title: Changes in urine levels of substance P, vasoactive intestinal peptide and calcitonin-gene-related peptide in patients with urinary tract infections.
abstract: Urinary tract infections (UTI) are important health problems and predisposing causes of UTI are not entirely known. Neuro-immune interactions play an important role in human health and disease. Capsaicin-sensitive sensory nerves which in nerve bladder extensively regulate immune system through neuropeptides such as substance P (SP), calcitonin-gene related peptide (CGRP) and vasoactive intestinal peptide (VIP). In addition these neuropeptides also have anti-bacterial effects. To determine how the levels of these peptides changes during UTI, 67 patients (50-90 years-old) diagnosed with UTI in Akdeniz University Faculty of Medicine Hospital were compared with 37 healthy people 50 years or older as the control group. Additionally, 7 patients with UTI symptoms (dysuria, urgency) but with sterile pyuria were also included in the study. Urine samples from 15 patients, whose symptoms regressed with control urine cultures being sterile, were taken after completion of the treatments. Urine neuropeptide levels were determined by ELISA. CGRP levels are significantly higher in patients with UTI, but did not associate with pyuria whereas SP and VIP levels were significantly lower in patients with sterile pyuria, indicating sensory nerve deficiency. Since CGRP exerts immunosuppressive effects, increased levels of the peptide may predispose to UTI. Furthermore, the connection between the observed sensory nerve deficiency and sterile pyuria warrants further studies.
authors.affiliation: Department of Internal Medicine, Akdeniz University, School of Medicine, Antalya, Turkey.
authors.forename: Seher Çetinkaya
authors.initials: SÇ
authors.lastname: Altuntaş
authors.affiliation: Department of Urology, Antalya Training and Research Hospital, Turkey.
authors.forename: Tümay
authors.initials: T
authors.lastname: Ipekçi
authors.affiliation: Department of Internal Medicine, Akdeniz University, School of Medicine, Antalya, Turkey.
authors.forename: Gülşen
authors.initials: G
authors.lastname: Yakupoğlu
authors.affiliation: Department of Medical Pharmacology, Akdeniz University, School of Medicine, Antalya, Turkey. Electronic address: nerin@akdeniz.edu.tr.
authors.forename: Nuray
authors.initials: N
authors.lastname: Erin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015740:Calcitonin Gene-Related Peptide / Q000652:urine*; D002443:Ceftriaxone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009479:Neuropeptides / Q000652:urine; D011776:Pyuria / Q000188:drug therapy / Q000652:urine; D013373:Substance P / Q000652:urine*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000652:urine*; D014660:Vasoactive Intestinal Peptide / Q000652:urine*
chemical_list: D009479:Neuropeptides; D013373:Substance P; D014660:Vasoactive Intestinal Peptide; D002443:Ceftriaxone; D015740:Calcitonin Gene-Related Peptide
keywords: Calcitonin gene related peptide; Capsaicin; Sterile pyuria; Substance P; Urinary tract infections; Vasoactive intestinal peptide