| One of the most pressing problems facing doctors today is antibiotic
resistance . Every time we take an antibiotic there are some bacteria
it does not kill.
- These "resistant" bacteria are able to multiply unhampered
by other competing bacteria that have been killed by the antibiotic;
- they are also able to pass that resistance on to other types
of bacteria. "What doesn't kill us makes us stronger," said
Nietzsche, and it's the same with bacteria.
Pharmaceutical companies are constantly trying to stay ahead of
the bacteria by developing more and better antibiotics, but the
bacteria seem to learn almost as fast as the FDA approves the new
- In some cases, because of animal testing and use, there have been
resistant bacteria even before the antibiotic was released for
- The primary cause of this problem is our overuse of antibiotics.
Doctors on the front lines want to help their patients get better
and patients wanting to get better expect antibiotics to help.
So we prescribe a lot of antibiotics.
- Yet infectious disease specialists
tell us we need to be more judicious in our use—"our
tactical decisions are hostile to our strategic interests."
could have been the words of any infectious diseases specialist,
but they come from Lt. General Moshe Yaalon of the Israeli
Ministry of Defense.
- There are many similarities between bacterial and human
levels of warfare, but their common ground is that violence
on both levels.
Our point is that we desperately need another option in our warfare.
In countries where antibiotics are used more sparingly they do
not have as much of a problem—the bacteria rapidly lose their
resistance when they are not challenged.
Biologists approach this problem in the same way that they address
symptoms that arise because of manipulations of bacteria that are
discussed elsewhere. Manipulations need to be blocked—like
we block malaria by using mosquito netting when we sleep or screens
on our windows. Or like we block the spread of sexually transmitted
diseases by using condoms, or a variety of communicable diseases
by washing our hands regularly. Blocking the spread of bacteria
in these simple ways means that they have to survive in their current
host without destroying it and over time tends to promote less
illness producing bacteria.
One area of research that will help reduce this problem is from
the field of glycobiology ('glyco' comes from the word for sugars
and 'biology' comes from life so this field studies the role of
sugars in living animals). Some people in this field look at how
bacteria attach to cells in the body.
- Attachment is necessary before bacteria can cause any kind of
infection. If they are not attached to cells they are just washed
away by the body's normal cleansing processes and don't cause any
- This approach uses the same strategy of blocking the manipulation
described above, but it puts it on an individual level—very
much like washing our hands.
- The overwhelming majority of bacteria have what are called
receptor sites or lectins that they use to hold on to cells in
- These lectins are like hands that fit specific sugar complexes
on the surface of cells and this is how they hang on to them.
- Again, this attachment is the first step in starting an infection—if
the bacteria are not attached they are washed out and don't cause
problems. [I know I've said this a jillion times, but I'll say
it another jillion if it helps people understand that this science
is really an untried option in our war with bacteria.]
Nathan Sharon is a researcher who has been looking at this attachment
for the past thirty years. One of his colleagues drew the following
picture to show how it works:
In Zafriri's picture the bacteria
are the happy ovals hanging on to the green sugar molecules and
the unhappy ovals not hanging on. When an appropriate sugar is
put into this environment the bacteria hold onto it and can't hang
on to the sugar on the cell wall. In the original the bacteria
were pictured as being unhappy (like the one at the top) if they
were holding on to the sugar in solution rather than that on the
bladder wall. If we can attribute emotions to bacteria I think
that they are just happy holding on to sugar, wherever it is and
edited the picture to make them so.
for means of interfering with bacterial adherence has been joined by many
others, but has not been too well known.
Part of the
reason for this lack of notoriety is that most of the sugars shown
to have this
effect are foods that cannot easily be classified as drugs.
If there was
a way for the pharmaceutical industry to make money from these foods
would all know about it, but because they are foods they can't do that.
just buy the food sugar that would be less expensive, but accomplish
the same thing as the "drug" sugar.
of these other, less well known, sugars are the
subject of Dr. Emil Mondoa's recent book, Sugars that Heal.
lectin that we know the most
about is that for mannose on Escherichia coli.
