D-Mannose is a monosaccharide, a simple sugar, the natural C-2 epimer of glucose. It is present in many fruits and plants. It is extracted from larch cane and occurs as a white or almost white crystalline powder, sweet and bitter taste easily soluble in water and pyridine, slightly soluble in methanol and ethanol and 1g of mannose is soluble in 0.4ml of water.

What it is used for and where

Take only under medical supervision

Medical

D-Mannose is an effective non-antibiotic protection for the prevention and treatment of urinary tract infections, e.g. cystitis, and in particular against the uropathogenic Escherichia coli and other members of the Enterobacteriaceae family that promote infection through adhesion to urothelial cells and an early inflammatory response. The efficacy of D-Mannose is comparable to that of antibiotics, it is well tolerated and can give minimal side effects, including diarrhoea (1).

D-Mannose has been reported in relatively recent research to be an immune modulator (2).

Another interesting discovery attributed D-Mannose's chondroprotective effect on osteoarthritis by attenuating the sensitivity of chondrocytes to ferroptosis and alleviating the progression of osteoarthritis itself by suppressing cartilage degeneration (3).

Like all drugs it can cause side effects. Always ask the physician.

D-Mannose studies

Typical commercial product characteristics D-Mannose

• Molecular Formula  C₆H₁₂O₆
• Molecular Weight    180.16
• Exact Mass    180.063385
• CAS  3458-28-4    530-26-7
• UNII    PHA4727WTP
• EC Number   208-474-2
• DSSTox Substance ID  DTXSID5040463
• IUPAC  (3S,4S,5S,6R)-6-(hydroxymethyl)oxane-2,3,4,5-tetrol
• InChI=1S/C6H12O6/c7-1-2-3(8)4(9)5(10)6(11)12-2/h2-11H,1H2/t2-,3-,4+,5+,6?/m1/s1 
• InChl Key      WQZGKKKJIJFFOK-QTVWNMPRSA-N
• SMILES   C(C1C(C(C(C(O1)O)O)O)O)O
• MDL number  MFCD00064122
• PubChem Substance ID    
• ChEBI  4208
• ICSC    
• NSC   
• RTECS   
• UN   
• NCI  

Synonyms:

• D-Mannopyranose
• D-Mannopyranoside

References_______________________________________________________________________

(1) Lenger SM, Bradley MS, Thomas DA, Bertolet MH, Lowder JL, Sutcliffe S. D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020 Aug;223(2):265.e1-265.e13. doi: 10.1016/j.ajog.2020.05.048.

(2) Zhang D, Chia C, Jiao X, Jin W, Kasagi S, Wu R, Konkel JE, Nakatsukasa H, Zanvit P, Goldberg N, Chen Q, Sun L, Chen ZJ, Chen W. D-mannose induces regulatory T cells and suppresses immunopathology. Nat Med. 2017 Sep;23(9):1036-1045. doi: 10.1038/nm.4375.

(3) Zhou X, Zheng Y, Sun W, Zhang Z, Liu J, Yang W, Yuan W, Yi Y, Wang J, Liu J. D-mannose alleviates osteoarthritis progression by inhibiting chondrocyte ferroptosis in a HIF-2α-dependent manner. Cell Prolif. 2021 Nov;54(11):e13134. doi: 10.1111/cpr.13134.

Compendium of the most significant studies with reference to properties, intake, effects.

Torretta S, Scagliola A, Ricci L, Mainini F, Di Marco S, Cuccovillo I, Kajaste-Rudnitski A, Sumpton D, Ryan KM, Cardaci S. D-mannose suppresses macrophage IL-1β production. Nat Commun. 2020 Dec 11;11(1):6343. doi: 10.1038/s41467-020-20164-6. 

Abstract. Here, we show that D-mannose suppresses LPS-induced macrophage activation by impairing IL-1β production. In vivo, mannose administration improves survival in a mouse model of LPS-induced endotoxemia as well as decreases progression in a mouse model of DSS-induced colitis. 

Domenici L, Monti M, Bracchi C, Giorgini M, Colagiovanni V, Muzii L, Benedetti Panici P. D-mannose: a promising support for acute urinary tract infections in women. A pilot study. Eur Rev Med Pharmacol Sci. 2016 Jul;20(13):2920-5. 

Abstract. The results of this study suggest that D-mannose can be an effective aid in acute cystitis management and also a successful prophylactic agent in a selected population; however, more studies will certainly be needed to confirm the results of our pilot study. 

Pugliese D, Acampora A, Porreca A, Schips L, Cindolo L. Effectiveness of a novel oral combination of D-Mannose, pomegranate extract, prebiotics and probiotics in the treatment of acute cystitis in women. Arch Ital Urol Androl. 2020 Apr 6;92(1):34-38. doi: 10.4081/aiua.2020.1.34.

Abstract. Our study suggests that the action of the compounds, administered in this new combination, could help in an effective management of symptoms of acute cystitis in women, without antibiotics, in a wide majority of the cases. Lack of microbiological assessment is a clear limitation of the study. Moreover, lack of a control group is another important limitation. Finally, hyperhydration could have been a confounding factor in interpretation of results.

Wang J, Jalali Motlagh N, Wang C, Wojtkiewicz GR, Schmidt S, Chau C, Narsimhan R, Kullenberg EG, Zhu C, Linnoila J, Yao Z, Chen JW. d-mannose suppresses oxidative response and blocks phagocytosis in experimental neuroinflammation. Proc Natl Acad Sci U S A. 2021 Nov 2;118(44):e2107663118. doi: 10.1073/pnas.2107663118.

Abstract. Inflammation drives the pathology of many neurological diseases. d-mannose has been found to exert an antiinflammatory effect in peripheral diseases, but its effects on neuroinflammation and inflammatory cells in the central nervous system have not been studied. We aimed to determine the effects of d-mannose on key macrophage/microglial functions-oxidative stress and phagocytosis.

Deng YL, Liu R, Cai ZD, Han ZD, Feng YF, Cai SH, Chen QB, Zhu JG, Zhong WD. Mannose inhibits the growth of prostate cancer through a mitochondrial mechanism. Asian J Androl. 2022 Feb 4. doi: 10.4103/aja2021104.

Abstract. In this study, we demonstrated that mannose inhibits the proliferation and promotes the apoptosis of PCa cells in vitro, and mannose was observed to have an anticancer effect in mice without harming their health.

Nakagawa Y, Ito Y. Mannose-binding analysis and biological application of pradimicins. Proc Jpn Acad Ser B Phys Biol Sci. 2022;98(1):15-29. doi: 10.2183/pjab.98.002.

Abstract. This article first outlines the challenges in studying Man-binding mechanisms and structural modifications of Pradimicins (PRMs) , and then describes our approach to address them. We also present our recent attempts toward the development of PRM-based research tools.