Immune Expression in Children With Vesicoureteral Reflux: A Pilot Study

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.