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UT Select - A New Urinary Tract Support Product From Moss Nutrition

10/01/2016 - Product Newsletter #295

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Any of you who have been in practice for more than a few months are well aware of how common urinary tract dysfunction is in many patients, particularly women.  Furthermore, because traditional approaches to this issue often provide only a short-term solution with a short-term impact on signs and symptoms, recurrent episodes of dysfunction can have a major adverse impact on quality of life. How common is the problem and what effect does it have on quality of life?  These questions were answered in the paper "D-mannose: a promising support for acute urinary tract infections in women. A pilot study" by Domenici et al (Domenici L et al.  Eur Rev Med Pharmacol Sci, Vol. 20, pp. 2920-2925, 2016):

"Urinary tract infections (UTIs) are extremely common in women; it is estimated that about 11% of women >18 years experience at least one episode of UTIs each year.

However these data are underestimated, in fact about 50% of UTI do not come to medical attention.  Over 65 years of age, the incidence of UTIs tends to increase due to functional and anatomical problems.

Isolated cases of UTIs are generally well tolerated by patients but in several occasions recurrent UTIs (defined as 2 infections in 6 months or 3 or more infections in one year) have a detrimental impact on the quality of life of these women.  Recurrent infections occur in 35-53% approximately of women who were treated within one year.'

With the above in mind, we are very excited to introduce to you our latest new product, UT Select.  As you will see from the enclose technical bulletin, UT Select contains several constituents that are designed to support urinary tract health.  However, based on research on the subject, two of these constituents have received the most attention, D-mannose and cranberry extract standardized for proanthocyanidins.  Therefore, in this newsletter I would like to review two studies: one that examined the efficacy of D-mannose and one that examined the efficacy of cranberry extract standardized for proanthocyanidins.

D-mannose

In the paper mentioned above by Domenici et al, the authors begin their discussion on D-mannose by providing some general information:

"D-mannose is a simple sugar, a monosaccharide extracted from larch rod, closely related to glucose.  D-mannose is rapidly absorbed and in about 30 minutes reaches the peripheral organs, then is excreted by the urinary tract.  It can't be transformed into glycogen, therefore, is not stored in the body.  A long-term use of D-mannose, in concentrations up to 20%, has not shown any side effect on human metabolism."

Why is D-mannose effective? It has to do with how bacteria adhere to cell surfaces.  As you will see in the quote below, one reason bacteria adhere to cell surfaces is because of the ability of bacteria to bind with D-mannose:

"The process of bacterial adhesion on the cell surface is a crucial factor for the onset of most infections.  This happens because specific lectins on the bacterial wall are able to bind molecules such as D-mannose and L-fucose distributed on the human cell surface."

With the above in mind, D-mannose demonstrates efficacy in the following manner:

"...D-mannose could be important in treating UTIs mediated by mannose specific binding...By inhibiting the adhesion of bacteria to the urothelium, D-mannose mimics urothelial barrier function.  Binding free D-mannose in the urine rather than proteins on the vescical cells surface, bacteria are trapped in the urinary flow and consequently eliminated by the urinary tract."

To assess the impact of D-mannose clinically, Domenici et al evaluated 43 patients aged between 18 and 65 years who were experiencing urinary tract dysfunction.  All received D-mannose twice daily for 3 days and then once a day for 10 days.  What were the results?  The authors note:

"In our study, D-mannose attested significant effects on specific symptoms control, such as on dysuria, pollachiuria, urgency, supra-pubic pain, tenesmus, and nicturia.  No statistically significant differences were observed regarding backache and haematuria."

With the above in mind, the authors concluded:

"Confirming our main endpoint, D-mannose...seems to own good efficacy and to be well tolerated in both pre- and postmenopausal women with history of UTIs.  Moreover, D-mannose demonstrated its effectiveness in reducing the incidence of UTI in a 6 month period and consequently in increasing quality of life.  Given this evidence, its administration might be beneficial in the prevention of UTIs in selection female populations."

Cranberry extract standardized for proanthocyanidins

Why is cranberry extract standardized for proanthocyanidins such an important component of UT Select?  This question was answered in the study "Effect of oral cranberry extract (standardized proanthocyanidin-A) in patients with recurrent UTI by pathogenic E. coli: a randomized placebo-controlled clinical research study" by Singh et al (Singh I et al.  Int Urol Nephrol, Vol. 48, pp. 1379-1386, 2016).  The paper begins by pointing that certain bacteria may be mannose resistant in terms of prevention of adhesion to epithelial cells of the urinary tract:

"The adhesin protein (pili/fimbriae) helps in adhesion of E. coli to uroepithelial cells causing UTI, and these proteins may be mannose resistant..."

With this fact in mind, the authors conducted an experiment employing the cranberry extract proanthocyanidin-A (PAC-A) in patients with recurrent UTIs due to E. coli.  Specifically, 36 patients demonstrating recurrent UTIs were supplemented with PAC-A for 12 weeks while another 36 patients demonstrating recurrent UTIs acted as a control group and received a placebo.  What were the results?  The authors pointed out:

"The overall efficacy and tolerability of standardized cranberry extract containing (PAC-A) were superior to placebo in terms of reduced bacterial adhesion; bacterial mannose-resistant hemagglutination assay negativity; urine pH reduction; and in preventing recurrent UTI (dysuria, bacteriuria and pyuria)."

SOME FINAL THOUGHTS

UT Select combines D-mannose, cranberry extract standardized for proanthocyanidins, and several other factors well known for their ability to optimize urinary tract health.  We are confident you will find UT Select to be an excellent adjunctive support product that, when employed with key lifestyle modifications, will be of great assistance in improving quality of life in those many patients who are experiencing the discomfort and erosion of quality of life due to recurrent suboptimal urinary tract function.

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