This bacteria causes most
urinary infections, in large part because the numerous mannose molecules on the wall of the
bladder provide a place for these bacteria to hold on.
be able to block many of these infections just by putting mannose into
can buy mannose; it is not a drug, so no one is going to pay for clinical
and without clinical studies few people know about the science.
juice has been found to have similar effects and studies have been
funded by manufacturers such as "Ocean Spray", but
mannose should be more effective because cranberry juice doesn't have
does have lots of fructose, which works the same way, but
is only about a tenth as effective as mannose.
One researcher tried to get funding for such studies and finally got her
department to fund a study using mannose to prevent infections in mares undergoing
the nature of this process there are a lot of infections in the mares.
Based on Sharon's
work she felt this would be a good use of a benign sugar.
When she put mannose on cells from
the lining of the mare's uteri the bacteria, both E. coli and another
bacteria, Pseudomonas aeruginosa, were blocked from attaching to
also found a side effect as she took the next step. This worked so well in
the laboratory she mixed some mannose with the semen used to inseminate the
It worked here too because none of the mares got infected, but neither did any
of them get pregnant. She found out what most fertility experts already knew:
that the acrosome, the point at the head of the sperm that attaches to the egg
in fertilizing it, is a mannose lectin. When she
looked at this under her microscope she saw all of the sperm hanging on to the
mannose that the bacteria were holding on to. They appeared to be sharing the
mannose. This is something that we apparently share with horse because the human
acrosome is also a mannose lectin. So if any of you young women are tired of
pumping hormones into your bodies to prevent pregnancy you might try using
some mannose in a small capsule
prior to intercourse. This recommendation has not been tested on any other than
Dr. King's horses because, of course, it won't make any money for anyone.
in people the same way it does in horses. We also have these mannose
molecules on our cells, especially in the bladder, which is why these
bacteria are the major
cause of bladder infections.
specific sugars into the environment fills up the binding sites on the bacteria
so that they cannot bind to the human cell.
Jonathan Wright is already recommending, as
do I, that people who have chronic problems with urinary tract infections eat
a teaspoon of mannose at
least twice a day.
is not absorbed as well as glucose in the intestine, but both absorbed
and non-absorbed mannose is effective.
absorbed mannose about a fifth is excreted in the kidneys. This mannose fills up the receptor sites on
Coli so that these bacteria cannot bind to cells in the bladder.
that is not absorbed can bind with strains of this bacteria in
the GI tract
these infections all come from bacteria in the GI tract this gets
them at their source.
use of mannose changes the flora in the GI tract to bacteria that
cannot cause UTI's
strains of E. coli, the good bacteria that help with digestion
of our food, are not effected.
was shown for cranberry and blueberry juice and Zafriri showed
that this was due to the fructose that is in the
fructose binds less strongly than does the mannose to these receptor sites,
but it still reduced the adherence of the bacteria. The cranberry
juice industry does not mention this decreased adherence as a reason for its
use in preventing urinary infections. They credit the benefits to acidifying
the urine which makes it less hospitable to bacteria and to substances in it
that kill bacteria. These factors, however, cannot
explain the results of the following study.
same Finnish researchers that looked at xylitol and ear infections looked at
using cranberry lingonberry (similar to our blueberries) extract regularly in women with recurrent urinary
only way to explain the presence of long-term benefits seen in a number of
people is that the treatment led to changes in either the nature or the
type of bacteria. And there is laboratory evidence that both happen.
When the adherence
of bacteria is competitively blocked by local sugars fewer of the effected
bacteria remain. So it is easy to see why the type
of bacteria can change.
But the nature
of bacteria can change as well. There are strains of E. coli that don't
have these mannose lectins. When
people eat mannose regularly these strains multiply, and they don't cause
has a similar effect on the bacteria causing tooth decay.
Decay, as we
the section on xylitol, is caused by the acids made by bacteria on the
teeth like S. mutans.
