# Novel Insights on Plant Extracts to Prevent and Treat Recurrent Urinary Tract Infections
## 6 Plants Commonly Used in the Treatment of rUTI
### Promising Medicinal Plants to Treat rUTI
#### 6.2.3 C. mas L.  
--Cornelian Cherry  
The cornelian cherry (_C. mas L._) is a member of the _Cornaceae_ family (_Cornaceae_), found in the wild throughout Europe's central and south-eastern areas and Asia, where fruits have been used for centuries in traditional medicine [71]. The considerable number of anthocyanins in cornelian cherry is linked to the fruits' main pro-health benefits; however, the chemical makeup of _C. mas_ is varied and primarily depends on variety, culture, and environmental and climatic circumstances [72]. Extracts from different parts of the plant revealed broad pharmacological activities. Various studies identified 101 compounds among active biological anthocyanins, flavonoids, iridoids, and vitamin C, especially in the fruits [73]. The highest antimicrobial activity of the _C. mas_ leaf extract was correlated with iridoids, ellagic acid, and ellagitannins, substances that were not detected in _A. melanocarpa_ leaf extract [64]. This study noted the more substantial effect of cornelian cherry leaf extract (1%) on Gram-negative bacteria compared to Gram-positive bacteria and explained that some interactions that may occur between polyphenols, iridoids, and cell walls, but the results are not in agreement with other data reported in the literature. Biologically active substances from cornelian cherry leaf extract produced morphological changes in bacterial aggregate formation-induced reactive oxygen species with various adverse intracellular effects, including suppressing the DNA gyrase activity that inhibits DNA synthesis [64]. Second-line antibiotics recommended in the therapy of rUTI, such as quinolones, especially ciprofloxacin, have a similar mechanism of action and target DNA gyrase. However, the _C. mas_ bark extract showed moderate antibacterial activity on some bacteria but no effect on others, including _E. coli_, or on the yeasts _C. albicans_ and _R. rubra_[74]. Cornelian cherry fruits are non-toxic and safe foods, based on toxicity studies in rat and human models. They can mainly treat diabetes, obesity, atherosclerosis, skin diseases, and gastrointestinal and rheumatic problems [75]. The data in the literature have suggested that polyphenols and iridoids are responsible for the therapeutic benefits of cornelian cherry fruits on many physiological parameters [76]. Moreover, the leaves from _C. mas_ have shown significant anti-inflammatory effects connected with inhibiting aldose reductase, an overexpressed enzyme in many inflammation processes and cancers [77]. The recent trends in herbal medicine open new insights into using _C. mas_ in the treatment of rUTI (Table 1). The administration of cornelian cherry tablet (500 mg) for six months in women affected by rUTI decreased dysuria and frequent urination. However, positive urine culture in the group that received _C. mas_ (19%) compared to the group that received placebo (33.4%) was not statistically significant [78]. More research must be conducted to clarify the action mechanism of cornelian cherry extract in rUTI cure. Still, polyphenols, anthocyanins, iridoids, and vitamin C with antioxidant effects seem to be the active molecules involved. At the same time, clinical trials are necessary to use a combination of plant extract and a combination of plant extract and pre- and probiotics to prove their effectiveness [79]. \begin{table}