Immunofluorescence Studies of the Bladder Defense Mechanism. I. Localization of Escherichia Coli in the Human Bladder

Drach, George W.; Cox, Clair E.

doi:10.1111/j.1532-5415.1967.tb02178.x

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…In the present clinical study, E.coli, or at least antigenic components thereof, were seen to penetrate the layer of mucus and the mucosal bladder tissues of at least 1 elderly adult with E.coli cystitis. This penetration also has been observed in younger patients (6). Hence, mucosal penetration occurs in the endogenous E.coli‐induced cystitis associated with urologic disease and approximates that seen in the disease created experimentally.…”

Section: Discussionsupporting

confidence: 77%

“…2c,d). When specimens from the elderly patients in this study were compared with those from younger patients studied previously (6), there was no apparent difference in the degree of inflammatory response, although no specific cell count was made.…”

Section: Results and Commentmentioning

confidence: 67%

“…The preoperative estimate of general health in these 20 patients was good for 18 and poor for the remaining 2 (because of severe diabetes in one, and pulmonary tuberculosis in the other). Renal function, as estimated by a serum creatinine concentration of more than 1.4 mg per 100 ml (6), was diminished in the 2 patients whose general condition was poor, but was normal in the remaining 18. In none of the patients was any vesical ureteral reflux demonstrable.…”

Section: Results and Commentmentioning

confidence: 99%

“…Serial preoperative and postoperative urine cultures were performed in the Urologic Research Laboratory of this institution. Culture methods and identification procedures have been outlined previously (6). Renal function was assessed by determination of the serum creatinine level (7).…”

Section: Methodsmentioning

confidence: 99%

“…Major attention was directed toward histologic and immunofluorescent studies of the local inflammatory response and to evidence of bacterial invasion as seen in bladder biopsy specimens obtained at the time of surgery. The detailed methodology has been described previously (6). In brief, bladder tissues were obtained at the time of operation, immediately immersed in liquid nitrogen, and fixed by the technique of freeze substitution.…”

Section: Methodsmentioning

confidence: 99%

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Studies of the Bladder Defense Mechanism. Ii. Postoperative Cystitis in the Elderly

Drach

Cox

1969

J American Geriatrics Society

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Chronic postoperative cystitis in the elderly patient is a difficult problem, and is especially annoying if all obvious anatomic abnormalities have been corrected. This study of 20 such patients who underwent bladder surgery indicates that several local resistance factors may be related to this continued urinary infection. In elderly postoperative patients with chronic cystitis the bladder defense mechanisms have reached such a state of imbalance that they cannot cope with the invading organisms either by the mechanism of voiding or by vesical‐wall defense factors. The relative importance of the various cellular and serologic local defense mechanisms in resisting bacteria in bladder urine and the bladder mucus layer, mucosa or submucosa is not known. There is no apparent quantitative histologic defect in the local bladder cellular response of the elderly patient. Therefore, a decreased quality of response is implied. In addition, trauma created by indwelling catheterization or by surgery destroys the anatomic integrity of the bladder wall and may thereby encourage the development of deep‐seated infection by permitting tissue invasion. Foci of tissue infestation by E. coli were demonstrated in 1 of 2 patients in whom it was possible to make such a study. These foci are not subject to the normal voiding defense mechanism and the antibacterial factors within the bladder or urine; they can be eliminated only by inflammatory cells, antibodies, or antibacterial agents capable of attaining bactericidal tissue levels. Two axioms were confirmed by this study: 1) any period of preoperative indwelling catheterization should be as brief as possible, and 2) specific antimicrobial therapy should be planned preoperatively so that surgery takes place at a time when the urine and tissues are sterile; this sterility should be maintained until all foreign bodies, such as catheters, are removed from the urinary tract.

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Section: Discussionsupporting

confidence: 77%

Section: Results and Commentmentioning

confidence: 67%

Section: Results and Commentmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Studies of the Bladder Defense Mechanism. Ii. Postoperative Cystitis in the Elderly

Drach

Cox

1969

J American Geriatrics Society

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Hydrodynamic Aspects of Urinary Tract Infection

HinmanJr.

1973

Urodynamics

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Antisera to a Rabbit Urinary Tract Antigen also React with Human Bladder and Kidney Tissue

et al. 1990

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The mucin layer covering the bladder transitional cell mucosa appears to function as a primary defense mechanism against bacterial infection. We have previously prepared a glycoprotein fraction (GP1) from the urinary bladder mucosa of NZW rabbits and raised murine antisera against it. These antisera react with bladder, ureter and kidney tissue from rabbits, rats, guinea pigs, and hamsters. We now show that a similar substance occurs in human kidneys and bladder. In order to remove antibodies reactive with the Tamm-Horsfall protein (THP), the antisera were initially absorbed with an immunoadsorbent composed of purified human THP covalently bound to Sepharose CL-4B gel. Using an enzyme linked immunosorbent assay (ELISA) it could be shown that the absorbed antisera did not react with THP but retained a high titer in binding to GP1. Immunohistochemical procedures involving avidin-biotin-immunoperoxidase staining demonstrated that the absorbed anti-GP1 reacted well with six human urinary bladder biopsy specimens and two kidney autopsy specimens while normal murine sera showed little or no binding. Although this reactivity was not as strong as that found with homologous tissue (rabbit) these studies suggest that GP1, an antigen common to several animal species, is also related to a human urinary tract component.

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Immunofluorescence Studies of the Bladder Defense Mechanism. I. Localization of Escherichia Coli in the Human Bladder

Cited by 8 publications

References 25 publications

Studies of the Bladder Defense Mechanism. Ii. Postoperative Cystitis in the Elderly

Studies of the Bladder Defense Mechanism. Ii. Postoperative Cystitis in the Elderly

Hydrodynamic Aspects of Urinary Tract Infection

Antisera to a Rabbit Urinary Tract Antigen also React with Human Bladder and Kidney Tissue

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