Cranberry mouthwash vs oral diseases: how A-type proanthocyanidins tame MMPs?

Cranberry Diseases and Cranberries

The cranberry contains several bioactive compounds that affect the activity of MMPs:

1. Proanthocyanidins (PAC) - especially A-type: The most studied and effective component of the cranberry. Contains a unique A-type bond structure that distinguishes it from other berries. Concentration: 300-500 mg/100g of berries.

2. Phenolic acids: - Benzoic acid and salicylic acid - Chlorogenic acid and cinnamic acid - Affect the regulation of MMP activity.

3. Flavonoids and anthocyanidins: - Quercetin and myricetin - Cyanidin-3-glucoside.

4. Triterpenoids: - Ursolic acid and oleanolic acid - Affectors of MMP expression.

The bioactive components of cranberry extract selectively affect different types of MMPs:

1. MMP-8 (collagenase-2): - The main target of cranberry extract in the treatment of periodontitis - A-type PACs directly inhibit the active part of MMP-8 - Studies show a 30-45% reduction in MMP-8 activity.

2. MMP-9 (gelatinase B): - Important role in the pathogenesis of periodontitis and peri-implantitis - Cranberry PACs reduce the expression and activity of MMP-9 - Phenolic compounds affect the activation pathways of MMP-9.

3. MMP-2 (gelatinase A): - Regulated by cranberry flavonoids - Less sensitive compared to MMP-8 and MMP-9.

4. MMP-13 (collagenase-3): - Ursolic acid inhibits MMP-13 expression - Important in bone tissue remodeling.

Anti-inflammatory mechanisms

1. Reduction of inflammatory cytokines:

- Decrease in the production of IL-1β, IL-6, and TNF-α.

- These cytokines usually induce the expression of MMPs.

2. Inhibition of COX-2:

- Reduction of prostaglandin synthesis.

- Prostaglandins induce the expression of MMPs.

3. Neutralization of reactive oxygen species:

- Antioxidant effect reduces oxidative stress.

- Oxidative stress activates the expression of MMPs.

Indicators of clinical efficacy

1. Changes in biomarkers:

- Reduction of aMMP-8 levels in crevicular fluid by 30-45%.

- Decrease in inflammatory markers (IL-1β, IL-6).

2. Clinical parameters:

- Reduction of pocket depth (average 0.8-1.2 mm).

- Improvement in bleeding index by 25-40%.

- Improvement in clinical attachment level (0.6-1.0 mm).

3. Microbiome:

- Decrease in the number of pathogenic bacteria.

- Improvement in oral microbial balance.

2. Synergistic components:

- Green tea (EGCG) - enhances MMP inhibition.

- Zinc - MMP cofactor, balances activity.

- Xylitol - antibacterial, increases efficacy.

Usage and protocol

1. Dosage: 15-20 ml of mouth rinse twice a day, rinse for 30-60 seconds - Optimal use after tooth brushing.

2. Duration: Acute periodontitis: 2-week intensive course, maintenance therapy: daily for 3-6 months, prophylaxis for peri-implantitis: long-term use.

3. Patient selection: Patients with elevated aMMP-8 levels (>20 ng/ml), high-risk patients for periodontitis, patients with implants (prophylaxis for peri-implantitis).

Summary and conclusions

Cranberry extract mouth rinse offers an evidence-based and effective solution for regulating MMPs in the oral cavity. Its special value lies in:

1. Selective MMP regulation - cranberry extract does not completely block MMP activity but modulates their excessive activity while maintaining normal physiological function.

2. Natural origin - cranberry extract offers an alternative to chemical MMP inhibitors and low-dose antibiotics.

3. Multilevel effect - in addition to direct inhibition of MMPs, cranberry extract affects inflammation, oxidative stress, and microbial balance.

4. Minimal side effects - very few side effects have been observed in clinical studies, indicating an excellent safety profile.

Come test your MMP levels!