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D-Xylitol pp 325–342Cite as

Medical Applications of Xylitol: An Appraisal

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Abstract

Xylitol is a sugar alcohol, normally produced by mammal metabolism, which has a great (and increasing) applicability in food and pharmaceutical industries due to its intriguing and proper characteristics. The most explored area is oral health, due to its non- and anti-cariogenic properties, followed by its use as a sweetener. Moreover, some other applicabilities in the medical area can be found in literature and patents, such as the use in the treatment and/or prevention of acute otitis media, respiratory diseases, parenteral nutrition, atopic dermatitis, wound repairing, gastrointestinal infections, osteoporosis, anti-aging and inflammatory processes. Market usage of xylitol for over 20 years, accompanied by toxicological studies, corroborated its safety for medical purposes. A great number of recent studies demonstrate that xylitol can be used to develop pharmaceutical products. Especially because of its activity against microorganisms, xylitol medical applications are still an important point for studies, with potential for novel medical applications in the upcoming years.

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References

  • Ackermann MR, Gallup JM, Zabner J, Evans RB, Brockus CW, Meyerholz DK, Grubor B, Brodgen KA (2004) Differential expression of sheep beta-defensin-1 and -2 and interleukin 8 during acute Mannheimia haemolytica pneumonia. Microb Pathog 37:21–27

    Article  PubMed  CAS  Google Scholar 

  • Amaechi BT, Higham SM, Edgar WM (1998) The influence of xylitol and fluoride on dental erosion in vitro. Arch Oral Biol 43:157–161

    Article  PubMed  CAS  Google Scholar 

  • Ammons MC, Ward LS, Fisher ST, Wolcott RD, James GA (2009) In vitro susceptibility of established biofilms composed of a clinical wound isolate of Pseudomonas aeruginosa treated with lactoferrin and xylitol. Int J Antimicrob Agents 33:230–236

    Article  PubMed  CAS  Google Scholar 

  • Ammons MC, Ward LS, James GA (2011) Anti-biofilm efficacy of a lactoferrin/xylitol wound hydrogel used in combination with silver wound dressings. Int Wound J 8:268–273

    Article  PubMed  Google Scholar 

  • Amo K, Arai H, Uebanso T, Fukaya M, Koganei M, Sasaki H, Yamamoto H, Taketani Y, Takeda E (2011) Effects of xylitol on metabolic parameters and visceral fat accumulation. J Clin Biochem Nutr 49:1–7

    Article  PubMed  CAS  Google Scholar 

  • Azarpazhooh A, Limeback H, Lawrence HP, Shah PS (2011) Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev 11:CD007095. doi:10.1002/14651858

  • Bader JD, Shugars DA, Vollmer WM, Gullion CM, Gilbert GH, Amaechi BT, Brown JP (2010) Design of the xylitol for adult caries trial (X-ACT). BMC Oral Health 10:22–29

    Article  PubMed  Google Scholar 

  • Bruggeman JP, Bettinger CJ, Langer R (2010) Biodegradable xylitol based elastomers: in vivo behavior and biocompatibility. J Biomed Mater Res A 95:92–104

    PubMed  Google Scholar 

  • Calorie Control Council (2005) Reduced-calorie sweeteners: xylitol. http://www.caloriecontrol.org/xylitol.html. Accessed 05 Oct 2005

  • Campus G, Cagetti MG, Sacco G, Solinas G, Mastroberardino S, Lingström P (2009) Six months of daily high-dose xylitol in high-risk schoolchildren: a randomized clinical trial on plaque pH and salivary mutans streptococci. Caries Res 43:455–461

    Article  PubMed  CAS  Google Scholar 

  • Campus G, Cagetti MG, Cocco F, Sale S, Sacco G, Strohmenger L, Lingström P (2011) Effect of sugar-free chewing gum containing Magnolia bark extract on different variables related to caries and gingivitis: a randomized controlled intervention trial. Caries Res 45:393–399

    Article  PubMed  CAS  Google Scholar 

  • Danhauer JL, Johnson CE, Corbin NE, Broccheri KG (2010) Xylitol as a prophylaxis for acute otitis media: systematic review. Int J Audiol 49:754–761

