title: Novel Strategies in the Prevention and Treatment of Urinary Tract Infections.
abstract: Urinary tract infections are one of the most common bacterial infections, especially in women and children, frequently treated with antibiotics. The alarming increase in antibiotic resistance is a global threat to future treatment of infections. Therefore, alternative strategies are urgently needed. The innate immune system plays a fundamental role in protecting the urinary tract from infections. Antimicrobial peptides form an important part of the innate immunity. They are produced by epithelial cells and neutrophils and defend the urinary tract against invading bacteria. Since efficient resistance mechanisms have not evolved among bacterial pathogens, much effort has been put into exploring the role of antimicrobial peptides and possibilities to utilize them in clinical practice. Here, we describe the impact of antimicrobial peptides in the urinary tract and ways to enhance the production by hormones like vitamin D and estrogen. We also discuss the potential of medicinal herbs to be used in the prophylaxis and the treatment of urinary tract infections.
authors.affiliation: Department of Microbiology, Tumor and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Stockholm SE-171 76, Sweden. Petra.Luthje@ki.se.
authors.forename: Petra
authors.initials: P
authors.lastname: Lüthje
authors.affiliation: Department of Microbiology, Tumor and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Stockholm SE-171 76, Sweden. Annelie.Brauner@ki.se.
authors.forename: Annelie
authors.initials: A
authors.lastname: Brauner
keywords: antimicrobial peptides; estrogen; herbal extracts; urinary tract infection; vitamin D
references.citation: Antimicrob Agents Chemother. 2014 Aug;58(8):4411-9
references.pmid: 24841266
references.citation: J Immunol. 2014 Dec 15;193(12):6081-9
references.pmid: 25398327
references.citation: Mol Urol. 2001 Spring;5(1):31-6
references.pmid: 11689149
references.citation: J Urol. 2013 Oct;190(4 Suppl):1596-1602
references.pmid: 23313203
references.citation: Infect Dis Clin North Am. 2014 Mar;28(1):135-47
references.pmid: 24484580
references.citation: Nephron. 2000 May;85(1):34-40
references.pmid: 10773753
references.citation: Proc Natl Acad Sci U S A. 2004 Feb 3;101(5):1333-8
references.pmid: 14739341
references.citation: Eur J Clin Invest. 2008 Oct;38 Suppl 2:50-7
references.pmid: 18826482
references.citation: Sci Transl Med. 2013 Jun 19;5(190):190ra80
references.pmid: 23785036
references.citation: PLoS One. 2014 Apr 04;9(4):e91939
references.pmid: 24705418
references.citation: PLoS Pathog. 2010 Jul 22;6(7):e1001010
references.pmid: 20661475
references.citation: Infect Immun. 2012 Feb;80(2):483-92
references.pmid: 22144482
references.citation: J Invest Dermatol. 2003 Mar;120(3):379-89
references.pmid: 12603850
references.citation: Infect Immun. 2013 Oct;81(10):3577-85
references.pmid: 23836819
references.citation: BMC Infect Dis. 2002 Sep 18;2:20
references.pmid: 12238953
references.citation: Biochem Biophys Res Commun. 2010 May 28;396(2):246-51
references.pmid: 20399752
references.citation: Exp Nephrol. 2002;10(5-6):332-7
references.pmid: 12381917
references.citation: Peptides. 2001 Oct;22(10):1643-50
references.pmid: 11587792
references.citation: J Biol Chem. 2002 Mar 1;277(9):7412-9
references.pmid: 11744708
references.citation: Acta Radiol. 1998 Jul;39(4):447-52
references.pmid: 9685836
references.citation: Curr Protein Pept Sci. 2005 Feb;6(1):35-51
references.pmid: 15638767
references.citation: FEMS Microbiol Lett. 2012 May;330(2):81-9
references.pmid: 22339775
references.citation: J Urol. 2009 Jul;182(1):21-8
references.pmid: 19447447
references.citation: Ann Epidemiol. 2000 Nov;10(8):509-15
references.pmid: 11118930
references.citation: Pediatr Radiol. 2005 Mar;35(3):275-81
references.pmid: 15490148
references.citation: J Infect Chemother. 2013 Oct;19(5):812-7
references.pmid: 23440506
references.citation: Subcell Biochem. 2010;53:101-22
references.pmid: 20593264
references.citation: J Biol Chem. 2001 Mar 16;276(11):7806-10
