de Man P, Jodal U, Lincoln K, Edén C S
Department of Clinical Immunology, University of Göteborg, Sweden.
J Infect Dis. 1988 Jul;158(1):29-35. doi: 10.1093/infdis/158.1.29.
The mechanism whereby attachment enhances Escherichia coli virulence in the urinary tract was studied by a detailed analysis of the host response to bacteriuria. Episodes of bacteriuria in 1473 children were followed prospectively from 1970 to 1984. To study the inflammatory response to the bacteriuric epidoses, we recorded body temperature, C-reactive protein, microsedimentation rate, urinary leukocyte count, and renal concentrating capacity. Bacterial isolates from each episode were identified and saved, and the adhesive capacity of 2669 E. coli strains was defined by their binding to galactose alpha 1----4galactose beta-containing receptors. Inflammatory response was significantly higher and renal concentrating capacity significantly lower during episodes caused by attaching strains. There was a linear relation between the number of indicators of inflammation and the proportion of galactose alpha 1----4galactose beta-binding strains present. Vesicoureteric reflux potentiated the inflammatory response. Attaching strains of E. coli thus appeared to be more capable of causing inflammation than were other bacteria. The potentiating effect of attachment on inflammation explains the over-representation of galactose alpha 1----4galactose beta-recognizing bacteria in patients with acute pyelonephritis.
通过对宿主对菌尿症反应的详细分析，研究了黏附增强大肠杆菌在泌尿道中致病性的机制。1970年至1984年对1473名儿童的菌尿症发作进行了前瞻性跟踪。为了研究对菌尿症发作的炎症反应，我们记录了体温、C反应蛋白、微量血沉率、尿白细胞计数和肾脏浓缩能力。对每次发作的细菌分离株进行鉴定并保存，通过2669株大肠杆菌与含半乳糖α1----4半乳糖β受体的结合来确定其黏附能力。在由黏附菌株引起的发作期间，炎症反应明显更高，肾脏浓缩能力明显更低。炎症指标数量与存在的半乳糖α1----4半乳糖β结合菌株比例之间存在线性关系。膀胱输尿管反流增强了炎症反应。因此，与其他细菌相比，黏附性大肠杆菌菌株似乎更易引发炎症。黏附对炎症的增强作用解释了急性肾盂肾炎患者中半乳糖α1----4半乳糖β识别细菌的过度表现。
