title: Monocyte chemoattractant protein-1 and interleukin-8 levels in urine and serum of patents with hemolytic uremic syndrome.
abstract: The epidemic form of the hemolytic uremic syndrome (HUS) in children is hallmarked by endothelial cell damage, most predominantly displayed by the glomerular capillaries. The influx of mononuclear (MO) and polymorphonuclear cells (PMNs) into the glomeruli may be an important event in the initiation, prolongation, and progression of glomerular endothelial cell damage in HUS patients. The molecular mechanisms for the recruitment of these leukocytes into the kidney are unclear, but monocyte chemoattractant protein-1 (MCP-1) and IL-8 are suggested to be prime candidates. In this study, we analyzed the presence of both chemokines in 24-h urinary (n = 15) and serum (n = 14) samples of HUS children by specific ELISAs. Furthermore, kidney biopsies of three different HUS children were examined for MO and PMN cell infiltration by histochemical techniques and electron microscopy. Whereas the chemokines MCP-1 and IL-8 were present in only very limited amounts in urine of 17 normal control subjects, serial samples of HUS patients demonstrated significantly elevated levels of both chemokines. HUS children with anuria showed higher initial and maximum chemokine levels than their counterparts without anuria. A strong positive correlation was observed between urinary MCP-1 and IL-8 levels. Whereas initial serum IL-8 levels were significantly increased in HUS children, serum MCP-1 levels were only slightly elevated compared with serum MCP-1 in control children. No correlation was found between urinary and serum chemokine concentrations. Histologic and EM studies of HUS biopsy specimens clearly showed the presence of MOs and to a lesser extent of PMNs in the glomeruli. The present data suggest an important local role for MOs and PMNs in the process of glomerular endothelial-cell damage. The chemokines MCP-1 and IL-8 may possibly be implicated in the pathogenesis of HUS through the recruitment and activation of MOs and PMNs, respectively.
authors.affiliation: Department of Pediatrics, University Hospital, Nijmegen, The Netherlands.
authors.forename: P A
authors.initials: PA
authors.lastname: van Setten
authors.forename: V W
authors.initials: VW
authors.lastname: van Hinsbergh
authors.forename: L P
authors.initials: LP
authors.lastname: van den Heuvel
authors.forename: F
authors.initials: F
authors.lastname: Preyers
authors.forename: H B
authors.initials: HB
authors.lastname: Dijkman
authors.forename: K J
authors.initials: KJ
authors.lastname: Assmann
authors.forename: T J
authors.initials: TJ
authors.lastname: van der Velden
authors.forename: L A
authors.initials: LA
authors.lastname: Monnens
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000652:urine; D001706:Biopsy; D001772:Blood Cell Count; D018932:Chemokine CCL2 / Q000097:blood* / Q000652:urine; D002648:Child; D002675:Child, Preschool; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000097:blood* / Q000473:pathology / Q000652:urine; D006801:Humans; D007223:Infant; D016209:Interleukin-8 / Q000097:blood* / Q000652:urine; D007668:Kidney / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D009000:Monocytes / Q000473:pathology; D009504:Neutrophils / Q000473:pathology; D012016:Reference Values
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D016209:Interleukin-8