Effects of vitamins A, C, and D and zinc on urinary tract infections: A systematic review and meta-analysis
Main Article Content
Keywords
urinary tract infection, meta-analysis, vitamin A, vitamin C, vitamin D, zinc
Abstract
Urinary tract infection (UTI) is responsible for a significant portion of the overall expenses of health care as well as mortality rates globally. We searched through the available research to evaluate whether micronutrient supplements affect the frequency and intensity of UTI in children Papers that investigated the effects of vitamins D and C, zinc, and multiple micronutrient supplementations (MMS) on the incidence and severity of UTI in pediatric patients were pooled together. A random effects model was used to conduct a meta-analysis of data. Vitamin D supplementation reduced the risk of UTI and shortened the duration of symptoms in children. If a clinical diagnosis or laboratory investigation was used to confirm UTI, the relative probability of UTI with vitamin D was remote from the null than using the self-report. If vitamin C was administrated, the frequency of UTI was reduced, and the period of clinical manifestations was cut to half. It was not possible to determine the impact of using zinc supplements. According to the findings of the current review, taking micronutrient supplements such as zinc, vitamins C and D, and multiple micronutrient supplementation could assist in preventing UTI and lessen its clinical outcome in pediatric patients. More research is required to establish the effect of individual or combination of micronutrients on the treatment outcomes of UTI.
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References
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Behzadi, P., 2020. Classical chaperone-usher (CU) adhesive fimbriome: uropathogenic Escherichia coli (UPEC) and urinary tract infections (UTIs). Folia microbiologica 65(1): 45–65. 10.1007/s12223-019-00719-x
Boonstra, A., Barrat et al., 2001. 1α, 25-Dihydroxyvitamin D3 has a direct effect on naive CD4+ T cells to enhance the development of Th2 cells. The Journal of Immunology 167(9): 4974–4980. 10.4049/jimmunol.167.9.4974
Borran, M., Dashti-Khavidaki et al., 2020. High-dose intravenous vitamin C reduces urinary tract infection post-kidney transplantation. African Journal of Urology 26(1): 1–4. 10.1186/s12301-020-00048-3
Borrelli, E. et al., 1996. Plasma concentrations of cytokines, their soluble receptors, and antioxidant vitamins can predict the development of multiple organ failure in patients at risk. Critical Care Medicine 24(3): 392–397. 10.1097/00003246-199603000-00006
Byron, J.K., 2019. Urinary tract infection. Veterinary Clinics: Small Animal Practice 49(2): 211–221. 10.1016/j.cvsm.2018.11.005
Calder, P.C. et al., 2020. Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections. Nutrients 12(4): 1181. 10.3390/nu12041181
Castelló, T., Girona, L., Gómez, M.R., Mena, M.A., and García L. 1996. The possible value of ascorbic acid as a prophylactic agent for urinary tract infection. Spinal Cord. 34(10): 592–593. 10.1038/sc.1996.105
Cheng, M. et al., 2022. Effect of dual-modified cassava starches on intelligent packaging films containing red cabbage extracts. Food Hydrocolloids 124: 107225. 10.1016/j.foodhyd.2021.107225
Farhadi, F. et al., 2019. Antibacterial activity of flavonoids and their structure–activity relationship: an update review. Phytotherapy Research 33(1): 13–40. 10.1002/ptr.6208
Freire, M.P. et al., 2020. Institutional protocol adherence in the incidence of recurrent urinary tract infection after kidney transplantation. Journal of Global Antimicrobial Resistance 23: 352–358. 10.1016/j.jgar.2020.10.013
