Wetenschappelijk onderzoek over blaasontsteking

Het protocol voor de behandeling een blaasontsteking is op basis van wetenschappelijke publicaties ontwikkeld. Hierbij is gebruik gemaakt van de National Library of Medicine. Daar waar mogelijk werden studies die opgezet zijn volgens het “placebo controlled cross-over” principe gebruikt. Andere vormen die vaak werden gebruik zijn reviews en epidemiologisch onderzoek. Publicaties uit bladen als The Lancet, American Journal of Cardiology, The New England Journal of Medicine etc. hadden de voorkeur.

Referenties wetenschappelijke artikelen blaasontsteking

Referenties blaasontsteking – Adhesie van bacterien aan de blaaswand

1. Bacterial adherence: adhesin-receptor interactions mediating the attachment of bacteria to mucosal surface
   
   Recent studies have indicated that the attachment of bacteria to mucosal surfaces is the initial event in the pathogenesis of most infectious diseases due to bacteria in animals and humans. An understanding of the mechanisms of attachment and a definition of the adhesive molecules on the surfaces of bacteria (adhesins) as well as those on host cell membranes (receptors) have suggested new approaches to the prevention of serious bacterial infections
2. Bacterial adherence in the pathogenesis of urinary tract infection: a review
   
   Bacterial adherence to the uroepithelium is recognized as an important mechanism in the initiation and pathogenesis of urinary tract infections (UTI). The uropathogens originate predominantly in the intestinal tract and initially colonize the periurethral region and ascend into the bladder, resulting in symptomatic or asymptomatic bacteriuria.

Referenties blaasontsteking – Cranberry

1. Cranberries for preventing urinary tract infections
   
   There is some evidence from two good quality RCTs that cranberry juice may decrease the number of symptomatic UTIs over a 12 month period in women.
2. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women
   
   Cranberry tablets provided the most cost-effective prevention for UTI.
3. Reduction of bacteriuria and pyuria after ingestion of cranberry juice
   
   These findings suggest that use of a cranberry beverage reduces the frequency of bacteriuria with pyuria in older women. Prevalent beliefs about the effects of cranberry juice on the urinary tract may have microbiologic justification.
4. Possible Interaction Between Warfarin and Cranberry Juice
   
   Since publication of my article1 on the use of cranberry for prevention of urinary tract infections, I have received numerous letters indicating concern about a possible interaction between cranberry and warfarin (Coumadin).
5. Role of cranberry juice on molecular-scale surface characteristics and adhesion behavior of Escherichia coli.
   
   Our results demonstrate molecular-level changes in the surfaces of P-fimbriated E. coli upon exposure to neutralized cranberry juice. (c) 2005 Wiley Periodicals, Inc.
6. Inhibitory activity of cranberry juice on adherence of type 1 and type P fimbriated Escherichia coli to eucaryotic cells
   
   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.
7. Cranberry juice and urinary tract infection
   
   Cranberries have long been the focus of interest for their beneficial effects in preventing urinary tract infections (UTIs). Cranberries contain 2 compounds with antiadherence properties that prevent fimbriated Escherichia coli from adhering to uroepithelial cells in the urinary tract.
8. Cranberry proanthocyanidins and the maintenance of urinary tract health
   
   Proanthocyanidins with unique molecular structures have been isolated from cranberry fruit that exhibit potent bacterial antiadhesion activity

Referenties blaasontsteking – Zink / selenium

1. Impact of trace elements and vitamin supplementation on immunity and infections in institutionalized elderly patients: a randomized controlled trial. MIN. VIT. AOX. geriatric network
   
   Low-dose supplementation of zinc and selenium provides significant improvement in elderly patients by increasing the humoral response after vaccination and could have considerable public health importance by reducing morbidity from respiratory tract infections
2. Nutritional strategies to boost immunity and prevent infection in elderly individuals
   
   Older adults are at risk for malnutrition, which may contribute to their increased risk of infection. Nutritional supplementation strategies can reduce this risk and reverse some of the immune dysfunction associated with advanced age. Specific syndromes may also be addressed by nutritional interventions (for example, cranberry juice consumption to reduce urinary tract infections) and may reduce antibiotic use in older adults, particularly those living in long-term care facilities.
3. Prostatic antibacterial factor. Identity and significance
   
   The data presented suggest that zinc may serve as an in vivo defense mechanism against prostatic invasion and subsequent urinary tract infections in men.