    Article  PubMed  Google Scholar 

  • Domenico RD, Lavecchia R (2002) Stabilization of human haemoglobin by naturally occurring osmolytes. Biochem Eng J 10:27–30

    Article  Google Scholar 

  • Durairaj L, Launspach J, Watt JL, Businga TR, Kline JN, Thorne PS, Zabner J (2004) Safety assessment of inhaled xylitol in mice and healthy volunteers. Respir Res 16:5–13

    Google Scholar 

  • Durairaj L, Launspach J, Watt JL, Mohamad Z, Kline J, Zabner J (2007) Safety assessment of inhaled xylitol in subjects with cystic fibrosis. J Cyst Fibros 6:31–34

    Article  PubMed  CAS  Google Scholar 

  • Ferreira AS, de Souza M, Barbosa NR, da Silva SS (2008) Leishmania amazonensis: xylitol as inhibitor of macrophage infection and stimulator of macrophage nitric oxide production. Exp Parasitol 119:74–79

    Article  PubMed  CAS  Google Scholar 

  • Ferreira AS, Barbosa NR, Rodrigues D Jr, Silva SS (2009a) In vitro mechanism of xylitol action against Staphylococcus aureus ATCC 25923. In: Mendez-Vilas A (ed) Current research topics in applied microbiology and microbial biotechnology. World Scientific Publishing Co. Pte. Ltd, Seville, pp 505–509

    Google Scholar 

  • Ferreira AS, Barbosa NR, Silva SS (2009b) In vivo xylitol dermal irritation and phototoxicity evaluation. Lat Am J Pharm 28:192–195

    CAS  Google Scholar 

  • Ferreira AS, Souza MA, Raposo NRB, Ferreira AP, Silva SS (2011) Xylitol inhibits J774A.1 macrophage adhesion in vitro. Braz Arch Biol Technol 54:1211–1216

    Article  CAS  Google Scholar 

  • Franz H, Kompa HE, Rozman T (1994) Pharmaceutical composition for topical application to the eye for treating increased intraocular pressure. Basotherm GmbH, CA2105530, 05 March 1994

    Google Scholar 

  • Franz H, Kompa E, Rozman T (1996) Pharmaceutical composition for topical application to the eye for treating increased intraocular pressure. USP 5.527.831, 18 June 1996

    Google Scholar 

  • Georgieff M, Oehmke M (1990) Hypocaloric low osmotic aqueous preparation for infusion. EP 0150053B1, 13 June 1990

    Google Scholar 

  • Georgieff M, Pscheidl E, Moldawer LL, Bistrian BR, Blackburn GL (1991) Mechanisms of protein conservation during xylitol infusion after burn injury in rats: isotope kinetics and indirect calorimetry. Eur J Clin Invest 21:249–258

    Article  PubMed  CAS  Google Scholar 

  • Hämäläinen MM, Mäkinen KK (1982) Metabolism of glucose, fructose and xylitol in normal and streptozotocin-diabetic rats. J Nutr 112:1369–1378

    PubMed  Google Scholar 

  • Han SJ, Jeong SY, Nam YJ, Yang KH, Lim HS, Chung J (2005) Xylitol inhibits inflammatory cytokine expression induced by lipopolysaccharide from Porphyromonas gingivalis. Clin Diagn Lab Immunol 12:1285–1291

    PubMed  CAS  Google Scholar 

  • Hildebrandt G, Lee I, Hodges J (2010) Oral mutans streptococci levels following use of a xylitol mouth rinse: a double-blind, randomized, controlled clinical trial. Spec Care Dentist 30:53–58

    Article  PubMed  Google Scholar 

  • Islam MS (2011) Effects of xylitol as a sugar substitute on diabetes-related parameters in nondiabetic rats. J Med Food 14:505–511

    Article  PubMed  CAS  Google Scholar 

  • Iwata C, Nakagaki H, Morita I, Sekiya T, Goshima M, Abe T, Isogai A, Hanali M, Kuwahara M, Tatematsu M, Robinsin C (2003) Daily use of dentifrice with and without xylitol and fluoride: effect of glucose retention in humans in vivo. Arch Oral Biol 48:389–395

