Pyuria is one of the main features of urinary tract infections (UTI). Nevertheless, the mechanism of polymorphonuclear leukocyte (PMN) recruitment into the urine remains to be investigated. We examined whether interleukin-8 (IL-8), a potent neutrophil chemoattractant and activator, was involved in pyuria seen in UTI. Of 113 patients, 112 had elevated levels of IL-8 in their urine (1,078.0 ± 181.5 pg/ml), regardless of whether they had an upper or lower UTI; this was in contrast to undetectable levels (less than 16 pg/ml) in the urine of all of the 20 normal individuals and 74 control patients without UTI. A concomitant study revealed increases in urine IL-6, but not IL-1I0, and tumor necrosis factor alpha levels in patients with UTI. In addition to gram-negative bacteria, a wide spectrum of microorganisms was capable of inducing IL-8 production in urine. Local production of IL-8 in the urinary tract was suggested by a urine IL-8 level that was higher than the paired serum IL-8 level. The urine IL-8 level correlated with the number of PMN in the urine, and an average of half of the chemotactic activity in urine from patients with UTI could be abrogated by anti-IL-8 antibody treatment in vitro. Furthermore, urine IL-8 purified from patients was bioactive and showed multiple forms on immunoblotting analysis. This is the first documentation of IL-8 in the urine of patients with UTI, and * Corresponding author.

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A new system for obtaining accurate and stable urine flow data was developed, in which patients have a key role in recording their own urinary flow data. Flow curves and urination data are recorded on an integrated circuit card, which the patient carries in a pocket. Before urinating, the patient inserts the card into the system. Urination data are recorded automatically. The card can record up to 14 days worth of urination data. A personal computer then calculates and prints all of the flow curves including maximum flow rate, average flow rate, voided volume, duration time, hesitation time, and date and time of urination. This system is useful for detecting subtle changes in urination patterns. Typical circadian rhythms for urination can also be recorded. With this integrated circuit card system the clinical course under alpha-blocker administration could be precisely monitored.

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