Urinary levels of interleukin-6 and interleukin-8 in patients with vesicoureteral reflux and renal parenchymal scar

Abstract

The objective of this study was to assess the urine levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) as noninvasive markers of vesicoureteral reflux (VUR) and renal parenchymal scarring (RPS) in children in the absence of a recent urinary tract infection (UTI) episode. Urine concentrations of IL-6 and IL-8 in 114 children aged 1 month to 16 years were evaluated. The children were divided into four groups: group 1, 26 children with VUR and RPS; group 2, 27 children with VUR without RPS; group 3, 34 children with RPS without VUR, group 4, 27 children without VUR and RPS, as the control group. After the first assessment, the children were divided into four larger groups for comparison purposes: group A (groups 1+2), 53 children with VUR; group B (groups 3+4), 61 children without VUR; group C (groups 1+3), 60 children with RPS; group D (groups 2+4), 54 children without RPS. Urinary IL-6 and IL-8 concentrations were determined. To avoid dilution effects and to the standardize samples, urinary levels of IL-6 and IL-8 were expressed as the ratio of cytokine to urinary creatinine (pg/mg). The median urine IL-6/creatinine was significantly higher in patients with VUR than in those without VUR (5.72 vs. 3.73). In patients with VUR, there was a significant but rather weak correlation between IL-6/creatinine concentrations and there flux grade (p<0.05, R=0.305). The median urine IL-8/creatinine was significantly higher in patients with RPS than in those without RPS (43.12 vs. 16.36). In patients with RPS, there was a significant but rather weak correlation between IL-8/creatinine concentrations and the renal scar grade (p<0.05, R=0.251). The results of this study provide preliminary evidence that children with VUR have a high urine IL-6 concentration, whereas children with RPS have a high urine IL-8 concentration.

Post-Inflammatory Nephropathy

“…revealed higher serum IL-6 level in children with vesicoureteral reflux of high grade as compared to controls. The study by Gokce et al (2010) showed the similar results. Increased serum IL-6 level was observed primarily in patients with febrile urinary tract infection (Benson et al, 1994;Hedges et al, 1991Hedges et al, ,1992Jacobson et al, 1994Jacobson et al, , 1998.…”

“…In patients with acute urinary tract infection and post-inflammatory nephropathy, increased serum IL-8 level and increased urinary IL-8 excretion were observed (Kassem et al, 2005;Tikhonov et al, 1997;Haraoka et al, 1996). Increased urinary IL-8 excretion is thought to be a marker of vesicoureteral reflux and postinflammatory nephropathy (Galanakis et al, 2006;Gokce et al, 2010;Haraoka et al, 1996;. Taha et al (2003) demonstrated increased urinary IL-8 excretion in patients with acute and chronic urinary tract infections.…”

Interleukin-18, CRP and procalcitonin levels in vesicoureteral reflux and reflux nephropathy

“…7 as severe. 23 The diagnosis of VUR was established within the 12 months before cytokine measurements.…”

Urine levels of interleukin-8 as diagnostic marker of acute pyelonephritis in children

“…Çocuklarda yineleyen İYE, böbrekte skar dokusu oluşmasına, hipertansiyona ve sonuçta kronik böbrek yetmezliğine yol açabilmektedir (2) . Ülkemizde çocuk-larda kronik böbrek yetmezliği etiyolojisinde yineleyen İYE ve vezikoüreteral reflü hala ilk sıralarda yer almaktadır (3,4) . Çocukluk çağında İYE tanısı konduktan sonra, akut piyelonefrit (APN) ile sistit ayrımının kısa zamanda, doğru yapılması ve tedavinin hemen baş-lanması önemlidir (2) .…”

“…İdrar yolu enfeksiyonunda, bakteriyel patojenlere karşı immün yanıt ve yangısal işlemde aracı olarak rol alırlar (4,5) . İnterlökin-8 (IL-8), pro-inflamatuvar bir mediatör olup, üroepitelden salınarak İYE'de kapillerden üroepitele ve idrara nötrofil geçişini sağlar (1) .…”