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Oral and physiological benefits of cranberries
Abstract
Cranberries are known to prevent urinary tract infection and it is also helpful in maintaining oral health. Cranberry juice is a widely consumed and recommended beverage for preventing urinary tract infections. Clinical studies in women have shown that cranberries help to stop the recurrence of infection, as the evidence showed the presence of various extracts of cranberries in the patients’ urinary tracts, proving the effectiveness and the mechanism. The primary compound involved in the fight against the infection is Proanthocyanidin A which is now the focus of studies to treat common diseases such as Helicobacter pylori-associated gastritis, as well as dental caries and periodontal disease, from which it is speculated the mechanism involves disrupting the bacterial adhesion.
... pylori activity. The dosage of cranberry extract varies depending on the specific product and the condition being treated [44]. However, most studies have used a dose of 500 mg to 1500 mg of cranberry extract per day. ...
Helicobacter pylori (H. pylori) infection is a major global health concern, with an estimated 50% of the world's population infected. The bacterium colonizes the stomach and is associated with a range of gastrointestinal diseases, including chronic gastritis, peptic ulcers, and gastric cancer. The current standard of care for H. pylori infection involves a combination of antibiotics and proton pump inhibitors (PPIs), but the widespread use of antibiotics has led to the development of antibiotic-resistant strains of H. pylori, making treatment more difficult. Recent advances in diagnostic strategies include the use of non-invasive tests and serological biomarkers. While the use of antibiotics and PPIs remains the primary treatment approach, there is a growing interest in alternative therapies, including botanical extracts, natural products, and traditional medicines. Recent research has also explored the potential of probiotics, phage therapy, and novel antibiotics, such as rifabutin and furazolidone, in the treatment of H. pylori infection. Recent studies have also explored the potential of artificial intelligence (AI) in the diagnosis and management of H. pylori infection. AI-assisted screening methods have identified novel botanical extracts and natural products with anti-H. pylori activity, providing new avenues for therapeutic development. Additionally, AI can improve diagnostic accuracy and treatment outcomes. Although these alternative approaches show promise, further research is needed to confirm their efficacy, safety, and optimal dosing. Novel therapies such as phage therapy and new antibiotics may provide an alternative to traditional treatments and help overcome antimicrobial resistance.
Background: periodontal disease is an inflammatory condition of the gums and the structures supporting the tooth(periodontium and alveolar bone), importance of diabetes mellitus type 2 and their effect on the periodontal disease andthe need further study about this subject.Objective: To compare the periodontal status of a group of diabetic patient with non-diabetic group.Material and method: case control study, 105 type 2 diabetics and 105 non diabetic(mean age: 50.47+_11.67) wereexamined in primary health center in AL-Adhamiyah sector, from the period 1 March 2018 until 1 July 2018, theperiodontal parameters were recorded, the plaque index (PI),gingival index (GI), Periodontal pocket depth (PPD), clinicalattachment level (CAL) and missing teeth these parameters were evaluated in a randomized half mouth examination.Result: Diabetics highly significant in PI(p=0.0001), GI(p=0.0001), CAL(p=0.0001) , PPD(p=0.0001) and missingteeth(p=0.0001).Conclusion: this study showed that diabetics had more severe and higher periodontal disease, diabetics and their healthcare givers should be informed of these findings so that diabetic patient can seek early management of periodontal disease.
Volatile compounds in fruits are responsible for their aroma. Among fruits, berries contain many volatile compounds, mainly esters, alcohols, terpenoids, aldehydes, ketones, and lactones. Studies for volatile compounds in berries have increased extensively as the consumption of berry products rapidly increased. In this paper, we reviewed biosynthesis and profiles of volatiles in some berries (strawberry, blueberry, raspberry, blackberry, and cranberry) and their bioavailability and health benefits, including anti-inflammatory, anti-cancer, anti-obesity, and anti-diabetic effects in vitro and in vivo. Each berry had different major volatiles, but monoterpene had an important role in all berries as aroma-active components. Volatile compounds were nonpolar and hydrophobic and rapidly absorbed and eliminated from our body after administration. Among them, monoterpenes, including linalool, limonene, and geraniol, showed many health benefits against inflammation, cancer, obesity, and diabetes in vitro and in vivo. More research on the health benefits of volatile compounds from berries and their bioavailability would be needed to confirm the bioactivities of berry volatiles.
