I often recommend quercetin to my clients that I educate on supplements that are beneficial for modulating inflammation. During my research on the benefits of quercetin, I found some interesting literature that seems promising in the therapy of bladder conditions. UTI’s are one of the most common bacterial infections of the bladder and account for almost 95% of all the visits to physicians for UTI’s (Wang et al., 2012). Patients with acute cystitis always have symptoms of dysuria and increased frequency and urgency of urination. As I have already experienced, this can seriously affect a person’s quality of life. The incidence of acute cystitis is high, and the course of acute cystitis is urgent. If acute cystitis cannot be treated promptly, it will be transformed into chronic cystitis. “It can also be transformed into cystitis glandularis, and finally into bladder cancer. It can also induce nephritis. Therefore, timely treatment of acute cystitis is necessary” (Wang et al., 2012).
Currently, acute cystitis is commonly treated by systemic application of antibiotics and anti-inflammation agents. However, only a small amount of systemically administered drugs can reach the bladder. In recent years, the anti-inflammatory effect of querctin (QU) has been well recognized, demonstrating promising clinical application. Recently, it was found that QU can be used to prevent interstitial cystitis (Wang et al., 2012). There are many quercetin containing supplements available in the market, and some of them specifically aimed to treat the bladder. One of them, Cystoprotek, contains QU and rutin with the aims of reducing bladder wall inflammation (Theoharides, Kempuraj, Vakali, & Sant, 2008). Unfortunately it was recently pulled off the market. An older product, Cysta-Q, was shown to provide symptomatic improvements in patients with IC (Katske et al., 2001). Personally, neither of these supplements did anything significant for my IC symptoms at the time I was taking them. This could be due to the inability of the active ingredients to reach the bladder.
Another product that seems promising is Perque Repair Guard. The antioxidant value is of 12 servings of fruits and vegetables. It has 1g of quercetin per tablet. And other healing ingredients such as pomegranate juice powder, OPC, magnesium, chlorophyll, turmeric, and vegetable fiber.
Interestingly, some clinicians are exploring intravesical administration. This means directly instilling the drug solution into the bladder through a urethral catheter, ensuring maximum delivery of active ingredients to the bladder (Wang et al., 2012). According to Wang et. al, the bladder is an idea organ for regional therapy because it urethra provides easy access of the therapeutic agent to the bladder (Wang et al., 2012). In addition, intravesical drug administration has other potential benefits such as avoiding the first-pass metabolism, increasing drug utilization and reducing system toxicity and side effects (Wang et al., 2012). The study conducted by Wang et. al involved encapsulating nanoparticles of water soluble QU into micelles to ensure proper absorption. The results of this study found that intravesical application of the micelles did not induce any toxicity to the bladder. Even better, intravesical administration of QU micelles efficiently reduced the inflammation of the bladder with E. coli-induced acute cystitis. Results indicated that the quercetin micelle treatment can efficiently reduce the edema and inflammatory cell infiltration of the bladder in an E. coli-induced acute cystitis model (Wang et al., 2012). The data from this study proved the hypothesis that QU had potential application in acute cystitis therapy. I am looking forward to seeing future studies in the application, as there are millions of men, women, and even children suffering from this very debilitating condition!
Katske, F., Shoskes, D. A., Sender, M., Poliakin, R., Gagliano, K., & Rajfer, J. (2001). Treatment of interstitial cystitis with a quercetin supplement. Tech Urol, 7(1), 44-46.
Theoharides, T. C., Kempuraj, D., Vakali, S., & Sant, G. R. (2008). Treatment of refractory interstitial cystitis/painful bladder syndrome with CystoProtek–an oral multi-agent natural supplement. Can J Urol, 15(6), 4410-4414.
Wang, B. L., Gao, X., Men, K., Qiu, J., Yang, B., Gou, M. L., . . . Wei, Y. Q. (2012). Treating acute cystitis with biodegradable micelle-encapsulated quercetin. Int J Nanomedicine, 7, 2239-2247. doi:10.2147/ijn.s29416
I love strawberries! They are high in Vitamin C and just delicious on salads. Sadly, they also can cause pain in many people who have mast cell activation disorder. Read below….
