Al Rushood Maysoun, Al-Eisa Amal, Al-Attiyah Rajaa'
Department of Pediatrics, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
J Inflamm Res. 2020 Oct 28;13:789-797. doi: 10.2147/JIR.S275570. eCollection 2020.
Urinary tract infection (UTI) is common in pediatrics. Infection of the upper urinary tract may cause renal scarring, and subsequently renal failure and hypertension. Permanent renal damage has been suggested to be caused by the host inflammatory response. Therefore, it is crucial to understand the host defense mechanisms against such infection in order to make timely diagnosis. The aim of this study was to evaluate interleukin-6 (IL-6) and IL-8 as potential biomarkers in differentiating acute pyelonephritis (AP) from cystitis (Cys) in children.
Forty-three children (21 with AP and 22 with Cys) were included. Serum and urinary IL-6 and IL-8 were measured during the acute phase (within 12 hours of presentation) and the convalescent phase (8 weeks post-infection). Thirty-eight healthy children were included as controls.
During the acute phase, the mean urinary IL-6 level in the Cys group was significantly higher than that in the controls (17.8 pg/mL vs 14.8 pg/mL, P=0.03), while the serum levels were significantly higher in both the Cys and AP groups than in the controls (19.5 pg/mL, 19.4 pg/mL, 15 pg/mL, P=0.005 and 0.02, respectively). During the convalescent phase, serum and urinary IL-6 levels were higher in patients than in controls. Urinary IL-8 levels were significantly higher in both the AP and Cys groups compared to controls (206.5 pg/mL, 291.8 pg/mL, 89.4 pg/mL, P=0.05 and 0.02, respectively) during the acute phase. Serum IL-8 was not significantly different between the 3 groups. Nonetheless, no significant differences were found between the AP and Cys groups, in urinary or serum levels of IL-6 or IL-8, during both phases.
IL-6 and IL-8 levels are elevated in patients with UTI. However, the levels did not differentiate between AP and cystitis. Further studies are warranted to evaluate their roles as indicators of the site of UTIs.
尿路感染（UTI）在儿科中很常见。上尿路感染可能导致肾瘢痕形成，进而导致肾衰竭和高血压。有人提出永久性肾损伤是由宿主炎症反应引起的。因此，了解宿主针对此类感染的防御机制对于及时诊断至关重要。本研究的目的是评估白细胞介素-6（IL-6）和IL-8作为区分儿童急性肾盂肾炎（AP）和膀胱炎（Cys）的潜在生物标志物。
纳入43名儿童（21名患有AP，22名患有Cys）。在急性期（就诊后12小时内）和恢复期（感染后8周）测量血清和尿液中的IL-6和IL-8。纳入38名健康儿童作为对照。
在急性期，Cys组的平均尿IL-6水平显著高于对照组（17.8 pg/mL对14.8 pg/mL，P = 0.03），而Cys组和AP组的血清水平均显著高于对照组（分别为19.5 pg/mL、19.4 pg/mL、15 pg/mL，P = 0.005和0.02）。在恢复期，患者的血清和尿IL-6水平高于对照组。急性期，AP组和Cys组的尿IL-8水平均显著高于对照组（分别为206.5 pg/mL、291.8 pg/mL、89.4 pg/mL，P = 0.05和0.02）。三组之间血清IL-8无显著差异。然而，在两个阶段，AP组和Cys组之间在尿或血清IL-6或IL-8水平上均未发现显著差异。
UTI患者的IL-6和IL-8水平升高。然而，这些水平并不能区分AP和膀胱炎。有必要进一步研究以评估它们作为UTI部位指标的作用。
