title: TLR-4 polymorphisms and leukocyte TLR-4 expression in febrile UTI and renal scarring.
abstract: BACKGROUND
  In this study, we aimed to determine the relation of TLR-4 Asp299Gly and Thr399Ile polymorphisms and monocyte/neutrophil TLR-4 expression to febrile urinary tract infection (UTI) and renal scar development in children.
  
  
  METHODS
  The study was performed in children with a history of febrile UTI. Patients with and without renal scarring were classified as group 1 and group 2, respectively, while the control cases in our previous study were used as the control group (group 3). All three groups were compared for the rate of TLR-4 Asp299Gly and Thr399Ile polymorphisms, and for basal and lipopolysaccharide-stimulated monocyte/neutrophil TLR-4 expression levels.
  
  
  RESULTS
  There were 168 patients (86 in group 1, 82 in group 2) and 120 control cases. Monocyte/neutrophil TLR-4 expression levels were similar in groups 1 and 2. However, both groups had lower TLR-4 expression than group 3. The rate of TLR-4 Asp299Gly polymorphism was not different in all groups. TLR-4 Thr399Ile polymorphism was higher in groups 1 and 2 than in group 3 (14.0, 12.2, and 2.0 %, respectively), while group 1 and group 2 were not different. Furthermore, monocyte TLR-4 expression level was lower in those having TLR-4 Thr399Ile polymorphism than in those without this polymorphism.
  
  
  CONCLUSIONS
  Patients with febrile UTI had more frequent TLR-4 Thr399Ile polymorphism and lower monocyte/neutrophil TLR-4 expression. These findings indicate that children carrying TLR-4 Thr399Ile polymorphism and/or having low level of monocyte/neutrophil TLR-4 expression have a tendency to develop febrile UTI. However, we could not show the association of TLR-4 polymorphisms and of TLR-4 expression level to renal scarring.
authors.affiliation: School of Medicine, Department of Pediatrics, Dokuz Eylul University, Izmir, Turkey. meralt.bayram@yahoo.com.tr
authors.forename: Meral Torun
authors.initials: MT
authors.lastname: Bayram
authors.forename: Alper
authors.initials: A
authors.lastname: Soylu
authors.forename: Halil
authors.initials: H
authors.lastname: Ateş
authors.forename: Sefa
authors.initials: S
authors.lastname: Kızıldağ
authors.forename: Salih
authors.initials: S
authors.lastname: Kavukçu
mesh_terms: D002648:Child; D004247:DNA / Q000235:genetics; D005260:Female; D005334:Fever / Q000150:complications / Q000378:metabolism; D005434:Flow Cytometry; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007962:Leukocytes / Q000378:metabolism*; D008070:Lipopolysaccharides / Q000494:pharmacology; D008297:Male; D009000:Monocytes / Q000378:metabolism; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D012150:Polymorphism, Restriction Fragment Length / Q000235:genetics; D011704:Pyelonephritis / Q000235:genetics / Q000378:metabolism; D051197:Toll-Like Receptor 4 / Q000096:biosynthesis* / Q000235:genetics*; D014552:Urinary Tract Infections / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology
chemical_list: D008070:Lipopolysaccharides; D051197:Toll-Like Receptor 4; D004247:DNA