    Article  PubMed  CAS  Google Scholar 

  • Jerry JB, Alonzo HJ (2005) Nasal administration of xylitol to a non-human mammal. Patent, NZ532885, 29 September

    Google Scholar 

  • Katsuyama M, Ichikawa H, Ogawa S, Ikezawa Z (2005a) A novel method to control the balance of skin microflora. Part 1. Attack on biofilm of Staphylococcus aureus without antibiotics. J Dermatol Sci 38:197–205

    Article  PubMed  Google Scholar 

  • Katsuyama M, Kobayashi Y, Ichikawa H, Mizuno A, Miyachi Y, Matsunaga K, Kawashima M (2005b) A novel method to control the balance of skin microflora. Part 2. A study to assess the effect of a cream containing farnesol and xylitol on atopic dry skin. J Dermatol Sci 38:207–213

    Article  PubMed  Google Scholar 

  • King NA, Craig SA, Pepper T, Blundell JE (2005) Evaluation of the independent and combined effects of xylitol and polydextrose consumed as a snack on hunger and energy intake over 10 d. Br J Nutr 93:911–915

    Article  PubMed  CAS  Google Scholar 

  • Kontiokari T, Uhari M, Koskela M (1995) Effects of xylitol of nasopharyngeal bacteria in vitro. Antimicrob Agents Chemother 39:1820–1823

    Article  PubMed  CAS  Google Scholar 

  • Kontiokari T, Uhari M, Koskela M (1998) Antiadhesive effects of xylitol on otopathogenic bacteria. J Antimicrob Chemother 41:563–565

    Article  PubMed  CAS  Google Scholar 

  • Korponyai C, Koyács RK, Erös G, Dikstein S, Keméry L (2011) Antiirritant properties of polyols and aminoacids. Dermatitis 22:141–146

    PubMed  CAS  Google Scholar 

  • Kruger G (2005) Efeitos refrescantes com xylitol. Aditivos Ingred 36:26–27

    Google Scholar 

  • Kurola P, Tapianen T, Sevander J, Kaijalainen T, Leinonen M, Uhari M, Saukkoriipo A (2011) Effects of xylitol and other carbono sources on Streptococcus pneumoniae biofilm formation and gene expression in vitro. APMIS 119:135–142

    Article  PubMed  CAS  Google Scholar 

  • Mäkinen KK (2000) Can the pentitol-hexitol theory explain the clinical observations made with xylitol? Med Hypotheses 54:603–613

    Article  PubMed  Google Scholar 

  • Mattila PT, Svanberg MJ, Pökkä P, Knuuttila ML (1998) Dietary xylitol protects against weakning of bone biomechanical properties in ovariectomized rats. J Nutr 128:1811–1814

    PubMed  CAS  Google Scholar 

  • Mattila P, Knuutila M, Koyanen V, Svanberg M (1999) Improved bone biomechanical properties in rats after oral xylitol administration. Calcif Tissue Int 64:340–344

    Article  PubMed  CAS  Google Scholar 

  • Mattila PT, Pelkonen P, Knuuttila ML (2005) Effects of a long-term dietary xylitol supplementation on collagen content and fluorescence of the skin in aged rats. Gerontology 51:166–169

    Article  PubMed  CAS  Google Scholar 

  • Merck Sharp & Dohme–Chibret Dohme (1993) Ophthalmic preparation containing an acceptable antimicrobial osmotic agent. Sharp Laboratoires Merck, FR2679773, 05 Febr 1993

    Google Scholar 

  • Milgrom P, Ly KA, Tut OK, Mancl L, Roberts MC, Briand K, Gancio MJ (2009) Xylitol pediatric topical oral syrup to prevent dental caries: a double-blind randomized clinical trial of efficacy. Arch Pediatr Adolesc Med 163:601–607

    Article  PubMed  Google Scholar 

  • Naaber P, Lehto E, Salminen S, Mikelsaar M (1996) Inhibition of adhesion of Clostridium difficile to Caco-2 cells. FEMS Immunol Med Microbiol 14:205–209

    Article  PubMed  CAS  Google Scholar 

  • Nakai Y, Shinga-Ishihara C, Kaji M, Moriya K, Murakami-Yamanaka K, Takimura M (2010) Xylitol gum and maternal transmission of mutans streptococci. J Dent Res 89:56–60

