title: Interleukin-6 and interleukin-8 in serum and urine in patients with acute pyelonephritis in relation to bacterial-virulence-associated traits and renal function.
abstract: Urine and serum concentrations of interleukin (IL)-6 and IL-8 were determined in 43 women with acute pyelonephritis caused by Escherichia coli. Urine and serum samples were also collected 2 weeks after the infection and during a subsequent episode of cystitis (n = 8) or asymptomatic bacteriuria (n = 8). Concentrations of IL-6 and IL-8 were related to the expression of 5 virulence markers of E. coli and glomerular filtration rate (GFR) after pyelonephritis. Patients with acute pyelonephritis had elevated urine and serum IL-6 and IL-8 levels as compared to 37 healthy women (IL-6: p < 0.001 in both cases, and IL-8: p < 0.001 in both cases). Patients infected with E. coli producing hemolysin and/or cytotoxic necrotizing factor (CNF) had significantly higher IL-6 levels in serum during acute pyelonephritis as compared to patients infected with strains without the ability to produce these factors (p = 0.0025 and p = 0.0154, respectively). Patients who had high concentrations of IL-8 in urine during acute pyelonephritis had lower GFR at follow-up as compared to patients with lower levels of IL-8 in urine (r = -0.48, p = 0.0123). In conclusion, acute pyelonephritis is accompanied by elevated urinary and serum IL-6 and IL-8 levels. Bacteria producing hemolysin and CNF seem to induce higher concentrations of IL-6 in serum. The secretion of IL-8 from renal cells may participate in the initiation and maintenance of renal inflammation which in turn may influence renal function.
authors.affiliation: Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
authors.forename: S H
authors.initials: SH
authors.lastname: Jacobson
authors.forename: B
authors.initials: B
authors.lastname: Hylander
authors.forename: B
authors.initials: B
authors.lastname: Wretlind
authors.forename: A
authors.initials: A
authors.lastname: Brauner
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins / Q000096:biosynthesis; D002097:C-Reactive Protein / Q000378:metabolism / Q000652:urine; D003603:Cytotoxins / Q000096:biosynthesis; D004926:Escherichia coli / Q000378:metabolism / Q000472:pathogenicity*; D004927:Escherichia coli Infections; D029968:Escherichia coli Proteins; D005260:Female; D010861:Fimbriae, Bacterial / Q000502:physiology; D005919:Glomerular Filtration Rate; D006460:Hemolysin Proteins / Q000096:biosynthesis; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis / Q000097:blood* / Q000652:urine*; D016209:Interleukin-8 / Q000096:biosynthesis / Q000097:blood* / Q000652:urine*; D007668:Kidney / Q000503:physiopathology*; D008875:Middle Aged; D011704:Pyelonephritis / Q000378:metabolism* / Q000382:microbiology* / Q000503:physiopathology; D014774:Virulence
chemical_list: D001427:Bacterial Toxins; D003603:Cytotoxins; D029968:Escherichia coli Proteins; D006460:Hemolysin Proteins; D015850:Interleukin-6; D016209:Interleukin-8; C060296:cytotoxic necrotizing factor type 1; D002097:C-Reactive Protein