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Urinary MMP-9/NGAL complex in children with acute cystitis
Sami Hatipoglu1, Esra Sevketoglu, Asuman Gedikbasi
1Department of Pediatrics, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. sahat55@gmail.com
Pediatric Nephrology (Berlin, Germany)
|May 11, 2011
Summary
Urinary matrix metalloproteinase-9/neutrophil gelatinase-associated lipocalin complex (MMP-9/NGAL) effectively diagnoses urinary tract infections (UTI) in children. This biomarker also helps differentiate contamination from infection and monitor treatment response.
Area of Science:
- Biochemistry
- Pediatric Nephrology
- Clinical Diagnostics
Background:
- Matrix metalloproteinase-9 (MMP-9) and neutrophil gelatinase-associated lipocalin (NGAL) are elevated during inflammation.
- Previous studies detected NGAL in the urine of children with urinary tract infections (UTI).
Purpose of the Study:
- To investigate the presence and diagnostic utility of the MMP-9/NGAL complex in the urine of children with UTI.
- To evaluate MMP-9/NGAL as a biomarker for differentiating UTI from contamination and assessing treatment response.
Main Methods:
- A prospective, multicenter study involving 71 children with symptomatic UTI, 37 with contaminated urine, and 37 healthy controls.
- Urine samples were analyzed for MMP-9/NGAL complex levels, normalized to creatinine (uMMP-9/NGAL/Cr).
- Receiver Operating Characteristic (ROC) analysis was used to determine optimal cut-off values and assess diagnostic accuracy.
Main Results:
- Mean uMMP-9/NGAL/Cr levels were significantly higher in the UTI group compared to both control (p < 0.0001) and contamination groups (p < 0.0001).
- An optimal cut-off of 0.08 ng/mg demonstrated high sensitivity (98.6%) and specificity (97.3%) for UTI prediction.
- Levels were significantly reduced after treatment (p < 0.0001) and correlated with urine nitrite, leukocyte esterase, and renal scarring.
Conclusions:
- Urinary MMP-9/NGAL/Cr is a highly sensitive and specific biomarker for diagnosing UTI in children.
- This biomarker aids in distinguishing true infection from urine sample contamination.
- uMMP-9/NGAL/Cr levels can effectively monitor treatment response in pediatric UTI cases.
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