    Article  PubMed  CAS  Google Scholar 

  • Renko M, Valkonen P, Tapiainen T, Kontiokari T, Mattila P, Knuuttila M, Svanberg M, Leinonen M, Karttunen R, Uhari M (2008) Xylitol-supplemented nutrition enhances bacterial killing and prolongs survival of rats in experimental pneumococcal sepsis. BMC Microbiol 8:45–51

    Article  PubMed  Google Scholar 

  • Sajjan U, Moreira J, Liu M, Humar A, Chaparro C, Forstner J, Keshavjee S (2004) A novel model to study bacterial adherence to the transplanted airway: inhibition of Burkholderia cepacia adherence to human airway by dextran and xylitol. J Heart Lung Transplant 23:1382–1391

    Article  PubMed  Google Scholar 

  • Sano H, Nakashima S, Songpaisan Y, Phantumvanit P (2007) Effect of xylitol and fluoride containing toothpaste on the remineralization of human enamel in vitro. J Oral Sci 49:67–73

    Article  PubMed  Google Scholar 

  • Sanróman MA, Domínguez H, Núnez M, Lema JM (1991) Xylitol: un alcohol com futuro. Afinidad 48:215–222

    Google Scholar 

  • Saulo AA (2005) Sugars and sweeteners in food. Food Saf Technol 16:1–7

    Article  Google Scholar 

  • Sawaguchi M, Sawaguchi Y, Nakao K, Kuromaru H, Haba H (2001) Xylitol nose spray. Patent, JP2001172150, 26 June 2001

    Google Scholar 

  • Shafer RB, Levine AS, Marlette JM, Morley JE (1987) Effects of xylitol on gastric emptying and food intake. Am J Clin Nutr 45:744–747

    PubMed  CAS  Google Scholar 

  • Silva SS, Vitolo M, Mancilha IM, Roberto IC (1994) Xilitol: um adoçante alternativo para indústria de alimentos. Alimentos e Nutrição (UNESP) 5:109–117

    Google Scholar 

  • Silva AF, Silva SS, Oliveira MG, Raposo NRB (2010a) Inibição in vitro da aderência de enteropatógenos pelo xilitol. Rev Ciênc Médicas e Biológicas 9:42–49

    Google Scholar 

  • Silva AF, Devito KL, Silva SS, Raposo NRB (2010b) Effects of xylitol on enamel erosion control. Arq Bras Odontol 6:3–9

    Google Scholar 

  • Silva AF, Suzuki EY, Ferreira AS, Oliveira MG, Silva SS, Raposo NRB (2011) In vitro inhibition of adhesion of Escherichia coli strains by xylitol. Braz Arch Biol Technol 54:235–241

    Article  Google Scholar 

  • Souza LP, Silva AF, Calil NO, Oliveira MG, Silva SS, Raposo NRB (2011) In vitro inhibition of Pseudomonas aeruginosa adhesion by xylitol. Braz Arch Biol Technol 54:877–884

    Article  Google Scholar 

  • Takahashi K, Onodera K, Akiba Y (1999) Effect of dietary xylitol on growth and inflammatory responses in immune stimulated chickens. Br Poult Sci 40:552–554

    Article  PubMed  CAS  Google Scholar 

  • Takahashi K, Mashiko T, Akiba Y (2000) Effect of dietary concentration of xylitol on growth in male broiler chicks during immunological stress. Poult Sci 79:743–747

    PubMed  CAS  Google Scholar 

  • Tamanini C, Hauly MCO (2004) Resíduos agroindustriais para produção biotecnológica de xilitol. Semina: Ciências Agrárias 25:315–330

    Google Scholar 

  • Tapiainen T, Kontiokari T, Sammalkiyi L, Ikäheimo I, Koskela M, Uhari M (2001) Effects of xylitol on growth of Streptococcus pneumoniae in the presence of fructose and sorbitol. Antimicrob Agents Chemother 45:166–169

    Article  PubMed  CAS  Google Scholar 

  • Tapiainen T, Sormunen R, Kaijalainen T, Kontiokari R, Ikäheimo I, Uhari M (2004) Ultrastructure of Streptococcus pneumoniae after exposure to xylitol. J Antimicrob Chemother 54:225–228

