Interleukin‐1α and interleukin‐1 receptor antagonist in the urine of children with acute pyelonephritis and relation to renal scarring

Abstract

Urinary concentrations of interleukin-1 alpha (IL-1 alpha) and interleukin-1 receptor antagonist (IL-lra) standardized to urinary creatinine concentrations were studied. The median standardized IL-1 alpha creatinine quotient in children with first-time acute pyelonephritis was 3.6 pg/mumol, but was nondetectable in children with recurrent pyelonephritis, children with non-renal febrile conditions and children convalescent after acute pyelonephritis (p < 0.05-0.01). IL-lra levels were also significantly higher in children with acute first-time pyelonephritis (median of 239 pg/mumol) compared to these three groups of children (p < 0.01-0.001). The highest urinary IL-lra levels, however, were found in the healthy controls (median value 1.019; p < 0.001). Both cytokines were higher among children younger than one year compared to older children. The acute IL-1 alpha creatinine quotients were lowest in children with uptake defects on 99mTC-dimercaptosuccinic acid (DMSA) scintigraphy both during the acute infection (reflecting the acute inflammation) (p < 0.001) and 1 year after the acute infection (reflecting permanent kidney scarring) (p < 0.001). In conclusion, persisting high urinary levels of IL-1 alpha were associated with less renal inflammation and scarring.

Transforming growth factor-?1 in the urine of young children with urinary tract infection

“…Inflammatory mediators, including cytokines such as interleukin (IL)-6 and IL-8, have been found in increased concentrations in the urine of children with UTI [12,13,14], suggesting that renal parenchymal cells produce local inflammatory mediators in response to invading pathogens. Furthermore, the initial concentrations of IL-6 in the urine of children with pyelonephritis have been correlated with DMSA uptake defects both in the acute phase and 1 year later [12].…”

Evaluation and Comparison of Urinary Cytokines for the Diagnosis of Acute Pyelonephritis

“…They are involved in B cell and T cell proliferation and neutrophil chemoattraction, along with secretion of CRP, immunoglobulins, and acute-phase proteins (2,6,8,10) Clinical manifestations of APN depend on the production of different cytokines, and measurement of urinary ILs seems to be useful for the rapid diagnosis and localization of inflammation within the urinary tract system. Increased urinary IL-1, IL-4, IL-6, and IL-8 concentrations have been reported in children with acute febrile UTIs compared to the healthy children and those with lower UTIs, asymptomatic bacteriuria, and non-renal febrile infections (2,(11)(12)(13)(14)(15). Similarly, urinary IL-1, IL-4, IL-6, and IL-8 increased during the acute phase of infection compared to non-renal febrile infections.…”

Cytokines and Cell Adhesion Molecules in the Inflammatory Response during Acute Pyelonephritis

“…IL-1 and IL-1RA levels were not significantly different from those of healthy controls, though acute levels were higher than convalescent values in the pyelonephritis group [17]. …”