Referenties blaasontsteking – Vitamine C

1. In vitro evaluation of a new treatment for urinary tract infections caused by nitrate-reducing bacter
   
   Dietary and endogenous nitrates are excreted in urine, and during infection with nitrate-reducing bacteria they are reduced to nitrite. At a low pH nitrite is converted to a variety of nitrogen oxides that are toxic to bacteria. We hypothesized that acidification of nitrite-rich infected urine would result in the killing of the nitrate-reducing bacteria.
2. Effects of pH, nitrite, and ascorbic acid on nonenzymatic nitric oxide generation and bacterial growth in urine
   
   In conclusion, we show that the growth of three common urinary pathogens is markedly inhibited in mildly acidified urine when nitrite is present. The bacteriostatic effect of acidified nitrite is likely related to the release of NO and other toxic reactive nitrogen intermediates. These results may help to explain the well-known beneficial effects of urinary acidification with, e.g., vitamin C in treatment and prevention of urinary tract infection.

Referenties blaasontsteking – D-Mannose

1. Anti-bacterial defense mechanism of the urinary bladder. Role of mannose in urine
   
   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.
2. Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats
   
   The results indicate that D-mannose and D-glucose can significantly reduce bacteriuria within 1 day and that their efficacy is dependent upon the concentration of both saccharide and bacteria
3. Conservation of the D-mannose-adhesion protein among type 1 fimbriated members of the family Enterobacteriaceae
   
   Our results may have implications for the development of broadly protective vaccines against Gram-negative bacillary infections in animals and perhaps in man
4. Protection against Escherichia coli-induced urinary tract infections with hybridoma antibodies directed against type 1 fimbriae or complementary D-mannose receptors.
   
   Hybridoma antibodies directed against quaternary structural epitopes of the type 1 fimbrial adhesin of Escherichia coli or against D-mannose, the sugar determinant in the complementary host cell receptor, prevented the attachment of mannose-sensitive E. coli to various eucaryotic cells. These studies provide evidence that bacterial colonization can be blocked or interrupted by antibodies directed against either the adhesin or the complementary host cell receptor of pathogenic microorganisms.
5. Mannose-sensitive adherence of Escherichia coli to epithelial cells from women with recurrent urinary tract infections
   
   D-mannose inhibited completely the adherence of 25 strains (42 per cent) that adhered to vaginal cells and inhibited an additional 11 strains (18 per cent) by at least 50 per cent. Similar results were obtained with buccal cells. The inhibitory effect of D-mannose was similar regardless of the origin of the strains.
6. Mannose-specific adherence of Escherichia coli freshly excreted in the urine of patients with urinary tract infections, and of isolates subcultured from the infected urine
   
   We propose that whereas at the initial stages of infection the bacteria may benefit from their ability to bind to mannose residues on epithelial cells, loss of this ability at the later stages of the infection is also beneficial, since the bacteria can no longer adhere to mannose residues on phagocytes, and are thus resistant to nonimmune phagocytosis

Referenties blaasontsteking – Probiotica

1. Probiotics to prevent urinary tract infections: the rationale and evidence.
   
   The concept of artificially boosting the lactobacilli numbers through probiotic instillation has long been conceived, but only in recent years shown to be possible.
2. Urogenital infections in women: can probiotics help?
   
   There is good clinical evidence to show that the intestinal and urogenital microbial flora have a central role in maintaining both the health and wellbeing of humans. Furthermore, the use of “good bacteria” to replace or augment bacterial populations is gradually achieving scientific acceptance. This application is termed probiotics: “live micro-organisms which when administered in adequate amounts confer a health benefit on the host”.
3. The role of cranberry and probiotics in intestinal and urogenital tract health
   
   There is also a mechanistic basis and clinical support for use of Lactobacillus strains such as L. rhamnosus GR-1 and L. fermentum RC-14 to colonize the intestine and vagina and reduce the risk of intestinal and urogenital infections.
4. Could probiotics be an option for treating and preventing urogenital infections?
   
   Although few strains have been selected and targeted for urogenital applications, and none are currently available on the market, evidence shows that probiotic therapy has the potential to make an impact on women’s health