Urine macrophage migration inhibitory factor (MIF) in children with urinary tract infection: a possible predictor of acute pyelonephritis

Otukesh, Hasan; Fereshtehnejad, Seyed‐Mohammad; Hoseini, Rozita; Hekmat, Sepideh; Chalian, Hamid; Chalian, Majid; Bedayat, Arash; Yazdi, Reza Salman; Sabaghi, Saeed; Mahdavi, S. Sharareh

doi:10.1007/s00467-008-0969-9

Cited by 20 publications

(16 citation statements)

References 28 publications

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“…We found that the urinary MIF level is a more sensitive indicator of kidney injury than the systemic MIF level, as suggested by Brown et al [17, 18]. Previous studies have focused on the use of elevated urinary MIF levels to detect the presence of UTIs and to distinguish kidney infections from acute cystitis [23, 24]. In patient with normal renal function, consistent with previous study, our study revealed that elevated urinary MIF indicated the presence of APN.…”

Section: Discussionsupporting

confidence: 73%

Urinary Macrophage Migration Inhibitory Factor Serves as a Potential Biomarker for Acute Kidney Injury in Patients with Acute Pyelonephritis

Hong

Tseng

Chuang

et al. 2012

Mediators of Inflammation

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Conventional markers of kidney function that are familiar to clinicians, including the serum creatinine and blood urea nitrogen levels, are unable to reveal genuine injury to the kidney, and their use may delay treatment. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine, and the predictive role and pathogenic mechanism of MIF deregulation during kidney infections involving acute kidney injury (AKI) are not currently known. In this study, we showed that elevated urinary MIF levels accompanied the development of AKI during kidney infection in patients with acute pyelonephritis (APN). In addition to the MIF level, the urinary levels of interleukin (IL)-1β and kidney injury molecule (KIM)-1 were also upregulated and were positively correlated with the levels of urinary MIF. An elevated urinary MIF level, along with elevated IL-1β and KIM-1 levels, is speculated to be a potential biomarker for the presence of AKI in APN patients.

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Section: Discussionsupporting

confidence: 73%

Urinary Macrophage Migration Inhibitory Factor Serves as a Potential Biomarker for Acute Kidney Injury in Patients with Acute Pyelonephritis

Hong

Tseng

Chuang

et al. 2012

Mediators of Inflammation

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“…This is in agreement with Otukesh et al [28], who studied urinary MIF in 25 children with acute pyelonephritis, 8 children with acute cystitis, and 40 controls without UTI. He used a cut-off point of uMIF/Cr > 4.89 pg/μmol to differentiate upper from lower UTI and found a sensitivity and specificity of 92% and 100%, respectively.…”

Section: Ahmed J Al-sayyad Salah M El-morshedy Ehab a Abd Al Hamidsupporting

confidence: 91%

Evaluation of Biomarkers to Differentiate Upper From Lower Urinary Tract Infections in Children

Al-Sayyad¹,

El-Morshedy²,

Hamid³

et al. 2011

UIJ

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Abbreviations and AcronymsAPN, acute pyelonephritis CRP, C-reactive protein DMSA, dimercaptosuccinic acid ELISA, enzymelinked immunosorbent assay ESR, erythrocyte sedimentation rate IL-6, interleukin-6 MIF, migration inhibitory factor PCT, procalcitonin RPI, renal parenchymal involvement UTI, urinary tract infection WBC, white blood cell ABSTRACT INTRODUCTION: Distinguishing upper from lower urinary tract infections (UTI) has important clinical implicationsin children, especially in those younger than 2 years of age. The objective of this study was to test differences between upper and lower UTIs by using serum and urine biomarkers. METHODS:Participants were 83 patients with UTI based on suggestive clinical symptoms and at least 1 positive urine culture. All had renal scintigraphy. Children with known concomitant diseases, any type of renal disorder, or a previous diagnosis of vesicoureteral reflux were excluded. Before the initiation of antibiotic treatment, blood was sampled for white blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT). Urinary interleukin-6 (uIL-6) and macrophage migration inhibitory factor (MIF) were also measured. Data were analyzed using the Mann-Whitney or t test. Sensitivity and specificity were calculated for some variables in isolation and in combination. RESULTS:There were 61 girls and 22 boys with mean (SD) age of 8.7 (3.4) months and 7.8 (4.5) months, respectively; 49 patients had acute pyelonephritis (APN) and 34 had lower UTI. The mean WBC counts were significantly higher in the group with APN than in the group with lower UTI (P < .01), as were CRP and ESR levels (P < .001). Significantly higher serum PCT, urinary IL-6, and MIF levels were detected in patients with APN when compared with patients with lower UTI (all with P < .001). For the prediction of APN, sensitivity and specificity levels were 95.9% and 88.2% for CRP, 87.8% and 91.2% for PCT, 71.4% and 94.1% for uIL-6, and 93.9% and 97.1% for urinary MIF. The sensitivity and specificity for CRP combined with other biomarkers were 93.9% and 91.2% (PCT with CRP), 95.9% and 91.2% (uMIF with CRP), and 85.7 % and 94.1% (uIL-6 with CRP), respectively. CONCLUSION: Some biomarkers, used solely or in combination, help to differentiate between upper and lower UTI and may make more aggressive and invasive testing unnecessary in the future. UroToday International Journal ® UI J

