Worth reading !!! CRANBERRIES [from memorial sloan-kettering cancer center] .........some parts of the article are colored by me]

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From cancer battle field:

One study conducted by Dr Neto, assistant professor of the University of Massachusetts-Dartmouth, reported that cranberries are toxic to lung cancer cells as well as to cervical, prostate, breast and leukemia cancer cells. Unlike cytotoxic drugs, they aren’t toxic to healthy cells.
As compared to other fruits, cranberries have the strongest capacity to inhibit proliferation of human liver cancer cells and breast cancer cells. Other studies suggest that phytochemicals in cranberries also inhibits skin, ovarian and brain cancer cells.

 

 

Cranberry [from Sloan kettering]

Scientific Name
Vaccinium macrocarpon
Common Name

Mossberry, Sassamanash, bounceberry

Clinical Summary

Cranberry is an evergreen shrub that is grown in North America and in Europe. The processed fruit and juice, which are rich in vitamin C, are widely consumed as food. The juice extract is marketed as a dietary supplement for urinary tract health. Cranberry is thought to have antibacterial, anti-inflammatory, and antioxidant activities. It is used for oral and gastrointestinal infections, cardiovascular diseases, and against cancer. The proanthocyanidins in cranberries inhibit the adherence of E. coli fimbriae to uroepithelial cells(1) in vitro. Clinical studies demonstrate that cranberry extracts can help prevent urinary tract infections (UTI) in adults (2) (3), in children (4) and in prostate cancer patients undergoing radiation therapy (5). However, regular consumption of cranberry juice did not confer protection against UTIs (6). While cranberry is not as effective as trimethoprim-sulfamethoxazole in preventing UTI, patients using cranberry are also less likely to develop antibiotic resistant bacteria (7) (8). But conclusions from a meta-analysis indicate that there is not enough evidence to recommend cranberry juice for the prevention of UTIs (9).
In studies of cancer prevention and treatment, cranberry extracts demonstrated anti-proliferative effects against prostate (10) (11) (12), liver (13), breast (14), ovarian (15), colon (12,16), and oral (12) cancer cell lines in vitro. However, cranberry juice consumption did not lower oxidative status in humans suggesting lack of protective effect against cancer or heart disease (17).
Cranberry juice also inhibited the adhesion of H. pylori to human gastric mucosa (18). Regular consumption of cranberry juice can suppress H. pylori infection (19) (20), a major factor in peptic ulcer disease and gastric cancer. When used with standard treatment,cranberry juice helps to eradicate H. pylori in women(21).
Cranberry juice has also been shown to prevent plaque formation and the development of gum disease due to its anti-colonizing and anti-adhesion properties (22) (23).

Cranberry products may interact with prescription drugs and may increase risk of kidney stone formation.

Food Sources

Cranberry can be consumed as juice, sauce, or dried fruit.

Purported Uses
  • Urinary Tract Infections
  • Cancer Prevention and Treatment
  • Antiaging
  • Ulcers
  • Atherosclerosis
  • Gum disease
Constituents

Flavonols, anthocyanins (Quercetin, myricetin, cyanidin and peonidin), and proanthocyanidins, Catechins, phenolic acids, triterpenoids (ursolic acid) (24).

Mechanism of Action

Proanthocyanidins found in cranberries inhibit P-fimbriated E. coli from adhering to the uroepithelial cells, thus preventing the development of infections (25) (26) (27) (28). Research suggests that the high number of A-type linkage proanthocyanidins found in cranberries may enhance in vitro and urinary bacterial anti-adhesion activities that prevent UTIs (27). A constituent of cranberry juice inhibits adhesion of H. pylori to immobilized human mucus, human erythrocytes, and cultured gastric epithelial cells, suggesting that cranberry juice may also prevent stomach ulcers caused by H. pylori via preventing the adhesion of bacteria to the stomach lining (18) (29). Cranberry juice was also shown to decrease adherence of oral streptococci strains to saliva-coated hydroxyapatite (23), glucan-coated hydroxyapatite, and impaired biofilm formation(22) (30) indicating that cranberry juice may slow the development of dental plaque and offer protection from plaque-related diseases. A proanthocyanidin from cranberry has been shown to arrest ovarian cancer cell growth by inhibiting vascular endothelial growth factor and by generating reactive oxygen species (15). Cranberry extract inhibits prostate cancer cell growth by decreasing the expression of cyclin-dependant kinase and cyclins (10). It also decreases matrix metalloproteinase activity (31).

Contraindications

Warfarin: Data are conflicting on cranberry's ability to enhance the potential of warfarin (34) (35).

Adverse Reactions

Case Reports
Several cases of increased INR (36) (37)and/or bleeding due to suspected interactions involving warfarin and cranberry juice have been reported. Two patients suffered internal hemorrhage following concurrent use of warfarin and cranberry juice that resulted in their deaths (38,39).

Cranberry products can increase urine oxalate excretion and may promote the formation of kidney stones(32) (33) (40).

