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DIAGNOSTIC ROLE OF CYTOKINE PROFILE IN CHRONIC
PYELONEPHRITIS IN CHILDREN.
Zakirova U.I.
Nurmatova N.F.
Khabibullaeva B.R.
Tashkent Medical Academy
https://doi.org/10.5281/zenodo.15082786
Currently, pyelonephritis, as a nonspecific microbial-inflammatory disease
of the renal calyceal-pelvic system and tubulointerstitial kidney tissue, has a
high prevalence among the pediatric population. Primarily, pyelonephritis,
although less common than lower urinary tract infections, poses a serious threat
to children's health and, in severe cases, can lead to kidney damage and the
development of chronic kidney disease [3,6]. The high prevalence of severe
complications of pyelonephritis, such as nephrosclerosis, kidney failure, and
renal arterial hypertension, justifies the need for timely early diagnosis and
prevention of this disease in children and adolescents. The outcome of chronic
pyelonephritis (CP) depends on early diagnosis and timely initiation of therapy
[2,5].
Despite the existence of numerous diagnostic methods for CP, new
approaches are still being explored to assess the activity of inflammation and the
persistence of clinical and laboratory remission. The study of
immunopathological mechanisms in pediatric kidney pathology is highly
relevant for analyzing the pathogenetic mechanisms of disease development [1] .
Recent studies emphasize the investigation of local inflammatory mechanisms
by examining interleukin levels in blood and urine. Interleukin-8 (IL-8) plays a
dominant role in neutrophil activation and belongs to the group of pro-
inflammatory cytokines [4,5].
The aim of this study was to analyze the cytokine profile in children with
chronic pyelonephritis to assess the severity of the inflammatory process in
renal tissue[6].
Materials and Methods
A clinical and laboratory examination was conducted on 35 children aged 1
to 15 years with chronic pyelonephritis (CP) during an exacerbation period, all
of whom were receiving inpatient treatment. All patients underwent general
clinical laboratory tests and specific blood analyses. The study material was
peripheral venous blood. The control group consisted of 40 practically healthy
children. IL-8 levels in the blood serum of children with CP were determined
using an enzyme-linked immunosorbent assay (ELISA). The diagnosis of chronic
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
147
pyelonephritis, as well as the severity of the disease and exacerbations in
children, was established according to existing standards provided by the
modern classification of clinical forms of the disease.
Results
The study results showed that during the exacerbation period of the
disease, the clinical picture included extrarenal manifestations such as
intoxication syndrome, abdominal pain syndrome, and lumbar pain. Children
exhibited the Pasternacki symptom and dysuric disorders, including frequent
urination. The urinary syndrome was characterized by isolated leukocyturia,
often accompanied by hematuria and proteinuria, with all cases of leukocyturia
having a neutrophilic nature.
The aim of our study was to assess the impact of chronic pyelonephritis on
the synthesis of interleukin-8 in the blood of affected children. The examination
was conducted during the exacerbation period, on the second day of hospital
admission. A thorough collection of clinical and anamnestic data in the examined
groups revealed that endogenous risk factors for chronic pyelonephritis (CP)
included anemia, paratrophy, and food allergies. Analysis of the obstetric and
somatic history of the mothers of the examined children showed that birth
asphyxia and prematurity were among the risk factors for CP development in
children. Among exogenous risk factors, frequent urinary tract infections were
noted.
The study results of IL-8 levels in peripheral blood in children with CP
demonstrated significant differences compared to the control group. The
cytokine profile of IL-8, classified as a pro-inflammatory cytokine, was measured
in all examined patients during the exacerbation of the primary disease. The
results showed a significant increase in IL-8 levels in the peripheral blood of
children with CP compared to the control group. The IL-8 level in children with
CP was
78.32±12.11 pg/ml
, whereas in the control group, it was
11.32±0.72
pg/ml
(p<0.001).
According to the study of pathogenetic mechanisms, these results confirm
the infectious nature of inflammation in CP in children. The elevated IL-8 levels
in children with CP may be associated with more frequent inflammatory
episodes throughout the year.
Conclusion
A comparative analysis of IL-8 levels and risk factors demonstrated a
significant increase in IL-8 in CP compared to healthy children. The elevated IL-8
levels in children with CP may be associated with recurrent inflammatory
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episodes, leading to frequent disease relapses. Increased IL-8 levels, combined
with risk factors, serve as a diagnostic criterion for chronic pyelonephritis, and
the most significant elevation of these indicators can be considered a prognostic
marker for the development of the disease in children.
References:
1.
Kuang-Yen Lin., Nan-Tsing Chiu., (2003). Acute pyelonephritis and
sequelae of renal scar in pediatric first febrile urinary tract infection. Pediatr
Nephrol (2003) 18: 362–365.
2.
Yarilin A.A. (2010). Immunology. Moscow: GEOTAR-Media; (Russian)
3.
Safoura Derakhshan., Sanaz Ahmad ., Erfan Ahmadi., Sherko Nasseri5 and
Abbas Aghaei., (2022). Characterization of Escherichia coli isolated from urinary
tract infection and association between virulence expression and antimicrobial
susceptibility. BMC Microbiology. https://doi.org/10.1186/s12866-022-02506-
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Medzhitov R., Janeway C., (2004). Innate Immunity. Kazan Medical
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5.
Jiandong Lu., Xiaozhu Liu., & el. Clinical and Microbial Etiology
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Druzhinina T.V. (2016). Pyelonephritis in Children (Lecture). Smolensk
Medical Almanac. № 3; pp. 210-220. (Russian).
