1
|
Yu J, Varella Pereira GM, Allen-Brady K, Cuffolo R, Siddharth A, Koch M, Chua JWF, Sorrentino F, Dytko O, Ng KY, Violette P, Khullar V, Wang ZT, Cartwright R. Genetic polymorphisms associated with urinary tract infection in children and adults: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 230:600-609.e3. [PMID: 38128862 DOI: 10.1016/j.ajog.2023.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION The lifetime risk of urinary tract infection is known from first-degree relative studies to be highly heritable. Associations have also been observed across the life course from pediatric urinary tract infection to recurrent urinary tract infection in adulthood, suggesting lifelong susceptibility factors. Candidate gene studies and genome-wide association studies have tested for genetic associations of urinary tract infection; however, no contemporary systematic synthesis of studies is available. OBJECTIVE We conducted a systematic review to identify all genetic polymorphisms tested for an association with urinary tract infection in children and adults; and to assess their strength, consistency, and risk of bias among reported associations. DATA SOURCES AND STUDY ELIGIBILITY CRITERIA PubMed, HuGE Navigator and Embase were searched from January 1, 2005 to November 16, 2023, using a combination of genetic and phenotype key words. STUDY APPRAISAL AND SYNTHESIS METHODS Fixed and random effects meta-analyses were conducted using codominant models of inheritance in metan. The interim Venice criteria were used to assess their credibility of pooled associations. RESULTS After removing 451 duplicates, 1821 studies reports were screened, with 106 selected for full-text review, 22 were included in the meta-analysis (7 adult studies and 15 pediatric studies). Our meta-analyses demonstrated significant pooled associations for pediatric urinary tract infection with variation in CXCR1, IL8, TGF, TLR4 and VDR; all of which have plausible roles in the pathogenesis of urinary tract infection. Our meta-analyses also demonstrated a significant pooled association for adult urinary tract infection with variation in CXCR1. All significant pooled associations were graded according to their epidemiological credibility, sample sizes, heterogeneity between studies, and risk of bias. CONCLUSION This systematic review provides a current synthesis of the known genetic architecture of urinary tract infection in childhood and adulthood; and should provide important information for researchers analysing future genetic association studies. Although, overall, the credibility of pooled associations was weak, the consistency of findings for rs2234671 single nucleotide polymorphisms of CXCR1 in both populations suggest a key role in the urinary tract infection pathogenesis.
Collapse
Affiliation(s)
- Jiakun Yu
- University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom.
| | - Glaucia Miranda Varella Pereira
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London, United Kingdom; Department of Urogynaecology, LNWH NHS Trust, London, United Kingdom; Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas, Brazil
| | - Kristina Allen-Brady
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Romana Cuffolo
- Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Aditi Siddharth
- John Radcliffe Hospital, Headley Way, Headington, Oxford, United Kingdom
| | - Marianne Koch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - John W F Chua
- Frimley Health NHS Foundation Trust, Frimley, United Kingdom
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
| | - Oskar Dytko
- Imperial College School of Medicine, Imperial College London, London, United Kingdom
| | - Kaa-Yung Ng
- Imperial College School of Medicine, Imperial College London, London, United Kingdom
| | - Philippe Violette
- Department of Health Research Methods, Evidence and Impact (HEI) and Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Vik Khullar
- Department of Urogynaecology, Imperial College London, United Kingdom
| | - Zhan Tao Wang
- Department of Surgery, Division of Urology, University of Western Ontario, London, Ontario, Canada
| | - Rufus Cartwright
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London, United Kingdom; Department of Urogynaecology, LNWH NHS Trust, London, United Kingdom; Department of Urogynaecology, Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
2
|
