Immune Expression in Children With Vesicoureteral Reflux: A Pilot Study

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Ashley W Johnston1, Jonathan C Routh1, J Todd Purves1

  • 1Division of Urologic Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC.

Urology
|October 13, 2020
PubMed

Insights

This pilot study found that children with vesicoureteral reflux (VUR) and bladder-bowel dysfunction (BBD) have increased immune cells in their bladder tissue. Pelvic inflammation may be a target for treating VUR and BBD.

Area of Science:

  • Pediatric Urology
  • Immunology
  • Inflammation Research

Background:

  • Vesicoureteral reflux (VUR) and bladder-bowel dysfunction (BBD) are common conditions in children.
  • The local and systemic immune environment in VUR and BBD is not well understood.

Purpose of the Study:

  • To explore the immune environment in children with VUR, with and without BBD.
  • To identify potential immune-related therapeutic targets for VUR and BBD.

Main Methods:

  • Pilot study of 7 children undergoing VUR surgery.
  • Analysis of blood and bladder tissue using flow cytometry and LegendPlex assays.
  • Assessment of immune cell composition, activation, and cytokine/chemokine levels.

Main Results:

  • Increased immune cell infiltrates, including B cells and T cells, were found in the bladder tissue of patients with VUR and BBD compared to VUR alone.
  • Elevated PD1 expression on T cells and PDL-1 on neutrophils was observed in VUR/BBD patients.
  • Circulating immune cell percentages were similar between groups, but local bladder inflammation was higher in VUR/BBD.

Conclusions:

  • VUR is associated with an immune-rich microenvironment, particularly when BBD is present.
  • Pelvic inflammation severity correlates with BBD, suggesting it as a potential therapeutic target.
  • Further research is warranted to investigate novel therapies targeting inflammation in VUR and BBD.
Abstract

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