[Urinary secretory immunoglobulin A in urinary tract infections in childhood]

The pathogenesis of urinary tract infections is not yet sufficiently explained despite of large progressions in this field. A special disposition for infections of the kidneys and the urinary tract more and more be seen not only as an anatomic and/or urodynamic but also as an immunologic problem. The secretory immunoglobulin A (S-IgA) in the urine is a measurable parameter for the function of the local immuno system of the mucous membranes in the urogenital system being subject of the present investigations. 87 children with different forms and stages of activity of the urinary tract infection and 59 healthy children have been chosen in order to measure the concentration and the excretion of S-IgA (mg S-IgA/g creatinine). The S-IgA is estimated by an enzyme immunoassay. We have found that the concentration, the excretion and the daily excretion of S-IgA are higher in all forms of pyelonephritis in an acute stage compared with healthy volunteers. There is a non-significant decrease of these values during an antibiotic therapy. It is evident that the values of patients with chronic pyelonephritis have been significantly diminished during the symptom-free interval compared with healthy volunteers (p less than 0.05). Considering the literature our results show that the function of the kidneys as well as inflammation and local immunity are in a close correlation.