references.pmid: 11113131
references.citation: J Biol Chem. 2006 Jan 20;281(3):1636-43
references.pmid: 16293630
references.citation: Arch Intern Med. 2011 Jul 25;171(14):1270-8
references.pmid: 21788542
references.citation: Clin Infect Dis. 2014 Dec 1;59(11):e158-64
references.pmid: 25091303
references.citation: Peptides. 2013 Nov;49:131-7
references.pmid: 24071034
references.citation: Pediatrics. 2005 Sep;116(3):644-8
references.pmid: 16140703
references.citation: J Ethnopharmacol. 2011 Jun 14;136(1):111-6
references.pmid: 21524700
references.citation: Pediatr Nephrol. 1995 Apr;9(2):256-7
references.pmid: 7794733
references.citation: Kidney Int. 2013 Apr;83(4):615-25
references.pmid: 23302724
references.citation: J Ethnopharmacol. 2010 May 4;129(1):59-63
references.pmid: 20211234
references.citation: J Urol. 2011 Oct;186(4 Suppl):1684-92
references.pmid: 21855919
references.citation: Biochem J. 2014 Nov 15;464(1):3-11
references.pmid: 25181554
references.citation: Drug Res (Stuttg). 2013 Feb;63(2):65-8
references.pmid: 23447075
references.citation: J Ethnopharmacol. 2011 Jun 1;135(3):672-7
references.pmid: 21497191
references.citation: Infect Immun. 2014 Apr;82(4):1572-8
references.pmid: 24452682
references.citation: J Cell Sci. 2001 Nov;114(Pt 22):4095-103
references.pmid: 11739641
references.citation: Mol Nutr Food Res. 2011 Jan;55(1):96-108
references.pmid: 20824663
references.citation: Urology. 2004 Mar;63(3):562-5; discussion 565
references.pmid: 15028458
references.citation: PLoS One. 2010 Dec 14;5(12):e15580
references.pmid: 21179490
references.citation: PLoS Pathog. 2007 Jul;3(7):e100
references.pmid: 17630833
references.citation: J Immunol. 2004 Mar 1;172(5):3070-7
references.pmid: 14978112
references.citation: J Med Microbiol. 2014 Apr;63(Pt 4):582-589
references.pmid: 24464694
references.citation: J Ethnopharmacol. 2011 Apr 12;134(3):1006-9
references.pmid: 21296143
references.citation: Pediatrics. 1998 Aug;102(2):e16
references.pmid: 9685461
references.citation: J Clin Microbiol. 2010 Jun;48(6):2316-7
references.pmid: 20357219
references.citation: J Urol. 2007 Jun;177(6):2357-60
references.pmid: 17509358
references.citation: Cochrane Database Syst Rev. 2004;(3):CD001209
references.pmid: 15266443
references.citation: J Ethnopharmacol. 2013 Jan 30;145(2):591-7
references.pmid: 23211661
references.citation: Infection. 2011 Dec;39(6):571-4
references.pmid: 22002732
references.citation: Pediatr Nephrol. 2014 Jul;29(7):1139-49
references.pmid: 23732397
references.citation: Int Urogynecol J. 2013 Jan;24(1):127-34
references.pmid: 22806485
references.citation: Kidney Int. 2004 Mar;65(3):791-7
references.pmid: 14871399
references.citation: Horm Res Paediatr. 2015;83(3):198-203
references.pmid: 25632848
references.citation: J Clin Invest. 1998 Apr 15;101(8):1633-42
references.pmid: 9541493
references.citation: Infect Dis Clin North Am. 2014 Mar;28(1):1-13
references.pmid: 24484571
references.citation: PLoS One. 2012;7(2):e31712
references.pmid: 22359618
references.citation: J Invest Dermatol. 2008 Apr;128(4):917-25
references.pmid: 17943185
references.citation: Electrophoresis. 1999 Feb;20(2):349-54
references.pmid: 10197442
references.citation: Curr Issues Mol Biol. 2005 Jul;7(2):179-96
references.pmid: 16053249
references.citation: Pathog Dis. 2013 Aug;68(3):78-81
references.pmid: 23733378
references.citation: Microbes Infect. 2009 Jan;11(1):57-65
references.pmid: 19007907
references.citation: J Pediatr. 1996 Dec;129(6):815-20
references.pmid: 8969722
references.citation: Kidney Int. 2011 Jul;80(2):174-80
references.pmid: 21525852
references.citation: J Pediatr. 1993 Jul;123(1):17-23
references.pmid: 8320616
references.citation: Curr Infect Dis Rep. 2013 Apr;15(2):124-9
references.pmid: 23378124
references.citation: Science. 2004 Mar 5;303(5663):1532-5
references.pmid: 15001782
references.citation: Wound Repair Regen. 2004 Jul-Aug;12(4):439-43
references.pmid: 15260809
references.citation: Curr Opin Hematol. 2002 Jan;9(1):18-22
references.pmid: 11753073
references.citation: J Clin Microbiol. 2012 Nov;50(11):3569-74
