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Wang Y, Chen E, Wang Y, Sun X, Dong Q, Chen P, Zhang C, Yang J, Sun Y. Biosynthesis of mannose from glucose via constructing phosphorylation-dephosphorylation reactions in Escherichia coli. Enzyme Microb Technol 2024; 177:110427. [PMID: 38518553 DOI: 10.1016/j.enzmictec.2024.110427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/20/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
d-mannose has been widely used in food, medicine, cosmetic, and food-additive industries. To date, chemical synthesis or enzymatic conversion approaches based on iso/epimerization reactions for d-mannose production suffered from low conversion rate due to the reaction equilibrium, necessitating intricate separation processes for obtaining pure products on an industrial scale. To circumvent this challenge, this study showcased a new approach for d-mannose synthesis from glucose through constructing a phosphorylation-dephosphorylation pathway in an engineered strain. Specifically, the gene encoding phosphofructokinase (PfkA) in glycolytic pathway was deleted in Escherichia coli to accumulate fructose-6-phosphate (F6P). Additionally, one endogenous phosphatase, YniC, with high specificity to mannose-6-phosphate, was identified. In ΔpfkA strain, a recombinant synthetic pathway based on mannose-6-phosphate isomerase and YniC was developed to direct F6P to mannose. The resulting strain successfully produced 25.2 g/L mannose from glucose with a high conversion rate of 63% after transformation for 48 h. This performance surpassed the 15% conversion rate observed with 2-epimerases. In conclusion, this study presents an efficient method for achieving high-yield mannose synthesis from cost-effective glucose.
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Affiliation(s)
- Yuyao Wang
- Tianjin University of Science and Technology, National Engineering Laboratory for Industrial Enzymes, Tianjin 300457, China; National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China
| | - Enhui Chen
- National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yanfei Wang
- Tianjin University of Science and Technology, National Engineering Laboratory for Industrial Enzymes, Tianjin 300457, China; National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China
| | - Xinming Sun
- Tianjin University of Science and Technology, National Engineering Laboratory for Industrial Enzymes, Tianjin 300457, China; National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China
| | - Qianzhen Dong
- National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Peng Chen
- Tianjin University of Science and Technology, National Engineering Laboratory for Industrial Enzymes, Tianjin 300457, China; National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China
| | - Chenglin Zhang
- Tianjin University of Science and Technology, National Engineering Laboratory for Industrial Enzymes, Tianjin 300457, China
| | - Jiangang Yang
- National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China.
| | - Yuanxia Sun
- National Engineering Laboratory for Industrial Enzymes, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin 300308, China; University of Chinese Academy of Sciences, Beijing 100049, China
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Dong W, Lin M, Zhang R, Sun X, Li H, Liu T, Xu Y, Lv L. D-mannose targets PD-1 to lysosomal degradation and enhances T cell-mediated anti-tumor immunity. Cancer Lett 2024:216883. [PMID: 38615929 DOI: 10.1016/j.canlet.2024.216883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
High expression of programmed cell death protein 1 (PD-1), a typical immune checkpoint, results in dysfunction of T cells in tumor microenvironment. Antibodies and inhibitors against PD-1 or its ligand (PD-L1) have been widely used in various malignant tumors. However, the mechanisms by which PD-1 is regulated are not fully understood. Here, we report a mechanism of PD-1 degradation triggered by D-mannose and the universality of this mechanism in anti-tumor immunity. We show that D-mannose inactivates GSK3β via promoting phosphorylation of GSK3β at Ser9, thereby leading to TFE3 translocation to nucleus and subsequent PD-1 proteolysis induced by enhanced lysosome biogenesis. Notably, combination of D-mannose and PD-1 blockade exhibits remarkable tumor growth suppression attributed to elevated cytotoxicity activity of T cells in vivo. Furthermore, D-mannose treatment dramatically improves the therapeutic efficacy of MEK inhibitor (MEKi) trametinib in vivo. Our findings unveil a universally unrecognized anti-tumor mechanism of D-mannose by destabilizing PD-1 and provide strategies to enhance the efficacy of both immune checkpoint blockade (ICB) and MEKi -based therapies.
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Affiliation(s)
- Wenjing Dong
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Mingen Lin
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Ruonan Zhang
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Xue Sun
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Hongchen Li
- Tongji Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China
| | - Tianshu Liu
- Dept of medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Yanping Xu
- Tongji Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.
| | - Lei Lv
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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Wu H, Wang J, Lin Y, He W, Hou J, Deng M, Chen Y, Liu Q, Lu A, Cui Z, Guan D, Yu B. Injectable Ozone-Rich Nanocomposite Hydrogel Loaded with D-Mannose for Anti-Inflammatory and Cartilage Protection in Osteoarthritis Treatment. Small 2024:e2309597. [PMID: 38279613 DOI: 10.1002/smll.202309597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/27/2023] [Indexed: 01/28/2024]
Abstract
Osteoarthritis (OA) is a dynamic condition characterized by cartilage damage and synovial inflammation. Ozone (O3 ) shows potential therapeutic effects owing to its anti-inflammatory properties; however, its high reactivity and short half-life substantially limit its effectiveness in OA treatment. In this study, an ozone-rich thermosensitive nanocomposite hydrogel loaded with D-mannose is developed for OA treatment. Briefly, O3 is encapsulated in nanoparticles (NPs) composed of perfluorotributylamine and fluorinated hyaluronic acid to improve its stability. Next, D-mannose is conjugated with α-amino of the hydroxypropyl chitin (HPCH) via Schiff base to prepare MHPCH. These nanoparticles are encapsulated in MHPCH to produce O3 NPs@MHPCH. In vitro cell experiments demonstrate that the O3 NPs@MHPCH treatment significantly reduced VEGF and inflammation levels, accompanied by a decrease in inflammatory factors such as IL-1β, IL-6, TNF-α, and iNOS. Furthermore, O3 NPs@MHPCH promotes the expression of collagen II and aggrecan and stimulates chondrocyte proliferation. Additionally, in vivo studies show that O3 NPs@MHPCH significantly alleviated OA by reducing synovial inflammation, cartilage destruction, and subchondral bone remodeling. O3 NPs@MHPCH offers a promising option for improving the efficacy of O3 therapy and reducing the risk of synovial inflammation and cartilage degeneration in OA.
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Affiliation(s)
- Hangtian Wu
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Jun Wang
- School of Medicine, Foshan University, Foshan, Guangdong, 528000, P. R. China
| | - Yanpeng Lin
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Wanling He
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Jiahui Hou
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Mingye Deng
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Yupeng Chen
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Qinwen Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Aiping Lu
- Institute of Integrated Bioinformedicine and Translational Science, Hong Kong Baptist University, Hong Kong, 999077, P. R. China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, 510515, P. R. China
| | - Zhuang Cui
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Daogang Guan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Bin Yu
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
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Joshi CS, Salazar AM, Wang C, Ligon MM, Chappidi RR, Fashemi BE, Felder PA, Mora A, Grimm SL, Coarfa C, Mysorekar IU. D-Mannose reduces cellular senescence and NLRP3/GasderminD/IL-1β-driven pyroptotic uroepithelial cell shedding in the murine bladder. Dev Cell 2024; 59:33-47.e5. [PMID: 38101412 PMCID: PMC10872954 DOI: 10.1016/j.devcel.2023.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 07/24/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
Aging is a risk factor for disease via increased susceptibility to infection, decreased ability to maintain homeostasis, inefficiency in combating stress, and decreased regenerative capacity. Multiple diseases, including urinary tract infection (UTI), are more prevalent with age; however, the mechanisms underlying the impact of aging on the urinary tract mucosa and the correlation between aging and disease remain poorly understood. Here, we show that, relative to young (8-12 weeks) mice, the urothelium of aged (18-24 months) female mice accumulates large lysosomes with reduced acid phosphatase activity and decreased overall autophagic flux in the aged urothelium, indicative of compromised cellular homeostasis. Aged bladders also exhibit basal accumulation of reactive oxygen species (ROS) and a dampened redox response, implying heightened oxidative stress. Furthermore, we identify a canonical senescence-associated secretory phenotype (SASP) in the aged urothelium, along with continuous NLRP3-inflammasome- and Gasdermin-D-dependent pyroptotic cell death. Consequently, aged mice chronically exfoliate urothelial cells, further exacerbating age-related urothelial dysfunction. Upon infection with uropathogenic E. coli, aged mice harbor increased bacterial reservoirs and are more prone to spontaneous recurrent UTI. Finally, we discover that treatment with D-mannose, a natural bioactive monosaccharide, rescues autophagy flux, reverses the SASP, and mitigates ROS and NLRP3/Gasdermin/interleukin (IL)-1β-driven pyroptotic epithelial cell shedding in aged mice. Collectively, our results demonstrate that normal aging affects bladder physiology, with aging alone increasing baseline cellular stress and susceptibility to infection, and suggest that mannose supplementation could serve as a senotherapeutic to counter age-associated urothelial dysfunction.
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Affiliation(s)
- Chetanchandra S Joshi
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX 77030, USA
| | - Arnold M Salazar
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX 77030, USA
| | - Caihong Wang
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Marianne M Ligon
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Rayvanth R Chappidi
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Bisiayo E Fashemi
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Paul A Felder
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Amy Mora
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Sandra L Grimm
- Department of Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Cristian Coarfa
- Department of Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Indira U Mysorekar
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX 77030, USA; Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA; Huffington Center of Aging, Baylor College of Medicine, Houston, TX 77030, USA.
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Zhang R, Tian Z, Xu Y, Lv L. D-mannose promotes the degradation of IDH2 through upregulation of RNF185 and suppresses breast cancer. Nutr Metab (Lond) 2024; 21:5. [PMID: 38167476 PMCID: PMC10763187 DOI: 10.1186/s12986-023-00774-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND D-mannose, an epimer of glucose, which is abundant in some fruits, such as cranberry, has been previously reported to inhibit urinary tract infection. In recent years, the potential function of D-mannose has been broadened into the regulation of other inflammation diseases and cancer. It was reported that D-mannose can increase reactive oxygen species (ROS) production, while IDH2 is important for the generation of NADPH, the crucial reducing factor. These findings prompted us to determine whether D-mannose can regulate IDH2 and IDH2-mediated NADPH production in tumor. METHODS The breast cancer cell line MDA-MB-231 was cultured and treated with 100mM D-mannose. IDH2 expression was detected by Western Blot and qRT-PCR. RNA-seq was conducted to identify the differentially expressed genes. BioGRID database was used to find the IDH2 interactors. Tumor cells were collected to measure the NADPH production using the NADP+/NADPH detection Kit. Colony formation assay and CCK-8 assay were conducted to evaluate the proliferation of cells. RESULTS D-mannose can promote IDH2 protein degradation through ubiquitination-proteasome pathway. Mechanistically, D-mannose treatment upregulated the expression of an E3 ligase - RNF185, which can interact with IDH2 and promotes its proteasomal degradation. Consequently, IDH2-mediated NADPH production was inhibited by D-mannose, the proliferation of breast cancer cells was retarded, and the sensitivity to pro-oxidant of breast cancer cells was elevated. CONCLUSIONS Our study demonstrated that D-mannose can degrade IDH2 and inhibit the production of NADPH to suppress the proliferation of breast cancer cells and render the breast cancer cells more sensitive to pro-oxidant treatment. Furthermore, we illustrated the E3 ligase RNF185 plays an important role in D-mannose-mediated proteasomal degradation of IDH2.
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Affiliation(s)
- Ruonan Zhang
- Nourse Centre for Pet Nutrition, 241200, Wuhu, China
| | - Ziyin Tian
- Nourse Centre for Pet Nutrition, 241200, Wuhu, China
| | - Yanping Xu
- Nourse Centre for Pet Nutrition, 241200, Wuhu, China.
| | - Lei Lv
- Nourse Centre for Pet Nutrition, 241200, Wuhu, China.
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Konesan J, Wang J, Moore KH, Mansfield KJ, Liu L. Cranberry, but not D-mannose and ibuprofen, prevents against uropathogenic Escherichia coli-induced cell damage and cell death in MDCK cells. Front Microbiol 2023; 14:1319785. [PMID: 38098676 PMCID: PMC10719950 DOI: 10.3389/fmicb.2023.1319785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction The main function of the urinary tract is to form an impermeable barrier against urinary solutes and bacteria. However, this barrier can be compromised by urinary tract infections, most commonly caused by uropathogenic Escherichia coli (UPEC). This can result in damage to the epithelial barrier, leading to decreased epithelial thickness, loss of tight junctions, loss of epithelial integrity, and apoptosis. Due to the rise in antimicrobial resistance, there is worldwide interest in exploring non-antibiotic agents as alternative therapy. Methods Using the Madin-Darby canine kidney (MDCK) cell line, a widely accepted epithelial cell model for the urinary tract, and the UPEC strain UTI89, this paper aimed to investigate the impact of UPEC on cell integrity, permeability, and barrier functions, and determine whether cranberry, D-mannose and ibuprofen could counteract the effects induced by UPEC. Furthermore, the study examined the protective potential of these agents against UPEC-induced increase in reactive oxygen species (ROS) production and programmed death-ligand 1 (PD-L1) expression. Results The results demonstrated that UTI89 caused a marked reduction in cell viability and monolayer integrity. Cranberry (3 mg/mL) was protective against these changes. In addition, cranberry exhibited protective effects against UPEC-induced damage to cell barrier integrity, escalation of oxidative stress, and UPEC/TNFα-triggered PD-L1 expression. However, no effect was observed for D-mannose and ibuprofen in alleviating UPEC-induced cell damage and changes in ROS and PD-L1 levels. Conclusion Overall, cranberry, but not D-mannose or ibuprofen, has a protective influence against UPEC associated damage in urinary epithelial cells.
