Cranberry (Vaccinium macrocarpon Ait., Ericaceae) juice has been used for urinary tract infections for approximately 50 years. Recent research suggests that this botanical blocks adherence of pathogenic E. coli to urinary tract cells, thus preventing infection. While current evidence indicates that proanthocyanidins are responsible for this activity, these compounds may not reach the urinary tract, thus further investigation is warranted. Fractionation of cranberry juice concentrate was guided by a recently published antiadherence assay, and the resulting fractions were phytochemically characterized. Two new coumaroyl iridoid glycosides, 10-p-trans-(1) and 10-p-cis-coumaroyl-1S-dihydromonotropein (2), and a depside, 2-O-(3,4-dihydroxybenzoyl)-2,4,6-trihydroxyphenylmethylacetate (3) were isolated, and although these compounds did not have antiadherent activity in isolation, they might constitute a new group of marker compounds for this active fraction of cranberry.Cranberry (Vaccinium macrocarpon Ait., Ericaceae) juice, generally in the form of cranberry juice cocktail consisting of a mixture of cranberry juice, water and sugar, is a popular botanical dietary supplement 1, 2 primarily used for the treatment and prevention of urinary tract infections, with documented human use for at least 47 years. 3 This use is supported by several clinical trials, 4-11 although some trials, notably for children with neuropathic bladder and catheterization, did not find cranberry to be effective. 12, 13 Cranberry juice was originally believed to be active due to its acidifying effect on urine, and/or the increased excretion of the cranberry urinary metabolite hippuric acid. 14, 15 However, subsequent research suggested that the bacteriostatic impact from acidification alone could not account for its demonstrated effects. 16,17 Inhibition of adherence of Escherichia coli to uroepithelial cells, 18-20 rather than direct bacteriostatic or bactericidal activity, has been proposed as the mechanism of action. Specifically, there is support for inhibition of the papG fimbrial attachment of uropathogenic strains of E. coli to human cells 21, 22 by cranberry's A-type proanthocyanidin compounds, but not by a B-type dimer or the (-)-epicatechin monomer. 18, 23 Proanthocyanidins, however, may not be assimilated in the gut, nor reach the urinary tract intact. 24 The putative active cranberry A-type proanthocyanidin oligomers, containing a second link (carbon-oxygen) between at least two of their epicatechin monomer units, are chemically similar to B-type proanthocyanidins, which contain only single, carbon-carbon links between units. Knowledge *To whom correspondence should be addressed. Tel: 312-355-1949. Fax: 312-355-2693. E-mail: gfp@uic.edu. † Equally contributing authors Supporting Information. HPLC chromatograms of the two lots of cranberry juice used in this research, including retention time for known cranberry compounds ideain chloride, resveratrol, and benzoic acid, are available free of charge via the Internet at http://pu...