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Urinary NGAL deficiency in recurrent urinary tract infections
Catherine S Forster1,2, Kathryn Johnson3, Viral Patel3
1Department of Medicine, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA. Catherine.Forster@cchmc.org.
Pediatric Nephrology (Berlin, Germany)
|February 18, 2017
Summary
Children with recurrent urinary tract infections (rUTI) may have lower urinary Neutrophil gelatinase-associated lipocalin (NGAL) levels. This deficiency might contribute to recurrent infections in some pediatric patients.
Area of Science:
- Pediatric Urology
- Nephrology
- Immunology
Background:
- Recurrent urinary tract infections (rUTI) in children often lack an identifiable cause.
- Neutrophil gelatinase-associated lipocalin (NGAL) has known bacteriostatic properties and is upregulated during UTIs.
- A local deficiency in NGAL production could potentially contribute to the pathogenesis of rUTI.
Purpose of the Study:
- To investigate whether a deficiency in urinary NGAL production is a factor in the development of rUTI in children.
- To compare urinary NGAL levels in children with rUTI to those in healthy controls.
Main Methods:
- Enrollment of pediatric patients (<21 years) with rUTI and age-matched healthy controls.
- Exclusion criteria for cases included active UTI, renal disease, or anatomical abnormalities.
- Measurement of urinary NGAL levels using immunoblotting.
Main Results:
- Fifteen cases and controls were enrolled.
- Median urinary NGAL levels were significantly lower in children with rUTI compared to controls (15 ng/ml vs 30 ng/ml, p=0.002).
- Measurable NGAL levels were detected in all rUTI patients, though diminished.
Conclusions:
- Urinary NGAL levels are significantly decreased in children with rUTI.
- These findings suggest a potential predisposition to rUTI in some children due to relative local deficiency in urinary NGAL production.
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