Biochemical and molecular mechanisms underlying the role of dietary polyphenols in modulating uropathogenic virulence in women with UTIS

Urinary tract infections (UTIs) are a common and recurrent health issue, especially in women, often requiring repeated antibiotic use that contributes to antimicrobial resistance. Uropathogenic Escherichia coli (UPEC), the leading cause of UTIs, can adhere to and invade bladder epithelial cells, forming intracellular bacterial communities that evade immune detection and antibiotic treatment. With rising resistance concerns, attention has turned to non-antibiotic alternatives such as dietary polyphenols. Found in fruits, vegetables, tea, and wine, polyphenols are plant-derived compounds with antioxidant, anti-inflammatory, and antimicrobial effects. Cranberry proanthocyanidins, in particular, prevent UPEC adhesion to urinary tract cells, reducing infection risk. Polyphenols exert multiple actions: inhibiting biofilm formation, disrupting quorum sensing, modulating bacterial enzyme activity, and enhancing epithelial barrier integrity. Additionally, they influence host immune responses by downregulating inflammatory cytokines and activating protective signalling pathways. While clinical and in vitro studies support their potential in reducing UTI frequency and severity, challenges remain, including low bioavailability and individual variability in response. Further research is needed to optimize formulations and delivery systems. Despite current limitations, incorporating polyphenol-rich foods into preventive healthcare represents a promising, sustainable strategy to manage UTIs and reduce dependence on antibiotics.