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“…In our study, uMIF/Cr was significantly higher in patients with leukocytosis (p=0.0001) and a positive CRP level in the serum (p=0.003) ( Table 2). Otukesh et al found that urinary MIF/Cr levels can be used to differentiate between upper and lower UTI in children [20]. In this study, 25 children with acute pyelonephritis, eight children with acute cystitis and 40 controls without UTI were compared; a uMIF/Cr >4.89 pg/µmol was determined to be the cut-off point for differentiating upper from lower UTI.…”

Section: Discussionmentioning

confidence: 99%

Urinary macrophage migration inhibitory factor in children with urinary tract infection

Şevketoğlu

Yılmaz²,

Gedikbaşı

et al. 2010

Pediatr Nephrol

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Macrophage migration inhibitory factor (MIF) plays an essential pathophysiological role in inflammatory reactions. The aim of this study was to investigate the clinical utility of urine MIF (uMIF) level in predicting urinary tract infections (UTI). This multicenter, prospective study was conducted over a 1-year period between March 2008 and March 2009. Sixty patients with symptomatic culture-proven UTI and 29 healthy children were recruited. Urine MIF was measured by enzyme-linked immunosorbent assay. The mean MIF level was found to be significantly higher in the UTI group than in the control group (1082.82 vs. 211.45 pg/ml, p = 0.0001). Receiver operating characteristic (ROC) analysis revealed that the optimal cut-off uMIF level was 295 pg/ml for uMIF to predict UTI. The sensitivity and specificity of this cut-off level were 91.7% and 69%, respectively. Mean uMIF/creatinine (Cr) was also significantly higher in the UTI group than in the control group (2400.69 vs. 267.56 pg/mgCr, p = 0.0001). At a cut-off of 815 pg/mgCr for uMIF/Cr, the sensitivity and specificity were 95 and 79%, respectively. The area under curve (AUC) was 0.848 (standard error 0.040, 95% confidence interval 0.756-0.915) for uMIF and 0.889 (0.034, 0.805-0.946) for uMIF/Cr. Urine MIF/Cr was significantly higher in the patients with a positive leukocyte esterase reaction in the urine (p = 0.047), leukocytosis (p = 0.0001) and positive C-reactive protein level in serum (p = 0.003). The uMIF level was not related to leukocytosis, positive CRP level in serum and leukocyte esterase reaction in the urine. Neither uMIF nor uMIF/Cr were correlated to the positive urine nitrite test, pyuria, urine pH and specific gravity (p > 0.05). These results suggest that urine MIF and uMIF/Cr can be used for the early prediction of UTI in children.

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Urine macrophage migration inhibitory factor (MIF) in children with urinary tract infection: a possible predictor of acute pyelonephritis

Cited by 20 publications

References 28 publications

Urinary Macrophage Migration Inhibitory Factor Serves as a Potential Biomarker for Acute Kidney Injury in Patients with Acute Pyelonephritis

Urinary Macrophage Migration Inhibitory Factor Serves as a Potential Biomarker for Acute Kidney Injury in Patients with Acute Pyelonephritis

Evaluation of Biomarkers to Differentiate Upper From Lower Urinary Tract Infections in Children

Urinary macrophage migration inhibitory factor in children with urinary tract infection

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