I have recently become very interested in histamine intolerance and mast cells, and strawberries is on the list of foods high in histamine. There is some significant research being done on mast cell activation, autoimmune disease and the immune system. Histamine intolerance is the disequilibrium between accumulated histamine and histamine degradation (Manzotti, Breda, Di Gioacchino, & Burastero, 2016). Histamine degradation is dependent on the primary enzyme, diamine oxidase (DAO). Histamine is a biogenic amine found in foods such as pickles, matured cheese, fermented foods and leftovers. Some foods are histamine liberators and that includes fruits such as pineapples, bananas, citrus fruits, papayas and strawberries. The ingestion of histamine rich foods can provoke a variety of symptoms such as digestive, arrhythmia, flushing, asthma, hypotension, rhinoconjunctivitis, and headaches. Impaired DAO production is often the culprit, which can result in increased enteral histamine uptake and increased plasma histamine concentrations (Manzotti et al., 2016). Interesting the study by Manzotti demonstrated that 71% of patients reported functional bloating after consuming high histamine foods.
The latest research indicates that mast cells that release histamine and other inflammation in the bloodstream are active participants in autoimmune disease related tissue damage. Increased mast cell activity, release of histamine and other inflammatory agents are frequently seen in autoimmune conditions such as MS, RA and many others (Healing Histamine, n.d.). A variety of receptors including those engaged by antibody, complement, pathogens, and intrinsic danger signals are implicated in mast cell activation in disease (Brown & Hatfield, 2012). Mast cells can also recruit other immune cells such as neutrophils, to the sites of autoimmune destruction. “Mast cells can only act as accessory cells to the self-reactive T and/or antibody driven autoimmune responses” (Brown & Hatfield, 2012). This includes mast cells among one of the major contributors to autoimmunity and should definitely be considered.
Autoimmune and allergic diseases share fundamentally important features in that both are the result of “hypersensitive” immune responses directed toward inherently harmless antigens (Brown & Hatfield, 2012). An early progress of autoimmune disease involves the activation and expansion of T and/or antibody producing B cells that wear autoreactive receptors. These autoreactive T or B cells can then enter the bloodstream and migrate to sites of inflamed tissues expressing relevant autoantigens (Brown & Hatfield, 2012). “T cells, through the elaboration of cytotoxic mediators, and antibodies, through complement fixation or their ability to activate resident accessory cells such as macrophages and mast cells via Fc receptor engagement, can play direct roles in tissue destruction at these sites” (Brown & Hatfield, 2012)
In addition to eliciting the above described adaptive immune response, antigens can engage a class of danger- associated receptors on both adaptive and innate immune cells, including mast cells. These receptors include toll-like receptors (TLRs) and Nacht-LRRs (NLRs) (Brown & Hatfield, 2012). Activation of immune cells through TLRs and NLRs induces the expression of multiple inflammatory mediators that can ultimately result in local tissue damage causing the release of normally sequestered tissue antigen (Brown & Hatfield, 2012). Subsequent recognition of these antigens by T or B cells will induce activation and initiate autoimmunity. Alternatively, infection-induced activation of accessory immune cells, including mast cells, macrophages, and neutrophils, can boost inflammation and transform a relatively modest autoreactive response.
There is evidence that other TLRs are expressed on mast cells. For example, activation of mature mast cells through TLR2 results in their production of several pro-inflammatory cytokines critical in autoimmunity including IL-17, IFNγ, TNF, and IL-1β. Mast cells also express multiple IgG Fc receptors. This is significant because IgG autoantibodies are hallmarks of many autoimmune diseases and have been detected in multiple autoimmune diseases.
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Brown, M. A., & Hatfield, J. K. (2012). Mast Cells are Important Modifiers of Autoimmune Disease: With so Much Evidence, Why is There Still Controversy? Front Immunol, 3, 147. doi:10.3389/fimmu.2012.00147
Healing Histamine (n.d.). Histamine Intolerance, Mast Cells & Autoimmunity. Retrieved (2018, May 15) from https://healinghistamine.com/histamine-mast-cells-autoimmune-disorders/
Manzotti, G., Breda, D., Di Gioacchino, M., & Burastero, S. E. (2016). Serum diamine oxidase activity in patients with histamine intolerance. Int J Immunopathol Pharmacol, 29(1), 105-111. doi:10.1177/0394632015617170