Cranberry/Chondroitin Sulfate Co-precipitate as a New Method for Controlling Urinary Tract Infections

Urinary tract infections (UTI), which are among the most frequent cases of infectious diseases, mainly affect women. The most common treatment approach involves the use of antibiotics, although this solution is not always the most suitable, mainly because of the resistance that bacterial strains develop. Proanthocyanidins are a class of polyphenols, abundantly contained in cranberry extracts, which have shown beneficial effects in the treatment of urinary tract infections, due to their anti-adhesive properties toward bacteria, with respect to the membranes of the cells of the urothelium and intestine, thus reducing their virulence. In this work, we demonstrate via microscopy and scattering measurements how a mixture of cranberry and chondroitin sulfate can form a crosslinked structure with barrier properties. By using a design of experiment (DOE), we optimized the mass ratio to obtain a precipitate between cranberry extract and chondroitin sulfate in the presence of N-acetylcysteine and hyaluronic acid. By using transepithelial electrical resistance (TEER) chambers, we confirmed the barrier properties of the best mixture obtained with the DOE. Lastly, the antibiofilm action was investigated against five strains of Escherichia coli with different antibiotic sensitivity. The precipitate displayed a variable inhibitory effect in biofilm formation with major effects in UTI with an antibiotic resistance profile.

Automated summary

Urinary tract infections primarily affect women and are commonly treated with antibiotics. However, antibiotic resistance can limit the effectiveness of this approach. Proanthocyanidins found in cranberry extracts have shown promise as a treatment for UTIs due to their ability to inhibit bacterial adhesion, reducing virulence. This study demonstrated via microscopy and scattering measurements that a mixture of cranberry and chondroitin sulfate can form a crosslinked structure with barrier properties. The best mixture was identified through experimentation and confirmed to have barrier properties using transepithelial electrical resistance chambers. Additionally, the mixture showed variable inhibitory effects on biofilm formation by antibiotic-resistant Escherichia coli strains, suggesting potential benefits for UTIs with antibiotic resistance profiles.