Immunology of Pyelonephritis. VIII. E. Coli Causes Granulocytic Aggregation and Renal Ischemia

Kaack, M. Bernice; Dowling, Keith J.; Patterson, George M.; Roberts, James A.

doi:10.1016/s0022-5347(17)45235-9

Cited by 52 publications

(9 citation statements)

References 15 publications

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“…Earlier models have required surgical manipulations or other invasive procedures to render the tissues vulnerable to infection [23,24]. Anti-inflammatory drugs or oxygen radical scavengers have been used to modify the inflammatory response to UTI and to link the inflammatory response to the scarring process [17], but tools to directly address the role of neutrophils have not been used.…”

Section: Discussionmentioning

confidence: 99%

Interleukin‐8 Receptor Knockout Mice Have Subepithelial Neutrophil Entrapment and Renal Scarring following Acute Pyelonephritis

et al. 2000

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Interleukin (IL)-8 receptor knockout (KO) mice were shown to have a dysfunctional neutrophil response to urinary tract infection and to develop renal scarring. Intravesical Escherichia coli infection stimulated epithelial chemokine secretion and IL-8 receptor expression in control mice. Neutrophils migrated through the tissues and crossed the epithelial barrier into the urinary tract lumen. In murine IL-8 receptor homologue (mIL-8Rh) KO mice, infection triggered a chemokine response, and neutrophils were recruited but failed to traverse the mucosal barrier and accumulated under the epithelium. After 7 days, control mice were healthy, and infection was cleared, but mIL-8Rh KO mice had swollen kidneys, with neutrophil abscesses and high numbers of bacteria. After 35 days, they developed kidney pathology and renal scarring. The results demonstrate that chemokine receptors drive transepithelial neutrophil migration. In their absence, the neutrophils are trapped, and the tissues are destroyed. This molecular deficiency may determine the progression from acute pyelonephritis to renal scarring.

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Section: Discussionmentioning

confidence: 99%

Interleukin‐8 Receptor Knockout Mice Have Subepithelial Neutrophil Entrapment and Renal Scarring following Acute Pyelonephritis

et al. 2000

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“…There are only a few reports about Tc-99m DMSA renal scan in adult patients with acute pyelonephritis 5 , 6 , 7 ) . Although exact mechanisms were not known, several pathophysiologic mechanisms 11 – 14 ) about renal cortical defects on Tc-99m DMSA renal scintigraphy-1) direct tubular renal cortical defects on Tc-99m DMSA renal scintigraphy-1) direct tubular defect due to bacterial infection, 2) interstitial edema and tubular dysfunction by intratubular aggregation of white blood cells, and 3) perinephronal capillary occlusion by aggregated inflammatory cells were postulated. Because these conditions may decrease focal renal perfusion in an involved area, that may cause focal cortical defects.…”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiologic mechanisms about the renal cortical defects of Tc-99m DMSA renal scan in the patients with acute pyelonephritis were not known. But several upkae mechanisms 11 ) such as 1) direct tubular defect due to bacterial infection 12 ) , 2) interstitial edema and tubular defect by intratubular aggregation of white blood cells 13 ) , 3 ) perinephronal capillary occlusion by aggregated inflammatory cells had been postulated 14 ) .…”

Section: Introductionmentioning

confidence: 99%

Tc-99m Dimercaptosuccinic AcidDMSA Renal Scintigraphy in Patients with Acute Pyelonephritis

Lee

Bin

Jeong

et al. 1995

Korean J Intern Med

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ObjectivesRecently, several authors reported that Tc-99m DMSA renal scan frequently showed cortical defects of the involved kidneys even in the patients with acute pyelonephritis who did not show abnormal findings in the ultrasonography and intravenous pyelography IVP).MethodsIn order to evaluate the utilities of Tc-99m DMSA renal scan and the clinical meanig of cortical defects in the Tc-99m DMSA renal scan of the patients with acute pyelonephritis, ninety two patients with acute pyelonephritis, from March 1991 to February 1994 in Chungnam National University Hospital(CNUH), were included in this study. Patients were subdivided as Group A:Patients showing normal Tc-99m DMSA renal scan(n=42) and Group B:Patients with definit cortical defects on the Tc-99m DMSA renal scan(n=50). We compared clinical characteristics such as age and sex, recurrency, duration of fever, bacterial culture study, incidence of renal insufficiency and the results of renal ultrasonography and intravenous pyelography between the two groups.ResultsFifty four percents of 92 patients with acute pyelonephritis showed a significantly longer febrile period after admission, higher positive rates on the urine and blood culture studies and higher incidence of renal insufficiency than those of the Group A patients. Sixty nine percents of Group B patients showed normal results in ultrasonography or IVP study.ConclusionsTc-99m DMSA renal scan was a more sensitive imaging test than ultrasonography in kidneys and IVP to detect pyelonephritis lesions and may be useful to predict the patient group with a severe disease course. These patients may need more careful management and further studies to evaluate the possibility of complications.

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“…The intravital model of pyelonephritis identified local ischemia occurring only hours after the first bacterium entered the tubule, which together with bacterial multiplication in the tubule lumen led to severe obstruction (17). Both are complex syndromes to which severe episodes of either condition can result in renal scarring (96) and lead to end-stage renal failure.…”

Section: Acute Kidney Injurymentioning

confidence: 99%

Integrated Pathophysiology of Pyelonephritis

2015

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Pyelonephritis represents a subset of urinary tract infections that occur from bacteria ascending from the lower to the upper reaches of the genitourinary system, such as the kidney. The renal system contains a range of hydrodynamically and immunologically challenging, interconnected microenvironments where the invading pathogen may populate during the course of the infection. The situation at the infection foci changes dynamically, vacillating between bacterial colonization and clearance, to which the outcome is a summation of all host-pathogen elements in play. A selection of important determinants includes factors of microbial origin, effects of eukaryotic cell signaling, physiological facets of the infected organ, and signals from distal organs. Improved understanding of the multifactorial aspects of molecular pathogenesis of infection requires intravital, cross-disciplinary approaches with high spatio-temporal resolution. The advancement of such approaches promises to eventually provide a comprehensive understanding of the integrated pathophysiology of pyelonephritis.

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Immunology of Pyelonephritis. VIII. E. Coli Causes Granulocytic Aggregation and Renal Ischemia

Cited by 52 publications

References 15 publications

Interleukin‐8 Receptor Knockout Mice Have Subepithelial Neutrophil Entrapment and Renal Scarring following Acute Pyelonephritis

Interleukin‐8 Receptor Knockout Mice Have Subepithelial Neutrophil Entrapment and Renal Scarring following Acute Pyelonephritis

Tc-99m Dimercaptosuccinic AcidDMSA Renal Scintigraphy in Patients with Acute Pyelonephritis

Integrated Pathophysiology of Pyelonephritis

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