Rational use of drugs underlies the development of a treatment strategy. In particular, it is important in dental practice to properly select odontoprotectors for the prevention, treatment and maintenance therapy of periodontal diseases. A methodological approach based on the Arskey & O’Malley’s framework was applied to analyse the state of knowledge and previous studies on the use of odontoprotector drug group at different stages of the therapeutic process of periodontal disease. Of the 6 initial scientific databases, the research was conducted in 3 databases that best met the specified search conditions: Google (Google Scholar); PubMed; Wiley InterScience (The Cochrane Library). The literature was selected for the last 5 years (2016-2021). A total of 492 scientific papers were analysed. It is established that the available scientific information is divided into 4 main areas: the use of herbal remedies and folk remedies; antibiotic therapy in dental practice; prospects for the use of nanotechnology in dentistry; results of experimental researches and review articles on a particular active pharmaceutical ingredient.
Among the chronic non-communicable degenerative diseases (CDNCDs), chronic kidney disease (CKD) represents a global public health problem. Recent studies demonstrate a mutual cause–effect relationship between CKD and oral diseases, in which the presence of one induces the onset and faster progression of the other. In particular, the oral cavity alterations more frequent in CKD patients are: chronic periodontitis diseases, bone lesions, oral infections, and oral cancer lesions. Currently, a standardized therapy for the treatment of oral diseases is lacking. For this reason, natural bioactive compounds (NBCs), characterized by several health effects, such as antioxidant, antimicrobial, anti-inflammatory and anti-cancer actions, represent a new possible adjuvant therapy in the management of these pathological conditions. Among NBCs, polyphenols play a leading role due to positive modulation of oral microbiota, preventing and correcting oral dysbiosis. Moreover, these compounds exert anti-inflammatory effects, such as inhibiting the production of pro-inflammatory cytokines and the expression of cycloxigenase-2. In this light, the formulation of a new mouthwash/gel/gingival paste, with a high content of polyphenols in association with NBCs characterized by antimicrobial action, could represent a future therapy of oral disease in CKD patients.
Periodontal diseases are one of the most significant challenges in dental health. It is estimated that only a few percent of the worldwide population have entirely healthy teeth, and according to WHO, oral diseases may affect up to 3.5 billion people worldwide. One of the most serious oral diseases is periodontitis, an inflammatory disease affecting periodontal tissues, caused by pathogenic bacteria and environmental factors such as the ageing population, abuse of tobacco products, and lack of adequate oral hygiene due low public awareness. Plant materials are widely and successfully used in the management of many conditions, including periodontitis. Plant materials for periodontitis exhibit antibacterial, anti-inflammatory, antioxidant activities and affect the periodontium structure. Numerous studies demonstrate the advantages of phytotherapy for periodontitis relief and indicate the usefulness of Baikal skullcap root, Pomegranate fruit peel and root cortex, Tea leaves, Chamomile flowers, Magnolia bark, Blackberry leaves and fruits, Cranberry fruits and Lippia sidoides essential oil. This review aims to analyze the use and applicability of selected plant materials in periodontitis management since it is of paramount importance to evaluate the evidence of the traditionally used plant materials in light of continuously growing interest in phytotherapy and its adjuvant role in the treatment of periodontitis.