Trahan showed that over a few
generations, a day or so in the life of bacteria, this bacteria learned not to eat the xylitol in its
environment; they became what he called xylitol resistant.
same time, however, something else changed, because the bacteria no
longer caused tooth decay.
I believe that
xylitol acts in this way when we use it in the mouth and the nose. Oral
use leads to fewer bacteria caused cavities and nasal use results in fewer
upper respiratory problems.
is too good of a time not to insert an editorial comment. Our
grandmother 20 to 50 thousand generations ago, according to the reasonable
conjecture of Rudyard Kipling, fed the wolf that was
threatening her children cooked meat. The wolf liked the cooked meat and
grandmother kept feeding it. But she had to feed it every day for a long,
long time before the wolf became dog and man's best friend. As a society
and culture we have concentrated on killing our enemies. We did it with
the Indians, the Germans did it with the Jews, we did it with the Germans, as well as with our current
al-Qaida enemiesójust like we do with bacteria. What
grandmother and these studies point out is that there is another
way. Feeding our enemies has the potential to change them into
friends. Today we want to use bacteria to carry modified DNA into
human cells so that we can try to cure genetic diseases like cystic
fibrosis and diabetes. Bacteria, having transferred genetic material among
themselves for over a billion years, are the undeniable experts. But attempts
have resulted in the patients dying from the infection we introduced with
the bacteria. Maybe we ought to make friends first.
do not people know about such sugars and their use to prevent
reason, specific for xylitol, is that it is not one of the sugars
found on our cell surfaces, nor has there ever been found a lectin
specific for xylitol.
has the advantage, however, of being very flexible so it is able
to look like a part of many of the
other sugars are all in a ring form and fixed.
is an open molecule and can bend and rotate so that it looks like parts
of many other sugars.
Zafriri showed that fructose in cranberry
juice could mimic mannose and impede the adherence of urinary
is able to mime many other sugars.
We have already seen how it impairs the
adherence of oral and nasal bacteria. It also blocks the adherence of the
bowel pathogen Clostridium dificile. The chart below, from a study by
Paul Naaber, shows how effectively it does
question of why these leads are not pursued more also has an economic
angle. It's not profitable since the sugars are not patentable.
faster people know about and use these alternatives the more successful
we will be at preventing the spread of antibiotic resistance and reducing
overuse of antibiotics that is the primary cause of the problem. Antibiotics
help individuals, but they don't help wars. As Lt. Gen. Yaalon said
opening statement, "Our tactical decisions are hostile to our
strategic interests." In countries
such as Norway, where more attention is paid to
strategic interests, both the use of antibiotics
and bacterial resistance are lower. Bacteria learn resistance when
they are challenged by the antibiotic and they do tend to forget when they
are not. The best way to prevent antibiotic resistance is to use
antibiotics much more judiciously. And one of the best ways to do that is to use these sugars to wash
bacteria out so they don't cause problems in the first place.
to HOME Read
more about sugars and Intelligent bacteria
Inhibitory activity of cranberry juice on
adherence of type 1 and type P fimbriated Escherichia coli to
Zafriri D, Ofek I, Adar R, Pocino M, Sharon N.
Department of Human Microbiology, Sackler Faculty of Medicine, Tel
Aviv University, Israel.
Inhibition of bacterial adherence to bladder cells has been assumed
to account for the beneficial action ascribed to cranberry juice and
cranberry juice cocktail in the prevention of urinary tract
infections (A. E. Sobota, J. Urol. 131:1013-1016, 1984). We have
examined the effect of the cocktail and juice on the adherence of
Escherichia coli expressing surface lectins of defined sugar
specificity to yeasts, tissue culture cells, erythrocytes, and mouse
peritoneal macrophages. Cranberry juice cocktail inhibited the
adherence of urinary isolates expressing type 1 fimbriae (mannose
specific) and P fimbriae [specific for
alpha-D-Gal(1----4)-beta-D-Gal] but had no effect on a diarrheal
isolate expressing a CFA/I adhesin. The cocktail also inhibited
yeast agglutination by purified type 1 fimbriae. The inhibitory
activity for type 1 fimbriated E. coli was dialyzable and could be
ascribed to the fructose present in the cocktail; this sugar was
about 1/10 as active as methyl alpha-D-mannoside in inhibiting the
adherence of type 1 fimbriated bacteria. The inhibitory activity for
the P fimbriated bacteria was nondialyzable and was detected only
after preincubation of the bacteria with the cocktail. Cranberry
juice, orange juice, and pineapple juice also inhibited adherence of
type 1 fimbriated E. coli, most likely because of their fructose
content. However, the two latter juices did not inhibit the P
fimbriated bacteria. We conclude that cranberry juice contains at
least two inhibitors of lectin-mediated adherence of uropathogens to
eucaryotic cells. Further studies are required to establish whether
these inhibitors play a role in vivo.
