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Using 2-Photon Microscopy to Quantify the Effects of Chronic Unilateral Ureteral Obstruction on Glomerular Processes
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Published on: March 4, 2022

Inflammation-Matrix Crosstalk in Vesicoureteral Reflux: Serum and Urinary ECM-Related Biomarkers and Renal Scarring

Marija Ratković-Janković1,2, Jelena Bašić3, Tatjana Jevtović-Stoimenov3

  • 1Department of Pediatrics, Faculty of Medicine, University of Niš, 18000 Niš, Serbia.

International Journal of Molecular Sciences
|June 12, 2026
PubMed

Insights

Urinary extracellular matrix (ECM) biomarkers like TIMP-1 and TGF-β may indicate kidney damage in pediatric vesicoureteral reflux (VUR). Higher levels correlate with severe VUR and renal scarring, suggesting potential diagnostic value.

Area of Science:

  • Nephrology
  • Pediatric Urology
  • Biomarker Research

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, increasing the risk of urinary tract infections and renal scarring.
  • Extracellular matrix (ECM) remodeling plays a role in kidney damage, but specific biomarkers for VUR are not well-established.
  • Identifying reliable biomarkers can aid in assessing VUR severity and predicting renal outcomes.

Purpose of the Study:

  • To evaluate serum and urinary ECM-related biomarkers in pediatric VUR patients.
  • To determine the association of these biomarkers with VUR severity and renal scarring.
  • To explore the potential clinical utility of ECM biomarkers in VUR management.

Main Methods:

  • Serum and urinary levels of MMP-9, TIMP-1, CD147, TGF-β, and MCP-1 were measured in children with VUR and controls.
  • Urinary biomarker concentrations were normalized to creatinine.
  • Statistical analyses and receiver operating characteristic (ROC) curves were used to assess biomarker levels and discriminative performance.

Main Results:

  • Serum MCP-1 was elevated in VUR patients; other serum markers showed no significant difference.
  • Urinary TIMP-1, TGF-β, and MCP-1 were elevated, while CD147 was reduced in VUR patients compared to controls.
  • Elevated urinary MMP-9, TIMP-1, and MCP-1 correlated with high-grade VUR and bilateral renal scarring.
  • Urinary TIMP-1/Cr, TGF-β/Cr, and CD147/Cr showed moderate discriminative ability for VUR.

Conclusions:

  • Urinary ECM-related biomarkers reflect intrarenal inflammatory and fibrotic processes in pediatric VUR.
  • Specific urinary biomarkers like TIMP-1 and TGF-β may serve as indicators of VUR severity and renal damage.
  • Further validation in larger, longitudinal studies is necessary to establish the clinical applicability of these biomarkers.

Keywords:
CD147MCP-1MMP-9TGF-βTIMP-1extracellular matrixrenal scarringvesicoureteral reflux

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