Cranberry (Vaccinium macrocarpon) may be a potent natural adjuvant for the prevention of oral diseases due to its anti-adherence, anti-cariogenic, and anti-inflammatory properties. However, the high titrable acidity of cranberry juice (CJ) has been reported to cause gastrointestinal discomfort, leading consumers to restrict their intake of this beverage. Electrodialysis with a bipolar membrane (EDBM) can reduce the organic acid content of CJ while retaining the flavonoids associated with potential health benefits. This study aimed to assess how the deacidification of CJ by EDBM impacts the antibacterial properties of the beverage against cariogenic (Streptococcus mutans, Streptococcus sobrinus) and commensal (Streptococcus gordonii, Streptococcus oralis, Streptococcus salivarius) streptococci, and how it affects oral epithelial barrier function and inflammatory response in an in vitro model. The removal of organic acids from CJ (deacidification rate ≥42%) reduced the bactericidal activity of the beverage against planktonic S. mutans and S. gordonii after a 15-min exposure, whereas only the viability of S. gordonii was significantly impacted by CJ deacidification rate when the bacteria were embedded in a biofilm. Moreover, conditioning saliva-coated hydroxyapatite with undiluted CJ samples significantly lowered the adherence of S. mutans, S. sobrinus, and S. oralis. With respect to epithelial barrier function, exposure to CJ deacidified at a rate of ≥19% maintained the integrity of a keratinocyte monolayer over the course of 24 h compared to raw CJ, as assessed by the determination of transepithelial electrical resistance (TER) and fluorescein isothiocyanate-conjugated dextran paracellular transport. These results can be in part attributed to the inability of the deacidified CJ to disrupt two tight junction proteins, zonula occludens−1 and occludin, following exposure, unlike raw CJ. Deacidification of CJ impacted the secretion of IL-6, but not of IL-8, by oral epithelial cells. In conclusion, deacidification of CJ appears to provide benefits with respect to the maintenance of oral health.
Cranberry fruits are rich in polyphenols, comprising small‐molecule flavonols, anthocyanins, and oligomeric A‐type proanthocyanidins. It is becoming increasingly clear that the gut microbiota plays a crucial role in maintaining the metabolic health of the human host, and the cranberry polyphenols‐gut microbiota interactions result in the production of an array of metabolites along with the compositional change of microbiota. Cranberry polyphenols‐induced these changes may be associated with improved host health and disease prevention. However, it is unclear to what extent microbiota‐derived metabolites are absorbed into the systemic circulation and exert pharmacological effects. Because the composition of gut microbiota influences the host energy metabolism and have systemic effects on lipid homeostasis, intake of cranberry rich diet may be beneficial in preventing metabolic syndrome associated with chronic diseases. Exploring connections between alterations in gut microbiome composition, and host metabolic health after chronic exposure to cranberry products is critical for understanding the potential health benefits of cranberry fruits.
The worrying rise in antibiotic resistances emphasizes the need to seek new approaches for treating and preventing periodontal diseases. The purpose of this study was to evaluate the antibacterial and anti-biofilm activity of cranberry in a validated in vitro biofilm model. After chemical characterization of a selected phenolic-rich cranberry extract, its values for minimum inhibitory concentration and minimum bactericidal concentration were calculated for the six bacteria forming the biofilm (Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans). Antibacterial activity of the cranberry extract in the formed biofilm was evaluated by assessing the reduction in bacteria viability, using quantitative polymerase chain reaction (qPCR) combined with propidium monoazide (PMA), and by confocal laser scanning microscopy (CLSM), and anti-biofilm activity by studying the inhibition of the incorporation of different bacteria species in biofilms formed in the presence of the cranberry extract, using qPCR and CLSM. In planktonic state, bacteria viability was significantly reduced by cranberry (p < 0.05). When growing in biofilms, a significant effect was observed against initial and early colonizers (S. oralis (p ≤ 0.017), A. naeslundii (p = 0.006) and V. parvula (p = 0.010)) after 30 or 60 s of exposure, while no significant effects were detected against periodontal pathogens (F. nucleatum, P. gingivalis or A. actinomycetemcomitans (p > 0.05)). Conversely, cranberry significantly (p < 0.001 in all cases) interfered with the incorporation of five of the six bacteria species during the development of 6 h-biofilms, including P. gingivalis, A. actinomycetemcomitans, and F. nucleatum. It was concluded that cranberry had a moderate antibacterial effect against periodontal pathogens in biofilms, but relevant anti-biofilm properties, by affecting bacteria adhesion in the first 6 h of development of biofilms.
Bioactive polyphenol components of cranberry (Vaccinium macrocarpon) are known to have virulence attenuating effects against several cariogenic virulence properties responsible for dental caries pathogenesis. In particular, cranberry A-type proanthocyanidins and flavonols have demonstrated potent inhibitory effects against cariogenic virulence targets such as bacterial acidogenicity, aciduricity, glucan synthesis, and hydrophobicity. Cranberry phenols have the ability to disrupt these cariogenic virulence properties without being bactericidal, a key quality essential for retaining the benefits of the symbiotic resident oral microbiome and preventing the emergence of resistant microbes. This review discusses the cariostatic mechanisms of specific cranberry phytochemicals and their potential use as therapeutic agents against cariogenic bacteria in the prevention and control of dental caries.
