Soluble Interleukin-6 Receptor, Interleukin-10 and Granulocyte Colony-Stimulating Factor in Acute Pyelonephritis: Relationship to Markers of Bacterial Virulence and Renal Function

• Published in: Nephron Vol. 80; no. 4; pp. 401 - 407
• Main Authors: Jacobson, Stefan H., Lu, Ying, Brauner, Annelie
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.12.1998
• Subjects: Acute Disease; Adolescent; Adult; Aged; Escherichia coli - pathogenicity; Escherichia coli Infections - drug therapy; Escherichia coli Infections - metabolism; Escherichia coli Infections - urine; Female; Granulocyte Colony-Stimulating Factor - blood; Granulocyte Colony-Stimulating Factor - metabolism; Granulocyte Colony-Stimulating Factor - urine; Humans; Interleukin-10 - blood; Interleukin-10 - metabolism; Interleukin-10 - urine; Kidney - physiopathology; Middle Aged; Original Paper; Pyelonephritis - drug therapy; Pyelonephritis - metabolism; Pyelonephritis - urine; Receptors, Interleukin-6 - blood; Receptors, Interleukin-6 - metabolism; Solubility; Virulence; Cytokine receptors; Interleukin-6 receptor; Cytokines; Interleukin-10; Granulocyte colony-stimulating factor; Acute pyelonephritis
• ISSN: 1660-8151; 2235-3186
• DOI: 10.1159/000045211

Background: Cytokines and cytokine receptors are involved in the systemic and local inflammatory response in patients with urinary tract infections. Methods: We examined urine and serum concentrations of soluble IL-6 receptor (sIL-6R), IL-10 and granulocyte colony-stimulating factor (G-CSF) in 29 women with acute pyelonephritis caused by Escherichia coli 2 weeks after the infection, during the subsequent episode of cystitis or asymptomatic bacteriuria and also later when the same patients were free from bacteriuria. Concentrations of sIL-6R, IL-10 and G-CSF were related to the expression of five virulence markers of E. coli and to glomerular filtration rate (GFR) after pyelonephritis. Results: On admission because of acute pyelonephritis the serum concentration of sIL-6R was similar to that of 12 healthy controls. Two weeks after the infection when all patients had received antibiotic treatment, the serum concentration of sIL-6R was significantly higher compared to that on admission (p < 0.001) and also higher compared to healthy controls (p = 0.001). Patients with increased concentrations of sIL-6R in serum 2 weeks after infection had significantly lower GFR at follow-up (p < 0.05). Patients with acute pyelonephritis had higher concentrations of G-CSF and IL-10 in serum compared to healthy subjects (p < 0.001 and p = 0.06, respectively). G-CSF in serum was higher in patients infected by E. coli producing cytotoxic necrotizing factor (p < 0.05). Patients infected by strains producing hemolysin had lower concentrations of sIL-6R (p < 0.001). Patients with detectable levels of the anti-inflammatory cytokine IL-10 in serum had significantly higher concentrations of IL-6 and the soluble tumor necrosis factor receptors I and II in serum as compared to patients in whom IL-10 was not detectable (p < 0.001, p = 0.001 and p < 0.05, respectively. Conclusion: These investigations, together with our previous findings summarized in this paper, contribute to an increased understanding of the local and systemic inflammatory response arising in response to acute pyelonephritis.