Urinary excretion of EGF and MCP-1 in children with vesico-ureteral reflux
نویسندگان
چکیده
PURPOSE The aim of this study was to investigate the urinary concentration of epidermal growth factor (EGF) and monocyte chemotactic protein-1 (MCP-1) as reflux nephropathy (RN) biomarkers before and after endoscopic treatment of moderate to severe vesico-ureteral reflux (VUR). MATERIALS AND METHODS A prospective study was carried out on 72 children with moderate to severe VUR. All patients underwent endoscopic treatment using Macroplastique ® or Deflux®. Vesico-ureteral reflux resolution was tested by post-operative voiding cystourethrography after 3 months and 2 years. Follow-up urinary samples were collected at that time. Control samples were taken from healthy children with no clinical evidence of renal and bladder disease and no history of UTI. RESULTS In VUR patients, pre-operative urinary EGF levels had a down-regulation when compared to controls. Following successful VUR repair, urinary EGF levels of VUR children progressively increased only at long term follow-up but without returning to normal levels. Urinary MCP-1 levels were highly expressed in pre-operative samples and decreased markedly during early post-operative measurements. Urinary MCP-1 levels did not further decreased in late post-operative follow-up. In fact, these levels remained significantly higher when compared to controls. CONCLUSIONS Urinary levels of EGF and MCP-1 may become useful markers for monitoring the response to surgical treatment in VUR patients. Although endoscopic VUR treatment is effective in reducing the inflammatory response, the persistence of significant abnormal levels of inflammatory cytokines (such as urinary MCP-1) at long term follow-up suggests that surgery alone may not completely treat the chronic renal inflammation evidenced in these children.
منابع مشابه
Diagnostic value of radioisotopic cystography in evaluation of VUR in children with urinary tract infection [Persian]
Radioisotope scanning is very important in evaluation, diagnosis and proper treatment of urinary tract infection (UTI) and vesicoureteral reflux (VUR) because of high sensitivity of this technique and less radiation dose delivered to the patients. This is a descriptive cross-sectional study to determine the frequency VUR in a group of children aged 28 days to 14 years referred to our depa...
متن کاملComparison of ureteral opening distance from midline in children with vesicoureteral reflux and healthy children: a brief report
Background: Vesicoureteral reflux (urinary reflux) is one of the most common congenital anomalies in children. This study aimed to compare the ureteral opening distance from the midline in children with vesicoureteral reflux (VUR) and healthy children Methods: This cross-sectional study was performed on the children with pyelonephritis who were referred to Afzalipour Hospital in Kerman, Iran f...
متن کاملMedical versus Surgical Management of Vesico Ureteral Reflux
Vesico ureteral reflux is the abnormal retrograde flow of urine from the bladder into the ureter and possibly the kidney. There are 2 types of reflux: Primary reflux – which is caused by a congenital abnormality at the ureterovesical junction Secondary reflux – occurs when high pressure in the bladder causes a breakdown of the normal antireflux mechanism at the ureterovesical junction that occu...
متن کاملEvaluation of hypermobility syndrome associated with vesico-ureteric reflux in children
Aims Considering the etiology of hypermobility syndrome that is involvement of connective tissue as a result of a disruption in the synthesis of collagen, there is a possibility of other organs involvement such as urinary system which the structure of connective tissue plays an important role. The aim of this study was to determine the association of hypermobility syndrome with vesico-ureteric ...
متن کامل