Diabetes mellitus (DM) is one of the most common metabolic disorders associated with morbidity and mortality. Type II diabetes may be due to peripheral insulin resistance, defected insulin secretion or both. Cranberries are an evergreen class of midget sapling in the subgenus Oxycoccus of genus Vaccinium and have many pharmacological effects including antibacterial, antioxidant, cardio protective activity, anticancer, and hypoglycemic effects. The aim of this study is to assess the effect of cranberry in enhancingoral hypoglycemic agents in uncontrolled type II diabetic patients. The population sample consists of 60 type II diabetic patients aged between 35 and 63 years who met the diagnostic criteria of type II DM. Each patient was assessed individually using a case sheet that including age & sex, medical history and medication history. They were divided into two groups; the 1 st group was treated with metformin and sulfonylurea alone, the 2 nd group were treated with those agents plus cranberry capsules as add on treatment. The results showed significantly decline in blood glucose & glycated hemoglobin (HbA1c) which was changed from uncontrolled level 9.51% to controlled level 6.97% with aid of cranberryin group 2 in comparison with its change from 9.38% to 7.65% with oral hypoglycemic agents alone in group1 (p-value <0.0001). In conclusion, cranberry has a good hypoglycemic effect in treatment of type II DM and enhancing the effect of oral hypoglycemic agents.
Effective management of biofilm-related oral infectious diseases is a global challenge. Oral biofilm presents increased resistance to antimicrobial agents and elevated virulence compared with planktonic bacteria. Antimicrobial agents, such as chlorhexidine, have proven effective in the disruption/inhibition of oral biofilm. However, the challenge of precisely and continuously eliminating the specific pathogens without disturbing the microbial ecology still exists, which is a major factor in determining the virulence of a multispecies microbial consortium and the consequent development of oral infectious diseases. Therefore, several novel approaches are being developed to inhibit biofilm virulence without necessarily inducing microbial dysbiosis of the oral cavity. Nanoparticles, such as pH-responsive enzyme-mimic nanoparticles, have been developed to specifically target the acidic niches within the oral biofilm where tooth demineralization readily occurs, in effect controlling dental caries. Quaternary ammonium salts (QAS) such as dimethylaminododecyl methacrylate (DMADDM), when incorporated into dental adhesives or resin composite, have also shown excellent and durable antimicrobial activity and thus could effectively inhibit the occurrence of secondary caries. In addition, custom-designed small molecules, natural products and their derivatives, as well as basic amino acids such as arginine, have demonstrated ecological effects by modulating the virulence of the oral biofilm without universally killing the commensal bacteria, indicating a promising approach to the management of oral infectious diseases such as dental caries and periodontal diseases. This article aims to introduce these novel approaches that have shown potential in the control of oral biofilm. These methods may be utilized in the near future to effectively promote the clinical management of oral infectious diseases and thus benefit oral health.
Aim
To evaluate the effectiveness on tissue response of the new nutritional supplement made of oligomeric proanthocyanidins in induced gingivitis after 21 days of use.
Material and Methods
A prospective, double-blind, randomized, controlled clinical trial was carried out on 20 patients; it is divided into an experimental group and a control group after fulfilling the selection criteria. Patients had to come 4 times during the study to register the Silness and Löe index, the gingival bleeding index, the plaque index, the inflammatory crevicular fluid study (IL6), and the changes in the brightness of the gingiva. No complementary hygiene methods were allowed during the 21 days.
Results
The Silness and Löe index was higher in the control group than in the experimental group, reaching a twofold difference between the groups (p < 0.0001). The gingival bleeding index also supports this fact, since the bleeding was lower in the experimental group (p < 0.005). However, the dental plaque on the tooth surface according to the plaque index was 33% higher in the experimental group (p < 0.006). Some differences in the IL-6 were found in the crevicular fluid (p < 0.0001).
