Reinhart H H, Obedeanu N, Robinson R, Korzeniowski O, Kaye D, Sobel J D
Division of Infectious Disease, Wayne State University, Detroit, Michigan.
J Urol. 1991 Sep;146(3):806-8. doi: 10.1016/s0022-5347(17)37926-0.
The incidence of urinary tract infection is higher in the geriatric population than in younger adults despite the exclusion of patients with known risk factors. Tamm-Horsfall protein, a renal glycoprotein excreted in urine, may constitute a natural defense mechanism against ascending urinary tract infection by binding mannose-sensitive fimbriated microorganisms. We hypothesized that the quantity of Tamm-Horsfall protein excreted is decreased in the elderly. Native aggregated Tamm-Horsfall protein was measured in urine samples from 24 young women (group 1, mean age 33 years) and 47 female nursing home patients (group 2, mean age 84 years) using enzyme-linked immunosorbent assay techniques. Another 16 elderly women (group 3, mean age 85 years) had active urinary tract infection. The aggregated Tamm-Horsfall protein was then disaggregated by dilution and quantified. Significant differences in mean urinary disaggregated Tamm-Horsfall protein concentrations were found between groups 1 (64.22 mg./l.) and 2 (35.07 mg./l.), and between groups 1 and 3 (34.71 mg./l.), respectively. In contrast, mean aggregated Tamm-Horsfall protein levels were significantly higher in group 2 (1.56 mg./l.) than in group 1 (0.92 mg./l.) or group 3 (0.97 mg./l.). Our studies show that urinary disaggregated Tamm-Horsfall protein concentration is decreased in the elderly, and that aggregated Tamm-Horsfall protein is increased compared to younger adults. The aggregated Tamm-Horsfall protein concentration is decreased in the elderly during episodes of urinary tract infection.
尽管排除了已知有风险因素的患者，但老年人群中尿路感染的发生率仍高于年轻成年人。Tamm-Horsfall蛋白是一种经尿液排泄的肾脏糖蛋白，它可能通过结合对甘露糖敏感的有菌毛微生物构成针对上行性尿路感染的天然防御机制。我们推测老年人排泄的Tamm-Horsfall蛋白量会减少。使用酶联免疫吸附测定技术对24名年轻女性（第1组，平均年龄33岁）和47名女性养老院患者（第2组，平均年龄84岁）的尿液样本中的天然聚集Tamm-Horsfall蛋白进行了测量。另有16名老年女性（第3组，平均年龄85岁）患有活动性尿路感染。然后通过稀释使聚集的Tamm-Horsfall蛋白解聚并进行定量。分别在第1组（64.22毫克/升）和第2组（35.07毫克/升）之间以及第1组和第3组（34.71毫克/升）之间发现平均尿液解聚Tamm-Horsfall蛋白浓度存在显著差异。相比之下，第2组（1.56毫克/升）的平均聚集Tamm-Horsfall蛋白水平显著高于第1组（0.92毫克/升）或第3组（0.97毫克/升）。我们的研究表明，老年人尿液中解聚的Tamm-Horsfall蛋白浓度降低，且与年轻成年人相比，聚集的Tamm-Horsfall蛋白增加。在尿路感染发作期间，老年人聚集的Tamm-Horsfall蛋白浓度降低。
