29 - Mucosal Immunity in the Urinary System

Abstract

This chapter focuses on the mucosal immunity in the urinary system. This chapter discusses the mucosal immune response to infection in the urinary tract, and the host factors That are important in the antibacterial defense of the urinary tract mucosa . The existence of a mucosal cytokine response to UTI was first recognized in the urinary tract of mice. The urinary tract mucosa forms an efficient barrier to microbes and molecules in the urine. It is constantly exposed to different organic and inorganic compounds that are excreted with urine as a result of filtration through the kidney. Urinary tract infections (UTI) are an excellent model for studies of antibacterial mucosal responses. The mucosal compartment is easily accessible for study because host response molecules and cells are excreted with urine and collected and characterized. UTI are one of the most common and non-epidemic bacterial infections in humans. The frequency of infection varies with age, gender, and predisposing factors. The frequency of acute cystitis in children is difficult to determine, however, most women have acute cystitis within their lifetime atleast once. There are a number of host factors thatmodify or prevent bacterial attachment to the urinary tract mucosa: mechanic defenses and bactericidal activities exert a nonspecific barrier to bacterial establishment, host receptor expression influences the ability of bacteria to attach, and anti-adhesive molecules are secreted into the urine. The chapter also discusses the prevention of urinary tract infection that includes: Receptor analogs, vaccination in acute UTI, and vaccination in recurrent UTI.