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Non-antibiotic prevention of urinary tract infection

Nicht-antibiotische Prävention von Harnwegsinfektionen

  • Sils Maria Symposium
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Summary

The identification of several glycoconjugates as receptors for attaching bacteria has resulted in optimism regarding the use of receptor analogues in preventing infection. The structure of receptor-active oligosaccharides and the patient groups which might benefit from such treatment are most thoroughly understood for urinary tract infections. Prevention of adhesion and delay or decrease of infection was achieved using oligosaccharides from the globoseries of glycolipids containing Galα1→4Gal. This minimal receptor structure as a free saccharide was, however, not sufficient. It was the intact P, P1 and pk determinants which showed optimal activityin vitro. In addition, protection against experimental UTI results from previous exposure to whole bacteria or isolated antigens. The mechanism(s) of protection and their relevance in clinical UTI remain to be defined.

Zusammenfassung

Verschiedene Glykokonjugate wurden als Rezeptoren für anheftende Bakterien identifiziert; daher besteht Hoffnung auf die Anwendung von Rezeptoranaloga zur Infektionsverhütung. Die Strukturen der Rezeptor-wirksamen Oligosaccharide und Patientengruppen, die von einer solchen Therapie profitieren könnten, sind für Harnwegsinfektionen sorgfältig erforscht. Mit Oligosacchariden der Globoserie von Glykolipiden, die Galα 1→4Gal enthalten, ist es gelungen, das Anheften zu verhindern und die Infektion zu verzögern oder zu vermindern. Jedoch erwies sich diese minimale Rezeptorstruktur als freies Saccharid als nicht ausreichend.In vitro konnte vielmehr durch die intakten P-, P1- und pk-Determinanten eine optimale Wirkung erzielt werden. Eine Schutzwirkung vor experimenteller Harnwegsinfektion entsteht zusätzlich durch frühere Exposition gegenüber den kompletten Bakterien oder isolierten Antigenen. Auf welche Weise die Protektion zustande kommt und welche Bedeutung sie für klinische Harnwegsinfektionen hat, muß noch geklärt werden.

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Authors and Affiliations

  1. Department of Clinical Immunology, University of Göteborg Medical School, S-413 46, Göteborg

    L. Hagberg M. D. &  C. Svanborg Edén M.D.

  2. Department of Medical and Physiological Biochemistry, University of Göteborg Medical School, S-413 46, Göteborg

    H. Leffler M. D.

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Hagberg, L., Leffler, H. & Svanborg Edén, C. Non-antibiotic prevention of urinary tract infection. Infection 12, 132–136 (1984). https://doi.org/10.1007/BF01641697

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