Nippon Hinyokika Gakkai Zasshi 1989 Dec;80(12):1816-23
[Anti-bacterial defense mechanism of the urinary
bladder. Role of mannose in urine].
[Article in Japanese]
Toyota S, Fukushi Y, Katoh S, Orikasa S, Suzuki Y
Bacterial adherence to mucosa is thought to be an initial and
important stage to cause urinary tract infection. Among some
mechanisms of bacterial adherence, the role of fimbriae and its
receptor is worthy of notice. In particular, type 1 fimbriae, for
which mannose is assumed as a receptor, is reported as the most
common type and called "common fimbriae". Therefore if
a certain amount of mannose is present in urine, it will cover
the fimbriae of bacteria and competitively block the bacterial
to bladder mucosa. As the first step, we tried to detect mannose
urine by high performance liquid chromatography (HPLC). Sugar can
be measured by detecting the fluorescence which is produced by
separated by ion exchange, reacting with arginine at high
temperature. The results using standard sugar samples should have
highly stable retention time and concentration curve with the
minimum detectable mannose concentration of 0.02 microgram. We
investigated mannose in urine from 186 cases. Since the mannose
peak was often masked by near unidentified peaks, the peak of mannose
could be detected only in 80 cases and its concentration could
measured only in 24 cases. Mannose concentration in the urine of
the 24 cases was between 2.6 and 108.7 micrograms/ml and in most
cases it was lower than 20 micrograms/ml. Secondary, we examined
the possibility of a mannose in urine to prevent bacterial adherence
mucosa by the hemagglutination test using guinea pig erythrocytes
and type 1 fimbriated E. coli.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID: 2576290, UI: 90172805
also Dr. Jonathan Wright's article on mannose and urinary tract
infections online at http://www.tahoma-clinic.com/mannose.shtml ]
Use of specific sugars to inhibit bacterial
adherence to equine endometrium in vitro.
King SS, Young DA, Nequin LG, Carnevale EM
Department of Animal Science, Food, and Nutrition, College of
Agriculture and Science, Southern Illinois University, Carbondale
OBJECTIVE: To determine whether specific sugars inhibit adhesion of
Streptococcus zooepidemicus, Pseudomonas aeruginosa, and Escherichia
coli to equine endometrial epithelial cells in vitro. SAMPLE
POPULATION: Endometrial biopsy specimens collected during estrus from
7 healthy mares. PROCEDURE: Endometrial specimens on glass slides were
incubated for 30 minutes at 4 C with suspensions of S. zooepidemicus,
P. aeruginosa, or E. coli in phosphate-buffered saline solution (PBSS)
alone or with various concentrations of D-(+)-mannose, N-acetyl-D-glucosamine,
N-acetyl-D-galactosamine, D-(+)-glucose, galactose, or N-acetyl-neuraminic
acid. Inhibition of bacterial adherence was determined by comparing
adhesion of bacteria (i.e., percentage of glandular epithelial cells
with adherent bacteria) suspended in each sugar solution with that of
bacteria suspended in PBSS. RESULTS: Mannose and N-acetyl-D-galactosamine
inhibited adhesion of E. coli and P. aeruginosa to epithelial cells,
whereas only mannose inhibited adhesion of S. zooepidemicus. The other
sugars did not affect bacterial adherence. CONCLUSIONS AND CLINICAL
RELEVANCE: Mannose and N-acetyl-D-galactosamine appear to play a role
in adhesion of S. zooepidemicus, P. aeruginosa, and E. coli to equine
endometrium. In horses with uterine infections, use of sugars to
competitively displace bacteria from attachment sites on cells may
provide an adjunct to antibiotic treatment.
