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Interleukin 6 response to urinary tract infection in childhood
M Benson1, U Jodal, A Andreasson
1Department of Pediatrics, Göteborg University, Sweden.
Insights
Urinary tract infections (UTIs) in children activate interleukin-6 (IL-6) production. Higher urinary IL-6 levels were observed in children with UTIs, especially those infected with specific E. coli strains.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Urinary tract infections (UTIs) are common in children.
- Interleukin-6 (IL-6) is a cytokine involved in inflammatory responses.
- The role of IL-6 in pediatric UTIs requires further elucidation.
Purpose of the Study:
- To analyze the interleukin-6 (IL-6) response in children with suspected urinary tract infections (UTIs).
- To compare urinary and serum IL-6 levels in children with and without UTIs.
- To investigate factors influencing IL-6 levels, including fever and bacterial virulence.
Main Methods:
- Analyzed urine and serum samples from 114 children with suspected UTIs.
- Measured urinary and serum IL-6 concentrations.
- Correlated IL-6 levels with clinical parameters (fever, bacteriuria) and laboratory findings (proteinuria, hematuria, leukocyte counts, C-reactive protein).
Main Results:
- Urinary IL-6 concentrations were significantly higher in children with UTIs compared to those without bacteriuria (P < 0.01).
- Serum IL-6 levels did not differ significantly between groups.
- Higher urinary IL-6 was noted in infections caused by P fimbriated Escherichia coli (P < 0.05).
- Urinary IL-6 correlated with proteinuria, hematuria, and urinary leukocyte counts (P < 0.001, P < 0.05, P < 0.05).
Conclusions:
- Urinary tract infections in children elicit a local IL-6 response.
- The magnitude of the urinary IL-6 response is influenced by the infecting bacterial strain's properties.
- Urinary IL-6 is a potential biomarker for pediatric UTIs, correlating with infection severity.
Abstract:
This study analyzed the interleukin 6 (IL-6) response in 114 children with suspected urinary tract infection (UTI). Urine and serum samples were obtained at the time of enrollment. There were 90 children with UTI, 41 with and 49 without a temperature > or = 38.5 degrees C. The remaining 24 children did not have bacteriuria; 11 were febrile and 13 were not. The urinary IL-6 concentrations were higher in the children with UTI (mean, 129 units/ml) than in the children without bacteriuria (mean, 7 units/ml, P < 0.01). In contrast the serum IL-6 did not differ between children with or without UTI or between children with or without a temperature > or = 38.5 degrees C. The urinary IL-6 response was higher in children who were infected with P fimbriated Escherichia coli than in other children with UTI (P < 0.05). There was a correlation of urinary IL-6 with the degree of proteinuria, hematuria and urinary leukocyte counts (P < 0.001, P < 0.05, P < 0.05, respectively) but not with serum IL-6, CRP or temperature, and of serum IL-6 to C-reactive protein (P = 0.053) and renal concentrating capacity (P < 0.05). The results demonstrate that infections of the urinary tract activate an IL-6 response in children and that the magnitude of the IL-6 response is influenced by the properties of the infecting strain.