Hemilä, H., 2003. Vitamin C, respiratory infections, and the immune system. Trends in Immunology 24(11): 579–580. 10.1016/j.it.2003.09.004
Hu, B. et al., 2022. Effects of ‘healthy’ fecal microbiota transplantation against the deterioration of depression in fawn-hooded rats. Msystems 7(3): e00218–e00222. 10.1128/msystems.00218-22
Gupta K, & Trautner B.W. 2022. Urinary tract infections, pyelonephritis, and prostatitis. Loscalzo, J, & Fauci, A, & Kasper, D, & Hauser, S, & Longo, D, & Jameson, J (Eds.), Harrison's Principles of Internal Medicine, 21e. McGraw Hill. https://accessmedicine.mhmedical.com/content.aspx
Khameneh, B. et al., 2016. Breakthroughs in bacterial resistance mechanisms and the potential ways to combat them. Microbial Pathogenesis 95: 32–42. 10.1016/j.micpath.2016.02.009
Khameneh, B. et al., 2019a. Review on plant antimicrobials: a mechanistic viewpoint. Antimicrobial Resistance & Infection Control 8(1): 1–28. 10.1186/s13756-019-0559-6
Khameneh, B. et al., 2019b. Non-antibiotic adjunctive therapy: a promising approach to fight tuberculosis. Pharmacological Research 146: 104289. 10.1016/j.phrs.2019.104289
Lei, G.-S. et al., 2017. Mechanisms of action of vitamin D as supplemental therapy for Pneumocystis pneumonia. Antimicrobial Agents and Chemotherapy 61(10): e01226–e01217. 10.1128/AAC.01226-17
Lemire, J.M. et al., 1995. Immunosuppressive actions of 1,-25-dihydroxyvitamin D3: preferential inhibition of Th1 functions. Journal of Nutrition 125(Suppl 6): 1704S–1708S. 10.1016/0960-0760(95)00106-A
Li, Y.-Y. and Liao R.-Z., 2022. Mechanism of water oxidation catalyzed by vitamin B12: redox non-innocent nature of corrin ligand and crucial role of phosphate. Chinese Chemical Letters 33(1): 358–361. 10.1016/j.cclet.2021.06.028
Liu, W. et al., 2018. Effective extraction of Cr (VI) from hazardous gypsum sludge via controlling the phase transformation and chromium species. Environmental Science & Technology 52(22): 13336–13342. 10.1021/acs.est.8b02213
Loubet, P. et al., 2020. Alternative therapeutic options to antibiotics for the treatment of urinary tract infections. Frontiers in Microbiology 11: 1509. 10.3389/fmicb.2020.01509
Lu, B., Guo, Z., Zhong, K., Osire, T., Sun, Y., Jiang, L. 2023. State of the art in CRISPR/Cas system-based signal conversion and amplification applied in the field of food analysis, Trends in Food Science & Technology, 135: 174–189. 10.1016/j.tifs.2023.04.002
Matulay, J.T. et al., 2016. Urinary tract infections in women: pathogenesis, diagnosis, and management. Current Bladder Dysfunction Reports 11: 53–60. 10.1007/s11884-016-0351-x
Mohsenpour, B. et al., 2019. Relation between serum zinc levels and recurrent urinary tract infections in female patients: a case-control study. Medical Journal of the Islamic Republic of Iran 33: 33. 10.47176/mjiri.33.33
Montorsi, F. et al., 2016. Effectiveness of a combination of cranberries, Lactobacillus rhamnosus, and vitamin C for the management of recurrent urinary tract infections in women: results of a pilot study. European Urology 70(6): 912–915. 10.1016/j.eururo.2016.05.042
Ochoa-Brust, G.J., Fernández, A.R., Villanueva-Ruiz, G.J., Velasco, R., Trujillo-Hernández, B., and Vásquez, C. 2007. Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy. Acta Obstet Gynecol Scand. 86(7): 783–787. 10.1080/00016340701273189
Olin, S.J. and Bartges, J.W. 2015. Urinary tract infections: treatment/comparative therapeutics. Veterinary Clinics: Small Animal Practice 45(4): 721–746. 10.1016/j.cvsm.2015.02.005
Padayatty, S.J. and Levine, M. 2016. Vitamin C: the known and the unknown and Goldilocks. Oral Diseases 22(6): 463–493. 10.1111/odi.12446
