233Intestinal colonization resistance is associated with hyperoxaluria in the patients with recurrent pyelonephritis
Eur Urol Suppl 2017; 16(3);e402Stepanova N.,
Introduction and objectives: Crystal-cell interaction has been reported as one of the most crucial steps in urinary stone formation. Recent experimental studies have demonstrated the leading role of IL-17 and IL-23 in the pathogenesis of inflammatory bowel disease. Moreover, the expression of intestinal epithelial cells cytokine IL-17 family depend on synanthropic bacteria, namely: The reduction of the total microbiota in the adult mice after the administration of antibiotics has resulted in increased expression of IL-23 and-17 in the colon, suggesting that the synanthropic bacteria are active inhibitors of IL-23 and IL-17. Although, it should be noted that there haven't been any descriptions of the results of clinical studies on the content of pro-and anti-inflammatory cytokines in the blood and urine in the patients with hyperoxaluria in the scientific literature yet. The aim of our study was to compare the cytokines concentration in the blood and urine in the patients with pyelonephritis depending on the presence of hyperoxaluria. Materials and methods: We evaluated the blood concentration of interleukins (IL)-4,-17,-18,-23 and monocyte chemoattractant protein-1 (MCP-1) and the tumour necrosis factor alpha (TNF-) level in the urine of 40 white adult women with recurrent pyelonephritis caused by E. coli or S. faecalis. The mean age in the patient population was 21-48 years (31.6±7.7). Recurrent pyelonephritis was defined as 2 upper urinary tract infection episodes within 6 months or 3 or more episodes during the previous12 months. According to the presence of hyperoxaluria, the women were allocated into two groups: The first group of the patients (n=29) had hyperoxaluria (>44mg in 24 hours) and the second one (n=11) didn't have any hyperoxaluria. The cytokines concentrations were analysed using ELISA and STAT FAX-303 PLUS (Diaclon, France; DRG, Germany; Ukrmedservice, Ukraine). All the statistical analyses were performed using MedCalc. Results: The results of our research have indirectly indicated in favor of the theory mentioned above. The blood levels of IL-4, IL-17 and IL-23 in the women with hyperoxaluria were significantly higher compared with the non-hyperoxaluria
Summary: The aim of our study was to compare the performance of mucosal immunity in urine and saliva of patients with chronic recurrent pyelonephritis subject to availability of hyperoxaluria.
Material and methods. To observational cross–sectional study included 40 women with chronic recurrent pyelonephritis, aged 21 to 48 years (31.6±7.7). Depending on the availability hyperoxaluria (oxalate excretion in the urine than 0.45 mmol per day) patients were divided into II Groups: for I (n=29) included women with hyperoxaluria, to II (n=11) – includes patients with normal excretion oxalate (7.2±2.4 vs 43.8±5.2; p <0.001). State of mucosal immunity was assessed by determining the content of lysozyme, lactoferrin, secretory immunoglobulin A (sIg A) and tumor necrosis factor alpha (TNF– a) in urine samples and content sIg A and class antibodies sIg A to lipopolysaccharide (LPS) of gram–negative bacteria (anti–LPS–sIgA) in saliva.
Results. We have identified significantly higher levels of sIg A and anti–LPS–sIgA in the saliva ofpatients with recurrent pyelonephritis with hyperoxaluria (298±104 vs 150.1±79.3 mg/1, p<0.001) and (0.353±0.16 vs 0.211±0.09, p<0.001), respectively. In the urine ofwomen of group I we havefound a statistically significant increase in the content of TNF– a 44 [16.2–130.5] vs 21 [14.2–3.45] pg/ml (p=0.04) and lysozyme 14.0[2.5– 36.5]vs 1.45[0.12–7.5]ng/ml (p=0.002). All the studied parameters (anti–LPS–sIg A in saliva and sIg A, lactofer– rin and lysozyme urine) had a direct correlation with the level of daily oxalate excretion.
Conclusions. Overproduction of indicators of mucosal immunity may be explained by the formation of intestinal dysbiosis under the influence of continuous antibiotic therapy. The imbalance of intestinal microflora, in turn, leads to the formation of hyperoxaluria and increases the production of antibodies to LPS, sIg A, lactoferrin and lysozyme.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.