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D‐mannose consumption and bacterial anti‐adhesion activity in human urine

Ingestion of D‐mannose has been hypothesized to prevent bacterial adhesion in the urinary tract, since it is the uroepithelial cell receptor for Type 1 E. coli. There are few, if any, studies on effects of D‐mannose on UTI prevention, and it is questionable whether sufficient urinary concentrations are achieved to elicit an anti‐adhesion effect. The aim of this study was to determine if consumption of D‐mannose alters urinary bacterial adhesion activity. D‐mannose was administered (1,000 mg, 2,000 mg, and 4,000 mg) in single doses on subsequent days, with 3‐d wash‐out periods between doses. Urines were collected prior to mannose consumption and every 3 h for 12 h, and again at 24 h following ingestion. Urines were tested utilizing a mannose‐sensitive guinea pig red blood cell hemagglutination assay specific for Type 1‐fimbriated E. coli. Effective anti‐adhesion concentrations of D‐mannose were determined by a dilution series, followed by an activity threshold. Urinary pH averaged 6.5, eliminating a bacteriostatic effect. Over 50% of urines demonstrated anti‐adhesion activity; but, there was no relationship between level of activity and amount of mannose ingested. This suggests the measured anti‐adhesion activity was a “background” effect caused by endogenous excretion of Tamms‐Horsfall glycoprotein, and that ingested mannose did not affect anti‐adhesion activity. This work was supported by Theralogix, LLC.