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Affiliation(s)
- Jenane Konesan
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - Jenny Wang
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - Kate H. Moore
- St George Hospital, UNSW Sydney, Sydney, NSW, Australia
| | - Kylie J. Mansfield
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Lu Liu
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW, Australia
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Li R, Song C, Zhang X, Jia Z. [Characterization of a D-mannitol oxidase from Paenibacillus sp. and its application in the preparation of D-mannose]. Sheng Wu Gong Cheng Xue Bao 2023; 39:4682-4693. [PMID: 38013192 DOI: 10.13345/j.cjb.230078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
D-mannose has many functional activities and is widely used in food, medicine, agriculture and other industries. D-mannitol oxidase that can efficiently convert D-mannitol into D-mannose has potential application in the enzymatic preparation of D-mannose. A D-mannitol oxidase (PsOX) was found from Paenibacillus sp. HGF5. The similarity between PsOX and the D-mannitol oxidase (AldO) from Streptomyces coelicolor was 50.94%. The molecular weight of PsOX was about 47.4 kDa. A recombinant expression plasmid pET-28a-PsOX was constructed and expressed in Escherichia coli BL21(DE3). The Km and kcat/Km values of PsOX for D-mannitol were 5.6 mmol/L and 0.68 L/(s·mmol). Further characterization of PsOX showed its optimal pH and temperature were 7.0 and 35 ℃, respectively, while its enzyme activity could be stably remained below 60 ℃. The molar conversion rate of 400 mmol/L D-mannitol by PsOX was 95.2%. The whole cells of PsOX and AldO were used to catalyze 73 g/L D-mannitol respectively. The reaction catalyzed by PsOX completed in 9 h and 70 g/L D-mannose was produced. PsOX showed a higher catalytic efficiency compared to that of AldO. PsOX may facilitate the enzymatic preparation of D-mannose as a novel D-mannose oxidase.
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Affiliation(s)
- Ran Li
- Institute of Biology, Hebei Academy of Sciences, Shijiazhuang 050000, Hebei, China
| | - Cong Song
- Institute of Biology, Hebei Academy of Sciences, Shijiazhuang 050000, Hebei, China
| | - Xiang Zhang
- Institute of Biology, Hebei Academy of Sciences, Shijiazhuang 050000, Hebei, China
| | - Zhenhua Jia
- Institute of Biology, Hebei Academy of Sciences, Shijiazhuang 050000, Hebei, China
- Hebei Research Institute of Microbiology Co., Ltd., Baoding 071000, Hebei, China
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Scaglione F, Minghetti P, Ambrosio F, Ernst B, Ficarra V, Gobbi M, Naber K, Schellekens H. Nature of the Interaction of Alpha-D-Mannose and Escherichia coli Bacteria, and Implications for its Regulatory Classification. A Delphi Panel European Consensus Based on Chemistry and Legal Evidence. Ther Innov Regul Sci 2023; 57:1153-1166. [PMID: 37578736 PMCID: PMC10579141 DOI: 10.1007/s43441-023-00548-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/05/2023] [Indexed: 08/15/2023]
Abstract
The nature of alpha-D-mannose-natural aldohexose sugar, C-2 glucose epimer, whose intended use is for preventing urinary tract infections-in the interaction with E. coli is addressed in order to drive the issue of its regulatory classification as a medicinal product or medical device. PRISMA systematic review approach was applied; Delphi Panel method was used to target consensus on statements retrieved from evidence. Based on regulatory definitions and research evidence, the mechanism of D-mannose does not involve a metabolic or immunological action while there is uncertainty regarding the pharmacological action. Specific interaction between the product and the bacteria within the body occurs, but its nature is inert: it does not induce a direct response activating or inhibiting body processes. Moreover, the action of D-mannose takes place, even if inside the bladder, outside the epithelium on bacteria that have not yet invaded the urothelial tissue. Therefore, its mechanism of action is not directed to host structures but to structures (bacteria) external to the host's tissues. On the basis of current regulation, the uncertainty as regard a pharmacological action of alpha-D-mannose makes possible its medical device classification: new regulations and legal judgments can add further considerations. From a pharmacological perspective, research is driven versus synthetic mannosides: no further considerations are expected on alpha-D-mannose.
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Affiliation(s)
- Francesco Scaglione
- Clinical Pharmacology and Toxicology Unit -GOM Niguarda, GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Paola Minghetti
- Department of Pharmaceutical Sciences, University of Milan, Via Mangiagalli 25, 20133 Milan, Italy
| | | | - Beat Ernst
- Group Molecular Pharmacy Pharmacenter, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland
| | - Vincenzo Ficarra
- Department of Human and Pediatric Pathology “Gaetano Barresi”, Urologic Section, University of Messina, Piazza Pugliatti, 1, Messina, Italy
| | - Marco Gobbi
- Laboratory of Pharmacodynamics and Pharmacokinetics, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri, 2, 20156 Milan, MI Italy
| | - Kurt Naber
- Department of Urology, Technical University of Munich, Munich, Germany
- Department of Urology, Technical University of Munich, Karl-Bickleder Str. 44C, 94315 Straubing, Germany
| | - Huub Schellekens
- Faculty of Sciences, Utrecht University, PO Box 80125, 3508 TC Utrecht, The Netherlands
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Zhao M, Chen N, Guo Y, Wu N, Cao B, Zhan B, Li Y, Zhou T, Zhu F, Guo C, Shi Y, Wang Q, Li Y, Zhang L. D-mannose acts as a V-ATPase inhibitor to suppress inflammatory cytokines generation and bacterial killing in macrophage. Mol Immunol 2023; 162:84-94. [PMID: 37660434 DOI: 10.1016/j.molimm.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/17/2023] [Accepted: 08/26/2023] [Indexed: 09/05/2023]
Abstract
Vacuolar-type H+-ATPase (V-ATPase) critically controls phagosome acidification to promote pathogen digestion and clearance in macrophage. However, the specific subunits of V-ATPase have been evidenced to play contradictory functions in inflammatory cytokines generation and secretion exposure to external bacterial or LPS stimulation. Therefore, identifying the unique function of the separate subunit of V-ATPase is extremely important to regulate macrophage function. Here, we found that D-mannose, a C-2 epimer of glucose, suppressed ATP6V1B2 lysosomal translocation to inhibit V-ATPase activity in macrophages, thereby causing the scaffold protein axis inhibitor protein (AXIN) recruitment to lysosomal membrane and AMPK activation. Correspondingly, LPS-stimulated macrophage M1 polarization was significantly suppressed by D-mannose via down-regulating NF-κB signaling pathway in response to AMPK activation, while IL-4 induced macrophage M2 polarization were not affected. Furthermore, the failure of lysosomal localization of ATP6V1B2 caused by D-mannose also led to the acidification defects of lysosome. Therefore, D-mannose displayed a remarkable function in inhibiting macrophage phagocytosis and bacterial killing. Taken together, D-mannose acts a novel V-ATPase suppressor to attenuate macrophage inflammatory production but simultaneously prevent macrophage phagocytosis and bacterial killing.
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Affiliation(s)
- Ming Zhao
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Nuo Chen
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Yaxin Guo
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Nan Wu
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Baihui Cao
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Bing Zhan
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Yubin Li
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Tian Zhou
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Faliang Zhu
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Chun Guo
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Yongyu Shi
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Qun Wang
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China
| | - Yan Li
- Department of Pathogen Biology, School of Basic Medical Science, Shandong University, Jinan, China.
| | - Lining Zhang
- Department of Immunology, School of Basic Medical Science, Shandong University, Jinan, China.
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10
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Venturini S, Reffo I, Avolio M, Basaglia G, Del Fabro G, Callegari A, Tonizzo M, Sabena A, Rondinella S, Mancini W, Conte C, Crapis M. The Management of Recurrent Urinary Tract Infection: Non-Antibiotic Bundle Treatment. Probiotics Antimicrob Proteins 2023:10.1007/s12602-023-10141-y. [PMID: 37584833 DOI: 10.1007/s12602-023-10141-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 08/17/2023]
Abstract
Recurrent urinary tract infections (rUTIs) are a common condition with high morbidity and negatively impact the quality of life. They account for approximately 25% of all antibiotic prescriptions and are a public health concern in an era of increasing multidrug-resistant organisms (MDROs). Several non-antibiotic treatment strategies have been tried to curb antimicrobial use, and many are effective to some degree, but no experience testing multimodal interventions. We created a "care bundle" consisting of behavioral interventions, vaginal and oral probiotics, D-mannose, and cranberry to be followed for six months. We enrolled women with rUTIs over three years. Changes in urinary tract infections, antibiotic use, chronic symptoms, and quality of life were compared in the six months before and after participation in the study. Forty-seven women were enrolled in the study, six of whom were excluded from the final analysis. We observed a 76% reduction in urinary tract infections (p < 0.001) and a reduction in total antibiotic exposure of more than 90% (p < 0.001); all chronic symptoms showed a trend toward reduction. Adherence to the bundle was high (87.2%). Overall, 80.5% of women experienced an improvement in their quality of life. In our experience, a bundle protocol is effective in reducing recurrences and antimicrobial use in a cohort of women with rUTIs and results in a subjective improvement in chronic symptoms and quality of life. Further research with larger sample size is needed to confirm these findings.
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Affiliation(s)
- Sergio Venturini
- Department of Infectious Diseases, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Ingrid Reffo
- Department of Anaesthesia and Intensive Care, ASFO Santa Maria dei Battuti Hospital of San Vito al Tagliamento (Pordenone), Pordenone, Italy.
| | - Manuela Avolio
- Department of Microbiology, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Giancarlo Basaglia
- Department of Microbiology, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Giovanni Del Fabro
- Department of Infectious Diseases, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Astrid Callegari
- Department of Infectious Diseases, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Maurizio Tonizzo
- Department of Internal Medicine, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Anna Sabena
- Department of Internal Medicine, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Stefania Rondinella
- Department of Internal Medicine, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Walter Mancini
- Department of Nephrology, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Carmina Conte
- Department of Nephrology, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
| | - Massimo Crapis
- Department of Infectious Diseases, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy
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11
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Crocetto F, Balsamo R, Amicuzi U, De Luca L, Falcone A, Mirto BF, Giampaglia G, Ferretti G, Capone F, Machiella F, Varriale D, Sicignano E, Pagano G, Lombardi A, Lucarelli G, Lasorsa F, Busetto GM, Del Giudice F, Ferro M, Imbimbo C, Barone B. Novel Key Ingredients in Urinary Tract Health-The Role of D-mannose, Chondroitin Sulphate, Hyaluronic Acid, and N-acetylcysteine in Urinary Tract Infections (Uroial PLUS ®). Nutrients 2023; 15:3573. [PMID: 37630763 PMCID: PMC10459296 DOI: 10.3390/nu15163573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
Urinary tract infections represent a common and significant health concern worldwide. The high rate of recurrence and the increasing antibiotic resistance of uropathogens are further worsening the current scenario. Nevertheless, novel key ingredients such as D-mannose, chondroitin sulphate, hyaluronic acid, and N-acetylcysteine could represent an important alternative or adjuvant to the prevention and treatment strategies of urinary tract infections. Several studies have indeed evaluated the efficacy and the potential use of these compounds in urinary tract health. In this review, we aimed to summarize the characteristics, the role, and the application of the previously reported compounds, alone and in combination, in urinary tract health, focusing on their potential role in urinary tract infections.
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Affiliation(s)
- Felice Crocetto
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Raffaele Balsamo
- Urology Unit, AORN Ospedali dei Colli, Monaldi Hospital, 80131 Naples, Italy;
| | - Ugo Amicuzi
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy;
| | - Luigi De Luca
- Division of Urology, Department of Surgical Multispecialty, AORN Antonio Cardarelli, 80131 Naples, Italy;
| | - Alfonso Falcone
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Benito Fabio Mirto
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Gaetano Giampaglia
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Gianpiero Ferretti
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Federico Capone
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Fabio Machiella
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Domenico Varriale
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Enrico Sicignano
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Giovanni Pagano
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Alessandro Lombardi
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Giuseppe Lucarelli
- Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy; (G.L.); (F.L.)
| | - Francesco Lasorsa
- Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy; (G.L.); (F.L.)
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, 71121 Foggia, Italy;
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy;
| | - Matteo Ferro
- Department of Urology, IEO—European Institute of Oncology, IRCCS—Istituto di Ricovero e Cura a Carattere Scientifico, 20141 Milan, Italy;
| | - Ciro Imbimbo
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (A.F.); (B.F.M.); (G.G.); (G.F.); (F.C.); (F.M.); (D.V.); (E.S.); (G.P.); (A.L.); (C.I.)
| | - Biagio Barone
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy;
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12
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Faustino M, Silva S, Costa EM, Pereira AM, Pereira JO, Oliveira AS, Ferreira CMH, Pereira CF, Durão J, Pintado ME, Carvalho AP. Effect of Mannan Oligosaccharides Extracts in Uropathogenic Escherichia coli Adhesion in Human Bladder Cells. Pathogens 2023; 12:885. [PMID: 37513732 PMCID: PMC10384913 DOI: 10.3390/pathogens12070885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/16/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Urinary tract infections (UTIs) are a common public health problem, mainly caused by uropathogenic Escherichia coli (UPEC). Patients with chronic UTIs are usually treated with long-acting prophylactic antibiotics, which promotes the development of antibiotic-resistant UPEC strains and may complicate their long-term management. D-mannose and extracts rich in D-mannose such as mannan oligosaccharides (MOS; D-mannose oligomers) are promising alternatives to antibiotic prophylaxis due to their ability to inhibit bacterial adhesion to urothelial cells and, therefore, infection. This highlights the therapeutic potential and commercial value of using them as health supplements. Studies on the effect of MOS in UTIs are, however, scarce. Aiming to evaluate the potential benefits of using MOS extracts in UTIs prophylaxis, their ability to inhibit the adhesion of UPEC to urothelial cells and its mechanism of action were assessed. Additionally, the expression levels of the pro-inflammatory marker interleukin 6 (IL-6) were also evaluated. After characterizing their cytotoxic profiles, the preliminary results indicated that MOS extracts have potential to be used for the handling of UTIs and demonstrated that the mechanism through which they inhibit bacterial adhesion is through the competitive inhibition of FimH adhesins through the action of mannose, validated by a bacterial growth impact assessment.