    Article  PubMed  CAS  Google Scholar 

  • Uhari M, Kontiokari T, Koskela M, Niemelä M (1996) Xylitol chewing gum in prevention of acute otitis media: double blind randomized trial. BMJ 313:1180–1184

    Article  PubMed  CAS  Google Scholar 

  • Uhari M, Tapiainen T, Kontiokari T (2001) Xylitol in preventing acute otitis media. Vaccine 19:144–147

    Article  Google Scholar 

  • Ukab WA, Sato J, Wang YM, van Eys J (1981) Xylitol mediated amelioration of acetylphenyl hydrazine-induced hemolysis in rabbits. Metabolism 30:1053–1059

    Article  PubMed  CAS  Google Scholar 

  • Valero MA, Léon-Sanz M, Escobar I, Gomis P, de la Cámara A, Moreno JM (2011) Evaluation of nonglucose carbohydrates in parenteral nutrition for diabetic patients. Eur J Clin Nutr 55:1111–1116

    Article  Google Scholar 

  • Wang YM, Patterson JH, van Eys J (1971) The potential use of xylitol in glucose-6-phospahte dehydrogenase deficiency anemia. J Clin Invest 50:1421–1428

    Article  PubMed  CAS  Google Scholar 

  • Welsh MJ, Zabner J (2004) Use of xylitol to reduce ionic strength and activate endogenous antimicrobials for prevention and treatment of infections. US Patent 6.716.819 B2, 06 April 2004 (University of Iowa Research Foundation )

    Google Scholar 

  • WHO/FAO (1997) Summary of toxicological data of certain food additives. Twenty-first report of the Joint FAO/WHO Expert Committee on Food Additives. WHO Technical Report Series, Geneva, 617:124–147

    Google Scholar 

  • Wills D, Bernard R (2006) Antipyretic preparation containing xylitol. Patent, US2006142254, 29 June 2006

    Google Scholar 

  • Ylikahri R (1979) Metabolic and nutritional aspects of xylitol. Adv Food Res 25:159–180

    Article  PubMed  CAS  Google Scholar 

  • Zabner J, Seiler MP, Launspach JL, Karp PH, Kearney WR, Look DC, Smith JJ, Welsh MJ (2000) The osmolyte xylitol reduces the salt concentration of airway surface liquid and may enhance bacterial killing. Proc Natl Acad Sci U S A 97:11614–11619

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The financial scholarship provided by CAPES and financial support provided by FAPESP, CNPq and FAPEMIG are gratefully acknowledged.

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Authors and Affiliations

  1. Faculty of Pharmacy, University Campus—Center of Research and Innovation in Health Sciences (Núcleo de Pesquisa e Inovação em Ciências da Saúde—NUPICS), Federal University of Juiz de Fora, Martelos, Juiz de Fora-MG, 36036900, Brazil

    Annelisa Farah da Silva, Aline Siqueira Ferreira & Nádia Rezende Barbosa Raposo

  2. Department of Biotechnology, Engineering School of Lorena, University of Sao Paulo, Estrada Municipal do Campinho, sn. 116, Lorena-SP, 12602810, Brazil

    Silvio Silvério da Silva

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  1. Annelisa Farah da Silva
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  2. Aline Siqueira Ferreira
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  3. Silvio Silvério da Silva
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  4. Nádia Rezende Barbosa Raposo
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Correspondence to Nádia Rezende Barbosa Raposo .

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Editors and Affiliations

  1. , Department of Biotechnology, University of São Paulo, Lorena-Estrada Municipal do Campinho, São Paulo, 12602810, Brazil

    Silvio Silvério da Silva

  2. , Department of Biotechnology, University of São Paulo, Lorena- Estrada Municipal do Campinho, São Paulo, 12602810, Brazil

    Anuj Kumar Chandel

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da Silva, A.F., Ferreira, A.S., da Silva, S.S., Raposo, N.R.B. (2012). Medical Applications of Xylitol: An Appraisal. In: da Silva, S., Chandel, A. (eds) D-Xylitol. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31887-0_15

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