Serum Interleukin-6 and Interleukin-8 are Sensitive Markers for Early Detection of Pyelonephritis and Its Prevention to Progression to Chronic Kidney Disease

Abstract

Background: Pyelonephritis is the most common bacterial infection in children that can cause renal failure if not diagnosed or treated early. We used serum biomarker interleukins (IL-6 and IL-8) and then confirmed the results by the findings dimercaptosuccinic acid (DMSA) scan to distinguish upper-tract infection from lower-tract infection. Methods: Serum IL-6 and IL-8 were measured in 57 children with newly diagnosed untreated urinary tract infection (UTI) documented by a positive urine culture. All children had a DMSA to determine whether serum IL6, IL-8 can be used as a marker to predict upper-tract from lower-tract infection. IL-6 and IL8 were determined by the enzyme link immunosorbent assay (ELISA) technique. Results: Of the 57 patients, 24 (42%) had renal parenchymal lesions on the DMSA scan. Patients with abnormal DMSA had significantly higher serum IL-6 and IL-8 compared with those with normal DMSA scan (187.1 ± 113.1 ng/mL vs. 396.1 ± 246.0 ng/mL, P = 0.005; and 165 ± 76.1 ng/mLvs. 190.8 ± 60.8 ng/mL, P = 0.026, respectively). Pyelonephritis was more frequent in children younger than 20 months old ( n = 36, 63%, P < 0.005) and more prevalent in girls ( n = 36, 63%, P = 0.005). Serum IL-6 had a sensitivity of 67.3% and a specificity of 63.0% and serum IL8 had a sensitivity of 80.1% and a specificity of 73.5% in the differential diagnosis of pyelonephritis and cystitis ( P = 0.03). Conclusions: Serum levels of IL-6 and IL-8 are both sensitive biomarkers of UTI and can discriminate the upper from lower tract urinary infections. Determination of these biomarkers may help to identify patients with acute pyelonephritis and need for DMSA study.

Proteomic adaptations in the kidney reveal orchestration of local and secreted antimicrobial peptides in human pyelonephritis

“…We observed that the expression of the AMPs did not correlate with the number of bacteria or leukocytes in the urine or blood but was negatively correlated with the plasma level of CRP, which is known to be elevated during the inflammatory response (Supplementary figure 2). Plasma CRP is produced by hepatocytes, predominantly under transcriptional control by the cytokine IL-6 [52], and a potential discriminative marker between cystitis and PN [53-55]. We speculate that higher levels of selective AMPs, i.e., azurocidin-1, are associated with a reduced systemic inflammatory response, whereas patients with reduced azurocidin-1 levels develop an IL-6-mediated acute-phase response, leading to CRP production.…”

Comparison of different ratios of cefoperazone/sulbactam in patients with pyelonephritis

“…Elevated CRP levels are often seen in acute pyelonephritis and is considered a significant biomarker for the urinary infections. 21 , 22 Mazaheri et al 12 reported that serum levels of IL-6 and IL-8 are also sensitive biomarkers of urinary infections. Our study found that the levels of CRP, IL-6, IL-8 and WBC in the two groups decreased significantly after the treatment and was significantly lower in the observation group compared to the control group.…”

“…C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and leukocyte count (WBC) were selected as the efficacy evaluation indicators. 12 , 13 CRP, IL-6 and IL-8 levels were detected by the enzyme-linked immunosorbent assay (reagents were provided by Shanghai enzyme-linked biology). WBC detection was done by visual counting using a microscope.…”

Laboratory markers of urinary tract infection in children: current state and prospects

“…В исследованиях продемонстрирована роль ИЛ-6 и ИЛ-8 в качестве биомаркеров ИМП, показано значение в дифференциации ИМП нижних и верхних отделов. При этом повышение концентраций данных маркеров при ИМП наблюдается и в сыворотке крови, и в моче [31][32][33][34][35][36][37]. ).…”

“…Пациенты с аномальным DMSA имели значительно более высокий уровень ИЛ-6 и ИЛ-8 в сыворотке крови по сравнению с пациентами с нормальными результатами сканирования (р = 0,005; р = 0,026). Сывороточный ИЛ-6 имел чувствительность 67,3% и специфичность 63,0%, а сывороточный ИЛ-8 имел чувствительность 80,1% и специфичность 73,5% при дифференциальной диагностике пиелонефрита и цистита (р = 0,03) [33].…”