Sarker P, Pereira GMV, Khullar V, Yu J, Cartwright R. VDR, CXCR1, CXCR2, PSCA Polymorphisms and Recurrent Urinary Tract Infections in Women: Genetic Association Study. Int Urogynecol J 2024; 35:695-701. [PMID: 38407596 PMCID: PMC11024019 DOI: 10.1007/s00192-024-05742-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/16/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary tract infection (UTI) is one of the most common human infections. Evidence suggests that there might be a genetic predisposition to UTI. Previous small candidate gene studies have suggested that common variants in genes involved in the immune response to UTI could increase susceptibility to the development of recurrent UTI (rUTI). The objective was to conduct a gene association study to replicate previous gene association studies identifying single nucleotide polymorphisms (SNPs) putatively associated with rUTI in adult women. METHODS Women with a history of rUTI and healthy controls were recruited (n = 1,008) from gynaecology outpatient clinics. Participants completed a signed consent form and questionnaire for phenotyping. DNA was extracted from blood or saliva samples for each participant. Putative associated SNPs were identified from a comprehensive systematic review of prior gene association studies. Primers for each selected SNP were designed, and genotyping was conducted using a competitive polymerase chain reaction (PCR) method. The Chi-squared test was used to assess the association between each variant and rUTI. Genotyping quality was assessed by checking for deviation from Hardy-Weinberg equilibrium. RESULTS We found no association between SNPs tested in the VDR (p = 0.16, p = 0.09, p = 0.36), CXCR1 (p = 0.09), CXCR2 (p = 0.39), PSCA (p = 0.74) genes, and rUTI in adult women. CONCLUSIONS To our knowledge, this is the largest study to date, finding no significant associations. Previously reported positive associations may have been due to type 1 error, or genotyping errors. Future studies should adjust for confounders and employ adequate sample sizes. A greater understanding of the genetic components associated with rUTI may influence future treatment guidelines and screening for susceptible patients.
Collapse
Affiliation(s)
- Paulomi Sarker
- Department of Urogynaecology, Imperial College London, London, UK
| | - Glaucia Miranda Varella Pereira
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
- Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Vik Khullar
- Department of Urogynaecology, Imperial College London, London, UK
| | - Jiakun Yu
- University Hospitals Sussex NHS Foundation Trust, London, UK
| | - Rufus Cartwright
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.
- Department of Urogynaecology, Chelsea & Westminster NHS Foundation Trust, London, UK.
| |
Collapse
|
3
|
Naser HH, Kadhim MJ, Almhanna H. Investigating the impact of the genetic variant CXCR1 (rs2234671) in individuals with urinary tract infections. Hum Antibodies 2024; 32:9-18. [PMID: 38339925 DOI: 10.3233/hab-230019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
BACKGROUND Urinary tract infections (UTIs) are currently posing a worldwide health concern by affecting millions of people. The genetic variant rs2234671 in the CXCR1-interleukin-8 receptor is closely related to a raised UTI risk. OBJECTIVES In this work, the impact of CXCR1 (rs2234671) on UTI individuals was examined. METHODS The demographic features of 30 recurrent UTI patients and 20 controls were thoroughly investigated. Bacterial isolation and identification were performed by the implementation of cultural and biochemical methods. DNA extraction, purification of all samples from both patients and healthy people, and IL-8 rs2234671 (C/G) SNP genotyping using T-ARMS-PCR were performed. The significance of the results was evaluated by carrying out a statistical analysis. FINDINGS The patient's average age was 34.63 ± 11.44 years, and controls averaged 30.30 ± 8.59 years (P= 0.156). No significant gender difference existed (P= 0.804). Escherichia coli (63.3%) was predominant, followed by Proteus mirabilis (26.7%), Enterococcus faecalis (23.3%), Klebsiella pneumoniae (10.0%), and Pseudomonas aeruginosa (20.0%). No significant association was found between bacterial species frequency, age, or sex. From the CXCR1 (rs2234671) frequency comparison, a higher GG genotype incidence in UTI patients than controls was extracted (26.7% vs. 15.0%), though not statistically significant. Risk analysis revealed that GG homozygous and C/G heterozygous genotypes were not UTI risk factors (OR = 2.47 and OR = 1.85, respectively). Moreover, the allele frequencies displayed no significant difference between the patients and controls (G allele: 66.7% vs. 66.7%; C allele: 33.3% vs. 33.3%). MAIN CONCLUSIONS Although no significant association between CXCR1 (rs2234671) and UTI was found, the GG genotype may point to the increasing probability of UTI risk. Additional research is required to confirm and expand these conclusions.
