Abstract
Anorectal malformations (ARM) occur in 1: 500 to 15 000 live births cases and in 25-54% of cases are combined with urinary tract congenital malformations (UTCM). Patients with ARM and UT CM have several factors of local chronic inflammatory process in UT persistence. Objective of the research - to conduct a comparative analysis of changes in proinflammatory (IL1s, IL6, IL8 and MCP1), anti-inflammatory (IL10) and proangiogenic (VEGF) cytokines in the urine of children with ARM in chronic pyelonephritis (CP) course dynamics. The study included 34 children with CP in the acute stage with UT CM. Patients were divided into two groups: 1 st group - 20 children with ARM, 2 nd group - 14 children without ARM. In addition to the standard examination, which included clinical data of blood and urine analysis, urine culture, kidneys ultrasound examination, cystourethrography, neрhroscintigraphy (99TcDMSA), examination included study of biomarkers in urine by enzyme-linked immunosorbent assay (ELISA) at three points: the patient’s admission to hospital before the start of antibiotic therapy (1 st study period), after 5-7 days of starting treatment (2 nd study period) and 1,5 months after treatment (3 rd study period).Patients with ARM combined with UT CM and CP in the acute stage have high concentrations of urinary cytokines (IL1β, IL6, IL8, MSR1, VEGF) even after 1,5 months after antibiotic therapy, when there are no clinical manifestations of inflammation in UT. Monitoring of cytokines is a new approach to the evaluation of inflammatory process activity in UT and personalized treatment strategies for patients with ARM and UT CM.
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