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Xylitol and its usage in ENT practice

Published online by Cambridge University Press:  07 July 2014

Ö Sakallioğlu
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Elazığ Research and Training Hospital, Turkey
I Adadan Güvenç*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Başkent University, Zübeyde Hanım Research and Training Hospital, İzmir, Turkey
C Cingi
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, University of Osmangazi, Eskişehir, Turkey
*
Address for correspondence: Dr I Adadan Guvenc, Başkent Üniversitesi, Zübeyde Hanım Araştırmave Uygulama Hastanesi, 6471/5 Sokak No: 7, Karşıyaka, İzmir, Turkey Fax: +90 232 336 48 49 E-mail: isiladadan@yahoo.com

Abstract

Background:

Xylitol is a five-carbon sugar alcohol. Natural sources of xylitol include plums, strawberries and raspberries. Xylitol is commercially available in chewing gums, lozenges, syrups, nasal sprays, toothpastes, mouthwashes and other products in some countries. It has gained relative prominence in the past decade as a naturally occurring antibacterial agent.

Objective:

A review of contemporary literature was conducted to evaluate the efficacy of xylitol usage in ENT practice.

Method:

The English-language literature was searched using the following terms: xylitol, otitis media, nasal, sinusitis, dental caries and preventive therapy. The articles identified were included in this review.

Results:

Xylitol has no antibacterial properties of its own; rather, it appears to enhance the body's own innate immunity. Xylitol has anti-adhesive effects on micro-organisms like Streptococcus pneumoniae and Streptococcus mutans, inhibiting their growth. Xylitol has already been used for preventing otitis media, rhinosinusitis and dental caries. The worldwide spread of drug-resistant strains of pneumococci substantiates the need for new approaches to prevent ENT-related infectious diseases.

Conclusion:

Xylitol may be a promising agent for this purpose in ENT practice, but further experimental and clinical studies are required.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Wang, YM, Van, EJ. Nutritional significance of fructose and sugar alcohols. Annu Rev Nutr 1981;1:437–75Google Scholar
2Vernacchio, L, Vezina, RM, Mitchell, AA. Tolerability of oral xylitol solution in young children: implications for otitis media prophylaxis. Int J Pediatr Otorhinolaryngol 2007;71:8994CrossRefGoogle ScholarPubMed
3Milgrom, P, Rothen, M, Milgrom, L. Developing public health interventions with xylitol for the US and US-associated territories and states. Suom Hammaslaakarilehti 2006;13:211Google Scholar
4Natah, SS, Hussien, KR, Tuominen, JA, Koivisto, VA. Metabolic response to lactitol and xylitol in healthy men. Am J Clin Nutr 1997;65:947–50CrossRefGoogle ScholarPubMed
5Ladefoged, K, Berthelsen, P, Brockner-Nielsen, J, Jarnum, S, Larsen, V. Fructose, xylitol and glucose in total parenteral nutrition. Intensive Care Med 1982;8:1923Google Scholar
6Kontiokari, T, Uhari, M, Koskela, M. Effect of xylitol on growth of nasopharyngeal bacteria in vitro. Antimicrob Agents Chemother 1995;39:1820–3CrossRefGoogle ScholarPubMed
7Kontiokari, T, Uhari, M, Koskela, M. Antiadhesive effects of xylitol on otopathogenic bacteria. J Antimicrob Chemother 1998;41:563–5CrossRefGoogle ScholarPubMed
8Goldman, MJ, Anderson, GM, Stolzenberg, ED, Kari, UP, Zasloff, M, Wilson, JM. Human beta-defensin-1 is a salt-sensitive antibiotic in lung that is inactivated in cystic fibrosis. Cell 1997;88:553–60Google Scholar
9Durairaj, L, Launspach, J, Watt, JL, Businga, TR, Kline, JN, Thorne, PS et al. Safety assessment of inhaled xylitol in mice and healthy volunteers. Respir Res 2004;5:13Google Scholar
10Milgrom, P, Ly, KA, Tut, OK, Mancl, L, Roberts, MC, Briand, K et al. Xylitol pediatric topical oral syrup to prevent dental caries: a double blind, randomized clinical trial of efficacy. Arch Pediatr Adolesc Med 2009;163:601–7CrossRefGoogle ScholarPubMed
11Miyasawa-Hori, H, Aizawa, S, Takahashi, N. Difference in the xylitol sensitivity of acid production among Streptococcus mutans strains and the biochemical mechanism. Oral Microbiol Immunol 2006;21:201–5Google Scholar
12Faden, H, Waz, MJ, Bernstein, JM, Brodsky, L, Stanievich, J, Ogra, PL. Nasopharyngeal flora in the first three years of life in normal and otitis-prone children. Ann Otol Rhinol Laryngol 1991;100:612–5CrossRefGoogle ScholarPubMed
13Uhari, M, Kontiokari, T, Koskela, M, Niemela, M. Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial. BMJ 1996;313:1180–4Google Scholar
14Uhari, M, Kontiokari, T, Niemela, M. A novel use of xylitol sugar in preventing acute otitis media. Pediatrics 1998;102:879–84Google Scholar
15Tapiainen, T, Luotonen, L, Kontiokari, T, Renko, M, Uhari, M. Xylitol administered only during respiratory infections failed to prevent acute otitis media. Pediatrics 2002;109:15Google Scholar
16Hautalahti, O, Renko, M, Tapiainen, T, Kontiokari, T, Pokka, T, Uhari, M. Failure of xylitol given three times a day for preventing acute otitis media. Pediatr Infect Dis 2007;26:423–7Google Scholar
17Sezen, OS, Kaytancı, H, Eraslan, G, Coşkuner, T, Kubilay, U, Aydın, S et al. Xylitol containing chewing gums in the management of chronic otitis media with effusion. Mediterranean J Otol 2008;4:203–10Google Scholar
18Jones, AH. Intranasal xylitol, recurrent otitis media and asthma: three case studies. Clinical Practice of Alternative Medicine 2001;2:112–7Google Scholar
19Zabner, J, Seiler, MP, Launspach, JL, Karp, PH, Kearney, WR, Look, DC et al. The osmolyte xylitol reduces the salt concentration of airway surface liquid and may enhance bacterial killing. Proc Natl Acad Sci USA 2000;97:11614–9Google Scholar
20Weissman, JD, Fernandez, F, Hwang, PH. Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study. Laryngoscope 2011;121:2468–72CrossRefGoogle ScholarPubMed
21Uhari, M, Tapiainen, T, Kontiokari, T. Xylitol in preventing otitis media. Vaccine 2001;19:144–7CrossRefGoogle Scholar
22Danhauer, JL, Johnson, CE, Corbin, NE, Bruccheri, KG. Xylitol as a prophylaxis for acute otitis media: systematic review. Int J Audiol 2010;49:754–61CrossRefGoogle ScholarPubMed
24Ganz, T. Antimicrobial polypeptides in host defense of the respiratory tract. J Clin Invest 2002;109:693–7Google Scholar
25Brown, CL, Graham, SC, Cable, BB, Ozer, EA, Taft, PJ, Zabner, J. Xylitol enhances bacterial killing in the rabbit maxillary sinus. Laryngoscope 2004;114:2021–4Google Scholar
26Renko, M, Valkonen, P, Tapiainen, T, Kontiokari, T, Mattila, P, Knuuttila, M et al. Xylitol-supplemented nutrition enhances bacterial killing and prolongs survival of rats in experimental pneumococcal sepsis. BMC Microbiol 2008;8:45CrossRefGoogle ScholarPubMed
27Shangari, N, O'Brien, PJ. The cytotoxic mechanism of glyoxal involves oxidative stress. Biochem Pharmacol 2004;68:433–42Google Scholar
28Morona, JK, Miller, DC, Morona, R, Paton, JC. The effect that mutations in the conserved capsular polysaccharide biosynthesis genes cpsA, cpsB, and cpsD have on virulence of Streptococcus pneumoniae. J Infect Dis 2004;189:1905–13CrossRefGoogle ScholarPubMed
29Kurola, P, Tapiainen, T, Kaijalainen, T, Uhari, M, Saokkoriipi, A. Xylitol and capsular gene expression in Streptococcus pneumoniae. J Med Microbiol 2009;58:1470–3Google Scholar
30Makinen, KK. Effect of long-term, peroral administration of sugar alcohols on man. Swed Dent J 1984;8:113–24Google Scholar
31Akerblom, HK, Koivukangas, KT, Puukka, R, Mononen, M. The tolerance of increasing amounts of dietary xylitol in children. Int J Vitam Nutr Res Suppl 1982;22:53–6Google Scholar
32Forster, H, Quadbeck, R, Gottstein, U. Metabolic tolerance to high doses of oral xylitol in human volunteers not previously adapted to xylitol. Int J Vitam Nutr Res Suppl 1982;22:6788Google Scholar
33Pfeiffer, H, Weiss, FU, Karger, B, Aghdassi, A, Lerch, MM, Brinkman, B. Fatal cerebro-renal oxalosis after appendectomy. Int J Legal Med 2004;118:98100Google Scholar