J Exp Med 1988 Jul
Receptor analogs and monoclonal antibodies that inhibit adherence of
Bordetella pertussis to human ciliated respiratory epithelial cells.
Tuomanen E, Towbin H, Rosenfelder G, Braun D, Larson G, Hansson GC,
Laboratory of Microbiology, Rockefeller University,
New York, New York 10021.
The adherence of Bordetella pertussis to human
respiratory cilia is critical to the pathogenesis of whooping cough. To
explore the development of agents that could interrupt adherence, the
structure of the receptor on the ciliary surface was investigated. Using
an in vitro adherence assay to human ciliated epithelial cells,
galactose, lactose, and complex carbohydrates containing lactose
eliminated adherence when preincubated with the bacteria. 10(-2) M
galactose eluted adherent bacteria from cilia. B. pertussis and its two
purified adhesins bound specifically to natural lactose-containing
glycolipids in a TLC assay. mAbs to eukaryotic glycoconjugates with
specificity for substituted galactose-glucose moieties blocked adherence
when preincubated with ciliated cells. The carbohydrates that serve as
receptors for B. pertussis on human cilia are
galactose-glucose-containing glycolipids. Receptor analogs and
anti-receptor antibodies effectively block adherence of B. pertussis to
cilia and thus should be considered candidates for therapeutic
intervention against disease.
Glycobiology and medicine: an introduction.
Department of Cellular and Molecular Sciences, St. George's Hospital
Medical School, London, England.
Following two articles deal with biofilms:
Nippon Jibiinkoka Gakkai Kaiho 1998
[Inhibitory effect of macrolide antibiotics on biofilm
formation by Pseudomonas aeruginosa].
[Article in Japanese]
Kondoh K, Hashiba M
Department of Otorhinolaryngology, Nagoya City University Medical
In recent years, various medical indwelling devices have been developed
and used. Bacteria adhering to these devices often cause refractory
infection. In the field of otolaryngology, refractory infection
accompanying these medical indwelling devices such as middle ear
ventilation tubes and artificial auditory ossicles has been reported.
The concept of bacterial biofilm infection has been suggested as an
explanation for the refractory infection. Furthermore it has been
reported that a bacterial biofilm is involved in refractory infection
unrelated to medical indwelling devices. Topical biofilm formation was
detected in patients with chronic sinusitis, chronic purulent otitis
media or habitual tonsillitis. In this study, we morphologically and
quantitatively examined the biofilm-forming capacity of a clinically
isolated strain of mucoid type Psecudomonas aeruginosa on Teflon to
investigate the effects of macrolide antibiotics on bacterial biofilm
formation. In the morphological examination, P.aeruginosa was cultured
together with a Teflon sheet in minimal medium containing various
concentrations of the macrolide antibiotics clarithromycin (CAM),
erythromycin (EM) and midecamycin (MDM), at 37 degrees C for 7 days.
The surfaces of the Teflon sheets were examined by electron microscopy.
