Urinary lnterleukin-8 in acute pyelonephritis of children: a before-after study

The aim of this study was to assess urinary interleukin-8 [IL-8] levels in pyelonephritis and its relation with the clinical course of the infection and of inflammatory changes detected by renal scintigraphy. In this quasi-experimental before-after study, we evaluated 91 children aged 1 to 144 months [mean 34.4 +/- 35.2 months] with pyelonephritis. Inflammatory markers including erythrocyte sedimentation rate, C-reactive protein, leukocyte count, and urinary IL-8, together with the results of ultrasonography, voiding cystourethrography, and dimercaptosuccinic acid renal scintigraphy were evaluated in these children. The ratios of urinary IL-8 to creatinine [IL-8/C] before and after the treatment were compared with each other. Urinary IL-8/C levels were significantly higher after the empirical treatment in comparison with those before the treatment [0.19 +/- 0.21 versus 0.51 +/- 0.53, P < .001]. No correlation was found between the urinary IL-8 levels and leukocyturia, urine culture results, other inflammatory markers, or findings of imaging examinations. We found high urinary IL-8 levels in children with pyelonephritis. We also documented its increasing after the treatment. We conclude that evaluation of urinary IL-8 can be a noninvasive test for diagnosis of upper urinary tract infection and its response to treatment

Urinary interleukin 6 and 8 concentrations in children with acute pyelonephritis, before and after treatment

Urinary tract infections [UTI] are common cause of morbidity and mortality especially in young children around the world. Pyelonephritis can lead to scar formation, and subsequent hypertension and renal failure. Interleukins play a major role in renal scar formation following febrile pyelonephritis. The aim of this study was to investigate the level of urinary interleukin-6 [UIL-6] and UIL-8 concentrations during the acute phase of pyelonephritis and after two kinds of treatment. UIL-6 and UIL-8 concentrations were determined by enzyme immunoassay in 34 children with acute pyelonephritis who were treated with Ceftriaxone plus steroids [case group] and in 20 patients treated with antibiotic alone [control group]. Cases and controls were age and sex matched. Urine samples were obtained at the time of presentation prior to drug administration and at follow-up 72 hours after initiation of medication. Creatinine concentrations were also determined, and cytokine/creatinine ratios were calculated. The differences between the cytokine/creatinine ratios in the initial urine samples and the follow-up samples were significant in the case group [p < 0.001], but not for the controls. In addition, combined antibiotic and steroids significantly decreased UIL-6 and UIL-8 concentrations compared with antibiotic alone [p < 0.05]. We conclude that steroids combined with antibiothics significantly decrease UIL-6 and UIL-8 levels in patients with acute pyelonephritis. This result can suggest that the clinical use of corticosteroids may prevent scar formation following pyelonephritis

Role of urinary interleukin-8 in children with febrile urinary tract infection

lnterleukin-8 [IL-8] is produced within the urinary tract during urosepsis and is involved in the recruitment of neutrophils to the urinary compartment, in addition, deliberate colonization of the human urinary tract with E.coli resulted in a rapid increase in urine IL-8 levels without a detectable rise in IL-8 in serum. This study was conducted in Mansoura University Children's Hospital, and comprised 56 children with febrile urinary tract infection [UTI] and 10 matched healthy controls. Urine samples were taken from patients and control subjects and were analyzed by microscopic examination and bacterial culture. Urinary IL-8 measurements were performed for all samples. A significant increase in urinary IL-8 level was recorded in patients with febrile urinary tract infection compared to healthy controls [P<0.001]. The highest median urinary IL-8 level was found in febrile UTI with E.Coli, followed by staphylococcal infection. In conclusion, urinary IL-8 level may help in the diagnosis, and follow up of children with febrile UTIs

Significance of urinary and serum IL -8 levels as indicator - tor for diagnosis of hositally acquired urinary tract infection

UTI is one of the main diseases affecting human beings especially when the infection is acquired inside hospital due to invasive medical procedures. Pyuria is one of the main features of U. T.I. The signs and symptoms may be nonsense and sometimes upper or lower UTI symptoms may not accompanied by pyuria. Nevertheless the mechanism of polymorph nuclear leucocytes [PNL] recruitment into the urine remain to be routinely investigated as an evidence for infection. Also the microbial urinary count more than 10[5] organism/ml urine coincide as an indicator for UTI. Although in many occasions it shows lower value or may be nil with eminent UTI. This study was done to detect level of interleukin-8 [IL-8] as potent neutrophil chemoattractant in cases of symptomatic and asymptomatic UTI. Urine and serum specimens were collected from three groups of patients with UTI: Group 1[20 patients with upper UTI], Group 11[20 patients with lower UTI], and Group III [20 patients with asymptomatic UTI] to compare between serum and urinary level of IL-8. A fourth group composed of ten apparently healthy normal controls with normal urine analysis and no bacteriuria were also included in the study. The study showed elevated mean levels of IL-8 in the urine of group 1[286. 9 pg/ml] and group 11[312 pg/ml] and group III [273.3 pg/ml] as compared to 8.9 pg/ml in controls. The mean urinary IL-8 levels were also raised more than the serum levels [96, 52, and 32 pg/ml in group I, II and III respectively] compared to 10.12 pg/ml in controls suggesting local production of IL-8 in the urinary tract mucosa which recruit into systemic circulation. The urinary IL-8 level was found to be correlated with the number of PNLs in the urine indicating exponential relation proving the role of IL-8 as chemoattractant. There was insignificant difference in mean urinary levels of IL-8 between upper or lower UTI, and also insignificant difference in serum IL-8 between both groups [P>0.05] although it was found to be higher in patients with upper UTI. In addition there was not any correlation between Gram -ve or Gram +ve isolated bacteria and variability of IL-8 level. Also, IL-8 level was not related to age or sex. The level of urinary IL-8 was raised in cases of UTI showing no symptoms or with oligopyuria and sometimes with microbial count less than 10[5] microorganism/ml urine. These results insure that IL-8 can be used as a sensitive indicator for all types of UTI either symptomatic or asymptomatic, with or without pyuria or significant bacterial count