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Affiliation(s)
- Margarida Faustino
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Sara Silva
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Eduardo M Costa
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Ana Margarida Pereira
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
- Amyris Bio Products Portugal, Unipessoal Lda, Rua Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Joana Odila Pereira
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
- Amyris Bio Products Portugal, Unipessoal Lda, Rua Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Ana Sofia Oliveira
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Carlos M H Ferreira
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
- Amyris Bio Products Portugal, Unipessoal Lda, Rua Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Carla F Pereira
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Joana Durão
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
- Amyris Bio Products Portugal, Unipessoal Lda, Rua Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Manuela E Pintado
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Ana P Carvalho
- CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Universidade Católica Portuguesa, Escola Superior de Biotecnologia, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
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13
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Quattrone C, Manfredi C, Napolitano L, Ferraro A, Distefano C, Di Girolamo A, Sciorio C, Imperatore V, Bottone F, La Rocca R, Arcaniolo D, De Sio M, Spirito L. D-Mannose Plus Saccharomyces boulardii to Prevent Urinary Tract Infections and Discomfort after Cystoscopy: A Single-Center Prospective Randomized Pilot Study. Medicina (Kaunas) 2023; 59:1165. [PMID: 37374369 DOI: 10.3390/medicina59061165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Patients undergoing cystoscopy can experience discomfort or pain during the procedure. In some cases, a urinary tract infection (UTI) with storage lower urinary tract symptoms (LUTS) may occur in the days following the procedure. This study aimed to assess the efficacy of D-mannose plus Saccharomyces boulardii in the prevention of UTIs and discomfort in patients undergoing cystoscopy. Materials and Methods: A single-center prospective randomized pilot study was conducted between April 2019 and June 2020. Patients undergoing cystoscopy for suspected bladder cancer (BCa) or in the follow-up for BCa were enrolled. Patients were randomized into two groups: D-Mannose plus Saccharomyces boulardii (Group A) vs. no treatment (Group B). A urine culture was prescribed regardless of symptoms 7 days before and 7 days after cystoscopy. The International Prostatic Symptoms Score (IPSS), 0-10 numeric rating scale (NRS) for local pain/discomfort, and EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) were administered before cystoscopy and 7 days after. Results: A total of 32 patients (16 per group) were enrolled. No urine culture was positive in Group A 7 days after cystoscopy, while 3 patients (18.8%) in Group B had a positive control urine culture (p = 0.044). All patients with positive control urine culture reported the onset or worsening of urinary symptoms, excluding the diagnosis of asymptomatic bacteriuria. At 7 days after cystoscopy, the median IPSS of Group A was significantly lower than that of Group B (10.5 vs. 16.5 points; p = 0.021), and at 7 days, the median NRS for local discomfort/pain of Group A was significantly lower than that for Group B (1.5 vs. 4.0 points; p = 0.012). No statistically significant difference (p > 0.05) in the median IPSS-QoL and EORTC QLQ-C30 was found between groups. Conclusions: D-Mannose plus Saccharomyces boulardii administered after cystoscopy seem to significantly reduce the incidence of UTI, the severity of LUTS, and the intensity of local discomfort.
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Affiliation(s)
- Carmelo Quattrone
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | | | - Concetta Distefano
- Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | | | - Carmine Sciorio
- Urology Unit, Ospedale Alessandro Manzoni, 23900 Lecco, Italy
| | | | - Francesco Bottone
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Lorenzo Spirito
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
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14
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Stangl FP, Schneidewind L, Kiss B, Kranz J, Wagenlehner FM, Johansen TEB, Köves B, Medina-Polo J, Tapia AM, Tandogdu Z. Non-Antibiotic Prophylaxis for Recurrent UTIs in Neurogenic Lower Urinary Tract Dysfunction (NAPRUN): Study Protocol for a Prospective, Longitudinal Multi-Arm Observational Study. Methods Protoc 2023; 6:52. [PMID: 37367996 DOI: 10.3390/mps6030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
INTRODUCTION Patients with neurogenic lower urinary tract dysfunction (NLUTD) reliant on intermittent self-catheterization for bladder emptying are at an increased risk of recurrent urinary tract infections (rUTI). So far, the most common practice in the prevention of rUTIs is long-term low-dose antibiotic prophylaxis, phytotherapy, and immunomodulation, whereby antibiotic prophylaxis inevitably leads to the emergence of drug-resistant pathogens and difficulty in treating infections. Therefore, non-antibiotic alternatives in the prevention of rUTIs are urgently required. We aim to identify the comparative clinical effectiveness of a non-antibiotic prophylaxis regimen in the prevention of recurrent urinary tract infections in patients with neurogenic bladder dysfunction who practice intermittent self-catheterization. METHODS AND ANALYSIS In this multi-centre, prospective longitudinal multi-arm observational study, a total of 785 patients practising intermittent self-catheterisation due to NLUTD will be included. After inclusion, non-antibiotic prophylaxis regimens will be instilled with either UroVaxom® (OM-89) standard regimen, StroVac® (bacterial lysate vaccine) standard regimen, Angocin®, D-mannose (oral dose 2 g), bladder irrigation with saline (once per day). The management protocols will be pre-defined, but the selection of the protocol will be at the clinicians' discretion. Patients will be followed for 12 months from the onset of the prophylaxis protocol. The primary outcome is to identify the incidence of breakthrough infections. The secondary outcomes are adverse events associated with the prophylaxis regimens and the severity of breakthrough infections. Other outcomes include the exploration of change in susceptibility pattern via the optional rectal and perineal swab, as well as health-related quality of life over time (HRQoL), which will be measured in a random subgroup of 30 patients. ETHICS AND DISSEMINATION Ethical approval for this study has been granted by the ethical review board of the University Medical Centre Rostock (A 2021-0238 from 28 October 2021). The results will be published in a peer-reviewed journal and presented at relevant meetings. STUDY REGISTRATION NUMBER German Clinical Trials Register: Number DRKS00029142.
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Affiliation(s)
- Fabian P Stangl
- Department of Urology, University Hospital of Bern, 3010 Bern, Switzerland
| | - Laila Schneidewind
- Department of Urology, University Medical Center Rostock, 18055 Rostock, Germany
| | - Bernhard Kiss
- Department of Urology, University Hospital of Bern, 3010 Bern, Switzerland
| | - Jennifer Kranz
- Department of Urology and Paediatric Urology, Uniklinik RWTH Aachen, 52074 Aachen, Germany
- Department of Urology and Kidney Transplantation, Martin Luther University, 06120 Halle (Saale), Germany
| | - Florian M Wagenlehner
- Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig-University Giessen, 35390 Giessen, Germany
| | - Truls E Bjerklund Johansen
- Institute of Clinical Medicine, University of Aarhus, 8200 Aarhus, Denmark
- Department of Urology, Oslo University Hospital, 0315 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
| | - Béla Köves
- Department of Urology, University of Szeged, 6725 Szeged, Hungary
| | - Jose Medina-Polo
- Department of Urology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Ana Maria Tapia
- Department of Urology, Hospital Universitario Río Hortega, 47012 Valladolid, Spain
| | - Zafer Tandogdu
- Department of Urology, University College London Hospitals, London W1G 8PH, UK
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15
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Al-Shukri AS, Maksimova AV, Dub NI, Kostyukov SV, Manchenko AA, Mayorov ID, Ponomareva YA, Petrov SB. [Prevention of the development of catheter-associated urinary system infections in the early postoperative period]. Urologiia 2023:13-19. [PMID: 37401699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND Bladder catheterization is a common medical manipulation that is associated with the risk of complications, including catheter-associated urinary tract infection (CAUTI), which accounts for 80% of all nosocomial infections of the urological profile. AIM To evaluate the combined use of the biologically active additive Uronext and ceftriaxone in the prevention of the development of CAUTI in the early postoperative period in 120 patients aged 20-80 years with a Foley indwelling catheter. MATERIALS AND METHODS The patients were divided into 2 groups: in group I (n=60), D-mannose with cranberry extract and vitamin D3 as part of Uronext dietary supplement was administered orally in the form of sachets 48 hours before surgery and after surgery until urethral catheter was placed, as well as intravenous ceftriaxone 1000 mg 2 hours before surgery and in the postoperative period within 7 days. In group II (n=60), ceftriaxone monotherapy was prescribed in a similar way. RESULTS According to the results of bacteriological examination of the removed urinary catheter on 3-7 days in Uronext group, bacterial growth was absent in 40 patients (66.67%, p<0.05), versus 23 cases (38.33%) in the control group. CONCLUSIONS The data obtained confirm the efficiency of the use of the biologically active additive Uronext in combination with an antibacterial drug, which allows to recommend this scheme in patients with an indwelling urinary catheter for the prevention of the development of CAUTI.
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Affiliation(s)
- A S Al-Shukri
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - A V Maksimova
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - N I Dub
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - S V Kostyukov
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - A A Manchenko
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - I D Mayorov
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - Yu A Ponomareva
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - S B Petrov
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
- FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia
- FGBU NMRC named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
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16
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Qu L, Wang C, Xu H, Li L, Liu Y, Wan Q, Xu K. Atractylodin targets GLA to regulate D-mannose metabolism to inhibit osteogenic differentiation of human valve interstitial cells and ameliorate aortic valve calcification. Phytother Res 2023; 37:477-489. [PMID: 36199227 DOI: 10.1002/ptr.7628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/22/2022] [Accepted: 09/03/2022] [Indexed: 11/07/2022]
Abstract
Atractylodin (ATL) has been reported to exert anti-inflammatory effects. Osteogenic changes induced by inflammation in valve interstitial cells (VICs) play a key role in the development of calcified aortic valve disease (CAVD). This study aimed to investigate the anti-calcification effects of ATL on aortic valves. Human VICs (hVICs) were exposed to osteogenic induction medium (OM) containing ATL to investigate cell viability, osteogenic gene and protein expression, and anti-calcification effects. Gas chromatography-mass spectroscopy (GC-MS) metabolomics analysis was used to detect changes in the metabolites of hVICs stimulated with OM before and after ATL administration. The compound-reaction-enzyme-gene network was used to identify drug targets. Gene interference was used to verify the targets. ApoE-/- mice fed a high-fat (HF) diet were used to evaluate the inhibition of aortic valve calcification by ATL. Treatment with 20 μM ATL in OM prevented calcified nodule accumulation and decreases in the gene and protein expression levels of ALP, RUNX2, and IL-1β. Differential metabolite analysis showed that D-mannose was highly associated with the anti-calcification effect of ATL. The addition of D-mannose prevented calcified nodule accumulation and inhibited succinate-mediated HIF-1α activation and IL-1β production. The target of ATL was identified as GLA. Silencing of the GLA gene (si-GLA) reversed the anti-osteogenic differentiation of ATL. In vivo, ATL ameliorated aortic valve calcification by preventing decreases in GLA expression and the up-regulation of IL-1β expression synchronously. In conclusion, ATL is a potential drug for the treatment of CAVD by targeting GLA to regulate D-mannose metabolism, thereby inhibiting succinate-mediated HIF-1α activation and IL-1β production.
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Affiliation(s)
- Linghang Qu
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Chunli Wang
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Haiying Xu
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Lanqing Li
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Yanju Liu
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
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Gu R, Liu H, Hu M, Zhu Y, Liu X, Wang F, Wu L, Song D, Liu Y. D-Mannose prevents bone loss under weightlessness. J Transl Med 2023; 21:8. [PMID: 36617569 PMCID: PMC9827691 DOI: 10.1186/s12967-022-03870-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/29/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Astronauts undergo significant microgravity-induced bone loss during space missions, which has become one of the three major medical problems hindering human's long-term space flight. A risk-free and antiresorptive drug is urgently needed to prevent bone loss during space missions. D-mannose is a natural C-2 epimer of D-glucose and is abundant in cranberries. This study aimed to investigate the protective effects and potential mechanisms of D-mannose against bone loss under weightlessness. METHODS The hind legs of tail-suspended (TS) rats were used to mimic weightlessness on Earth. Rats were administered D-mannose intragastrically. The osteoclastogenic and osteogenic capacity of D-mannose in vitro and in vivo was analyzed by micro-computed tomography, biomechanical assessment, bone histology, serum markers of bone metabolism, cell proliferation assay, quantitative polymerase chain reaction, and western blotting. RNA-seq transcriptomic analysis was performed to detect the underlying mechanisms of D-mannose in bone protection. RESULTS The TS rats showed lower bone mineral density (BMD) and poorer bone morphological indices. D-mannose could improve BMD in TS rats. D-mannose inhibited osteoclast proliferation and fusion in vitro, without apparent effects on osteoblasts. RNA-seq transcriptomic analysis showed that D-mannose administration significantly inhibited the cell fusion molecule dendritic cell-specific transmembrane protein (DC-STAMP) and two indispensable transcription factors for osteoclast fusion (c-Fos and nuclear factor of activated T cells 1 [NFATc1]). Finally, TS rats tended to experience dysuria-related urinary tract infections (UTIs), which were suppressed by treatment with D-mannose. CONCLUSION D-mannose protected against bone loss and UTIs in rats under weightlessness. The bone protective effects of D-mannose were mediated by inhibiting osteoclast cell fusion. Our findings provide a potential strategy to protect against bone loss and UTIs during space missions.
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Affiliation(s)
- Ranli Gu
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Hao Liu
- grid.11135.370000 0001 2256 9319The Central Laboratory, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Menglong Hu
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Yuan Zhu
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Xuenan Liu
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Feilong Wang
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Likun Wu
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Danyang Song
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
| | - Yunsong Liu
- grid.11135.370000 0001 2256 9319Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081 China
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Ligon MM, Joshi CS, Fashemi BE, Salazar AM, Mysorekar IU. Effects of aging on urinary tract epithelial homeostasis and immunity. Dev Biol 2023; 493:29-39. [PMID: 36368522 DOI: 10.1016/j.ydbio.2022.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
A global increase in older individuals creates an increasing demand to understand numerous healthcare challenges related to aging. This population is subject to changes in tissue physiology and the immune response network. Older individuals are particularly susceptible to infectious diseases, with one of the most common being urinary tract infections (UTIs). Postmenopausal and older women have the highest risk of recurrent UTIs (rUTIs); however, why rUTIs become more frequent after menopause and during old age is incompletely understood. This increased susceptibility and severity among older individuals may involve functional changes to the immune system with age. Aging also has substantial effects on the epithelium and the immune system that led to impaired protection against pathogens, yet heightened and prolonged inflammation. How the immune system and its responses to infection changes within the bladder mucosa during aging has largely remained poorly understood. In this review, we highlight our understanding of bladder innate and adaptive immunity and the impact of aging and hormones and hormone therapy on bladder epithelial homeostasis and immunity. In particular, we elaborate on how the cellular and molecular immune landscape within the bladder can be altered during aging as aged mice develop bladder tertiary lymphoid tissues (bTLT), which are absent in young mice leading to profound age-associated change to the immune landscape in bladders that might drive the significant increase in UTI susceptibility. Knowledge of host factors that prevent or promote infection can lead to targeted treatment and prevention regimens. This review also identifies unique host factors to consider in the older, female host for improving rUTI treatment and prevention by dissecting the age-associated alteration of the bladder mucosal immune system.