adherent bacteria and biofilm formation on Teflon sheets soaked in
minimal medium containing CAM or EM were found to be decreased in a
dose-dependent manner. However, in the Teflon sheets soaked in minimal
medium containing MDM, there was no decrease in biofilm formation
regardless of the MDM concentration. In the quantitative examination,
P. aeruginosa was cultured in minimal medium containing various
concentrations of the macrolide antibiotics at 37 degrees C for 7 days
together with Teflon beads. The levels of hexose, protein and alginate
adhering to the Telfon beads were quantified as an estimation of biofilm
formation. On Teflon beads treated with CAM or EM, there were
dose-dependent decreases in hexose, protein and alginate levels. In
particular, marked decreases were noted when CAM and EM concentrations
were 10 micrograms/ml or more. Furthermore, there was no significant
difference between CAM and EM. However, in the presence of MDM, there
was no decrease in hexose, protein or alginate levels regardless of the
MDM concentration. The minimal inhibitory concentration (MIC100) of each
macrolide against P. aeruginosa used in this experiment was 100
micrograms/ml or more. There may be no bactericidal effect on this
strain at the macrolide concentrations used in this experiment. However,
this experiment used 7-day treatment. The long-term bactericidal
activity of macrolides was examined. In the presence of CAM or MDM,
bacterial levels after culture were similar to preculture levels or
slightly lower than the preculture levels. In the presence of EM,
bacterial levels were similar to the preculture levels. These results
demonstrated that CAM and EM, which are 14-membered macrolides inhibited
biofilm formation, while MDM which is 16-membered macrolide, did not.
These inhibitory effects of CAM and EM may be related to actions other
than bactericidal activity. In our experiment, CAM and EM inhibited
biofilm formation at 10 micrograms/ml or more. This concentration
corresponded to 1/20 x MIC. This concentration can be achieved in
tissues, nasal discharge and sputum with actual clinical doses.
Therefore, these agents may be effective against biofilm disease caused
by P. aeruginosa in the field of otolaryngology.
FEMS Immunol Med
Microbiol 1996 Jul;14(4):205-9
Inhibition of adhesion of Clostridium difficile to Caco-2 cells.
Naaber P, Lehto E, Salminen S, Mikelsaar M
Institute of Microbiology, University of Tartu, Estonia.
For many microorganisms, including Clostridium difficile,
mucosal association is an important factor influencing intestinal
colonisation and subsequent infection. Inhibition of adhesion of C.
difficile to intestinal mucosa could be a new promising strategy for
prevention and treatment of antibiotic-associated diarrhoea. We
investigated the possibilities of influencing the adhesion of C. difficile
by xylitol and bovine colostrum whey. Caco-2 cells and C. difficile cells
were incubated with 1%, 5% and 10% solutions of xylitol and colostrum. Our
study revealed that both xylitol and colostrum inhibited the adhesion of
C. difficile to Caco-2 cells. Inhibition by xylitol was dose-dependent.
When compared to the control, the count of adherent C. difficile decreased
3.4 times when treated with 1% xylitol, 12 times when 5% xylitol was
applied, and 18.7 times when treated with 10% xylitol. The inhibition of
adherence by colostrum was partially dose-dependent: 3.1 times in the case
of 1%, and 5.5 times in the cases of 5% and 10% colostrum. Further
experimental and clinical studies are needed for the application of
xylitol and colostrum in the treatment and prophylaxis of
Human milk kappa-casein and inhibition of Helicobacter pylori
adhesion to human gastric mucosa.
Stromqvist M, Falk P, Bergstrom S, Hansson L, Lonnerdal B, Normark S,
Symbicom AB, Umea University, Sweden.
Readily digested caseins, which account for almost half of the protein
content in human milk, are important as nutritional protein for breast-fed
infants. It has also been advocated that part of the antimicrobial
activity of human milk resides in the caseins, most likely the glycosyated
K-casein. Top explore this possibility, we purified K-casein from human
milk to homogeneity by a two-step size-exclusion chromatography procedure.
Purified human K-casein, in contrast to K-casein purified from bovine
milk, effectively inhibited the cell lineage-specific adhesion of
fluoroisothiocyanate-labeled Helicobacter pylori to human gastric surface
mucous cells. The inhibitory activity was abolished by metaperiodate
oxidation and considerably reduced by preincubation with alpha-L-fucosidase
but not with alpha-N-acetylneuraminidase or endo-beta-galactosidase. These
results strongly support the view that fucose containing carbohydrate
moieties of human K-casein are important for inhibition of H. pylori
adhesion and, thus, infection. They also suggest that breastfeeding may
protect from infection by H. pylori during early life and that
species-specific glycosylation patterns, as illustrated by human bovine
K-casein, partly determine both the narrow host spectrum of this human
gastric pathogen and the capacity to resist infection.
