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Urinary tract infections in children: microbial virulence versus host susceptibility.

Svanborg, Catharina LU (2013) In Advances in Experimental Medicine and Biology 764(2013). p.205-210
Abstract
Urinary tract infections (UTI) are common, dangerous and interesting. This review includes a general background on UTIs and molecular mechanisms of pathogenesis. In addition, we discuss UTI susceptibility and especially the effect of genetic variation on innate immunity. The symptoms of acute pyelonephritis are caused by the innate immune response and inflammation in the urinary tract decreases renal tubular function and may give rise to renal scarring, especially in childhood. The disease severity is explained by pathogens and their virulence factors triggering signaling through Toll-like receptors (TLRs), interferon regulatory factors (IRFs) and type 1 interferons, and the activation of a host response mediating disease or pathology or... (More)
Urinary tract infections (UTI) are common, dangerous and interesting. This review includes a general background on UTIs and molecular mechanisms of pathogenesis. In addition, we discuss UTI susceptibility and especially the effect of genetic variation on innate immunity. The symptoms of acute pyelonephritis are caused by the innate immune response and inflammation in the urinary tract decreases renal tubular function and may give rise to renal scarring, especially in childhood. The disease severity is explained by pathogens and their virulence factors triggering signaling through Toll-like receptors (TLRs), interferon regulatory factors (IRFs) and type 1 interferons, and the activation of a host response mediating disease or pathology or clearance of infection. In children with asymptomatic bacteriuria (ABU), in contrast, bacteria persist without causing symptoms or pathology. ABU strains mostly lack virulence factors, and the lack of symptoms has largely been attributed to their lack of virulence. Recently, rapid progress has been made in the understanding of host susceptibility mechanisms. For example, genetic alterations that reduce TLR4 function are associated with ABU while polymorphisms reducing IRF3 or CXCR1 expression are associated with acute pyelonephritis and an increased risk for renal scarring. Understanding bacterial virulence and host resistance promises new tools to improve the diagnostic accuracy in children with UTI. By combining information on bacterial virulence and the host response, it should be possible to start individualizing diagnosis and therapy. Finally, we propose that the prediction of future disease risk and decisions on prophylaxis and invasive diagnostic procedures might be improved by genetic analysis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Advances in Experimental Medicine and Biology
volume
764
issue
2013
pages
205 - 210
publisher
Kluwer
external identifiers
  • pmid:23654069
  • wos:000338206700018
  • scopus:84873579338
ISSN
0065-2598
DOI
10.1007/978-1-4614-4726-9_17
language
English
LU publication?
yes
id
59e707e0-d1ae-48df-a759-d8a8d3512c68 (old id 3804770)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23654069?dopt=Abstract
date added to LUP
2013-06-06 21:45:02
date last changed
2019-02-20 07:14:04
@article{59e707e0-d1ae-48df-a759-d8a8d3512c68,
  abstract     = {Urinary tract infections (UTI) are common, dangerous and interesting. This review includes a general background on UTIs and molecular mechanisms of pathogenesis. In addition, we discuss UTI susceptibility and especially the effect of genetic variation on innate immunity. The symptoms of acute pyelonephritis are caused by the innate immune response and inflammation in the urinary tract decreases renal tubular function and may give rise to renal scarring, especially in childhood. The disease severity is explained by pathogens and their virulence factors triggering signaling through Toll-like receptors (TLRs), interferon regulatory factors (IRFs) and type 1 interferons, and the activation of a host response mediating disease or pathology or clearance of infection. In children with asymptomatic bacteriuria (ABU), in contrast, bacteria persist without causing symptoms or pathology. ABU strains mostly lack virulence factors, and the lack of symptoms has largely been attributed to their lack of virulence. Recently, rapid progress has been made in the understanding of host susceptibility mechanisms. For example, genetic alterations that reduce TLR4 function are associated with ABU while polymorphisms reducing IRF3 or CXCR1 expression are associated with acute pyelonephritis and an increased risk for renal scarring. Understanding bacterial virulence and host resistance promises new tools to improve the diagnostic accuracy in children with UTI. By combining information on bacterial virulence and the host response, it should be possible to start individualizing diagnosis and therapy. Finally, we propose that the prediction of future disease risk and decisions on prophylaxis and invasive diagnostic procedures might be improved by genetic analysis.},
  author       = {Svanborg, Catharina},
  issn         = {0065-2598},
  language     = {eng},
  number       = {2013},
  pages        = {205--210},
  publisher    = {Kluwer},
  series       = {Advances in Experimental Medicine and Biology},
  title        = {Urinary tract infections in children: microbial virulence versus host susceptibility.},
  url          = {http://dx.doi.org/10.1007/978-1-4614-4726-9_17},
  volume       = {764},
  year         = {2013},
}