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Affiliation(s)
- Marianne M Ligon
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Chetanchandra S Joshi
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Bisiayo E Fashemi
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Arnold M Salazar
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Indira U Mysorekar
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, 77030, USA; Department of Molecular Microbiology and Virology, Baylor College of Medicine, Houston, TX, 77030, USA; Huffington Center on Aging, Baylor College of Medicine, Houston, TX, 77030, USA.
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19
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Nashivochnikova NA, Leanovich VE. [Clinical and pathogenetic aspects of the treatment and prevention of pyelonephritis in children]. Urologiia 2022:97-104. [PMID: 36625621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Treatment of pyelonephritis in children should be combined, long-term and individual-based. The success of the therapy in children largely depends on the prompt appointment and the correct choice of antimicrobial therapy. AIM To evaluate the efficiency of the dietary supplement "Cystenium II" in a group of children aged 7 to 14 years with a diagnosis of acute and chronic recurrent pyelonephritis in the acute phase. MATERIALS AND METHODS A total of 60 children aged 7 to 14 years with a diagnosis of acute or chronic recurrent pyelonephritis in the acute stage were included in the study. The clinical group consisted of 30 patients (mean age 12.1+/-1.8 years), while the control group included 30 patients of mean age 11.2+/-1.7 years. In the control group patients received only standard antibiotic therapy, while in the clinical group it was combined with a dietary supplement "Cystenium II" 1 tablet 2 times a day with meals for 14 days. After the course of antibacterial treatment, the children in the clinical group continued to take the studied dietary supplement for another 14 days in order to prevent the recurrence of pyelonephritis. The results of treatment (patient's condition, presence of pain, dysuria, fever) were assessed on the 3rd, 7th, 14th day, 1 and 6 months after the start of treatment. A urinalysis was performed at the baseline, on the 7th and 14th days, as well as after 1 and 6 months. Urine culture was performed before and after antibiotic therapy at the baseline, on the 14th day, 1 and 6 months after the start of treatment. RESULTS The main indicators of urinalysis (leukocytes, red blood cells, protein) returned to normal values in 26 (86.7%) patients of the clinical group and in 23 (76.7%) patients of the control group on the 7th day after the start of treatment. At the completion of the basic therapy (after 14 days) normal clinical parameters (absence of leukocyturia, microhematuria, proteinuria) were observed in all patients of the clinical group and in 28 (93.3%) patients of the control group. After a month of follow-up, the disturbances in urinalysis (leukocytes, red blood cells, protein) in the control group were again seen in 3 (10%) patients, as well as after 6 months. However, in the clinical group all patients had normal urinalysis (absence of leukocyturia, microhematuria, proteinuria) after 1 month and only in 1 (3.3%) case leukocyturia, as well as an increase in the number of red blood cells and protein was detected by 6 months. DISCUSSION According to our results, the use of dietary supplements "Cystenium II" (manufactured by Akvion, Russia), due to the constituents of D-mannose (450 mg), cranberry fruit extract with a standardized activity of 500 mg (36 mg of proanthocyanidins) and vitamin C (60 mg), may cause anti-inflammatory and anti-adhesive effects (resolving of leukocyturia and bacteriuria). This allows to use the dietary supplement Cystenium II in children from 7 years of age in the combination therapy of acute pyelonephritis, as well as exacerbation of chronic pyelonephritis. The obtained results showed a high overall therapeutic efficacy of combination therapy using Cystenium II after 6 months from the start of treatment (relapse in 1 patient), in contrast to the control group (relapse in 6 patients). CONCLUSIONS the use of dietary supplement "Cystenium II" allowed to reduce the number of repeated courses of antibiotic therapy in children during 6 months of follow-up and, most likely, reduced the frequency of development of chronic pyelonephritis after an acute inflammation. Therefore, the wide clinical use of dietary supplements "Cystenium II" for the combined treatment of acute and exacerbation of chronic pyelonephritis in children older than 7 years seems to be very reasonable.
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Affiliation(s)
- N A Nashivochnikova
- Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia.,Akvion AO, Moscow, Russia
| | - V E Leanovich
- Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia.,Akvion AO, Moscow, Russia
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20
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Cassano R, Curcio F, Procopio D, Fiorillo M, Trombino S. Multifunctional Microspheres Based on D-Mannose and Resveratrol for Ciprofloxacin Release. Materials (Basel) 2022; 15:ma15207293. [PMID: 36295357 PMCID: PMC9607382 DOI: 10.3390/ma15207293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/03/2022] [Accepted: 10/16/2022] [Indexed: 06/01/2023]
Abstract
This article describes the preparation, characterization, and performance evaluation of functional microspheres useful for the release of ciprofloxacin. The particles were obtained using D-mannose, a natural aldohexose sugar, and resveratrol, a powerful antioxidant. In particular, the above compounds were initially converted into D-mannose carboxylate and resveratrol methacrylate and, therefore, subjected to an esterification reaction. The resulting product was used for the preparation of the microspheres which were characterized by light scattering, FT-IR spectrophotometry and scanning electron microscopy (SEM). Subsequently, their degree of bloating was evaluated at pH 1.2 to simulate the pH of the stomach, at pH 6.8 and pH 7.4 to mimic the intestinal environment. The antibiotic ciprofloxacin was then loaded into the microspheres, with an encapsulation efficiency of 100%. The cumulative amount of drug released was 55% at pH 6.8 and 99% at pH 7.4. The tests conducted to evaluate the antibacterial activity demonstrated the ability of the microspheres obtained to inhibit the growth of Escherichia coli. The antioxidant efficacy, due to the presence of resveratrol in their structure, was confirmed using rat liver microsomal membranes. The results obtained have highlighted how the microspheres based on D-mannose and resveratrol can be considered promising multifunctional vectors useful in the treatment of intestinal and urinary infections.
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21
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Yang H, Han N, Luo Z, Xu J, Guo L, Liu Y. D-Mannose alleviated alveolar bone loss in experimental periodontitis mice via regulating the anti-inflammatory effect of amino acids. J Periodontol 2022; 94:542-553. [PMID: 36031720 DOI: 10.1002/jper.22-0294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/31/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Periodontitis is a chronic infectious disease caused by dysbiosis of oral microbiota, ultimately leading to periodontal alveolar bone loss. The oral subgingival microbiome, a key role in periodontitis pathogenesis, could alter the composition of gut microbiomes resulting in intestinal microbiota disorder. D-Mannose plays an important role in glucose metabolism, whether it is beneficial to prevention and treatment of periodontitis and the regulation of oral and intestinal microbiota changes is still unknown. METHODS To explore the effect of D-mannose, we established experimental periodontitis models in mice and then treated with supplementation of D-mannose in drinking water or gavage to examine the extent of periodontal bone loss using methylene blue staining. Moreover, the oral and fecal samples of mice were collected for 16S rRNA deep sequencing to analyze the changes of oral and gut microbiota after 14 days. Furthermore, amino acid content assays were used to test the concentration of amino acid of gingival tissues and intestinal tissues. RESULTS We found that D-mannose could alleviate periodontal bone loss whether in the manner of drinking water or gavage. 16S rRNA results revealed that the abundance of Firmicutes changed significantly in oral samples, while Firmicutes and Akkermansia. Muciniphila were dominated in gut microbiota. In addition, we demonstrated that D-Mannose inhibited inflammation and alleviated alveolar bone loss in periodontitis via regulating amino acid metabolism of oral and gut microbiomes. CONCLUSION Our findings provided insight into the mechanism underlying the abilities of D-mannose in improving periodontitis treatment, suggesting that D-mannose has potential application in the dental clinic. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hua Yang
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, P. R. China.,Immunology Research Center for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Nannan Han
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, P. R. China.,Immunology Research Center for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Zhenhua Luo
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, P. R. China.,Immunology Research Center for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Junji Xu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, P. R. China.,Immunology Research Center for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Lijia Guo
- Department of Orthodontics School of Stomatology, Capital Medical University, Beijing, P. R. China
| | - Yi Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, P. R. China.,Immunology Research Center for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
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22
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Pooresmaeil M, Namazi H. D-mannose functionalized MgAl-LDH/Fe-MOF nanocomposite as a new intelligent nanoplatform for MTX and DOX co-drug delivery. Int J Pharm 2022; 625:122112. [PMID: 35970281 DOI: 10.1016/j.ijpharm.2022.122112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022]
Abstract
Commonly the directly administered chemotherapy drugs lack targeting in tumor treatment. Thus, trying to improve cancer treatment efficiency led us to design a new intelligent system for cancer treatment. Considering these, in the current work, at first, the 2-aminoterephthalic acid (NH2-BDC) intercalated layered double hydroxides (MgAl-(NH2-BDC) LDH) were synthesized simply. Afterward, the in situ growth of the iron-based metal-organic frameworks in the presence of MgAl-(NH2-BDC) LDH occurred (MgAl-LDH/Fe-MOF). In the end, the reaction of MgAl-LDH/Fe-MOF with D-mannose (D-Man) achieved the MgAl-LDH/Fe-MOF/D-Man ternary hybrid nanostructure. Scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) analysis confirmed the formation of the monodisperse Fe-MOF with nanosize in the presence of MgAl-LDH. Importantly, methotrexate (MTX) and doxorubicin (DOX) entrapment efficiency reached respectively about 28 wt% and 21% for MgAl-LDH/Fe-MOF/D-Man. The in vitro drug release experiments revealed a higher drug release at pH 5.0 in comparison with pH 7.4 which revealed its promising potential for anticancer drug delivery applications. Bioassay results revealed that the co-drug-loaded MgAl-LDH/Fe-MOF/D-Man has higher cytotoxicity on MDA-MB 231 cells. At last, fluorescence microscopy and flow cytometric analysis confirmed the successful uptake of MgAl-LDH/Fe-MOF/D-Man into MDA-MB 231 cell lines, as well as its bioimaging potential. A survey in the published literature approved that this work is the first report on the evaluation of the MgAl-LDH/Fe-MOF/D-Man for targeted co-delivery of both MTX and DOX. Finally, results collectively demonstrate the importance of the biocompatible MgAl-LDH/Fe-MOF/D-Man as a hopeful candidate for biomedicinal applications from the targeted co-drug delivery and bioimaging potential viewpoints.
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Affiliation(s)
- Malihe Pooresmaeil
- Polymer Research Laboratory, Department of Organic and Biochemistry, Faculty of Chemistry, University of Tabriz, Tabriz, Iran
| | - Hassan Namazi
- Polymer Research Laboratory, Department of Organic and Biochemistry, Faculty of Chemistry, University of Tabriz, Tabriz, Iran; Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Science, Tabriz, Iran.
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23
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Kenee PRM, Christie AL, Zimmern PE. Cranberry Supplement, D-Mannose, and Other OTC Modalities for Prevention of Recurrent UTI in Women Post-Electrofulguration. Int J Womens Health 2022; 14:643-653. [PMID: 35535150 PMCID: PMC9078870 DOI: 10.2147/ijwh.s355469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/23/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To assess patient reliance on various over-the-counter (OTC) modalities used for prevention of recurrent urinary tract infection (RUTI) after electrofulguration (EF). Patients and Methods Following IRB approval, qualifying women were offered a short survey over the phone by a medical researcher to collect information about their use of various OTC modalities for prophylaxis of RUTI. Data was compared between two cohorts, ≥70 years old and <70 years old, using chi-squared and Student’s t-tests. Results From a database of 324 patients, 163 accepted the interview. 17% (28/163) reported current use of cranberry supplements, 10% (16/163) D-mannose supplements, and 42% (69/163) another non-prescription modality for RUTI prophylaxis. The non-geriatric (<70 years old) cohort spent, on average, $80 less annually on cranberry/D-mannose supplements (P=0.043) than the geriatric cohort and were more likely to use non-prescription modalities for the prevention of UTI (52% vs 30%; P=0.0061). Individuals using D-mannose were also much more likely to purchase their product online compared to those using cranberry supplements (85% vs 56%). Across all modalities, the perceived benefit difference in reducing UTI/year ranged from a median of 0 for Pyridium® (phenazopyridine hydrochloride) to four for probiotics, with D-mannose and cranberry at two/year, and those increasing daily fluid consumption at 2.5 fewer UTI/year. Conclusion Continued use of non-prescription modalities for RUTI prophylaxis were common among women with an EF history, but varied based on age groups. Across both age cohorts, annual expenditure and perceived benefit also varied among different OTC prophylactic modalities. Awareness of type and method of OTC modality implementation by patients with RUTI is essential to aligning use with current field recommendations.
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Affiliation(s)
- Parker R M Kenee
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, 75290-9110, USA
| | - Alana L Christie
- Simmons Comprehensive Cancer Center Biostatistics, UT Southwestern Medical Center, Dallas, TX, 75390-8852, USA
| | - Philippe E Zimmern
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, 75290-9110, USA
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Zhang Y, Zhou Z, Xiao W, Tang Y, Guan W, Wang J, Shu F, Shen J, Gu S, Zhang L, Wang Q, Xie L. Inosine and D-Mannose Secreted by Drug-Resistant Klebsiella pneumoniae Affect Viability of Lung Epithelial Cells. Molecules 2022; 27:2994. [PMID: 35566345 DOI: 10.3390/molecules27092994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 11/29/2022] Open
Abstract
The antibiotic resistance rates of Klebsiella pneumoniae have been steadily increasing in recent years. Nevertheless, the metabolic features of the drug-resistant Klebsiella pneumoniae and its associated benefits for bacterial pathogenicity are far from expounded. This study aims to unravel the unique physiological and metabolic properties specific to drug-resistant K. pneumoniae. Using scanning electron microscopy (SEM), we observed a thicker extracellular mucus layer around a drug-resistant K. pneumonia strain (Kp-R) than a drug-sensitive K. pneumonia strain (Kp-S). Kp-R also produced more capsular polysaccharide (CPS) and biofilm, and appeared to have a significant competitive advantage when co-cultured with Kp-S. Moreover, Kp-R was easier to adhere to and invade A549 epithelial cells than Kp-S but caused less cell-viability damage according to cell counting kit-8 (CCK-8) tests. Immunofluorescence revealed that both Kp-R and Kp-S infection destroyed the tight junctions and F-actin of epithelial cells, while the damage caused by Kp-S was more severe than Kp-R. We detected the extracellular metabolites secreted by the two strains with UHPLC-Q-TOF MS to explore the critical secretion products. We identified 16 predominant compounds that were differentially expressed. Among them, inosine increased the viability of epithelial cells in a dose-dependent manner, and an A2AR antagonist can abolish such enhancement. D-mannose, which was secreted less in Kp-R, inhibited the viability of A549 cells in the range of low doses. These findings provide potential targets and research strategies for preventing and treating drug-resistant K. pneumoniae infections.
