He Mengzhen, Yin Yisheng, Yu Gan, Zhou Hui
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Phytother Res. 2025 Mar;39(3):1261-1276. doi: 10.1002/ptr.8429. Epub 2024 Dec 30.
Urinary tract infections (UTIs) are exceptionally common in postmenopausal female or patients with diabetes mellitus or nephrolithiasis, carrying substantial burden on patients and healthcare system. Increasing proportion and ongoing spread of antibiotic-resistant pathogens have further debilitated the condition in battlefield against the UTIs. Lack of estrogen may contribute to high inclination of UTIs after menopause and hormone replacement therapy can mitigate symptoms of hot flashes, vaginal dryness and UTIs, rationalizing the usage of estrogen and analogues in treatment and prophylaxis of UTIs. Phytoestrogens which comprise flavonoids, coumerins, stilbenes, and lignans, are natural botanical compounds with estrogen structural similarity and biochemical features. Phytoestrogens have emerged as adjuvant remedy and prophylaxis for uropathogenic bacteria even for multidrug-resistant ones, with the multifaceted mechanisms such as inhibition of adhesion and invading ability of bacteria, destruction of biofilms, synergistically enhancement of antibiotics activity. It is plausible to propose phytoestrogens as potential agents or combination with other strategies to ameliorate the challenge of multi-drug resistance in UTIs.
尿路感染（UTIs）在绝经后女性、糖尿病患者或肾结石患者中极为常见，给患者和医疗系统带来了沉重负担。抗生素耐药病原体比例的增加和持续传播，进一步削弱了对抗UTIs的能力。雌激素缺乏可能导致绝经后UTIs高发，激素替代疗法可以缓解潮热、阴道干燥和UTIs症状，这使得雌激素及其类似物在UTIs治疗和预防中的应用具有合理性。植物雌激素包括黄酮类、香豆素类、芪类和木脂素类，是具有雌激素结构相似性和生化特性的天然植物化合物。植物雌激素已成为治疗尿路致病菌甚至多重耐药菌的辅助治疗和预防药物，其作用机制具有多方面性，如抑制细菌的黏附和侵袭能力、破坏生物膜、协同增强抗生素活性。提出将植物雌激素作为潜在药物或与其他策略联合使用，以应对UTIs中多重耐药的挑战是合理的。
