The role of increased intestinal permeability markers in developing urinary tract infection in children of the first three years of life

Abstract

Urinary tract infection is one of the urgent problems of pediatric nephrology and pediatrics. Despite numerous works devoted to the study of pathogenetic mechanisms and the development of new diagnostic measures in patients with urinary tract infection, many questions of pathogenesis have not yet received a clear interpretation. Considering that nonspecific symptoms prevail in the clinical picture of the disease in children of the first three years of life, it is necessary to search for reliable, early, non–invasive methods for diagnosing urinary tract infections. Purpose of the study. To determine the diagnostic and pathetic significance of proteins that bind fatty acids and the zone of action in the diagnosis of urinary tract infection in children of the first three years of life. Material and research methods. We examined 120 children aged at the time of participation in the study from 29 days of life to 2 years 11 months and 29 days inclusive with urinary tract infection. Control group – 30 healthy children. All children were tested for the level of proteins that bind fatty acids L–FABP and I–FABP in blood serum, and the level of I–FABP, L–FABP and zonulin was determined in urine by enzyme–linked immunosorbent assay. Results. In the blood serum of children with urinary tract infection, the levels of L–FABP and I–FABP were significantly increased in comparison with their values in children of the control group (L–FABP – 753.94±26.16 ng/ml and 148.7±19.6 ng/ml, I–FABP – 92.97±1.41 ng/ml and 18.03±3.03 ng/ml, respectively, p 0.001). Fractions of proteins L – FABP and I – FABP in sick children’s urine were also determined at a higher level than in healthy children’s urine (6.96±0.19 ng/ml and 1.01±0.25 ng/ml and 0.37±0.01 ng/ml and 0,1±0,02, respectively, at p 0.001). The content of zonulin in urine was increased (2.84±0.12 ng/ml) in sick children compared with healthy children (0.17±0.04, at p 0.05). Conclusion. The study made it possible to identify early markers of kidney and urinary tract damage (L – FABP, I – FABP, ZO) involved in the development of the inflammatory bacterial process, and the determination of I – FABP, L – FABP, zonulin in urine can be used for non–invasive diagnosis of UTI in infants and young children.