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Hu M, Chen Y, Deng F, Chang B, Luo J, Dong L, Lu X, Zhang Y, Chen Z, Zhou J. D-Mannose Regulates Hepatocyte Lipid Metabolism via PI3K/Akt/mTOR Signaling Pathway and Ameliorates Hepatic Steatosis in Alcoholic Liver Disease. Front Immunol 2022; 13:877650. [PMID: 35464439 PMCID: PMC9021718 DOI: 10.3389/fimmu.2022.877650] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
This study investigated the protective properties and mechanisms of D-mannose against hepatic steatosis in experimental alcoholic liver disease (ALD). Drinking-water supplementation of D-mannose significantly attenuated hepatic steatosis in a standard mouse ALD model established by chronic-binge ethanol feeding, especially hepatocyte lipid deposition. This function of D-mannose on lipid accumulation in hepatocytes was also confirmed using ethanol-treated primary mouse hepatocytes (PMHs) with a D-mannose supplement. Meanwhile, D-mannose regulated lipid metabolism by rescuing ethanol-mediated reduction of fatty acid oxidation genes (PPARα, ACOX1, CPT1) and elevation of lipogenic genes (SREBP1c, ACC1, FASN). PI3K/Akt/mTOR signaling pathway was involved in this effect of D-mannose on lipid metabolism since PI3K/Akt/mTOR pathway inhibitors or agonists could abolish this effect in PMHs. Overall, our findings suggest that D-mannose exhibits its anti-steatosis effect in ALD by regulating hepatocyte lipid metabolism via PI3K/Akt/mTOR signaling pathway.
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Affiliation(s)
- Mengyao Hu
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yu Chen
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Department of Medical Laboratory, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Fan Deng
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Department of Medical Laboratory, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Bo Chang
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Jialiang Luo
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Department of Medical Laboratory, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Lijun Dong
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Department of Medical Laboratory, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Xiao Lu
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yi Zhang
- Department of Medical Laboratory, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Zhengliang Chen
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Jia Zhou
- Department of Immunology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
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Ching CB. Non-antibiotic Approaches to Preventing Pediatric UTIs: a Role for D-Mannose, Cranberry, and Probiotics? Curr Urol Rep 2022. [PMID: 35441976 DOI: 10.1007/s11934-022-01094-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW While antibiotics have been a staple in the management and even prevention of urinary tract infections (UTIs), it is not without significant consequences due to intolerance and development of antibiotic resistant bacteria. These concerns necessitate alternatives to antibiotic use in the management of pediatric UTIs. This review seeks to evaluate non-antibiotic means of preventing UTI in the pediatric population. RECENT FINDINGS The search for preventative alternatives to antibiotics has included D-mannose, cranberry, and probiotics. These products similarly work through competitive inhibition of uropathogens in the urinary tract. Pediatric studies exist highlighting the use of cranberry extract/juice and probiotics in UTI prevention, although significant heterogeneity amongst studies have limited overarching recommendations for their use. Data of D-mannose use is extrapolated from adult literature. More studies are required in the utility of each treatment, with some emphasis on larger sample sizes and clarifications regarding dosing and formulation.
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Pani A, Valeria L, Dugnani S, Senatore M, Scaglione F. Pharmacodynamics of D-mannose in the prevention of recurrent urinary infections. J Chemother 2022; 34:459-464. [PMID: 35416116 DOI: 10.1080/1120009x.2022.2061184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Recurring urinary tract infections (rUTIs) are frequently caused by Escherichia coli, which invades urothelial cells and forms quiescent bacterial reservoirs. D-mannose, an inert monosaccharide, represents a notable agent for rUTI prevention; however, there is no agreement on its dosage. To provide pharmacological basis for an effective dose, we evaluated its ability to inhibit adhesion of E. coli to urothelial cells. E. coli strains isolated from the urine of a woman with recurrent urinary tract infections were selected according to adhesion capacity. Anti-adhesive efficacy and invasion were tested using the TCC-5637 urothelial cell line. The IC50 for the anti-adhesive efficacy and anti-invasion activity of D-mannose were 0.51 mg/ml and 0.30 mg/ml, respectively, both with concentration-dependent inhibition. Lastly, the biofilm interference of D-mannose was evaluated to be 50 mg/ml. D-mannose inhibited the adhesion of E. coli to urothelial cells at high concentrations, whereas inhibition of invasion occurred at much lower concentrations.
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Affiliation(s)
- Arianna Pani
- Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy
| | - Lucini Valeria
- Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy
| | - Silvana Dugnani
- Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy
| | - Michele Senatore
- Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy
| | - Francesco Scaglione
- Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy
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Ala-Jaakkola R, Laitila A, Ouwehand AC, Lehtoranta L. Role of D-mannose in urinary tract infections - a narrative review. Nutr J 2022; 21:18. [PMID: 35313893 PMCID: PMC8939087 DOI: 10.1186/s12937-022-00769-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/04/2022] [Indexed: 12/27/2022] Open
Abstract
Urinary tract infections (UTIs) are one of the most prevalent bacterial diseases worldwide. Despite the efficacy of antibiotics targeted against UTI, the recurrence rates remain significant among the patients. Furthermore, the development of antibiotic resistance is a major concern and creates a demand for alternative treatment options. D-mannose, a monosaccharide naturally found in fruits, is commonly marketed as a dietary supplement for reducing the risk for UTIs. Research suggests that supplemented D-mannose could be a promising alternative or complementary remedy especially as a prophylaxis for recurrent UTIs. When excreted in urine, D-mannose potentially inhibits Escherichia coli, the main causative organism of UTIs, from attaching to urothelium and causing infection. In this review, we provide an overview of UTIs, E. coli pathogenesis and D-mannose and outline the existing clinical evidence of D-mannose in reducing the risk of UTI and its recurrence. Furthermore, we discuss the potential effect mechanisms of D-mannose against uropathogenic E.coli.
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Affiliation(s)
- Reeta Ala-Jaakkola
- Health & Biosciences, International Flavors & Fragrances, Sokeritehtaantie 20, FIN-02460, Kantvik, Finland
| | - Arja Laitila
- Health & Biosciences, International Flavors & Fragrances, Sokeritehtaantie 20, FIN-02460, Kantvik, Finland
| | - Arthur C Ouwehand
- Health & Biosciences, International Flavors & Fragrances, Sokeritehtaantie 20, FIN-02460, Kantvik, Finland.
| | - Liisa Lehtoranta
- Health & Biosciences, International Flavors & Fragrances, Sokeritehtaantie 20, FIN-02460, Kantvik, Finland
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Zhang R, Yang Y, Dong W, Lin M, He J, Zhang X, Tian T, Yang Y, Chen K, Lei QY, Zhang S, Xu Y, Lv L. D-mannose facilitates immunotherapy and radiotherapy of triple-negative breast cancer via degradation of PD-L1. Proc Natl Acad Sci U S A 2022; 119:e2114851119. [PMID: 35181605 DOI: 10.1073/pnas.2114851119] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 12/14/2022] Open
Abstract
PD-L1 is well known as an immune checkpoint molecule, which suppresses immune surveillance through binding to its receptor PD-1. Intracellular PD-L1 can also protect messenger RNAs of several DNA damage repair–related genes from degradation and enhance tumor resistance to DNA-damaging therapy. Triple-negative breast cancer (TNBC) has the worst prognosis and highest risk of distant relapse in breast cancer and shows resistance to immunotherapy and radiotherapy. In this study, we found that D-mannose can promote the degradation of PD-L1 and significantly enhance immunotherapy and radiotherapy of TNBC. Since TNBC treatment is still a clinical challenge, our findings provide strategies to enhance the therapeutic efficacy of TNBC and may have clinical application. Breast cancer is the most frequent malignancy in women worldwide, and triple-negative breast cancer (TNBC) patients have the worst prognosis and highest risk of recurrence. The therapeutic strategies for TNBC are limited. It is urgent to develop new methods to enhance the efficacy of TNBC treatment. Previous studies demonstrated that D-mannose, a hexose, can enhance chemotherapy in cancer and suppress the immunopathology of autoimmune diseases. Here, we show that D-mannose can significantly facilitate TNBC treatment via degradation of PD-L1. Specifically, D-mannose can activate AMP-activated protein kinase (AMPK) to phosphorylate PD-L1 at S195, which leads to abnormal glycosylation and proteasomal degradation of PD-L1. D-mannose–mediated PD-L1 degradation promotes T cell activation and T cell killing of tumor cells. The combination of D-mannose and PD-1 blockade therapy dramatically inhibits TNBC growth and extends the lifespan of tumor-bearing mice. Moreover, D-mannose–induced PD-L1 degradation also results in messenger RNA destabilization of DNA damage repair–related genes, thereby sensitizing breast cancer cells to ionizing radiation (IR) treatment and facilitating radiotherapy of TNBC in mice. Of note, the effective level of D-mannose can be easily achieved by oral administration in mice. Our study unveils a mechanism by which D-mannose targets PD-L1 for degradation and provides methods to facilitate immunotherapy and radiotherapy in TNBC. This function of D-mannose may be useful for clinical treatment of TNBC.
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Jin Cho E, Gyo Lee Y, Song Y, Nguyen DT, Bae HJ. An integrated process for conversion of spent coffee grounds into value-added materials. Bioresour Technol 2022; 346:126618. [PMID: 34954357 DOI: 10.1016/j.biortech.2021.126618] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Spent coffee grounds (SCG) are inexpensive materials with a complex composition that makes them promising feedstocks for a biorefinery.Here, conversion of SCG into a wide range of high value-added products (coffee oil, bio-ethanol, D-mannose, manno-oligosaccharide (MOS), cafestol and kahweol) using a novel integrated system was evaluated. The process involves oil extraction, MOS production by mannanase obtained from Penicillium purpurogenum, NaOH (Na) and hydrogen peroxide (HP) pretreatment for the degradation of lignin and phenolic compounds, diterpenes extraction, enzymatic hydrolysis, and fermentation, which can be performed using environmentally friendly technologies. Approximately 97 mL of coffee oil, 164 g of D-mannose, 102 g of MOS, 99 g of bioethanol and a dash of cafestol/kahweol were produced from 1 kg of dry SCG. Producing high-value co-products from SCG using an integrated approach as demonstrated here may be an efficient strategy to reduce waste generation, while improving the economics of the biorefinery production process.
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Affiliation(s)
- Eun Jin Cho
- Bio-Energy Research Center, Chonnam National University, Gwangju 500-757, Republic of Korea
| | - Yoon Gyo Lee
- Department of Bioenergy Science and Technology, Chonnam National University, Gwangju 500-757, Republic of Korea
| | - Younho Song
- Bio-Energy Research Center, Chonnam National University, Gwangju 500-757, Republic of Korea
| | | | - Hyeun-Jong Bae
- Bio-Energy Research Center, Chonnam National University, Gwangju 500-757, Republic of Korea; Department of Bioenergy Science and Technology, Chonnam National University, Gwangju 500-757, Republic of Korea.
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31
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Hwang D, Boehm A, Rostami A, Zhang GX, Ciric B. Oral D-mannose treatment suppresses experimental autoimmune encephalomyelitis via induction of regulatory T cells. J Neuroimmunol 2022; 362:577778. [PMID: 34814011 PMCID: PMC8724449 DOI: 10.1016/j.jneuroim.2021.577778] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 01/17/2023]
Abstract
D-mannose (D-m) is a glucose epimer found in natural products, especially fruits. In mouse models of diabetes and airway inflammation, D-m supplementation via drinking water attenuated pathology by modifying cellular energy metabolism, leading to the activation of latent transforming growth factor beta (TGF-β), which in turn induced T regulatory cells (Tregs). Given that Tregs are important in controlling neuroinflammation in experimental autoimmune encephalomyelitis (EAE) and likely in multiple sclerosis (MS), we hypothesized that D-m could also suppress EAE. We found that D-m delayed disease onset and reduced disease severity in two models of EAE. Importantly, D-m treatment prevented relapses in a relapsing-remitting model of EAE, which mimics the most common clinical manifestation of MS. EAE suppression was accompanied by increased frequency of CD4+FoxP3+ Tregs in the central nervous system, suggesting that EAE suppression resulted from Treg cell induction by D-m. These findings suggest that D-m has the potential to be a safe and low-cost complementary therapy for MS.
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Affiliation(s)
- Daniel Hwang
- Department of Neurology, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA
| | - Alexandra Boehm
- Department of Neurology, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA
| | - Abdolmohamad Rostami
- Department of Neurology, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA
| | - Guang-Xian Zhang
- Department of Neurology, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA
| | - Bogoljub Ciric
- Department of Neurology, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA.,Corresponding author at: Department of Neurology, Jefferson Hospital for Neuroscience, Thomas Jefferson University, 900 Walnut Street, Suite 300, Philadelphia, PA, 19107.
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Wang P, Zheng Y, Li Y, Shen J, Dan M, Wang D. Recent advances in biotransformation, extraction and green production of D-mannose. Curr Res Food Sci 2022; 5:49-56. [PMID: 35005631 PMCID: PMC8718577 DOI: 10.1016/j.crfs.2021.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/10/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
D-mannose is a natural and biologically active monosaccharide. It is the C-2 epimer of glucose and a component of a variety of polysaccharides in plants. In addition, D-mannose also naturally exists in some cells of the human body and participates in the immune regulation of cells as a prebiotic. Its good physiological benefits to human health and wide application in the food and pharmaceutical industries have attracted widespread attention. Therefore, in-depth research on preparation methods of D-mannose has been widely developed. This article summarizes the main production methods of D-mannose in recent years, especially the in-depth excavation from biomass raw materials such as coffee grounds, konjac flour, acai berry, etc., to provide new ideas for the green manufacture of D-mannose. Various methods of recent mannose production were comprehensively summarized. The new technical progress of obtaining mannose from biomass as emphatically discussed. Discuss various preparation methods including different pretreatments, enzymatic hydrolysis, etc.
