 1989;  33 92-98
• 64 Zhang L, Ma J, Pan K, Go V L, Chen J, You W C. Efficacy of cranberry juice on Helicobacter pylori infection: a double-blind, randomized placebo-controlled trial.  Helicobacter. 2005;  10 (2) 139-145

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