Collapse
Affiliation(s)
- Hassan Hachim Naser
- Zoonotic Disease Research Unit, College of Veterinary Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq
| | - Mohanad Jawad Kadhim
- Department of Medical Biotechnology, College of Biotechnology, Al-Qasim Green University, Babylon, Iraq
| | - Hazem Almhanna
- Department of Anatomy, Histology and Embryology, College of Veterinary Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq
| |
Collapse
|
4
|
Schwartz L, de Dios Ruiz-Rosado J, Stonebrook E, Becknell B, Spencer JD. Uropathogen and host responses in pyelonephritis. Nat Rev Nephrol 2023; 19:658-671. [PMID: 37479904 PMCID: PMC10913074 DOI: 10.1038/s41581-023-00737-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/23/2023]
Abstract
Urinary tract infections (UTIs) are among the most common bacterial infections seen in clinical practice. The ascent of UTI-causing pathogens to the kidneys results in pyelonephritis, which can trigger kidney injury, scarring and ultimately impair kidney function. Despite sizable efforts to understand how infections develop or are cleared in the bladder, our appreciation of the mechanisms by which infections develop, progress or are eradicated in the kidney is limited. The identification of virulence factors that are produced by uropathogenic Escherichia coli to promote pyelonephritis have begun to fill this knowledge gap, as have insights into the mechanisms by which kidney tubular epithelial cells oppose uropathogenic E. coli infection to prevent or eradicate UTIs. Emerging data also illustrate how specific cellular immune responses eradicate infection whereas other immune cell populations promote kidney injury. Insights into the mechanisms by which uropathogenic E. coli circumvent host immune defences or antibiotic therapy to cause pyelonephritis is paramount to the development of new prevention and treatment strategies to mitigate pyelonephritis and its associated complications.
Collapse
Affiliation(s)
- Laura Schwartz
- The Kidney and Urinary Tract Center, Nationwide Children's Abigail Wexner Research Institute, Columbus, OH, USA.
- The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Juan de Dios Ruiz-Rosado
- The Kidney and Urinary Tract Center, Nationwide Children's Abigail Wexner Research Institute, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Emily Stonebrook
- The Kidney and Urinary Tract Center, Nationwide Children's Abigail Wexner Research Institute, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Brian Becknell
- The Kidney and Urinary Tract Center, Nationwide Children's Abigail Wexner Research Institute, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - John David Spencer
- The Kidney and Urinary Tract Center, Nationwide Children's Abigail Wexner Research Institute, Columbus, OH, USA.
- The Ohio State University College of Medicine, Columbus, OH, USA.
| |
Collapse
|
5
|
Dicu-Andreescu I, Penescu MN, Căpușă C, Verzan C. Chronic Kidney Disease, Urinary Tract Infections and Antibiotic Nephrotoxicity: Are There Any Relationships? MEDICINA (KAUNAS, LITHUANIA) 2022; 59:49. [PMID: 36676673 PMCID: PMC9862113 DOI: 10.3390/medicina59010049] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
Chronic kidney disease (CKD) has been a constant burden worldwide, with a prevalence of more than 10% of the population and with mortality reaching 1.2 million deaths and 35.8 million disability-adjusted life years (DALYs) in 2017, as it is claimed by the Global Burden of Diseases. Moreover, an increase in its prevalence is expected in the next years due to a rise in the number of people suffering from obesity, diabetes mellitus and hypertension. On the other hand, with cardiovascular morbidity and mortality showing a downward trend, maybe it is time to focus on CKD, to minimize the preventable risk factors involved in its progression toward end-stage kidney disease (ESKD) and to offer a better quality of life. Another major health burden is represented by infectious diseases, particularly urinary tract infections (UTIs), as it is considered that approximately 40-50% of women and 5% of men will have at least one episode during their lifetime. Additionally, CKD consists of a constellation of immunological and metabolical disturbances that lead to a greater risk of UTIs: increased apoptosis of lymphocytes, elevated levels of tumor necrosis factor α and interleukin 6, which lower the function of neutrophils and increased levels of uremic toxins like p-cresyl sulfate and indoxyl sulfate, which alter the adherence and migration of leukocytes to the sites of injury. Moreover, UTIs can lead to a more rapid decline of kidney function, especially in stages G3-G5 of CKD, with all the complications involved. Last, but not least, antibiotherapy is often complicated in this category of patients, as antibiotics can also negatively affect the kidneys. This review will try to focus on the particularities of the urinary microbiome, asymptomatic bacteriuria and UTIs and the subtle balance between the risks of them and the risks of antibiotherapy in the evolution of CKD.