Pseudomonas aeruginosa II lectin stops human ciliary beating:
therapeutic implications of fucose.
Adam EC, Mitchell BS, Schumacher DU, Grant G, Schumacher U
Department of Human Morphology, University of Southampton, United Kingdom.
Respiratory tract infection by Pseudomomas aeruginosa may be
life-threatening for intensive care patients and patients with cystic
fibrosis (CF). The colonization of airways can be facilitated by bacterial
lectins (carbohydrate-binding proteins) that attach bacteria to the
glycoconjugates of the mucosa. We show in this paper that the
fucose-specific lectin P. aeruginosa agglutinin II (PAII) produced by
these bacteria can, in addition to facilitating bacterial adhesion, arrest
ciliary beating in human airways in vitro. This inhibitory effect of the
lectin can be abolished by preincubating PAII with its specific sugar,
fucose. Furthermore, ciliary beating is completely restored by addition of
fucose 2 h after administration of PAII to cell cultures. Therefore,
adding a simple monosaccharide to nebulizers may improve the management of
P. aeruginosa infection by abrogating the effect of PAII on ciliary
beating, thus restoring part of the nonspecific pulmonary defense
mechanisms of the airways.
Safe as mother's milk: carbohydrates as future
anti-adhesion drugs for bacterial diseases.
Sharon N, Ofek I.
Department of Biological Chemistry, The Weizmann Institute of Science,
Rehovot, Israel. firstname.lastname@example.org
The majority of infectious diseases are initiated by adhesion of pathogenic
organisms to the tissues of the host. In many cases, this adhesion is
mediated by lectins present on the surface of the infectious organism
that bind to complementary carbohydrates on the surface of the host tissues.
Lectin-deficient mutants often lack ability to initiate infection. Soluble
carbohydrates recognized by the bacterial lectins block the adhesion
bacteria to animal cells in vitro. Moreover, they have also been shown
to protect against experimental infection by lectin-carrying bacteria
different organs of mammals such as mice, rabbits, calves and monkeys.
In a phase II clinical trial, a pentasaccharide shown to have anti-adhesive
activity against Streptococcus pneumoniae and Hemophilus influenzae in
failed to protect young children from nasopharyngeal colonization with
these organisms and from developing otitis media. This could be because
insufficient drug was delivered via nasal spray, because bacteria express
multiple specificities, the inhibition of which may require a cocktail
oligosaccharides, or because children have different carbohydrate receptors
from those of adults. The results of a clinical trial in which
N-acetylneuraminyl(alpha2-3)lactose was administered orally to Helicobacter
pylori positive patients in an effort to reduce or eradicate bacterial
colonization, are awaited with interest. Although the high cost of
production of the required oligosaccharides is falling with the recent
introduction of enzymatic methods of synthesis, new technologies, in
particular the use of engineered bacteria, promise to lower it even further.
Attachment of the oligosaccharides to soluble polymeric carriers will
increase greatly their effectiveness as antiadhesion agents. There is
no doubt that anti-adhesive oligosaccharides will in the near future
arsenal of drugs for the therapy of bacterial diseases.
BMJ 2001 Jun 30;322(7302):1571
Randomised trial of cranberry-lingonberry juice and
Lactobacillus GG drink for the prevention of urinary tract infections in
Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari M.
Department of Pediatrics, University of Oulu, Oulu, Fin-90220, Finland.
Objective: To determine whether recurrences of urinary tract infection
can be prevented with cranberry-lingonberry juice or with Lactobacillus
drink. Design: Open, randomised controlled 12 month follow up trial.
Setting: Health centres for university students and staff of university
hospital. Participants: 150 women with urinary tract infection caused
by Escherichia coli randomly allocated into three groups. Interventions:
ml of cranberry-lingonberry juice concentrate daily for six months
or 100 ml of lactobacillus drink five days a week for one year, or
intervention. Main outcome measure: First recurrence of symptomatic
urinary tract infection, defined as bacterial growth >/=10(5 )colony
forming units/ml in a clean voided midstream urine specimen. Results:
The cumulative rate of first recurrence of urinary tract infection
12 month follow up differed significantly between the groups (P=0.048).