Poulios, E. et al., 2021. Medicinal plant consumption against urinary tract infections: a narrative review of the current evidence. Expert Review of Anti-Infective Therapy 19(4): 519–528. 10.1080/14787210.2021.1828061
Prasad, A.S. 2009. Zinc: role in immunity, oxidative stress, and chronic inflammation. Current Opinion in Clinical Nutrition & Metabolic Care 12(6): 646–652. 10.1097/MCO.0b013e3283312956
Read, S.A. et al., 2019. The role of zinc in antiviral immunity. Advances in Nutrition 10(4): 696–710. 10.1093/advances/nmz013
Rolston, K.V. 2001. The spectrum of pulmonary infections in cancer patients. Current Opinion in Oncology 13(4): 218–223. 10.1097/00001622-200107000-00002
Sheerin, N.S. 2011. Urinary tract infection. Medicine 39(7): 384–389. 10.1016/j.mpmed.2011.04.003
Sheerin, N.S. and Glover, E.K. 2019. Urinary tract infection. Medicine 47(9): 546–550. 10.1016/j.mpmed.2019.06.008
Storme, O. et al., 2019. Risk factors and predisposing conditions for urinary tract infection. Therapeutic Advances in Urology 11: 1756287218814382. 10.1177/1756287218814382
Tanumihardjo, S.A. et al., 2016. Biomarkers of Nutrition for Development (BOND)—vitamin A review. Journal of Nutrition 146(9): 1816S–1848S. 10.3945/jn.115.229708
Van Schoor, N. and Lips, P., 2017. Global overview of vitamin D status. Endocrinology and Metabolism Clinics 46(4): 845–870. 10.1016/j.ecl.2017.07.002
Wessells, K.R. and Brown, K.H. 2012. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PLoS One 7(11): e50568. 10.1371/journal.pone.0050568
Xu, R. et al., 2023. External sodium acetate improved Cr (VI) stabilization in a Cr-spiked soil during chemical-microbial reduction processes: insights into Cr (VI) reduction performance, microbial community and metabolic functions. Ecotoxicology and Environmental Safety 251: 114566. 10.1016/j.ecoenv.2023.114566
Yang, Y. et al., 2022. Bisphenol A and its analogues in paired urine and house dust from South China and implications for children's exposure. Chemosphere 294: 133701. 10.1016/j.chemosphere.2022.133701
Yilmaz, A., Bahat, E., Yilmaz, G.G., Hasanoglu, A., Akman, S., and Guven, A.G. 2007. Adjuvant effect of vitamin A on recurrent lower urinary tract infections. Pediatr Int. 49(3): 310–313. 10.1111/j.1442-200X.2007.02370.x
Baker, J.H. et al., 2018. Role of complementary and alternative therapies in infectious disease. Primary Care: Clinics in Office Practice 45(3): 533–539. 10.1016/j.pop.2018.05.009
Bazzaz, B.S.F., Fakori et al., 2019. Effects of omeprazole and caffeine alone and in combination with gentamicin and ciprofloxacin against antibiotic resistant staphylococcus aureus and escherichia coli strains. Journal of Pharmacopuncture 22(1): 49. 10.3831/KPI.2019.22.006
Bazzaz, B.S.F., Sarabandi et al., 2016. Effect of catechins, green tea extract, and methylxanthines in combination with gentamicin against Staphylococcus aureus and Pseudomonas aeruginosa: combination therapy against resistant bacteria. Journal of Pharmacopuncture 19(4): 312. 10.3831/KPI.2016.19.032
Behzadi, P., 2020. Classical chaperone-usher (CU) adhesive fimbriome: uropathogenic Escherichia coli (UPEC) and urinary tract infections (UTIs). Folia microbiologica 65(1): 45–65. 10.1007/s12223-019-00719-x
Boonstra, A., Barrat et al., 2001. 1α, 25-Dihydroxyvitamin D3 has a direct effect on naive CD4+ T cells to enhance the development of Th2 cells. The Journal of Immunology 167(9): 4974–4980. 10.4049/jimmunol.167.9.4974
Borran, M., Dashti-Khavidaki et al., 2020. High-dose intravenous vitamin C reduces urinary tract infection post-kidney transplantation. African Journal of Urology 26(1): 1–4. 10.1186/s12301-020-00048-3
