D-mannose- a natural aid in the treatment of urinary tract infection

Do you often suffer from bladder and urinary tract infections? Do frequent infections turn into chronic ones and you feel that antibiotics no longer help? About 150 million cases of urinary tract infections are recorded worldwide each year, of which 80% are caused by E. Coli. Women suffer from infections more often than men due to anatomical differences (the urethra in women is shorter than in men) and due to sensitivity of the urogenital area. About 50% of women suffer from urine infections at least once in their lives and in 20-30% of patients, re-infection occurs after 6 months. Uropathogenic E. coli is part of the normal physiological flora and is found in the small and large intestine. Due to the proximity of the anus and urethra, bacteria migrate to the urinary tract and contaminate the bladder. When they reach the bladder through the urethra, they form colonies of bacteria, which are dormant or form a biofilm, inside the urothelial cells.

The bladder urothelium, as well as other cells in our body, is renewed constantly by layers of mature cells being peeled off and replaced by new, young cells. The urothelium is made of uroplakin protein Ia, which, on its surface, has receptors glycosylated with mannose sugar, which bacteria recognize as their food. Mannose is key to adhering bacteria to the urinary tract walls. When bacterial colonies within urothelial cells become invasive, they migrate from the cells to the surface of the urothelium and cause acute, chronic, and recurrent urinary tract and bladder infections. If the conditions for the survival of bacteria in the bladder are met, such as pH, temperature, nutrients, and iron level (optimal for development and invasion), bacteria begin to develop fimbriae (pili) that move and recognize mannose on the bladder urothelium. In other words, when there is contact between a bacterial cell and a urothelial cell on the surface of the bladder, an infection occurs. Frequent recurrence of urinary tract infections and unsuccessful antibiotic treatments lead to chronic and recurrent infections due to bacterial resistance to antibiotics, which are prescribed in many cases, even if antibiotic treatment is not required or the cause is not yet known. Therefore, scientists began to find new ways to treat infections, with the intention of reducing the occurrence of bacterial resistance to antibiotics, and came to the following conclusion: it is necessary to introduce control over antibiotic treatment and find a different way to treat infections. Primarily, in order to prevent infection, contact between bacteria and host cells should be prevented. This has become their guiding thought.

Today, we distinguish three basic ways to treat urinary tract infections. Treatment with antibiotics with bacteriostatic action, treatment with antibiotics with bactericidal action and the latest one: anti-adhesion therapy. In case of bacteriostatic action, antibiotics work in a way to prevent further bacterial growth. Antibiotics, which act as a bactericide, kill the bacteria that cause infections. Antibiotic treatment also kills the bacteria beneficial to the body, therefore, the frequent consequences of antibiotic treatment are inevitable. Diarrhoea, bloating, and indigestion occur due to the killing of beneficial probiotic bacteria in the intestines; by killing beneficial bacteria in the vagina that maintain vaginal acidity, fungal or bacterial vaginosis occurs in women. The use of bacteriostatics leads to changes and manipulation of the genetic material of bacteria. Therefore, the bacteria themselves have developed their own mechanism of defence against antibiotics, which results in bacterial resistance to antibiotics.

The third form of infection treatment involves preventing the contact between bacteria and host cells and is, therefore, called anti-adhesion therapy. This type of treatment has no side effects and it is important to know that resistance to anti-adhesives cannot be developed. In the treatment of bladder infections with anti-adhesives, the objective is to use an active substance that mimics mannose, which is found on the surface of urothelial cells and which will be recognized by bacteria as food and as their receptor. Therefore, mannose, which is previously absorbed in the body and reaches the bladder, will float freely in the bladder contents. Bacteria will recognize mannose by the receptor tips of their fimbriae and thus bacteria will not be able to adhere to urothelium by their fimbriae. This will prevent contact between bacteria and host cells. The bacteria-mannose complex, which floats freely in the bladder contents, will be eliminated from the body by urination, which is stimulated by abundant hydration and natural diuretics of plant origin, in the form of tea or already available in food supplements in combination with mannose.

UroBalance contains an innovative combination of vitamin C, common knotgrass as a diuretic, mannose (located on the bladder urothelium and is an integral part of uroplakin Ia) and American cranberry extract, rich in proanthocyanidins. D-mannose is a simple sugar and belongs to a group of organic compounds called carbohydrates. In the human body, it plays an important role in metabolic processes and the most important one is the glycosylation of proteins. It is found in cranberries, blueberries, pears, apples, oranges, corn, potatoes, cabbage… Mannose plays a key role in UroBalance because it blocks mannose receptors on E. coli fimbriae.

In addition, the potentiated synergistic action of D-mannose to block the adhesion of E. Coli to bladder walls is enabled by proanthocyanidins from American cranberry. It is important to mention that E. Coli has two types of fimbriae on its surface – fimbriae H, which recognize mannose, and fimbriae P, which do not recognize mannose, and with their help E. Coli is also adhered to the bladder walls. The main task of proanthocyanidins is the inhibition of fimbriae P. Thus, the combination of mannose and proanthocyanidins acts synergistically and completely blocks the adhesion of bacteria to the bladder walls because proanthocyanidins and mannose occupy all receptors on fimbriae. Proanthocyanidins belong to the group of polyphenols and are found in cranberries, elderberries, chokeberries, fresh grapes, red wine, red grapefruit…. Common knotgrass extract acts as a diuretic and stimulates the excretion of urine and consequently eliminates bacteria from the body. Vitamin C contributes to the normal function of the immune system and as an acid (ascorbic acid) increases the acidity of urine. It is known that acidic pH is not suitable for bacteria, so we can say that this innovative combination is a powerful “cocktail” for solving urinary tract problems. Mannose and proanthocyanidins, as natural medicinal substances, enable the safe treatment of urinary tract infections without the development of resistance and open the door to a new period of discovery of natural and safe “antibiotics”.


Suzana Kranjčec, MPharm

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