Prevention and treatment of cystitis during menopause: efficacy of a nutraceutical containing D-mannose, inulin, cranberry, bearberry, Olea europaea, Orthosiphon and Lactobacillus acidophilus

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.

Cranberry: Chemical Composition, Antioxidant Activity and Impact on Human Health: Overview

“…The most common issues on the cranberry effect on human health are investigated in reviews [ 18 , 31 , 32 , 33 ]. Cranberries have an anti-bacterial effect and in various forms (juice, concentrated powders, capsules and tablets) have been traditionally used to treat cystitis and urinary tract infections (UTIs) [ 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. A study noted that the consumption of cranberry juice reduced the number of UTIs by 39% in women [ 34 ].…”

Considerations on D-mannose Mechanism of Action and Consequent Classification of Marketed Healthcare Products

“…Indeed, if urine contains sufficiently high levels of free D-mannose to saturate the FimH adhesin of UPEC, bacteria are unable to grapple onto the epithelial cells and are flushed away by shear forces due to the urinary flow ( Ofek et al, 1982 ; Schwartz et al, 2013 ). Starting from such scientific evidence, D-mannose and its derivatives (e.g., α-D-mannosides) have been investigated as non-antibiotic prevention strategies for both acute and recurrent UTIs ( Kranjcec et al, 2014 ; Porru et al, 2014 ; Domenici et al, 2016 ; Phé et al, 2017 ; Parrino et al, 2019 ; Mainini et al, 2020 ). Moreover, due to this physical mechanism of action, D-mannose has a negligible risk of developing bacterial resistance, unlike antibiotics ( Sarshar et al, 2020 ; Scribano et al, 2020 ).…”

“…D-mannose is contained both in the EU and the United States in different types of healthcare products, such as food supplements ( Altarac and Papes, 2013 ), and class IIa medical devices. The rational of such healthcare products has its bases on several clinical studies demonstrating the efficacy of D-mannose for the prophylaxis of UTIs ( Kranjcec et al, 2014 ; Porru et al, 2014 ; Domenici et al, 2016 ; Phé et al, 2017 ; Mainini et al, 2020 ).…”

An integrative analysis to predict the Active Ingredients and explore Polypharmacological Mechanisms of Orthosiphon stamineus Benth. for human health

“…A few investigations also evaluated its neuroprotection in epilepsy, depression, and Alzheimer’s disease(Chung et al, 2020). However, most of these studies were at the pre-clinical phase; only three clinical trials of an herbal combination containing O. aristatus proved effective in treating hypertension, metabolic syndrome(Cicero et al, 2012), and urinary tract infections(Mainini et al, 2020; Vahlensieck et al, 2019). Based on the I-T-D network and DO analysis in our study, it seems to give an insight that O. aristatus was a versatile therapeutic agent.…”

“…Plenty of pre-clinical experiments demonstrated that the various extracts of O. stamineus exerted pharmacological properties, including anti-proliferative(Doleckova et al, 2012; Ahamed et al, 2012), antioxidant(Awale et al, 2003; Hsu et al, 2010), analgesic(Chen et al, 2020), anti-inflammatory(Hsu et al, 2010; Yam et al, 2010), antimicrobial(Alshawsh et al, 2012; Ho et al, 2010), diuretic(Bode et al, 1991), among others. Recently, two rare clinical trials have been performed, and the results showed that the herbal combination with O. stamineus seems to be useful in the reduction of discomfort and prevention of antibiotic use in women with urinary tract infections(Mainini et al, 2020; Vahlensieck et al, 2019). Despite the fact that dozens of phytochemical studies investigated the natural compounds in O. stamineus from all over the world and hundreds of chemical compounds such as flavones, polyphenols, and terpenoids have been detected, very little is known about active substances, their targets, interactions, and specific molecular mechanisms.…”