At six months, eight (16%) women in the cranberry group, 19 (39%) in
the lactobacillus group, and 18 (36%) in the control group had had
one recurrence. This is a 20% reduction in absolute risk in the cranberry
group compared with the control group (95% confidence interval 3% to
36%, P=0.023, number needed to treat=5, 95% confidence interval 3 to
Conclusion: Regular drinking of cranberry juice but not lactobacillus
seems to reduce the recurrence of urinary tract infection.
Emergence of multiple xylitol-resistant (fructose PTS-) mutants from
human isolates of Mutans streptococci during growth on dietary sugars in
the presence of xylitol.
Trahan L, Bourgeau G, Breton R
Groupe de Recherche en Ecologie Buccale, Faculte de medecine dentaire,
Universite Laval, Quebec, Canada.
The growth inhibition of Mutans streptococci is one of the proposed mechanisms
of action of xylitol, a caries-preventive natural carbohydrate sweetener.
Xylitol is taken up and accumulated as non-metabolizable, toxic xylitol
phosphate via a constitutive fructose PTS, and selects, during in vitro
growth at the expense of glucose, for natural xylitol-resistant mutants
constitutive fructose PTS activity. Since long-term xylitol consumption
leads to the emergence of xylitol-resistant Mutans populations in humans
in an oral
environment containing sugars of dietary origin, we wanted to test the
hypothesis that xylitol-resistant cells could be selected from Mutans
streptococci strains during in vitro growth on fructose, sucrose, or lactose.
Three laboratory strains and three fresh Mutans streptococcal isolates
were repeatedly transferred in trypticase-yeast extract medium supplemented
glucose, fructose, sucrose, or lactose in the presence and absence of xylitol.
Depending on the growth sugar, the presence of xylitol resulted in the
selection of xylitol-resistant populations for several of the six strains
tested, but not necessarily in the presence of all four sugars. All six
strains rapidly became xylitol-resistant when grown on glucose in the presence
of xylitol. All three fresh isolates became xylitol-resistant after 9 to
16 transfers in the presence of fructose or sucrose plus xylitol, while
the laboratory strains became xylitol-resistant after 16 transfers in the
presence of these sugars. The growth rates of 12 xylitol-resistant mutants
in the presence of eight sugars suggested the existence of various types
of xylitol-resistant mutants. The data partially explain the occurrence
xylitol-resistant Mutans populations in long-term xylitol consumers and
suggest a mechanism consistent with a selection process. Since various
preliminary results suggest that xylitol-resistant natural mutants may
be less virulent and less cariogenic than their parent strains, this selection
process may alter, for the better, the Mutans streptococci population of
and play a role in the caries-preventive action of xylitol.
Christian Science Monitor Oct 31, 2003 Sharon's newest critic:
Israeli army chief. By Cameron W. Barr JERUSALEM The chief of staff of
Defense Forces has added his voice to those
criticizing Prime Minister Ariel Sharon's hard-line policies for dealing
with the Palestinians. Lt. Gen. Moshe Yaalon, in remarks published this
week that were initially attributed to "IDF officials" but later
revealed as having been spoken by him, said that "in our tactical
decisions, we are operating contrary to our strategic interest."
Anti-Escherichia coli adhesin activity of cranberry and
Ofek I, Goldhar J, Zafriri D, Lis H, Adar R, Sharon N.
The spray described in these pages
is not a drug. This means that the people manufacturing this spray
cannot advertise what the spray does to prevent disease and illness.
The spray only helps to clean your nose. The benefits come from
a clean nose. The only way people will learn about this practical
and sensible way to help the immune system wash pollutants from
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A. H. 'Lon' Jones D.O.
812 West 8th St. Suite 2A
Plainview, Texas 79072
Phone (806) 291-0700
Fax (806) 293-8229