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Urine levels of transforming growth factor-beta 1 in children with ureteropelvic junction obstruction
L S Palmer1, M Maizels, W E Kaplan
1Division of Urology, Children's Memorial Medical Center/Northwestern University Medical School, Chicago, Illinois, USA.
Insights
Transforming growth factor-beta 1 (TGF-beta 1) is measurable in children's urine. Elevated TGF-beta 1 in renal pelvic urine may indicate ureteropelvic junction obstruction (UPJO) in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Urology
- Biomarker Discovery
Background:
- Urinary tract conditions in children, such as vesicoureteral reflux (VUR) and ureteropelvic junction obstruction (UPJO), require accurate diagnostic markers.
- Transforming growth factor-beta 1 (TGF-beta 1) is a cytokine implicated in renal development and disease, but its role as a urinary biomarker in pediatric urologic conditions is not well-established.
Purpose of the Study:
- To quantify urinary TGF-beta 1 levels in children with normal urinary tracts, VUR, and UPJO.
- To investigate whether urinary TGF-beta 1 can differentiate between obstructed and non-obstructed urinary tracts in children.
Main Methods:
- Urine samples were collected from the bladder of children undergoing procedures for UPJO, VUR, or controls (circumcision/orchiopexy).
- Renal pelvic urine was also collected from the UPJO group.
- Quantitative sandwich enzyme immunoassay was used to measure urine TGF-beta 1 concentrations.
Main Results:
- Urinary TGF-beta 1 was detected in all study groups.
- Children with UPJO showed significantly higher TGF-beta 1 concentrations in renal pelvic urine compared to bladder urine (p = 0.03).
- Bladder urine TGF-beta 1 levels were comparable across all three groups (control, VUR, UPJO).
Conclusions:
- Urinary TGF-beta 1 is a detectable marker in children, irrespective of urinary tract pathology.
- Elevated TGF-beta 1 in renal pelvic urine is associated with UPJO, suggesting its potential as a localized biomarker for upper urinary tract obstruction.
Objectives:
To determine if there are measurable quantities of transforming growth factor-beta 1 (TGF-beta 1) in the urine of children with either normal or pathologic conditions of the urinary tract, specifically vesicoureteral reflux (VUR) and ureteropelvic junction obstruction (UPJO). We also sought to determine if the urine TGF-beta level could distinguish between renal obstruction and no obstruction.
Methods:
Preoperative bladder urine from consecutive patients undergoing pyeloplasty (UPJO group; n = 13), ureteral reimplantation (VUR group; n = 11), or circumcision/orchiopexy (control group; n = 19) as well as urine from the renal pelvis of the UPJO group was collected. The urine level of TGF-beta 1 was measured using a quantitative sandwich enzyme immunoassay technique.
Results:
Urine level of TGF-beta 1 was detected in each group: control (26.6 +/- 6.3 pg/mL), reflux (22.1 +/- 9.6), UPJO-pelvic urine (82.4 +/- 19.3), UPJO-bladder urine (31.2 +/- 8.2). The urine TGF-beta 1 concentration in pelvic urine in the UPJO group was significantly higher than that in bladder urine in children in the UPJO group (p = 0.03). TGF-beta 1 concentrations were similar from the bladder of children in all three study groups (p = NS).
Conclusions:
Urine TGF-beta 1 is detectable in children with normal and pathologic urinary tracts. The level of this urine marker is elevated in the renal pelvis of children with UPJO compared to the level in the bladder of either obstructed or nonobstructed upper urinary tracts.