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Leptospirosis renal disease.

C W Yang1, M S Wu, M J Pan

  • 1Department of Nephrology, Chang Gung Memorial Hospital and Graduate Institute of Veterinary Medicine, National Taiwan University, Taipei, Taiwan.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 18, 2001
PubMed
Summary

Leptospira outer membrane proteins trigger kidney tubule injury by activating inflammatory genes. Early penicillin treatment is crucial for treating this re-emerging infectious disease and preventing organ failure.

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Area of Science:

  • Infectious Diseases
  • Nephrology
  • Molecular Biology

Background:

  • Leptospirosis is a global re-emerging infectious disease affecting humans and animals.
  • Renal involvement, including tubulo-interstitial nephritis and tubular dysfunction, is a common complication.
  • Acute renal failure occurred in all 12 Taiwanese patients studied, with half requiring dialysis.

Purpose of the Study:

  • To investigate the in vitro mechanism of leptospiral-induced tubular injury.
  • To identify the role of leptospiral outer membrane proteins (OMPs) in kidney damage.

Main Methods:

  • Outer membrane proteins (OMPs) from pathogenic Leptospira were isolated.
  • OMPs were applied to cultured tubular cells to assess cellular responses.
  • Expression of inflammatory markers, including NFkappaB, iNOS, MCP-1, and TNF-alpha, was measured.

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Main Results:

  • Leptospiral OMPs activated nuclear NFkappaB binding in tubular cells.
  • OMPs stimulated the expression of inducible nitric oxide synthase (iNOS), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-alpha (TNF-alpha).
  • These findings suggest OMPs are key mediators of leptospiral tubulo-interstitial nephritis.

Conclusions:

  • Leptospiral outer membrane proteins play a significant role in inducing tubulo-interstitial nephritis.
  • The activation of inflammatory gene expression by OMPs contributes to kidney damage in leptospirosis.
  • Early intervention with antibiotics like penicillin is vital for managing severe leptospirosis and preventing organ failure.