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Affiliation(s)
- Peiyao Wang
- College of Food Science, Southwest University, Chongqing, 400715, China
| | - Yuting Zheng
- College of Food Science, Southwest University, Chongqing, 400715, China
| | - Yanping Li
- College of Food Science, Southwest University, Chongqing, 400715, China
| | - Ji Shen
- College of Food Science, Southwest University, Chongqing, 400715, China
| | - Meiling Dan
- College of Food Science, Southwest University, Chongqing, 400715, China
| | - Damao Wang
- College of Food Science, Southwest University, Chongqing, 400715, China
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Gao X, Liu N, Wang Z, Gao J, Zhang H, Li M, Du Y, Gao X, Zheng A. Development and Optimization of Chitosan Nanoparticle-Based Intranasal Vaccine Carrier. Molecules 2021; 27:molecules27010204. [PMID: 35011436 PMCID: PMC8746444 DOI: 10.3390/molecules27010204] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022]
Abstract
Chitosan is a natural polysaccharide, mainly derived from the shell of marine organisms. At present, chitosan has been widely used in the field of biomedicine due to its special characteristics of low toxicity, biocompatibility, biodegradation and low immunogenicity. Chitosan nanoparticles can be easily prepared. Chitosan nanoparticles with positive charge can enhance the adhesion of antigens in nasal mucosa and promote its absorption, which is expected to be used for intranasal vaccine delivery. In this study, we prepared chitosan nanoparticles by a gelation method, and modified the chitosan nanoparticles with mannose by hybridization. Bovine serum albumin (BSA) was used as the model antigen for development of an intranasal vaccine. The preparation technology of the chitosan nanoparticle-based intranasal vaccine delivery system was optimized by design of experiment (DoE). The DoE results showed that mannose-modified chitosan nanoparticles (Man-BSA-CS-NPs) had high modification tolerance and the mean particle size and the surface charge with optimized Man-BSA-CS-NPs were 156 nm and +33.5 mV. FTIR and DSC results confirmed the presence of Man in Man-BSA-CS-NPs. The BSA released from Man-BSA-CS-NPs had no irreversible aggregation or degradation. In addition, the analysis of fluorescence spectroscopy of BSA confirmed an appropriate binding constant between CS and BSA in this study, which could improve the stability of BSA. The cell study in vitro demonstrated the low toxicity and biocompatibility of Man-BSA-CS-NPs. Confocal results showed that the Man-modified BSA-FITC-CS-NPs promote the endocytosis and internalization of BSA-FITC in DC2.4 cells. In vivo studies of mice, Man-BSA-CS-NPs intranasally immunized showed a significantly improvement of BSA-specific serum IgG response and the highest level of BSA-specific IgA expression in nasal lavage fluid. Overall, our study provides a promising method to modify BSA-loaded CS-NPs with mannose, which is worthy of further study.
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Affiliation(s)
| | | | | | | | | | | | - Yimeng Du
- Correspondence: (Y.D.); (X.G.); (A.Z.); Tel.: +86-010-6693-1694 or +86-135-2046-7936 (A.Z.)
| | - Xiang Gao
- Correspondence: (Y.D.); (X.G.); (A.Z.); Tel.: +86-010-6693-1694 or +86-135-2046-7936 (A.Z.)
| | - Aiping Zheng
- Correspondence: (Y.D.); (X.G.); (A.Z.); Tel.: +86-010-6693-1694 or +86-135-2046-7936 (A.Z.)
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De Seta F, Johnson Z, Stabile G, Martin A, Larsen B. Rational development and evaluation of novel formulations for urinary health. Eur J Obstet Gynecol Reprod Biol 2021; 269:90-97. [PMID: 34979364 DOI: 10.1016/j.ejogrb.2021.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/23/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Urinary tract infections (UTI) among women form a substantial part of medical practice and both patients and medical professionals have an interest in non-antibiotic treatments and preventative measures. This research provides preliminary data on a multi-functional composition, DAPAD, which explored several biologic activities of relevance to UTI. STUDY DESIGN This formulation included D-mannose, citric acid, three prebiotic compounds, and extracts of dandelion and astragalus. Studies performed employed 4 bacterial strains that have relevance to UTI including E. coli, Proteus mirabilis, Streptococcus agalactiae and Enterococcus faecalis. RESULTS Key findings from in vitro studies included: DAPAD at full- and half-strength inhibited growth of all UTI bacteria. Evidence for D-mannose agglutination of E. coli was demonstrated. D-mannose also showed unexpected effects on bacterial membrane integrity with vital staining and modest growth restriction. We did not demonstrate growth inhibition by dandelion or astragalus extracts but the latter showed diminished cytokine elaboration by bladder epithelial cells. CONCLUSION DAPAD is a multifunctional composition that may warrant further development as a UTI treatment or preventive if supported by clinical evaluation.
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Affiliation(s)
- Francesco De Seta
- Department of Medical Sciences, University of Trieste, Institute for Maternal and Child Health- IRCCS, Burlo Garofolo, Trieste, Italy
| | - Zoe Johnson
- OB/GYN PGY1, Metro Health Hospital, Wyoming, MI, USA
| | - Guglielmo Stabile
- Institute for Maternal and Child Health-IRCCS, Burlo Garofolo, Trieste, Italy.
| | | | - Bryan Larsen
- Marian University College of Osteopathic Medicine (Retired), Indianapolis, IN, USA
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Abstract
BACKGROUND Although Abelson (ABL) tyrosine kinase inhibitors (TKIs) have demonstrated potency against chronic myeloid leukemia (CML), resistance to ABL TKIs can develop in CML patients after discontinuation of therapy. OBJECTIVE Glucose metabolism may be altered in CML cells because glucose is a key metabolite used by tumor cells. We investigated whether D-mannose treatment induced metabolic changes in CML cells and reduced CML growth in the presence of ABL TKIs. METHODS We investigated whether D-mannose treatment induced metabolic changes in CML cells and reduced CML growth in the presence of ABL TKIs. RESULTS Treatment with D-mannose for 72 h inhibited the growth of K562 cells. Combined treatment using ABL TKIs and D-mannose induced a significantly higher level of cytotoxicity in Philadelphia chromosome (Ph)-positive leukemia cells than in control cells. In the mouse model, severe toxicity was observed as evidenced by body weight loss in the ponatinib and D-mannose combination treatment groups. CONCLUSION Our results indicate that metabolic reprogramming may be a useful strategy against Ph-positive leukemia cells. However, caution should be exercised during clinical applications.
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MESH Headings
- Animals
- Drug Resistance, Neoplasm/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Mannose/pharmacology
- Mannose/therapeutic use
- Mice
- Philadelphia Chromosome
- Protein Kinase Inhibitors/pharmacology
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Jalali Motlagh N, Wang C, Kuellenberg EG, Wojtkiewicz GR, Schmidt S, Chen JW. D-Mannose Slows Glioma Growth by Modulating Myeloperoxidase Activity. Cancers (Basel) 2021; 13:6360. [PMID: 34944979 DOI: 10.3390/cancers13246360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Inflammation and oxidative stress are important host defense responses. However, while the host response can be cytotoxic and kill tumor cells, tumor cells can also alter and exploit the host immune environment to further their survival. Thus, the host response can impact both tumor suppression and progression. Modulating the tumor–host response interaction to favor tumor suppression would be highly desirable. D-mannose has been found to have anti-inflammatory properties and can block signaling related to myeloperoxidase (MPO), a highly oxidizing pro-inflammatory enzyme secreted in host defense. However, the effect of D-mannose on host immune response in the glioma microenvironment has not been explored. We found that D-mannose slowed glioma growth by increasing MPO activity and oxidative stress in the glioma microenvironment. Our findings revealed that D-mannose may be able to shift the host immune response toward tumor suppression and could be a potential new therapeutic direction for these difficult-to-treat tumors. Abstract Host immune response in the tumor microenvironment plays key roles in tumorigenesis. We hypothesized that D-mannose, a simple sugar with anti-inflammatory properties, could decrease oxidative stress and slow glioma progression. Using a glioma stem cell model in immunocompetent mice, we induced gliomas in the brain and tracked MPO activity in vivo with and without D-mannose treatment. As expected, we found that D-mannose treatment decreased the number of MPO+ cells and slowed glioma progression compared to PBS-treated control animals with gliomas. Unexpectedly, instead of decreasing MPO activity, D-mannose increased MPO activity in vivo, revealing that D-mannose boosted the MPO activity per MPO+ cell. On the other hand, D-glucose had no effect on MPO activity. To better understand this effect, we examined the effect of D-mannose on bone marrow-derived myeloid cells. We found that D-mannose modulated MPO activity via two mechanisms: directly via N-glycosylation of MPO, which boosted the MPO activity of each molecule, and indirectly by increasing H2O2 production, the main substrate for MPO. This increased host immune response acted to reduce tumor size, suggesting that increasing MPO activity such as through D-mannose administration may be a potential new therapeutic direction for glioma treatment.
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Bernikov AN, Kupriyanov AA, Stroganov RV, O AA, Khodyreva LA, Zaitsev AV. [Lower urinary tract symptoms and COVID-19]. Urologiia 2021:78-83. [PMID: 34743438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The data presented in the review showed that the coronavirus affects not only the lungs, but also the organs of the urinary system. The new virus causes a mosaic, multi-organ disease with severe consequences after the egg and has a wide organotropism. The role of SARS-CoV-2 in the development of lower urinary tract symptoms (LUTs), which are manifested by frequent, imperative urges, dysuria, nocturia, is not entirely clear. It is assumed that biologically active substances, the activation of which is caused by a virus, play a certain role in the development of SNMP, namely the expression of angiotensin converting enzyme 2 (ACE2), cytokines, activation of toll-like receptor 4 (TLR4), etc. An increase in cytokines that are released into the urine and / or expressed in the bladder and the presence of SNMP in patients with coronavirus infection have been called de novo urinary symptoms or COVID-19 associated cystitis (CAC) in the literature. Urinary symptoms de novo or associated cystitis COVID-19 (CAC) develops against the background of a complete lack of data for the presence of a bacterial pathogen in the urine. Despite the unusual manifestation of coronavirus infection, similar mechanisms of damage to urothelial cells in viral and bacterial infections give us the right to think about the use of pathogenetically justified prevention of the development of an inflammatory reaction in the urinary tract, as well as short-and long-term consequences of this disease. For this purpose, it is necessary to recommend drugs that have a multifactorial effect: diuretic, anti-adhesive, anti-inflammatory and regulate the local immunity of the bladder mucosa. We assume that against this background, we can expect a decrease in the number of complications from the organs of the urinary system, and more successful rehabilitation of patients with coronavirus infection and in the post-ovarian period. Final conclusions and recommendations will be available after well-planned clinical trials have been conducted.
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Affiliation(s)
- A N Bernikov
- Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Ministry of Health of the Russian Federation, Moscow, Russia
- State Budgetary Institution Research Institute of Health Organization and Medical Management of the Moscow Department of Health, Moscow, Russia
| | - A A Kupriyanov
- Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Ministry of Health of the Russian Federation, Moscow, Russia
- State Budgetary Institution Research Institute of Health Organization and Medical Management of the Moscow Department of Health, Moscow, Russia
| | - R V Stroganov
- Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Ministry of Health of the Russian Federation, Moscow, Russia
- State Budgetary Institution Research Institute of Health Organization and Medical Management of the Moscow Department of Health, Moscow, Russia
| | - Arefieva A O
- Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Ministry of Health of the Russian Federation, Moscow, Russia
- State Budgetary Institution Research Institute of Health Organization and Medical Management of the Moscow Department of Health, Moscow, Russia
| | - L A Khodyreva
- Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Ministry of Health of the Russian Federation, Moscow, Russia
- State Budgetary Institution Research Institute of Health Organization and Medical Management of the Moscow Department of Health, Moscow, Russia
| | - A V Zaitsev
- Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Ministry of Health of the Russian Federation, Moscow, Russia
- State Budgetary Institution Research Institute of Health Organization and Medical Management of the Moscow Department of Health, Moscow, Russia
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Faggian M, Bernabè G, Valente M, Francescato S, Baratto G, Brun P, Castagliuolo I, Dall'Acqua S, Peron G. Characterization of PACs profile and bioactivity of a novel nutraceutical combining cranberry extracts with different PAC-A oligomers, D-mannose and ascorbic acid: An in vivo/ex vivo evaluation of dual mechanism of action on intestinal barrier and urinary epithelium. Food Res Int 2021; 149:110649. [PMID: 34600651 DOI: 10.1016/j.foodres.2021.110649] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/04/2021] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Abstract
In this paper, an A-type procyanidin (PAC)-rich cranberry extract (CB-B) was obtained mixing different extracts and was formulated with D-mannose and ascorbic acid to obtain a novel nutraceutical (URO-F) aimed at preventing non-complicated bacterial urinary tract infections (UTIs). To assess the bioactivity of CB-B and URO-F, urine samples collected from six healthy volunteers undergoing a 2-days oral consumption of 0.41 g/day of CB-B or 10 g/day of URO-F (corresponding to 72 mg/day of PACs) were tested against uropathogenic E. coli (UPEC) incubated on urinary bladder epithelial cells (T24). Urinary markers of CB-B and URO-F consumption were assessed in the same urine output by UPLC-QTOF-based untargeted metabolomics approach. CB-B and URO-F were evaluated for their ability to promote the intestinal barrier function by restoring the trans-epithelial electrical resistance (TEER) and to inhibit the production of inflammatory cytokines in intestinal epithelial Caco2 cells. CB-B was characterized by a high PAC-A content (70% of total PACs) and a broad distribution of different PACs polymers (dimers-hexamers). Urine from subjects consuming CB-B and URO-F showed a significant effect in reducing the adhesion of UPEC to urothelium in vitro, supporting their efficacy as anti-adhesive agents after oral intake. CB-B inhibited the release of cytokine IL-8, and both products were effective in restoring the TEER. Overall, our results show that the beneficial effects of CB-B and URO-F on UTIs are not only due to the antiadhesive activity of cranberry on UPEC in the urothelium, but also to a multi-target activity involving anti-inflammatory and permeability-enhancing effects on intestinal epithelium.
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Affiliation(s)
- Marta Faggian
- Unired srl, Via Niccolò Tommaseo 69, 35131 Padova, Italy.
| | - Giulia Bernabè
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35121 Padova, Italy.
| | - Marco Valente
- Unifarco spa, Via Cal Longa 62, 32035 Santa Giustina, Belluno, Italy.
| | | | - Gianni Baratto
- Unired srl, Via Niccolò Tommaseo 69, 35131 Padova, Italy; Unifarco spa, Via Cal Longa 62, 32035 Santa Giustina, Belluno, Italy.
| | - Paola Brun
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35121 Padova, Italy.
| | - Ignazio Castagliuolo
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35121 Padova, Italy.
| | - Stefano Dall'Acqua
- Unired srl, Via Niccolò Tommaseo 69, 35131 Padova, Italy; Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via Marzolo 5, 35131 Padova, Italy.
| | - Gregorio Peron
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via Marzolo 5, 35131 Padova, Italy.