Collapse
Affiliation(s)
- Ioana Dicu-Andreescu
- Clinical Department No 3, Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Dr. Carol Davila” Teaching Hospital of Nephrology, Nephrology Department, Cal. Grivitei No 4, Sector 1, 010731 Bucharest, Romania
| | - Mircea Niculae Penescu
- Clinical Department No 3, Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Dr. Carol Davila” Teaching Hospital of Nephrology, Nephrology Department, Cal. Grivitei No 4, Sector 1, 010731 Bucharest, Romania
| | - Cristina Căpușă
- Clinical Department No 3, Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Dr. Carol Davila” Teaching Hospital of Nephrology, Nephrology Department, Cal. Grivitei No 4, Sector 1, 010731 Bucharest, Romania
| | - Constantin Verzan
- Clinical Department No 3, Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Dr. Carol Davila” Teaching Hospital of Nephrology, Nephrology Department, Cal. Grivitei No 4, Sector 1, 010731 Bucharest, Romania
| |
Collapse
|
6
|
Sorić Hosman I, Cvitković Roić A, Lamot L. A Systematic Review of the (Un)known Host Immune Response Biomarkers for Predicting Recurrence of Urinary Tract Infection. Front Med (Lausanne) 2022; 9:931717. [PMID: 35860746 PMCID: PMC9289160 DOI: 10.3389/fmed.2022.931717] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
Recurrent urinary tract infections (rUTI) represent a major healthcare and economic burden along with a significant impact on patient’s morbidity and quality of life, even in the absence of well-known risk factors, such as vesicoureteral reflux. Despite numerous attempts to find a suitable therapeutic option, there is no clear benefit of any currently available intervention for prevention of UTI recurrence and its long-term consequences such as hypertension, renal scarring and/or insufficiency. The common treatment practice in many centers around the globe involves the use of continuous low-dose antibiotic prophylaxis, irrespective of various studies indicating increased microbial resistance against the prophylactic drug, leading to prolonged duration and escalating the cost of UTI treatment. Moreover, the rapid appearance of multi-drug resistant uropathogens is threatening to transform UTI to untreatable disease, while impaired host-microbiota homeostasis induced by a long-term use of antibiotics predisposes patients for various autoimmune and infectious diseases. New biomarkers of the increased risk of UTI recurrence could therefore assist in avoiding such outcomes by revealing more specific patient population which could benefit from additional interventions. In this light, the recent findings suggesting a crucial role of urothelial innate immunity mechanisms in protection of urinary tract from invading uropathogens might offer new diagnostic, prognostic and even therapeutic opportunities. Uroepithelial cells detect uropathogens via pattern recognition receptors, resulting in activation of intracellular signaling cascade and transcription factors, which ultimately leads to an increased production and secretion of chemokines, cytokines and antimicrobial peptides into the urinary stream. Emerging evidence suggest that the disturbance of a single component of the urinary tract innate immunity system might increase susceptibility for rUTI. The aim of the current review is to update clinicians and researchers on potential biomarkers of host immune response alterations predisposing for rUTI and propose those well worth exploring further. For this purpose, over a hundred original papers were identified through an extensive PubMed and Scopus databases search. This comprehensive review might enrich the current clinical practice and fill the unmet clinical needs, but also encourage the development of therapeutic agents that would facilitate urinary bacterial clearance by enhancing the host immune response.
