Anti-Bacterial Defense Mechanism of the Urinary Bladder

Abstract

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 adherence to bladder mucosa. As the first step, we tried to detect mannose in urine by high performance liquid chromatography (HPLC). Sugar can be measured by detecting the fluorescence which is produced by a sugar 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 be 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 of cases it was lower than 20 micrograms/ml. Secondary, we examined the possibility of a mannose in urine to prevent bacterial adherence to mucosa by the hemagglutination test using guinea pig erythrocytes and type 1 fimbriated E. coli.(ABSTRACT TRUNCATED AT 250 WORDS)

Architecture and function of human uromodulin filaments in urinary tract infections

“…Pre-formed clumps could only be dissolved at the highest mannose concentration (1 M) (A) Table illustrating the sustained presence of Umod-type 1 piliated E. coli clumps when incubated at different D-mannose (Man) concentrations. The normal physiological range of Man concentration in the urine (60) is highlighted in yellow. + denotes the presence of clumps observed at t = 0 for all conditions.…”

AIM and NBO analyses on hydrogen bonds formation in sugar-based surfactants (α/β-d-mannose and n-octyl-α/β-d-mannopyranoside): a density functional theory study

“…[1] Mannose are generally found in a number of fruits (including cranberries), [2] and dextro mannose (D-mannose) is thought to keep bacteria from remaining on the walls of the urinary tract, which is why it is used to prevent and treat urinary tract infections. [3] Mannose and glucose are different from each other since they are epimers at the C2 position but, surprisingly, many of their physical behaviours are different. [4] In addition, there are two possible stereoisomers at the C1 position, two possible orientations (axial/equatorial) of the hydroxyl group, thus resulting in two anomers, namely, α-D-mannose and β-D-mannose.…”

Role of D-mannose in urinary tract infections – a narrative review

“…In addition, good affinity of mannose and mannosides to E.coli type 1 pilus structures has been shown by several in vitro experiments [ 57 – 60 ]. Furthermore, based on an animal trial even at concentrations as low as 20 μg/ml, D-mannose can efficiently block uropathogenic E. coli adhesion to the urinary tract, subsequently lowering the risk for UTI [ 61 ]. Several clinical trials have assessed the potential of D-mannose supplementation to improve either acute clinical and symptomatic outcome of UTI or/and shorten the time-to-relapse in rUTIs.…”

“…Bouckaert et al [ 57 ] demonstrated that the affinity of mannose to FimH is very high, especially compared to other monosaccharides (fructose 15-fold less, glucose 4000-fold less). Animal trials have shown that free D-mannose in urine, even in low concentrations (< 20 μg/ml) can inhibit bacterial adherence mediated by type 1 pili to urinary tract mucosa of pigs [ 61 ]. A rat study by Michaels et al , [ 62 ] demonstrated that beneficial effects on bacteriuria can be reached already after one day of saccharide injection (D-mannose or D-glucose), the efficacy being dependent on both the injected dose and the amount of E. coli .…”