Conclusion
Oligomeric proanthocyanidins have an effect on the periodontal tissue's health. No effects on the accumulation of plaque on the tooth surface were found, so further studies are needed to determine the nature of the plaque.
Dental diseases if left unchecked can lead to major health problems, on the other side periodontal diseases are recognized as a major public health problem throughout the world and is the most common cause of tooth loss in adults. Plant products are recently introduced herbal formulations that are more beneficial than the conventional therapies. There are number of traditional herbal remedies for the treatment and management of diseases related to teeth, gum and oral hygiene. The aim of this review is to present a brief overview of the various herbal formulations and their application in prevention, treatment and maintenance of oral health.
In the past decade, cranberry extracts have been attracting ever-growing attention by dental researchers. The potential benefits of cranberry components in reducing oral diseases, including dental caries and periodontitis, are discussed in this review. A non-dialysable cranberry fraction enriched in high molecular weight polyphenols has very promising properties with respect to cariogenic and periodontopathogenic bacteria, as well as to the host inflammatory response and enzymes that degrade the extracellular matrix. Cranberry components are potential anti-caries agents since they inhibit acid production, attachment, and biofilm formation by Streptococcus mutans. Glucan-binding proteins, extracellular enzymes, carbohydrate production, and bacterial hydrophobicity, are all affected by cranberry components. Regarding periodontal diseases, the same cranberry fraction inhibits host inflammatory responses, production, and activity of enzymes that cause the destruction of the extracellular matrix, biofilm formation, and adherence of Porphyromonas gingivalis, and proteolytic activities and coaggregation of periodontopathogens. The above-listed effects suggest that cranberry components, especially those with high molecular weight, could serve as bioactive molecules for the prevention and/or treatment of oral diseases.
Periodontal disease is a persistent condition that damages tooth-related structures and causes tooth loss. It can be seen as gingivitis or periodontitis. Approximately 80% of adults suffer from gingivitis worldwide. Bacteria are essential for the development of this destructive disease. Although many of these bacteria are normal oral microflora, some risk factors help them produce biofilm, which causes inflammation in the oral cavity. Numerous therapeutic approaches are used to treat periodontal disease, minimize its symptoms, and possibly restore lost tissues, including behavioral-change techniques, systemic and local chemical drugs (chlorhexidine, zinc oxide, and silver-containing materials), and different kinds of surgeries. Natural materials comprise various chemical structures that have several biological activities. Therefore, they are at the center of attention in this decade. Herbal medicines have been used to manage periodontal disease, owing to their general safety and efficacy. Some of these studies are performed on volunteer patients, and some of them on laboratory animals. In this review, the results of in vitro, in vivo, and clinical trial studies (Recent decade) of chemical and herbal medicinal materials were collected to treat periodontal diseases to help future studies.
We present a series of multilayered alginate/chitosan microparticles fabricated via combining ionic gelation with the layer-by-layer (LbL) approach to improve oral administration of large cranberry fruit extract (CFE). Sodium alginate of low (ALGlv) or medium (ALGmv) viscosity was used as a core polymer, and chitosan (CHIT) and ALGmv layers were alternately assembled to form up to seven layers’ coating. Microparticles size ranged between 640 and 1120 μm, and their morphology, moisture content, and structural integrity were affected mainly by the outermost layer’s composition. Both the microgel core and shell composition of these microparticles influenced the mechanical properties determined by the parallel plates compression test. Microparticles exhibited good CFE entrapment efficiency (E.E. > 55%) and favorable release profiles in the simulated gastro-intestine environment, well described by the hybrid model of the release kinetics. Our results evidence that polysaccharide-inspired microparticles are good platforms for enhancing the oral bioavailability of poorly water-soluble therapeutic agents.