Herb-Drug Interactions
  • Warfarin: Cranberry juice may potentiate warfarin-induced anticoagulation, but data are conflicting(34) (41).
  • Cyclosporin: A randomized controlled trial has shown that 240 mL of cranberry juice had no clinically significant effect on the disposition of a 200 mg dose of cyclosporin (42).
  • UGT (Uridine 5'-diphospho-glucuronosyltransferase) substrates: Cranberry modulates UGT enzymes in vitro and can increase risk of side effects of drugs metabolized by them (35).
  • Cytochrome P450 substrates: Cranberry inhibits enteric CYP3A activities and may interfere with the absorption of substrate drugs (43). Cranberry inhibits CYP2C9 in in vitro studies, but this activity was not observed in humans (44).
Herb Lab Interactions

Urinary pH has been shown to decrease after drinking cranberry juice (32) (33).

Literature Summary and Critique

Beerepoot MAJ, Riet GT, Nys S, et al. Cranberries vs Antibiotics to Prevent Urinary Tract Infections. A Randomized Double-blind Noninferiority Trial in Premenopausal Women. Arch Intern Med.2011;171(14):1270-1278.
In this study, 221 premenopausal women with recurrent urinary tract infections (UTIs) were randomized to receive trimethoprim-sulfamethoxazole (TMP-SMX), 480 mg once daily, or cranberry capsules, 500mg twice daily for one year. The primary end points were the mean number of symptomatic UTIs, the proportion of patients with at least 1 symptomatic UTI, the median time to first UTI, and development of antibiotic resistance in indigenous Escherichia coli. Researchers observed the mean number and proportion of patients with at least 1 symptomatic UTI to be higher in the cranberry group. The median time to first symptomatic UTI was 4 and 8 months for the cranberry and TMP-SMX groups respectively. However, increased resistance was observed for TMP-SMX, trimethoprim, amoxicillin, and ciprofloxacin in the E.coliisolates in the TMP-SMX group. No such increases were seen in women who took cranberry.
TMP-SMX is more effective than cranberry capsules in preventing recurrent UTIs but antibiotic resistance is a major concern.

Barbosa-Cesnik C, Brown MB, Buxton M, et al. Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clin Infect Dis. 2011 Jan;52(1):23-30.
In this double-blind, placebo-controlled trial 319 college-aged women with acute urinary tract infection (UTI) were randomized to receive 8 ounces of 27% cranberry juice twice daily or placebo for six months. The subjects were followed up for 6 months or until the occurrence of a second UTI. Researchers failed to find any significant differences in urinary symptoms between the treatment and placebo groups at follow-up. Although small studies have reported the benefits of cranberry juice for prevention of UTIs, large randomized studies are lacking. Further research is needed to determine the usefulness of cranberry juice.

Zhang L, Ma J, Pan K, Go VL, Chen J, You WC. Efficacy of cranberry juice on Helicobacter pylori infection: a double-blind, randomized placebo-controlled trial. Helicobacter 2005;10(2):139-45.
This randomized, double-blind, placebo-controlled trial was conducted to test the effectiveness of cranberry juice in the suppression of H. pylori in an endemically infected population. One hundred and eighty seven adults with H. pylori infection were randomly assigned to receive cranberry juice or a placebo for 90 days. The extent of H. pylori infection was determined using the 13C-urea breath test. The study concluded that significantly more subjects in the cranberry juice group (14.43%) than the placebo group (5.44%) yielded negative test results, suggesting that regular consumption of cranberry juice can suppress H. pylori infection in endemically infected populations.

References
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    1. Beerepoot MA, ter Riet G, Nys S, et al. Cranberries vs antibiotics to prevent urinary tract infections: a randomized double-blind noninferiority trial in premenopausal women. Archives of internal medicine. Jul 252011;171(14):1270-1278.
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    1. Foo LY, Lu Y, Howell AB, et al. The structure of cranberry proanthocyanidins which inhibit adherence of uropathogenic P-fimbriated Escherichia coli in vitro. Phytochemistry. May 2000;54(2):173-181.
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    1. Howell AB, Vorsa N, Der Marderosian A, et al. Inhibition of the adherence of P-fimbriated Escherichia coli to uroepithelial-cell surfaces by proanthocyanidin extracts from cranberries. The New England journal of medicine. Oct 8 1998;339(15):1085-1086.
    1. Burger O, Weiss E, Sharon N, et al. Inhibition of Helicobacter pylori adhesion to human gastric mucus by a high-molecular-weight constituent of cranberry juice. Critical reviews in food science and nutrition. 2002;42(3 Suppl):279-284.
    1. Koo H, Nino de Guzman P, Schobel BD, et al. Influence of cranberry juice on glucan-mediated processes involved in Streptococcus mutans biofilm development. Caries research. 2006;40(1):20-27.
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    1. Kessler T, Jansen B, Hesse A. Effect of blackcurrant-, cranberry- and plum juice consumption on risk factors associated with kidney stone formation. European journal of clinical nutrition. Oct 2002;56(10):1020-1023.
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