Cranberries have long been the focus of interest for their beneficial effects in preventing urinary tract infections (UTIs). The objective of this study was to determine in vitro activity of cranberry extract on common etiologic agents of urinary tract infections isolated from patients. Filter sterilized methanol extract of cranberry was prepared and used in the present study. The minimum inhibitory concentration (MIC) was evaluated for active crude extract. The MIC value of methanol extract were 0.391 mg/ml for
Enterobacter aerogenes and Staphylococcus aureus whereas the MIC of methanol extract of cranberry were 1.2500 and 0.0195 mg/ml for Escherichia coli and Klebsiella pneumoniae respectively. The lower MIC value of cranberry extract against K. pneumoniae in comparison to other three organisms suggests that K. pneumoniae showed greater sensitivity towards the extracts of the cranberry extract.

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

Ethyl acetate extracts of Sephadex LH20-purified proanthocyanidins of American cranberry (Vaccinium macrocarpon Ait.) exhibited potent biological activity by inhibiting adherence of uropathogenic isolates of P-fimbriated Escherichia coli bacteria to cellular surfaces containing a-Gal(1 4 4)b-Gal receptor sequences similar to those on epithelial cells in the urinary tract. The chemical structures of the proanthocyanidins were determined by 13C NMR, electrospray mass spectrometry, matrix-assisted
laser absorption time-of-flight mass spectrometry and by acid catalyzed degradation with phloroglucinol. The proanthocyanidin molecules consisted predominantly of epicatechin units with mainly DP of 4 and 5 containing at least one A-type linkage. The procyanidin A2 was the most common terminating unit occurring about four times as frequently as the epicatechin monomer

Cranberry and its products are important components of the cranberry processing industry and have historically been associated with positive health benefits such as preventing urinary tract infections. These health benefits are associated with phenolic phytochemicals in the juice which are now known to have potential for inhibition of development and progression of cancer and cardiovascular diseases. Helicobacter pylori is an important human pathogen linked to peptic ulcer and now to cardiovascular diseases. Control of this pathogen using synthetic antimicrobials such as currently approved antibiotics has limitations due to potential development of resistance and low compliance. We believe a profile of antimicrobials compared to a single compound could be potentially more effective in managing H. pylori infections. We have investigated the effect of cranberry, blueberry and grape seed extracts on inhibiting H. pylori have been investigated. The ability of blueberry, grape seed and oregano extract on enhancing the antioxidant and anti-H. pylori activity of cranberry powder in a mixture was also investigated. The anti-H. pylori activity of the cranberry fruit extracts and their synergies correlated with antioxidant activity and the presence of biphenyls as well as polyphenolic phytochemicals. The anti-H. pylori activity of cranberry juice extract was significantly improved by its synergistic blending with blueberry, grape seed and oregano extract. The lower efficacy of purified phenolics in inhibiting H. pylori compared with fruit powder at similar dosage levels suggests a synergistic mode of functionality of these individual phenolics in whole food background. Consumption of blends of fruit juices with other fruit as well as herb extracts can impart unique functional attributes and could be an effective strategy in developing diet-based management of H. pylori infections as well as other oxidation linked diseases.

Cranberry fruit is a rich source of polyphenols, and has shown biological activities against Streptococcus mutans. In the present study, we examined the influence of extracts of flavonols (FLAV), anthocyanins (A) and proanthocyanidins (PAC) from cranberry on virulence factors involved in Streptococcus mutans biofilm development and acidogenicity. PAC and FLAV, alone or in combination, inhibited the surface-adsorbed glucosyltransferases and F-ATPases activities, and the acid production by S. mutans cells. Furthermore, biofilm development and acidogenicity were significantly affected by topical applications of PAC and FLAV (P0.05). Anthocyanins were devoid of any significant biological effects. The flavonols are comprised of mostly quercetin glycosides, and the PAC are largely A-type oligomers of epicatechin. Our data show that proanthocyanidins and flavonols are the active constituents of cranberry against S. mutans.

Several studies have shown the antimutagenic DNA protective functions of some naturally occurring phenolic phytochemicals. Emerging research also indicates that synergistic functionality of these phytochemicals in whole foods benefits the management of many diseases. This study investigated the potential antimutagenic properties of cranberry phenolics, ellagic acid (EA), rosmarinic acid (RA) and their synergistic interactions on enhancing the antimutagenic properties in Salmonella typhimurium tester system against the mutagens sodium azide and N-methyl-N'-nitro-N-nitrosoguanidine. The ability of these phytochemical treatments to protect oxidative damage to DNA was also investigated using the supercoiled DNA strand scission assay. The results showed that EA was most effective in inhibiting the mutations in S. typhimurium system, whereas RA and EA were equally effective in protecting the DNA from oxidative damage. In addition, the antimutagenic activity of cranberry powder (CP) made from juice extracts was significantly enhanced when 30% (w/w) of phenolics in CP was substituted with RA and EA, possibly because of synergistic redox modulation that can influence mutagen function. It was also suggested that the synergistic mixture of cranberry phenolics with RA could also be protecting the cell from mutations by modulating the DNA repair systems