Collapse
Affiliation(s)
- Iva Sorić Hosman
- Department of Pediatrics, Zadar General Hospital, Zadar, Croatia
| | - Andrea Cvitković Roić
- Department of Nephrology and Urology, Clinic for Pediatric Medicine Helena, Zagreb, Croatia
- School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Lovro Lamot
- Division of Nephrology, Dialysis and Transplantation, Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
- Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia
- *Correspondence: Lovro Lamot,
| |
Collapse
|
7
|
Abbas HM, Al-Mathkhury HJF. Association between the rs2234671 polymorphism and the risk of recurrent urinary tract infections in Iraqi women. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
8
|
Ma Y, Zhou Y, Zhang H, Su X. Immune Response-Related Genes - STAT4, IL8RA and CCR7 Polymorphisms in Lung Cancer: A Case-Control Study in China. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2020; 13:511-519. [PMID: 33116765 PMCID: PMC7585862 DOI: 10.2147/pgpm.s271983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/22/2020] [Indexed: 12/24/2022]
Abstract
Purpose This study aimed to evaluate the associations between immune response-related genes – STAT4, IL8RA and CCR7 polymorphisms and risk of lung cancer. Methods Seven polymorphisms of STAT4, IL8RA and CCR7 were genotyped in 350 cases and 350 controls using a MassARRAY platform. Results The STAT4 rs1400656-G and rs7574865-T alleles may decrease the susceptibility to lung cancer (prs1400656= 0.020; prs7574865= 0.014); while IL8RA rs1008562-C and CCR7 rs3136685-T alleles may increase the risk of disease (prs1008562< 0.001; prs3136685= 0.018). The STAT4 rs1400656-GA and rs7574865-GT genotypes were determined as protective genotypes against lung cancer risk (prs1400656= 0.048; prs7574865= 0.042). However, IL8RA rs1008562-CG/GG and CCR7 rs3136685-TT genotypes were significantly associated with an elevated risk of disease (prs1008562< 0.0001; prs3136685= 0.020). Genetic model analysis revealed that STAT4 rs1400656 and rs7574865 were relate to a declining risk of disease under dominant and log-additive models (rs1400656: pdominant = 0.014, plog-additive= 0.016; rs7574865: pdominant = 0.013, plog-additive= 0.013). In contrast, IL8RA rs1008562 exhibited a strong correlation with an elevated risk of lung cancer under all three models (pdominant < 0.0001, precessive = 0.011, plog-additive< 0.0001). Moreover, CCR7 rs3136685 was correlated with an increased risk of disease under recessive and log-additive models (precessive = 0.007, plog-additive= 0.019); and CCR7 rs17708087 was also identified as a risk factor in the dominant model (p = 0.038). Conclusion These results widen the scope of knowledge about the association between STAT4, IL8RA and CCR7 polymorphisms and risk of lung cancer.
Collapse
Affiliation(s)
- Yunfan Ma
- Department of Thoracic Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, People's Republic of China
| | - Yinxi Zhou
- Department of Thoracic Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, People's Republic of China
| | - Huixin Zhang
- Department of Thoracic Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, People's Republic of China
| | - Xiaoan Su
- Department of Thoracic Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, People's Republic of China
| |
Collapse
|
9
|
Ching C, Schwartz L, Spencer JD, Becknell B. Innate immunity and urinary tract infection. Pediatr Nephrol 2020; 35:1183-1192. [PMID: 31197473 PMCID: PMC6908784 DOI: 10.1007/s00467-019-04269-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/17/2019] [Accepted: 04/25/2019] [Indexed: 01/31/2023]
Abstract
Urinary tract infections are a severe public health problem. The emergence and spread of antimicrobial resistance among uropathogens threaten to further compromise the quality of life and health of people who develop acute and recurrent upper and lower urinary tract infections. The host defense mechanisms that prevent invasive bacterial infection are not entirely delineated. However, recent evidence suggests that versatile innate immune defenses play a key role in shielding the urinary tract from invading uropathogens. Over the last decade, considerable advances have been made in defining the innate mechanisms that maintain immune homeostasis in the kidney and urinary tract. When these innate defenses are compromised or dysregulated, pathogen susceptibility increases. The objective of this review is to provide an overview of how basic science discoveries are elucidating essential innate host defenses in the kidney and urinary tract. In doing so, we highlight how these findings may ultimately translate into the clinic as new biomarkers or therapies for urinary tract infection.
Collapse
Affiliation(s)
- Christina Ching
- Nephrology and Urology Research Affinity Group, Nationwide Children's Hospital, Columbus, OH, USA
- Center of Clinical and Translational Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Division of Urology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Laura Schwartz
- Nephrology and Urology Research Affinity Group, Nationwide Children's Hospital, Columbus, OH, USA
- Center of Clinical and Translational Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - John David Spencer
- Nephrology and Urology Research Affinity Group, Nationwide Children's Hospital, Columbus, OH, USA
- Center of Clinical and Translational Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Division of Pediatric Nephrology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Brian Becknell
- Nephrology and Urology Research Affinity Group, Nationwide Children's Hospital, Columbus, OH, USA.
- Center of Clinical and Translational Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Division of Pediatric Nephrology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
| |
Collapse
|