Biomarkers in Vesicoureteral Reflux: An Overview

Abstract

<jats:p> Aim: This article aimed to review the role of cytokines, chemokines, growth factors and cellular adhesion molecules as biomarkers for vesicoureteral reflux (VUR) and reflux nephropathy (RN). Methods: We reviewed articles from 1979 onward by searching PubMed and Scopus utilizing the combination of words: ‘VUR’ or ‘RN’ and each one of the biomarkers. Results: Genetic, inflammatory, fibrogenic, environmental and epigenetic factors responsible for renal scarring need to be better understood. TGF-β, IL-10, IL-6, IL-8 and TNF seem to exert a role in VUR particularly in RN based on the current literature. Serum levels of procalcitonin have been also associated with high-grade VUR and RN. These molecules should be more intensively evaluated as potential biomarkers for renal scarring in VUR. Conclusion: Further studies are necessary to define which molecules will really be of utility in clinical decisions and as therapeutic targets for VUR and RN. </jats:p>

Vesicoureteral Reflux and Innate Immune System: Physiology, Physiopathology, and Clinical Aspects

“…Other studies suggest that MCP1, TGFβ1, and VEGF may be useful in the diagnosis and monitoring of renal parenchymal fibrosis in patients with VUR. One more noninvasive marker in the diagnosis and prediction of renal scarring in children with VUR seems to be urinary NGAL [ 50 , 97 , 98 ].…”

“…The studies performed on animal models with a lack of IL-6 expression have shown that in individuals with IL-6 deficiency, bacterial colonization is more intense, with uropathogens being able to escape the innate immune response and thus promote chronic inflammation. These individuals also present more severe UTIs, more pronounced structural alterations of the renal parenchyma, and ultimately, higher mortality rates [ 50 , 51 ].…”

“…Other studies performed by Jutley et al and Sheu et al have shown that there were higher concentrations of serum IL-6 in patients with VUR or RN, and that elevated serum and urine IL-6 concentrations are correlated with a higher risk of renal scar development. Wang et al conducted a study that revealed that children with reflux nephropathy present higher concentrations of IL-6 in urine, with these concentrations correlating with the severity of renal scars [ 46 , 48 , 49 , 50 , 51 ].…”

Urinary exosomal vitronectin predicts vesicoureteral reflux in patients with neurogenic bladders and spinal cord injuries

“…The present study identified the differences in urine exosomal protein profiles between VUR and non-VUR patients and revealed that exosomal VTN could be used as a potential marker in predicting disease progression in patients with NGB. At present, there are no recognized non-invasive, effective biochemical indicators to predict urinary reflux ( 25 ). The present results demonstrated that urine exosomal VTN may be an early biomarker for monitoring VUR.…”

Effect of pneumovesicoscopic Cohen surgery with adjustable suspension technique through natural channel on the treatment of primary vesicouretral reflux disease in infants

“…Many studies have shown that KIM-1 and MCP-1 in urinary can re ect the severity of kidney injury and brosis. [14][15][16] Before surgery and 6 months after surgery, urological ultrasound was routinely performed to investigate anteroposterior diameter of hydronephrosis and distal ureter diameter, voiding cystourethrography to investigate the grade of re ux, dimercaptosuccinic acid to investigate the formation and grade of renal scar, and renal function status. The levels of KIM-1 and MCP-1 in morning urine were detected to evaluate the progression of renal injury and brosis.…”