URINE CYTOKINES ARE NONINVASIVE MARKERS OF CLINICAL AND LABORATORY REMISSION IN CHILDREN WITH CHRONIC PYELONEPHRITIS

Abstract

THE AIM:to evaluate diagnostic significance of clinical and laboratory resistance in determining urine cytokines in patients with chronic pyelonephritis (CP).PATIENTS AND METHODS.This prospective study included 110 children with CP aged 6 to 16 years in a state of clinical and laboratory remission. The control group consisted of 20 apparently healthy children. Laboratory tests used to determine EGF, TGF-β1, IGF-1, β2 – MG, IL-4, IL-10, IL-17 and IL-12 by ELISA in the morning urine of patients.RESULTS.Comparison of cytokines values depending on the clinical form of the disease revealed the prevalence of levels of TGF-β1 and IL-17 in the urine of patients with obstructive CP. The highest uTGF-β1 / uCr and uIL-17 / uCr were obtained in patients, which have vesicoureteral reflux in anamnesis. Level uIL-10 / uCr almost 2 times was elevated in children with both clinical forms of CP. In patients with the disease experience up to 6 years, were identified unidirectional changes of urine cytokines – increase in both pro- and anti-inflammatory parameters. As the duration of the microbial-inflammatory processes more than 6 years there was a significant decrease in the levels uIGF-1 / uCr and uEGF-1 / uCr relative to the control group, with no significant changes in the uIL-12 / uCr and uIL-10 / uCr at continuing higher levels uTGF-β1 / uCr, uIL-17 / uCr, uIL-4 / uCr. In patients having one or less exacerbation of CP per year, regardless of the duration of the disease, no pathological changes in cytokine levels have been detected. Most of the studied parameters were dependent on renal function.CONCLUSION.Increased concentration of studied urine cytokines indicates the presence of a latent inflammatory process more than in half of studied patients.