Usefulness of serum procalcitonin and urinary interleukin-8 in pediatric urinary tract infection

This work studied 40 infants and children [14 males and 26 females] with manifestation suggestive of urinary track infection [UTI], their ages ranged from 6 months to 8 years, in addition to 40 apparently healthy children of matched age and sex, as a control group. Serum PCT, urinary IL-8, C-reactive protein [CRP] and total leukocytic were measured in all patients and controls. In cases with positive urine culture, renal parenchymal involvement was assessed by 99TcDMSA renal scan in the first five days after admission. From the results obtained, it was concluded that in infants and children with suspected UTI, serum PCT and urinary IL-8 may be used as markers of infection, their levels vary with the severity of infection and were increased significantly when renal parenchymal involvement is present. Taking the appropriate clinical situations into account, their measurement might be a useful and practical tool for differentiating acute pyelonephritis from lower UTI

Evaluation of human neutrophil chemotactic cytokine [IL-8] role in the development of lupus nephritis: correlation with disease activity and pathological type

Aim of the work: was to evaluate the human neutrophil chemotactic cytokine [IL-8] role in the development of Lupus nephritis [LN] and its correlation with disease activity and pathological type. this study was conducted on 20 patients with lupus nephritis and 20 controls with matched age and sex. Patients were subjected to thorough history taking, and clinical examination, routine investigations including CBP, ESR, and renal function tests [blood urea, serum creatinine, and creatinine clearance] and 24 hours urinary protein. Level of anti-ds DNA was measured in SLE patients. IL-8 measurement in both serum and urine was done using ELISA technique. Renal biopsies were taken from all patients and were studied for histopathological changes, cellular infiltration and sings of activity. IL-8 was not detected in the serum of any patient with LN. Urinary IL-8 were elevated in patients with WHO class IVa, IVb, IVc, IIIa, and IIa. The highest levels were detected in class IVb, and undetected in any patient with class IId, IIIa and I, and some patients with class IIa. Urinary IL-8 was increased significantly in patients with glomerular cell proliferation, fibrinoid necrosis, cellular crescents, hyaline deposit and interstitial inflammation and leukocyte exudation. Urinary IL-8 correlated well activity index. IL-8 produced locally in LN and may be involved in the pathogenesis of glomerular and tubulo-interstitial diseases. IL-8 in urine is correlated well with activity index, thus its measurement in urine in LN patients may be a useful tool for monitoring disease activity

Interleukin-8 levels the urine of patients with urinary tract in fections

Pyuria is one of the main features of urinary tract infections [U.T.I]. Nevertheless, the mechanism of polymorphonuclear leukocyte [PMN] recruitment into the urine remains to be investigated. This study was done to examine whether interleukin-[8] [IL-[8]], a potent neutrophil chemoattractant and activator, was involved in pyuria seen in UTI. Urine specimens were collected from two groups of patients with UTI, group [I] [30 patients with upper UTI] and group [II] [30 patients with lower UTI]. Serum samples were additionally taken [10 out of each group] to compare between serum and urinary levels of IL-[8]. A third group composed of 10 normal controls, who had normal urine analysis and no bacteriuria, was also included in the study. Elevated levels of IL-[8] were detected in the urine of group [I] [mean = 286.9 +/- 343.8 pg/ml] and [II] [mean=312 +/- 356.6 pg/ml] as compared to controls [mean = 8.9 +/- 1.2 pg/ml]. The mean serum levels were raised but to a lesser extent than the urinary levels [96 +/- 8.9 pg/ml in group [I] and 52+28.7 pg/ml in group [II]] suggesting local production of IL-[8] in the urinary tract. The urine IL-[8] level correlated with the number of PMN in the urine indicating the role of IL-[8] as a chemoattractant. In addition to gram-negative bacteria, any of the organisms commonly encountered in UTI can induce IL-[8] production in urine. The increased IL-[8] level in urine was not associated with age or sex. These results imply that IL-[8] acts as a potent neutrophil chemoattractant causing an influx of PMN locally at the mucosal surface