Cranberry cocktail has been reported to reduce bacteriuria and pyuria in elderly women and self-reported urinary tract infection (UTI) in young female undergraduates, but commercially prepared cranberry concentrate supplements have never been evaluated in multiple sclerosis (MS) patients with neurogenic bladder. The purpose of this study was to determine whether one 8,000-mg cranberry concentrate supplement daily could prevent UTI in MS participants with bladder symptoms. We conducted a double-blind, randomized, placebo-controlled longitudinal trial of cranberry supplement versus placebo with participants who have MS. After informed consent had been obtained from the participants, baseline data were collected and participants were randomized to receive either one cranberry supplement or placebo daily for 6 months. The sample consisted of 135 participants. In the cranberry group 34.6% of participants failed (i.e., developed a UTI) versus 32.4% in the control group (p = .849). Not all cranberry supplements have been found to contain proanthocyanidins, the active ingredient of cranberries. Because there is no way for the consumer to distinguish supplements that contain proanthocyanidins from those that do not, taking juice or whole cranberries may be preferrable.

Cranberry, the fresh or dried ripe fruit of Vaccinium macrocarpon Ait. (Ericaceae), is currently used as adjunct therapy for the prevention and symptomatic treatment of urinary tract infections. Data from clinical trials suggest that extracts of cranberry or cranberry juice reduce the bacterial load of E. coli and also suppress the inflammatory symptoms induced by E. coli infections. A methanol extract prepared from 10 kg of dehydrated cranberries did not directly inhibit the growth of E coli strains ATCC 700336 or ATCC 25922 in concentrations up to 256 mug/mL in vitro. However, the methanol extract (CR-ME) inhibited the activity of cyclooxygenase-2, with an IC(50) of 12.8 mug/mL. Moreover, CR-ME also inhibited the NF-kappabeta transcriptional activation in human T lymphocytes with an IC(50) of 19.4 mug/mL, and significantly (p 0.01) inhibited the release of interleukin (IL)-1beta, IL-6, IL-8 and tumor necrosis factor-alpha from E. coli lipopolysaccharide (LPS)-stimulated human peripheral blood mononuclear cells in vitro, at a concentration of 50 mug/mL. The extract had no effect on inducible nitric oxide synthase activity in the murine macrophage cell line RAW 264.7. The compounds responsible for this activity were identified using a novel LC-MS based assay as ursolic acid and ursolic acid derivatives. Taken together, these data suggest CR-ME and its constituent chemical compounds target specific pathways involved in E. coli-induced inflammation.

Background. A number of observational studies and a few small or open randomized clinical trials suggest that
the American cranberry may decrease incidence of recurring urinary tract infection (UTI).
Methods. We conducted a double-blind, placebo-controlled trial of the effects of cranberry on risk of recurring
UTI among 319 college women presenting with an acute UTI. Participants were followed up until a second UTI or
for 6 months, whichever came first. A UTI was defined on the basis of the combination of symptoms and a urine
culture positive for a known uropathogen. The study was designed to detect a 2-fold difference between treated and
placebo groups, as was detected in unblinded trials. We assumed 30% of participants would experience a UTI during
the follow-up period.
Results. Overall, the recurrence rate was 16.9% (95% confidence interval, 12.8%–21.0%), and the distribution
of the recurrences was similar between study groups, with the active cranberry group presenting a slightly higher
recurrence rate (20.0% vs 14.0%). The presence of urinary symptoms at 3 days, 1–2 weeks, and at >1 month was
similar between study groups, with overall no marked differences.
Conclusions. Among otherwise healthy college women with an acute UTI, those drinking 8 oz of 27% cranberry
juice twice daily did not experience a decrease in the 6-month incidence of a second UTI, compared with those
drinking a placebo.

CONTEXT: Cranberry juice has long been recognized in folk medicine as a therapeutic agent, mainly in urinary tract infections. Its proposed mechanism of action is antiadhesion of bacteria.

OBJECTIVE: Investigation of the potential antiadhesion effect of nondialyzed material of cranberry (NDM) via its influence on secretion, gene expression, and promoter activity of the fructosyltransferase (FTF), which is among the extracellular enzymes associated with dental biofilm formation and pathogenesis of oral bacteria.

MAIN OUTCOME MEASURES: Secretion of FTF from Streptococcus mutans, in the presence of NDM, was measured by immunoblotting and confocal scanning laser microscopy. Its influence on ftf gene expression was determined by reverse transcription followed by real-time RT-PCR. The luciferase assay was used to detect bioluminescence expressed by the ftf promoter activity of bacteria exposed to NDM.

RESULTS: NDM at concentrations between 0.2/mL and 1mg/mL significantly (P.05) decreased secretion of extracellular FTF, as well as down-regulated ftf expression in a dose-dependent manner. NDM also markedly reduced the luciferase activity under the ftf promoter.