Borrelli, E. et al., 1996. Plasma concentrations of cytokines, their soluble receptors, and antioxidant vitamins can predict the development of multiple organ failure in patients at risk. Critical Care Medicine 24(3): 392–397. 10.1097/00003246-199603000-00006
Byron, J.K., 2019. Urinary tract infection. Veterinary Clinics: Small Animal Practice 49(2): 211–221. 10.1016/j.cvsm.2018.11.005
Calder, P.C. et al., 2020. Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections. Nutrients 12(4): 1181. 10.3390/nu12041181
Castelló, T., Girona, L., Gómez, M.R., Mena, M.A., and García L. 1996. The possible value of ascorbic acid as a prophylactic agent for urinary tract infection. Spinal Cord. 34(10): 592–593. 10.1038/sc.1996.105
Cheng, M. et al., 2022. Effect of dual-modified cassava starches on intelligent packaging films containing red cabbage extracts. Food Hydrocolloids 124: 107225. 10.1016/j.foodhyd.2021.107225
Farhadi, F. et al., 2019. Antibacterial activity of flavonoids and their structure–activity relationship: an update review. Phytotherapy Research 33(1): 13–40. 10.1002/ptr.6208
Freire, M.P. et al., 2020. Institutional protocol adherence in the incidence of recurrent urinary tract infection after kidney transplantation. Journal of Global Antimicrobial Resistance 23: 352–358. 10.1016/j.jgar.2020.10.013
Hemilä, H., 2003. Vitamin C, respiratory infections, and the immune system. Trends in Immunology 24(11): 579–580. 10.1016/j.it.2003.09.004
Hu, B. et al., 2022. Effects of ‘healthy’ fecal microbiota transplantation against the deterioration of depression in fawn-hooded rats. Msystems 7(3): e00218–e00222. 10.1128/msystems.00218-22
Gupta K, & Trautner B.W. 2022. Urinary tract infections, pyelonephritis, and prostatitis. Loscalzo, J, & Fauci, A, & Kasper, D, & Hauser, S, & Longo, D, & Jameson, J (Eds.), Harrison's Principles of Internal Medicine, 21e. McGraw Hill. https://accessmedicine.mhmedical.com/content.aspx
Khameneh, B. et al., 2016. Breakthroughs in bacterial resistance mechanisms and the potential ways to combat them. Microbial Pathogenesis 95: 32–42. 10.1016/j.micpath.2016.02.009
Khameneh, B. et al., 2019a. Review on plant antimicrobials: a mechanistic viewpoint. Antimicrobial Resistance & Infection Control 8(1): 1–28. 10.1186/s13756-019-0559-6
Khameneh, B. et al., 2019b. Non-antibiotic adjunctive therapy: a promising approach to fight tuberculosis. Pharmacological Research 146: 104289. 10.1016/j.phrs.2019.104289
Lei, G.-S. et al., 2017. Mechanisms of action of vitamin D as supplemental therapy for Pneumocystis pneumonia. Antimicrobial Agents and Chemotherapy 61(10): e01226–e01217. 10.1128/AAC.01226-17
Lemire, J.M. et al., 1995. Immunosuppressive actions of 1,-25-dihydroxyvitamin D3: preferential inhibition of Th1 functions. Journal of Nutrition 125(Suppl 6): 1704S–1708S. 10.1016/0960-0760(95)00106-A
Li, Y.-Y. and Liao R.-Z., 2022. Mechanism of water oxidation catalyzed by vitamin B12: redox non-innocent nature of corrin ligand and crucial role of phosphate. Chinese Chemical Letters 33(1): 358–361. 10.1016/j.cclet.2021.06.028
Liu, W. et al., 2018. Effective extraction of Cr (VI) from hazardous gypsum sludge via controlling the phase transformation and chromium species. Environmental Science & Technology 52(22): 13336–13342. 10.1021/acs.est.8b02213
Loubet, P. et al., 2020. Alternative therapeutic options to antibiotics for the treatment of urinary tract infections. Frontiers in Microbiology 11: 1509. 10.3389/fmicb.2020.01509
Lu, B., Guo, Z., Zhong, K., Osire, T., Sun, Y., Jiang, L. 2023. State of the art in CRISPR/Cas system-based signal conversion and amplification applied in the field of food analysis, Trends in Food Science & Technology, 135: 174–189. 10.1016/j.tifs.2023.04.002