The aim of this study is to evaluate the clinical and microbiological effect of the systemic antibiotic therapy of proanthocyanidins and secnidazole on periodontitis. Seventy-five subjects with chronic periodontitis were randomly divided into two treatment groups (secnidazole or proanthocyanidins) and one placebo control group (25 cases each). Plaque index (PI), gingival index (GI), gingival bleeding index (BI), probing pocket depth (PPD), and clinical attachment level (CAL) were carried out at baseline, post-treatment and 3 months after treatment. Microbial analysis was performed at baseline and posttreatment. The results show that the two treatment groups had greater mean reduction in BI, GI, and PPD evaluated at both post-treatment and 3 months after treatment compared to the control group (p < 0.05), but there were no significant differences in those of PI and CAL (except CAL evaluated at posttreatment, p > 0.05). After treatment, culturable bacteria counts significantly decreased. In conclusion, the adjunctive use of proanthocyanidins or secnidazole in combination with scaling and root planing in adults with periodontitis is effective in reducing the pathogenic flora and achieves significantly better clinical results to a certain degree.
The present work aims to investigate the efficacy of thermoreversible gel of cranberry juice concentrate (CJC) as local drug delivery for the treatment of periodontitis. CJC was initially tested for its antimicrobial activities like MIC, MBC, antiadhesion, antibiofilm and time kill assay against the panel of organisms (S. mutans (SM), E. faecalis (EF), A. actinomycetemcomitans (AA), P. gingivalis (PG), T. forsythia (TF)) responsible for periapical and periodontal infections. Antimicrobial activity of CJC showed MIC value of 50 mg/ml and MBC value of 100 mg/ml with desirable antiadhesion (83–90%) and antibiofilm activity (70–85%). CJC was evaluated for its biocompatibility using periodontal fibroblasts by cell based MTT assay and found to be nontoxic. Influence of CJC on periodontopathogen PG derived virulence factors (fimA and kgp) was studied using real time polymerized chain reaction (RT-PCR) technique wherein down regulation of the expression of selected genes demonstrated inhibitory effect against PG virulence factors. Thermoreversible gel of CJC was formulated by cold method using poloxamer 407 as thermosensitive polymer and carbopol 934 as mucoadhesive polymer and evaluated for its gelation temperature, viscosity, gel strength and mucoadhesive strength. Comparison of optimized thermoreversible gel of CJC (500 mg/ml) with commercially available chlorhexidine gluconate gel (0.2%) using agar well diffusion demonstrated equal zone of inhibition against SM, EF, AA, PG & TF. Hence the formulated thermoreversible gel of CJC could serve as a novel herbal alternative to currently available periodontal treatment modalities.
Clinical, epidemiological and mechanistic studies support the role of cranberry (Vaccinium macrocarpon Ait.) in maintaining urinary tract health. Cranberry proanthocyanidins contain A-type linkages and have been associated with preventing adhesion of P-fimbriated uropathogenic Escherichia coli to uroepithelial cells. It is not known if the presence of the A-type linkage is a prerequisite for anti-adhesion activity. Other commercial sources of proanthocyanidins with all B-type linkages have not previously been screened for this activity. The goals of this study were to compare the in vitro anti-adhesion activity of A-linked proanthocyanidins from cranberry juice cocktail with the anti-adhesion activities of B-linked proanthocyanidins from commercial grape and apple juices, green tea and dark chocolate, and determine if anti-adhesion activity is detectable in human urine following consumption of single servings of each commercial food product. Structural heterogeneity and presence of the A-type linkage in cranberry proanthocyanidins was confirmed utilizing MALDI-TOF/MS and DI/ESI MS, as was the presence of all B-type linkages in the proanthocyanidins from the other commercial products. The isolated A-type proanthocyanidins from cranberry juice cocktail elicited in vitro anti-adhesion activity at 60 microg/ml, the B-type proanthocyanidins from grape exhibited minor activity at 1200 microg/ml, while other B-type proanthocyanidins were not active. Anti-adhesion activity in human urine was detected following cranberry juice cocktail consumption, but not after consumption of the non-cranberry food products. Results suggest that presence of the A-type linkage in cranberry proanthocyanidins may enhance both in vitro and urinary bacterial anti-adhesion activities and aid in maintaining urinary tract health.
Comparing the effect of three different mouthwashes cranberry, HIORA and chlorhexidine on the management of periodontal diseases
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Phytochemical and bioactive potential of Cranberry (Vaccinium macrocarpon) juice and its applications against Kidney and urinary tract infection (UTI)
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Epub 2010 Feb 22. PMID: 20176905; PMCID: PMC2863644.