references.pmid: 22915606
references.citation: Int J Infect Dis. 2013 Dec;17(12):e1121-4
references.pmid: 23911156
references.citation: Infect Immun. 2013 Mar;81(3):733-9
references.pmid: 23264047
references.citation: Curr Opin Infect Dis. 2015 Feb;28(1):88-96
references.pmid: 25539411
references.citation: Curr Med Chem. 2015;22(14):1665-77
references.pmid: 25760092
references.citation: Infect Immun. 2007 Jul;75(7):3233-44
references.pmid: 17420234
references.citation: Genome Biol. 2003;4(5):R31
references.pmid: 12734011
references.citation: J Ethnopharmacol. 2013 Nov 25;150(2):770-4
references.pmid: 24120518
references.citation: J Am Soc Nephrol. 2006 Dec;17(12):3267-3272
references.pmid: 37001006
references.citation: J Innate Immun. 2014;6(6):860-8
references.pmid: 25012862
references.citation: FASEB J. 2005 Jul;19(9):1067-77
references.pmid: 15985530
references.citation: Cochrane Database Syst Rev. 2008 Apr 16;(2):CD005131
references.pmid: 18425910
references.citation: Infect Immun. 2001 Jul;69(7):4572-9
references.pmid: 11402001
references.citation: Clin Infect Dis. 2014 Jan;58(2):147-60
references.pmid: 24065333
references.citation: Eur J Obstet Gynecol Reprod Biol. 2011 Jun;156(2):131-6
references.pmid: 21349630
references.citation: Sex Transm Infect. 1998 Feb;74(1):11-9
references.pmid: 9634294
references.citation: J Biol Chem. 2003 Aug 1;278(31):28540-6
references.pmid: 12759353
references.citation: PLoS Med. 2007 Dec;4(12):e329
references.pmid: 18092884
references.citation: Eur J Clin Microbiol Infect Dis. 2011 Dec;30(12):1587-93
references.pmid: 21509475
references.citation: J Invest Dermatol. 2002 Nov;119(5):1090-5
references.pmid: 12445197
references.citation: Kidney Int. 2000 May;57(5):2004-10
references.pmid: 10792619
references.citation: Cell Microbiol. 2006 Apr;8(4):704-17
references.pmid: 16548895
references.citation: FEMS Microbiol Lett. 2013 Aug;345(1):64-71
references.pmid: 23710656
references.citation: J Clin Invest. 2014 Jul;124(7):2963-76
references.pmid: 24937428
references.citation: Nat Immunol. 2005 Jan;6(1):57-64
references.pmid: 15568027
references.citation: Cochrane Database Syst Rev. 2012 Oct 17;10:CD001321
references.pmid: 23076891
references.citation: J Clin Invest. 1969 Nov;48(11):2032-7
references.pmid: 4310770
references.citation: J Infect Dis. 2001 Mar 1;183 Suppl 1:S41-2
references.pmid: 11171012
references.citation: Science. 2003 Jul 4;301(5629):105-7
references.pmid: 12843396
references.citation: FEBS Lett. 1996 Nov 4;396(2-3):319-22
references.pmid: 8915011
references.citation: Crit Rev Immunol. 2006;26(6):545-76
references.pmid: 17341194
references.citation: Acta Paediatr Scand Suppl. 1974;(252):1-20
references.pmid: 4618418
references.citation: BMC Microbiol. 2011 May 23;11:114
references.pmid: 21605457
references.citation: J Am Soc Nephrol. 1999 Dec;10(12):2465-73
references.pmid: 10589683
references.citation: PLoS One. 2013 Oct 21;8(10):e77714
references.pmid: 24204930
references.citation: PLoS One. 2011 Mar 14;6(3):e17755
references.pmid: 21448240
references.citation: Curr Med Res Opin. 2007 Oct;23(10):2415-22
references.pmid: 17723159
references.citation: Biochim Biophys Acta. 2015 Nov;1848(11 Pt B):3055-61
references.pmid: 25701233
references.citation: Infect Immun. 2007 Jan;75(1):52-60
references.pmid: 17074856
references.citation: BMC Med. 2010 May 26;8:30
references.pmid: 20504298
references.citation: Pediatr Nephrol. 2001 Jan;16(1):69-72
references.pmid: 11198607
references.citation: Infect Immun. 2006 Sep;74(9):5106-13
references.pmid: 16926402
references.citation: J Infect Dis. 2015 Apr 1;211(7):1164-73
references.pmid: 25336727
references.citation: JAMA. 2007 Jul 11;298(2):179-86
references.pmid: 17622599
references.citation: Acta Paediatr. 1998 May;87(5):549-52
references.pmid: 9641738
references.citation: Infect Immun. 2008 Sep;76(9):4176-82
references.pmid: 18591225
references.citation: J Obstet Gynaecol Can. 2010 Nov;32(11):1082-1090
references.pmid: 21176321
references.citation: J Clin Microbiol. 2006 May;44(5):1776-81
references.pmid: 16672406