Matulay, J.T. et al., 2016. Urinary tract infections in women: pathogenesis, diagnosis, and management. Current Bladder Dysfunction Reports 11: 53–60. 10.1007/s11884-016-0351-x
Mohsenpour, B. et al., 2019. Relation between serum zinc levels and recurrent urinary tract infections in female patients: a case-control study. Medical Journal of the Islamic Republic of Iran 33: 33. 10.47176/mjiri.33.33
Montorsi, F. et al., 2016. Effectiveness of a combination of cranberries, Lactobacillus rhamnosus, and vitamin C for the management of recurrent urinary tract infections in women: results of a pilot study. European Urology 70(6): 912–915. 10.1016/j.eururo.2016.05.042
Ochoa-Brust, G.J., Fernández, A.R., Villanueva-Ruiz, G.J., Velasco, R., Trujillo-Hernández, B., and Vásquez, C. 2007. Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy. Acta Obstet Gynecol Scand. 86(7): 783–787. 10.1080/00016340701273189
Olin, S.J. and Bartges, J.W. 2015. Urinary tract infections: treatment/comparative therapeutics. Veterinary Clinics: Small Animal Practice 45(4): 721–746. 10.1016/j.cvsm.2015.02.005
Padayatty, S.J. and Levine, M. 2016. Vitamin C: the known and the unknown and Goldilocks. Oral Diseases 22(6): 463–493. 10.1111/odi.12446
Poulios, E. et al., 2021. Medicinal plant consumption against urinary tract infections: a narrative review of the current evidence. Expert Review of Anti-Infective Therapy 19(4): 519–528. 10.1080/14787210.2021.1828061
Prasad, A.S. 2009. Zinc: role in immunity, oxidative stress, and chronic inflammation. Current Opinion in Clinical Nutrition & Metabolic Care 12(6): 646–652. 10.1097/MCO.0b013e3283312956
Read, S.A. et al., 2019. The role of zinc in antiviral immunity. Advances in Nutrition 10(4): 696–710. 10.1093/advances/nmz013
Rolston, K.V. 2001. The spectrum of pulmonary infections in cancer patients. Current Opinion in Oncology 13(4): 218–223. 10.1097/00001622-200107000-00002
Sheerin, N.S. 2011. Urinary tract infection. Medicine 39(7): 384–389. 10.1016/j.mpmed.2011.04.003
Sheerin, N.S. and Glover, E.K. 2019. Urinary tract infection. Medicine 47(9): 546–550. 10.1016/j.mpmed.2019.06.008
Storme, O. et al., 2019. Risk factors and predisposing conditions for urinary tract infection. Therapeutic Advances in Urology 11: 1756287218814382. 10.1177/1756287218814382
Tanumihardjo, S.A. et al., 2016. Biomarkers of Nutrition for Development (BOND)—vitamin A review. Journal of Nutrition 146(9): 1816S–1848S. 10.3945/jn.115.229708
Van Schoor, N. and Lips, P., 2017. Global overview of vitamin D status. Endocrinology and Metabolism Clinics 46(4): 845–870. 10.1016/j.ecl.2017.07.002
Wessells, K.R. and Brown, K.H. 2012. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PLoS One 7(11): e50568. 10.1371/journal.pone.0050568
Xu, R. et al., 2023. External sodium acetate improved Cr (VI) stabilization in a Cr-spiked soil during chemical-microbial reduction processes: insights into Cr (VI) reduction performance, microbial community and metabolic functions. Ecotoxicology and Environmental Safety 251: 114566. 10.1016/j.ecoenv.2023.114566
Yang, Y. et al., 2022. Bisphenol A and its analogues in paired urine and house dust from South China and implications for children's exposure. Chemosphere 294: 133701. 10.1016/j.chemosphere.2022.133701
Yilmaz, A., Bahat, E., Yilmaz, G.G., Hasanoglu, A., Akman, S., and Guven, A.G. 2007. Adjuvant effect of vitamin A on recurrent lower urinary tract infections. Pediatr Int. 49(3): 310–313. 10.1111/j.1442-200X.2007.02370.x
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Aug 10, 2023
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