Open Access Highly Accessed Research article

Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study

Amy B Howell1, Henry Botto2, Christophe Combescure3, Anne-Béatrice Blanc-Potard4, Lluis Gausa5, Tetsuro Matsumoto6, Peter Tenke7, Albert Sotto4 and Jean-Philippe Lavigne48*

Author Affiliations

1 Marucci Center for Blueberry and Cranberry Research and Extension, Rutgers, The State University of New Jersey, Chatsworth, NJ, USA

2 Service d'Urologie, Hôpital Foch, Suresnes, France

3 Faculté de Médecine, Université de Genève, Genève, Switzerland

4 Institut National de la Santé et de la Recherche Médicale, Espri26, Université Montpellier 1, Nîmes, France

5 Fundació Puigvert, Barcelona, Spain

6 Department of Urology, Graduate School of Medical Sciences, Kyushu University, Kitakyushu, Japan

7 Department of Urology, South-Pest Hospital, Budapest, Hungary

8 Laboratoire de Bactériologie, Virologie, Parasitologie, University Hospital Carémeau, Nîmes, France

For all author emails, please log on.

BMC Infectious Diseases 2010, 10:94  doi:10.1186/1471-2334-10-94

Published: 14 April 2010



Ingestion of cranberry (Vaccinium macrocarpon Ait.) has traditionally been utilized for prevention of urinary tract infections. The proanthocyanidins (PACs) in cranberry, in particular the A-type linkages have been implicated as important inhibitors of primarily P-fimbriated E. coli adhesion to uroepithelial cells. Additional experiments were required to investigate the persistence in urine samples over a broader time period, to determine the most effective dose per day and to determine if the urinary anti-adhesion effect following cranberry is detected within volunteers of different origins.


Two separate bioassays (a mannose-resistant hemagglutination assay and an original new human T24 epithelial cell-line assay) have assessed the ex-vivo urinary bacterial anti-adhesion activity on urines samples collected from 32 volunteers from Japan, Hungary, Spain and France in a randomized, double-blind versus placebo study. An in vivo Caenorhabditis elegans model was used to evaluate the influence of cranberry regimen on the virulence of E. coli strain.


The results indicated a significant bacterial anti-adhesion activity in urine samples collected from volunteers that consumed cranberry powder compared to placebo (p < 0.001). This inhibition was clearly dose-dependent, prolonged (until 24 h with 72 mg of PAC) and increasing with the amount of PAC equivalents consumed in each cranberry powder regimen. An in vivo Caenorhabditis elegans model showed that cranberry acted against bacterial virulence: E. coli strain presented a reduced ability to kill worms after a growth in urines samples of patients who took cranberry capsules. This effect is particularly important with the regimen of 72 mg of PAC.


Administration of PAC-standardized cranberry powder at dosages containing 72 mg of PAC per day may offer some protection against bacterial adhesion and virulence in the urinary tract. This effect may offer a nyctohemeral protection.