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Kuzmin IV, Slesarevskaya MN, Al-Shukri SH. [Antiadhesive strategy for non-antibacterial prophylaxis of recurrent lower urinary tract infections]. Urologiia 2021:5-12. [PMID: 34251095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The importance of recurrent lower urinary tract infection (LUTI) is associated with its high frequency, a significant decrease in the quality of life and insufficient efficiency of currently available treatment methods. Due to the high antibiotic resistance of uropathogens, the role of alternative therapeutic strategies increases, including substances with antiadhesive properties. AIM to evaluate the efficiency of a biologically active additive (BAA) "Ecocystin" containing D-mannose and inulin for the prevention of recurrent LUTI in women. MATERIALS AND METHODS A total of 74 women aged 21 to 75 years (mean 47.4+/-13.6 years) with recurrent LUTI were included in the study. After the initial treatment of LUTI all the patients were divided into two groups. Patients of the main group (n=44) received BAA "Ecocystin", containing D-mannose with antiadhesive properties and inulin, which is a prebiotic, to prevent recurrence of LUTI. Ecocystin was prescribed 1 sachet packet 2 times a day for the first 3 days, and then 1 sachet packet 1 time a day for 6 months. The Ecocystin sachet contains 1.5 g of D-mannose and 1.5 g of inulin. In the control group (n=30) were not prescribed Ecocystin. Clinical indicators were assessed on the 3rd day, as well as after 3 and 6 months from the beginning of the study. RESULTS During the first 3 months, recurrent LUTI were diagnosed in 51.7% of patients in the control group and only in 15.9% of patients in the main group (p=0.002). By the 6th month of follow-up, relapses were seen in 75.9% and 29.5% of patients, respectively (p<0.001). In the main group a significant increase in the time interval before the onset of recurrence was found. During the first three months of follow-up, the recurrence of LUTI in the main group developed on average after 43.4+/-14.3 days compared to 28.2+/-13.5 days in the control group (p=0.026). In addition, severity and duration of recurrent LUTI in patients of the main group were less pronounced than in the control group. CONCLUSION Our results showed that Ecocystin is an effective drug for the prevention of recurrences in patients with recurrent LUTI. Considering antiadhesive properties of D-mannose, which is part of Ecocystin, this drug can be recommended as a pathogenetically justified alternative to the antibacterial drugs.
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Affiliation(s)
- I V Kuzmin
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - M N Slesarevskaya
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - S H Al-Shukri
- Department of Urology of FGBOU VO Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
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De Nunzio C, Bartoletti R, Tubaro A, Simonato A, Ficarra V. Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives. Antibiotics (Basel) 2021; 10:373. [PMID: 33915821 DOI: 10.3390/antibiotics10040373] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Urinary tract infections (UTI) are highly frequent in women, with a significant impact on healthcare resources. Although antibiotics still represent the standard treatment to manage recurrent UTI (rUTI), D-mannose, an inert monosaccharide that is metabolized and excreted in urine and acts by inhibiting bacterial adhesion to the urothelium, represents a promising nonantibiotic prevention strategy. The aim of this narrative review is to critically analyze clinical studies reporting data concerning the efficacy and safety of D-mannose in the management of rUTIs. METHODS A non-systematic literature search, using the Pubmed, EMBASE, Scopus, Web of science, Cochrane Central Register of Controlled Trials, and Cochrane Central Database of Systematic Reviews databases, was performed for relevant articles published between January 2010 and January 2021. The following Medical Subjects Heading were used: "female/woman", "urinary tract infection", and "D-mannose". Only clinical studies, systematic reviews, and meta-analyses reporting efficacy or safety data on D-mannose versus placebo or other competitors were selected for the present review. Evidence was limited to human data. The selected studies were organized in two categories according to the presence or not of a competitor to D-mannose. RESULTS After exclusion of non-pertinent studies/articles, 13 studies were analyzed. In detail, six were randomized controlled trials (RCTs), one a randomized cross-over trial, five prospective cohort studies, and one a retrospective analysis. Seven studies compared D-mannose to placebo or others drugs/dietary supplements. Six studies evaluated the efficacy of D-mannose comparing follow-up data with the baseline. D-mannose is well tolerated, with few reported adverse events (diarrhea was reported in about 8% of patients receiving 2 g of D-mannose for at least 6 months). Most of the studies also showed D-mannose can play a role in the prevention or rUTI or urodynamics-associated UTI and can overlap antibiotic treatments in some cases. The possibility to combine D-mannose with polyphenols or Lactobacillus seems another important option for UTI prophylaxis. However, the quality of the collected studies was very low, generating, consequently, a weak grade of recommendations as suggested by international guidelines. Data on D-mannose dose, frequency, and duration of treatment are still lacking. CONCLUSION D-mannose alone or in combination with several dietary supplements or Lactobacillus has a potential role in the non antimicrobial prophylaxis or recurrent UTI in women. Despite its frequent prescription in real-life practice, we believe that further well-designed studies are urgently needed to definitively support the role of D-mannose in the management of recurrent UTIs in women.
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Scaglione F, Musazzi UM, Minghetti P. Considerations on D-mannose Mechanism of Action and Consequent Classification of Marketed Healthcare Products. Front Pharmacol 2021; 12:636377. [PMID: 33762956 PMCID: PMC7982833 DOI: 10.3389/fphar.2021.636377] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/05/2021] [Indexed: 01/07/2023] Open
Abstract
Urinary tract infections (UTIs) are very common disorders that affect adult women. Indeed, 50% of all women suffer from UTIs at least one time in their lifetime; 20-40% of them experience recurrent episodes. The majority of UTIs seems to be due to uropathogenic Escherichia coli that invades urothelial cells and forms quiescent bacterial reservoirs. Recurrences of UTIs are often treated with non-prescribed antibiotics by the patients, with increased issues connected to antibiotics resistance. D-mannose, a monosaccharide that is absorbed but not metabolized by the human body, has been proposed as an alternative approach for managing UTIs since it can inhibit the bacterial adhesion to the urothelium. This manuscript discusses the mechanisms through which D-mannose acts to highlight the regulatory aspects relevant for determining the administrative category of healthcare products placed on the market. The existing literature permits to conclude that the anti-adhesive effect of D-mannose cannot be considered as a pharmacological effect and, therefore, D-mannose-based products should be classified as medical devices composed of substances.
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Affiliation(s)
- Francesco Scaglione
- Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milano, Milan, Italy
- Clinical Pharmacology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Umberto M. Musazzi
- Department of Pharmaceutical Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Paola Minghetti
- Department of Pharmaceutical Sciences, Università Degli Studi Di Milano, Milan, Italy
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Abstract
BACKGROUND Systemic lupus erythematosus is an autoimmune disease characterized by an overproduction of autoantibodies resulting from dysregulation in multiple immune cell types. D-mannose is a C- 2 epimer of glucose that exhibits immunoregulatory effects in models of autoimmune diseases, such as type 1 diabetes, induced rheumatoid arthritis, and airway inflammation. This study was conducted to evaluate the efficacy of D-mannose treatment in mouse models of lupus. RESULTS Firstly, the effect of D-Mannose was evaluated by flow cytometry on the in vitro activation of non-autoimmune C57BL/6 (B6) bone marrow-derived dendritic cells (BMDCs) and their ability to induce antigen-specific CD4+ T cell proliferation and activation. D-mannose inhibited the maturation of BMDCs and their induction of antigen-specific T cell proliferation and activation. In vivo, D-mannose increased the frequency of Foxp3+ regulatory T cells in unmanipulated B6 mice. To assess the effect of D-mannose in mouse models of lupus, we used the graft-versus-host disease (cGVHD) induced model and the B6.lpr spontaneous model. In the cGVHD model, D-mannose treatment decreased autoantibody production, with a concomitant reduction of the frequency of effector memory and follicular helper T cells as well as germinal center B cells and plasma cells. These results were partially validated in the B6.lpr model of spontaneous lupus. CONCLUSION Overall, our results suggest that D-mannose ameliorates autoimmune activation in models of lupus, at least partially due to its expansion of Treg cells, the induction of immature conventional dendritic cells and the downregulation of effector T cells activation. D-Mannose showed however a weaker immunomodulatory effect in lupus than in other autoimmune diseases.
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Affiliation(s)
- Haiting Wang
- Department of Rheumatology, RenJi Hospital South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiangyu Teng
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, JHMHC 275, Box 100275, Gainesville, FL, 32610-0275, USA
| | - Georges Abboud
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, JHMHC 275, Box 100275, Gainesville, FL, 32610-0275, USA
| | - Wei Li
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, JHMHC 275, Box 100275, Gainesville, FL, 32610-0275, USA
| | - Shuang Ye
- Department of Rheumatology, RenJi Hospital South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Laurence Morel
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, JHMHC 275, Box 100275, Gainesville, FL, 32610-0275, USA.
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Wu H, Chen M, Guang C, Zhang W, Mu W. Identification of a novel recombinant D-lyxose isomerase from Thermoprotei archaeon with high thermostable, weak-acid and nickel ion dependent properties. Int J Biol Macromol 2020; 164:1267-1274. [PMID: 32750472 DOI: 10.1016/j.ijbiomac.2020.07.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Abstract
Recently, production of D-mannose becomes a hotspot owing to it exhibiting many physiological functions on people's health and wide applications in food and pharmaceutical field. The use of biological enzymes to production of D-mannose is of particular receiving considerable concerns due to it possessing many merits over chemical synthesis and plant extraction strategies. D-Lyxose isomerase (D-LIase) plays a pivotal role in preparation of D-mannose from d-fructose through isomerization reaction. Thus, a novel putative D-LIase from thermophiles strain Thermoprotei archaeon which was expressed in E. coli BL21(DE3) was first identified and biochemically characterized. The recombinant D-LIase showed an optimal temperature of 80 and 85 °C and pH of 6.5. It was highly thermostable at 70 °C and 80 °C after incubating for 48 h and 33 h, respectively, with retaining over 50% of the initial activity. A lower concentration of Ni2+ (0.5 mM) could greatly increase the activity by 25-fold, which was rare reported in other D-LIases. It was a dimer structure with melting temperature of 88.3 °C. Under the optimal conditions, 15.8 g L-1 of D-mannose and 33.8 g L-1 of D-xylulose were produced from 80 g L-1 of d-fructose and D-lyxose, respectively. This work provided a promising candidate sugar isomerase T. archaeon D-LIase for the production of D-mannose and D-xylulose.
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Affiliation(s)
- Hao Wu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Ming Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Cuie Guang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Wenli Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, China.
| | - Wanmeng Mu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, China; International Joint Laboratory on Food Safety, Jiangnan University, Wuxi, Jiangsu 214122, China
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Girard M, Douillard C, Debray D, Lacaille F, Schiff M, Vuillaumier-Barrot S, Dupré T, Fabre M, Damaj L, Kuster A, Torre S, Mention K, McLin V, Dobbelaere D, Borgel D, Bauchard E, Seta N, Bruneel A, De Lonlay P. Long term outcome of MPI-CDG patients on D-mannose therapy. J Inherit Metab Dis 2020; 43:1360-1369. [PMID: 33098580 DOI: 10.1002/jimd.12289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/27/2020] [Accepted: 07/15/2020] [Indexed: 11/10/2022]
Abstract
Mannose phosphate isomerase MPI-CDG (formerly CDG-1b) is a potentially fatal inherited metabolic disease which is readily treatable with oral D-mannose. We retrospectively reviewed long-term outcomes of patients with MPI-CDG, all but one of whom were treated with D-mannose. Clinical, biological, and histological data were reviewed at diagnosis and on D-mannose treatment. Nine patients were diagnosed with MPI-CDG at a median age of 3 months. The presenting symptoms were diarrhea (n = 9), hepatomegaly (n = 9), hypoglycemia (n = 8), and protein loosing enteropathy (n = 7). All patients survived except the untreated one who died at 2 years of age. Oral D-mannose was started in eight patients at a median age of 7 months (mean 38 months), with a median follow-up on treatment of 14 years 9 months (1.5-20 years). On treatment, two patients developed severe portal hypertension, two developed venous thrombosis, and 1 displayed altered kidney function. Poor compliance with D-mannose was correlated with recurrence of diarrhea, thrombosis, and abnormal biological parameters including coagulation factors and transferrin profiles. Liver fibrosis persisted despite treatment, but two patients showed improved liver architecture during follow-up. This study highlights (i) the efficacy and safety of D-mannose treatment with a median follow-up on treatment of almost 15 years (ii) the need for life-long treatment (iii) the risk of relapse with poor compliance, (iii) the importance of portal hypertension screening (iv) the need to be aware of venous and renal complications in adulthood.
