The bacterium responsible for cystitis has a long appendage called pili or fimbriae, which looks like a hair, with the protein FimH at its end as a constituent element. This protein then adheres to sugars in the cells of the urinary tract. Scientists have observed that the more the bacteria is under pressure, particularly from the urinary flow, the more strongly it attaches to the urinary tract. In other words, the FimH protein prevents the E.Coli bacteria from being eliminated through the urine and as soon as the pressure is released, the bacteria can detach and “swim” upstream towards the bladder.
For the prevention and therapy of urinary tract infections caused by E.Coli, drugs that could prevent the binding of the FimH protein to the cells of the urinary tract could prove to be an interesting treatment alternative making the use of antibiotics superfluous.
The teacher. Ernst from the University of Basel has been working intensively for years on the development of antagonists to this protein. The elucidation of this mechanism should contribute significantly to the forthcoming identification of suitable solutions.
Mannose: natural remedy for recurrent cystitis as effective as antibiotics
Mannose is often an attractive alternative to antibiotics for the treatment of uncomplicated recurrent cystitis because it binds to the FimH protein of E.Coli bacteria. Mannose is a simple sugar, it can be bought in pharmacies, for example in the form of D-mannose. The dosage for the prevention of cystitis is 2 gr per day, simply dissolved in a glass of water. Mannose thus acts as a natural antagonist of the FimH protein. A Croatian study carried out on more than 300 women showed that mannose was as effective as antibiotics for the prevention of recurrent urinary tract infections. Mannose leads to fewer side effects than antibiotics, one side effect sometimes seen with mannose is diarrhea. Another excellent way to prevent cystitis is to drink plenty and regularly.
Elderly people: risk of delirium
In older people (eg 80 years or older), the classic symptoms of cystitis such as the constant urge to urinate can often be absent, which greatly complicates the diagnosis. The elderly person may, however, present symptoms such as confusion, memory problems, delusions or even hallucinations. Restlessness and dizziness are two other possible symptoms. Delusions can, for example, be characterized by forgetting the first names of grandchildren, aggressiveness, strange behavior, etc. The origin of these delusions comes from a change in the immune system of the elderly person. These mental symptoms often precede the typical symptoms of cystitis such as pain or frequent urination and may even sometimes be the only symptoms of cystitis in the elderly.
Sauer, Jakob: Catch-bond mechanism of the bacterial adhesin FimH. Common Nature.7;7:10738. doi: 10.1038/ncomms10738.
Kranjčec, Papeš: D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial.World J Urol.32(1):79-84. doi: 10.1007/s00345-013-1091-6.