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Affiliation(s)
- Muriel Girard
- Paediatic Liver Unit, National Reference Center for Biliary Atresia and Genetic Cholestasis and French Network for Rare Liver Disease (Filfoie) Necker-Enfants-Malades University Hospital, APHP, Paris, France
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Université de Paris, Paris, France
| | - Claire Douillard
- Endocrinology and Metabolism department, Reference Metabolism Center of inborn metabolic diseases, Lille University Hospital, Paris, France
| | - Dominique Debray
- Paediatic Liver Unit, National Reference Center for Biliary Atresia and Genetic Cholestasis and French Network for Rare Liver Disease (Filfoie) Necker-Enfants-Malades University Hospital, APHP, Paris, France
- Université de Paris, Paris, France
| | - Florence Lacaille
- Department of Gastroenterology-Hepatology-Nutrition, Necker-Enfants-Malades University Hospital, APHP, Paris, France
| | - Manuel Schiff
- Université de Paris, Paris, France
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Paris, France
- Inserm U1163, Institut Imagine, Paris, France
| | - Sandrine Vuillaumier-Barrot
- Université de Paris, Paris, France
- Biochemistry and Genetic Department, AP-HP, Bichat Hospital, Paris, France
- Centre de recherche sur l'inflammation, Inserm U1149, Paris, France
| | - Thierry Dupré
- Université de Paris, Paris, France
- Biochemistry and Genetic Department, AP-HP, Bichat Hospital, Paris, France
- Centre de recherche sur l'inflammation, Inserm U1149, Paris, France
| | - Monique Fabre
- Department of Pathology, Necker-Enfants-Malades University hospital, APHP, Université de Paris, Paris, France
| | - Lena Damaj
- Department of Pediatrics, Competence Center of Inherited Metabolic Disorders, Rennes Hospital, Rennes, France
| | - Alice Kuster
- Department of Pediatric Intensive care, Competence Center of Inherited Metabolic Disorders, Nantes Hospital, Nantes, France
| | - Stéphanie Torre
- Department of Neonatal Pediatrics and Intensive Care, Rouen University Hospital, Rouen, France
| | - Karine Mention
- Department of Pediatric Metabolism, Reference Center of Inherited Metabolic Disorders, Jeanne de Flandre Hospital, Lille, France
| | - Valérie McLin
- Swiss Pediatric Liver Center, Department of Pediatrics, Gynecology, and Obstetrics, University Geneva Hospitals, Geneva, Switzerland
| | - Dries Dobbelaere
- Department of Pediatric Metabolism, Reference Center of Inherited Metabolic Disorders, Jeanne de Flandre Hospital, Lille, France
| | - Delphine Borgel
- Hematology Department, Necker-Enfants-Malades University Hospital, APHP, Paris, France
- INSERM-URM-S1176, Université Paris Saclay, Le Kremlin-Bicêtre, France
| | - Eric Bauchard
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Paris, France
| | - Nathalie Seta
- Université de Paris, Paris, France
- Biochemistry, Bichat Hospital, AP-HP, Paris, France
| | - Arnaud Bruneel
- Biochemistry, Bichat Hospital, AP-HP, Paris, France
- INSERM UMR1193, Mécanismes cellulaires et moléculaires de l'adaptation au stress et cancérogenèse, Paris-Saclay University, Châtenay-Malabry, France
| | - Pascale De Lonlay
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Université de Paris, Paris, France
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Paris, France
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Mainini G, Passaro M, Schiattarella A, Franciscis PD, Donna MCD, Trezza G. Prevention and treatment of cystitis during menopause: efficacy of a nutraceutical containing D-mannose, inulin, cranberry, bearberry, Olea europaea, Orthosiphon and Lactobacillus acidophilus. Prz Menopauzalny 2020; 19:130-134. [PMID: 33100948 PMCID: PMC7573332 DOI: 10.5114/pm.2020.99567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022]
Abstract
AIM OF THE STUDY To evaluate the efficacy of a nutraceutical compound containing Uticlin® (D-mannose, cranberry, bearberry, Olea europaea), inulin, Orthosiphon and Lactobacillus acidophilus, in preventing recurrent urinary tract infections (UTIs) in menopausal women. MATERIAL AND METHODS This was a prospective cohort study of menopausal women recruited with a history of recurrent UTIs in the previous twelve months and who intended to treat their bladder problem without the use of antibiotics and/or anti-inflammatories. Women were proposed the use of an oral nutraceutical compound. The drug was taken for ten days, every month. Women were assigned to two parallel cohorts: patients using (group 1) or not using (group 2) this nutraceutical compound. The primary objective of the study was to evaluate the number of women with less than two infective episodes in the 6-month follow-up and less than three episodes in the 12-month follow-up. The secondary endpoints were to evaluate the reduction of related symptoms at 12-month follow-up, according to the Visual Analog Scale (VAS). RESULTS At 6 months of therapy, the reduction in the number of patients with ≥ 2 UTIs was statistically significant (p < 0.05) compared to baseline only in group 1. At 12 months, the number of patients who were disease-free was significantly higher (p < 0.05) in group 1 compared to group 2. Moreover, the improvement of related symptoms was statistically significant (p < 0.05) in group 1, as shown by the reduction in the VAS scale value. CONCLUSIONS In menopausal women, the combination of D-mannose, inulin, cranberry, bearberry, Olea europaea, Orthosiphon and Lactobacillus acidophilus SGL 11 per os represents a useful therapy for recurrent UTIs in women wanting a natural approach.
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Affiliation(s)
- Giampaolo Mainini
- Menopausal Center, San Leonardo Hospital, ASL NA3 SUD, Castellammare di Stabia, Naples, Italy
| | | | - Antonio Schiattarella
- Unit of Gynecology and Obstetrics, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Pasquale De Franciscis
- Unit of Gynecology and Obstetrics, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mariano C. Di Donna
- Department of Gynecologic Oncology, Arnas Civico, University of Palermo, Palermo, Italy
| | - Gennaro Trezza
- Unit of Gynecology and Obstetrics, Rummo Hospital, Benevento, Italy
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Kuz'min IV, Slesarevskaya MN, Al-Shukri SH. [ D-mannose for prevention and treatment of lower urinary tract infection: pathogenetic basics and clinical results]. Urologiia 2020:131-138. [PMID: 32897027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Non-antibacterial methods of prevention and treatment of lower urinary tract infection are described in the article. The current view on the mechanism of treatment effect of D-mannose is presented, which contributes to the prevention of bacterial invasion. Pathogenetic concepts for using D-mannose as specific antiadhesin or a competitive blocker of bacterial invasion is provided. In addition, we discussed the results of basic and clinical studies, proving the efficiency of D-mannose for prevention and treatment of lower urinary tract infection.
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Affiliation(s)
- I V Kuz'min
- Department of Urology of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - M N Slesarevskaya
- Department of Urology of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - S H Al-Shukri
- Department of Urology of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
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47
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Lenger SM, Bradley MS, Thomas DA, Bertolet MH, Lowder JL, Sutcliffe S. D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis. Am J Obstet Gynecol 2020; 223:265.e1-265.e13. [PMID: 32497610 DOI: 10.1016/j.ajog.2020.05.048] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 05/23/2020] [Accepted: 05/28/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis to determine whether D-mannose reduces urinary tract infection recurrence (ie, cumulative incidence) in adult women with recurrent urinary tract infection compared with other prevention agents. Secondary outcomes included side effects and compliance with D-mannose use. DATA SOURCES Ovid Medline 1946-, Embase 1947-, Scopus 1823-, Cochrane Library, Web of Science 1900-, and ClinicalTrials.gov were searched through 4/15/2020. STUDY ELIGIBILITY CRITERIA Systematic review inclusion: randomized controlled trials, prospective cohorts, and retrospective cohorts written in English of women ≥18 years old with recurrent urinary tract infection in which D-mannose was utilized as an outpatient prevention regimen. Systematic review exclusion: lab or animal-based research, study protocols only, and conference abstracts. Meta-analysis inclusion: stated D-mannose dose, follow-up time ≥6 months, a comparison arm to D-mannose, and data available from women ≥18 years of age. STUDY APPRAISAL AND SYNTHESIS METHODS Two independent reviewers made abstract, full text, and data extraction decisions. Study methodologic quality was assessed using the Cochrane Risk of Bias tool. Relative risks, confidence intervals, and heterogeneity were computed. RESULTS Searches identified 776 unique citations. Eight publications met eligibility: 2 using D-mannose only; 6 using D-mannose combined with another treatment. Seven studies were prospective: 2 randomized controlled trials, 1 randomized cross-over trial, and 4 prospective cohort studies. One retrospective cohort study was included. Three studies met meta-analysis eligibility (1 randomized controlled trial, 1 randomized cross-over trial, and 1 prospective cohort). Pooled relative risk of urinary tract infection recurrence comparing D-mannose to placebo was 0.23 (95% confidence interval, 0.14-0.37; heterogeneity=0%; D-mannose n=125, placebo n=123). Pooled relative risk of urinary tract infection recurrence comparing D-mannose to preventative antibiotics was 0.39 (95% confidence interval, 0.12-1.25; heterogeneity=88%; D-mannose n=163, antibiotics n=163). Adverse side effects were reported in 2 studies assessing D-mannose only (1 study (n=10) reported none; the other reported a low incidence (8/103 participants) of diarrhea). Two studies reported compliance, which was high. CONCLUSION D-mannose appears protective for recurrent urinary tract infection (vs placebo) with possibly similar effectiveness as antibiotics. Overall, D-mannose appears well tolerated with minimal side effects-only a small percentage experiencing diarrhea. Meta-analysis interpretation must consider the small number of studies with varied study design and quality and the overall small sample size.
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Affiliation(s)
- Stacy M Lenger
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO.
| | - Megan S Bradley
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Urogynecology and Reconstructive Pelvic Surgery, University of Pittsburgh, Pittsburgh, PA
| | - Debbie A Thomas
- Becker Library, Washington University School of Medicine, St. Louis, MO
| | - Marnie H Bertolet
- Departments of Epidemiology, Biostatistics, and the Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA
| | - Jerry L Lowder
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO
| | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
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48
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Salinas-Casado J, Méndez-Rubio S, Esteban-Fuertes M, Gómez-Rodríguez A, Vírseda-Chamorro M, Luján-Galán M, Iglesias-García C, Rituman G. Large study (283 women) on the effectiveness of Manosar®: 2 g of d-mannose + 140 mg of proanthocyanidins (PAC), of prolonged release. ARCH ESP UROL 2020; 73:491-498. [PMID: 32633244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To compare the efficacy and safety in the prophylasis of urinary tract infections (UTIs) with a food supplement that contains D-mannose like active ingredient (Manosar®), in comparison to another preparation in which the active ingredient are the proanthocyanidins (PAC), both of them, in prolonged released, after, they was administered for 24 weeks. METHODS A multicenter, randomized and double blind experimental study was carried out. 283 women with a history of recurrent UTIs without evidence of complication were included. They were randomized 1: 1 in two groups. In one group, 1 oral sachet of Manosar® a day was administered, and in the other group 1 oral sachet of a compound of 240 mg of continuous-release PAC. Prior to inclusion in the study, the episode of UTI was confirmed at least by the clinical symptoms and positivity of the Combur test. RESULTS Valid data were obtained from 184 patients with an average age of 49.5 years: 90 received Manosar® and 94 isolated PAC. A total of 72 patients suffered an UTI due to E.coli: 25 patients in the arm with Manosar® versus 47 patients in the isolated PAC group, this difference being statistically significant (p=0.002). The free time of new UTI recurrences was 98.6 days in the group treated with Manosar® and 84.6 days in the group with isolated PAC. CONCLUSION The oral taking of a daily sachet of Manosar® is effective and safe in preventing recurrent UTIs in women, being superior to the oral taking of isolated PAC.
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Affiliation(s)
| | | | | | | | | | - Marcos Luján-Galán
- Servicio de Urología. Hospital Universitario Infanta Cristina. Parla. Madrid. España
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49
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Kuzmenko AV, Kuzmenko VV, Gyaurgiev TA. [Use of D-mannose in the prevention of recurrent lower urinary tract infection in women]. Urologiia 2020:128-132. [PMID: 32597599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Lower urinary tract infections (LUTI) currently retain the status of one of the most urgent problems of urology. According to extensive microbiological studies of UTIAP I and II, "DARMIS" the most common pathogens that are detected in the urine of women with LUTI are gram-negative bacteria of the Enterobacteriales family, in particular E. Coli. Antibacterial therapy demonstrates high effectiveness in the treatment of uncomplicated LUTI. However, the problem of recurrent infection remains unresolved. Taking into account known side effects of continuous antimicrobial prevention, as well as data on the high frequency of relapses after its cancellation, it is necessary to identify alternative LUTI prevention strategies. The use of D-mannose can be one of these strategies. D-mannose use for the prevention of relapses of INMP is indicated in the clinical recommendations of the American (AUA) and European (EUA) urological associations. D-mannose is a monosaccharide that is extracted from a larch rod. It is relatively quickly absorbed and reaches the peripheral organs in about 30 minutes, after which it is excreted in the urine. The structure of d-mannose allows it to bind to mannose-sensitive E. Coli fimbriae and prevent their adhesion to the urinary tract mucosa. Several studies demonstrated high safety profile and effectiveness of long-term D-mannose treatment in preventing LUTI. The data presented in the literature allow us to recommend patients with recurrent LUTI long term D-mannose intake helps to reduce the severity of symptoms in acute episodes and prolong relapse-free period. As a source of D-mannose, we can recommend Ecocystin 1 sachet 1 time a day.
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Affiliation(s)
- A V Kuzmenko
- Voronezh State Medical University n.a. N.N. Burdenko, Voronezh, Russia, Department of Urology of FGBOU VO Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia
| | - V V Kuzmenko
- Voronezh State Medical University n.a. N.N. Burdenko, Voronezh, Russia, Department of Urology of FGBOU VO Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia
| | - T A Gyaurgiev
- Voronezh State Medical University n.a. N.N. Burdenko, Voronezh, Russia, Department of Urology of FGBOU VO Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia
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50
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Liu H, Gu R, Zhu Y, Lian X, Wang S, Liu X, Ping Z, Liu Y, Zhou Y. D-mannose attenuates bone loss in mice via Treg cell proliferation and gut microbiota-dependent anti-inflammatory effects. Ther Adv Chronic Dis 2020; 11:2040622320912661. [PMID: 32341776 PMCID: PMC7169364 DOI: 10.1177/2040622320912661] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/05/2020] [Indexed: 12/16/2022] Open
Abstract
Background: D-mannose exhibits strong anti-inflammatory properties, but whether it has beneficial effects on preventing and treating osteoporosis remains unknown. Methods: Female, 12-month-old senile C57BL6/J mice (s-Man group) and 8-week-old ovariectomized C57BL6/J mice (OVX-Man group) were treated with D-mannose in drinking water for 2 months (six mice/group). Microcomputed tomography analysis and hematoxylin and eosin staining were performed to investigate the effect of D-mannose on attenuation of bone loss. Tartrate-resistant acid phosphatase staining of tissue sections, flow cytometry, enzyme-linked immunosorbent assay, quantitative real-time polymerase chain reaction, and gut microbiome biodiversity tests were used to explore the underlying mechanisms. Results: D-mannose-induced marked increases in cortical bone volume and trabecular bone microarchitecture in the s-Man and OVX-Man group compared with that in the s-CTRL (senile control) and OVX group, respectively. Moreover, D-mannose downregulated osteoclastogenesis-related cytokines in the bone marrow and expanded regulatory T cells in the spleen of mice. Furthermore, D-mannose reconstructed the gut microbiota and changed the metabolite composition. Conclusion: D-mannose attenuated bone loss induced by senility and estrogen deficiency in mice, and this effect may be mediated by D-mannose-induced proliferation of regulatory T cells and gut microbiota-dependent anti-inflammatory effects.
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Affiliation(s)
- Hao Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ranli Gu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yuan Zhu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiaomin Lian
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Siyi Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xuenan Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Zhang Ping
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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