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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute pyelonephritis (but not cystitis or "asymptomatic" bacteriuria) due to Escherichia coli induces serum antibodies to O-but rarely to K-antigens, especially not to the most common antigen, K1. Locally produced secretory IgA and IgG antibodies to O-and K-antigens appear in urine during most infections. The E. coli in urine of patients with asymptomatic bacteriuria are different from those in patients with acute pyelonephritis and cystitis and undergo continuous changes, presumably caused by the local antibody response. The E. coli become less virulent and are less able to attach to uroepithelial cells than E. coli causing acute symptomatic infections. Antibodies in urine prevent epithelial adherence. Parenteral and intravesicular injections of killed bacteria can protect against ascending pyelonephritis in rats. A few K-antigens dominate among E. coli that cause urinary tract infections. Vaccination of problem cases is a possibility because of the protective nature of K-antibodies. The mechanism of renal scarring that appears in some patients with urinary tract infections is unknown. Autoantibodies to the Tamm-Horsfall protein that increase after acute pyelonephritis or the cross-reactions noted between certain E. coli and antigens on the kidney may be involved.
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PMID:Antigens of Escherichia coli, human immune response, and the pathogenesis of urinary tract infections. 33 Jul 73

Pyelonephritis is accompanied by complex immunological reactions, the study of which is just now being undertaken. Study of 216 patients with a significant monomicrobial urinary infection showed that in more than 95 per cent of cases of Gram negative infection the urine contained IgG type antibodies, often associated with IgA. These antibodies may be easily detected using an immunofluorescent technique, which would appear to be the best method available at present for distinguishing between pyelonephritis and an infection of the lower urinary tract. They may also be found in the serum, though less frequently. Detection by immunofluorescence is markedly more sensitive than using the classical passive haemagglutination technique. The biological significance of these antibodies remains imprecise, and their protective or facilitating role may be discussed. Their specificity must be determined, in order that sequential study of these immunological reactions may be of help in the conduct of treatment.
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PMID:[Serum and urinary antibodies in pyelonephritis (author's transl)]. 33 Dec 41

In 105 adults with E.Coli urinary tract infections, IgG coated bacteriuria was found in 8/9 with acute pyelonephritis (PN), 17/20 with chronic PN, and in only 2/76 with lower UTI. IgA was present in 66% of PN, but IgA secretory piece in less than 10%. These urinary IgG antibodies were, at least in part, synthesised in the kidney because serum IgG antibodies were detected by indirect immunofluorescence in only half the patients. 06, 018, 022 E.Coli serotypes were the three most frequently found O groups, but their prevalence in PN is not significant. The immunology of urinary tract infection (UTI) is still a subject of little interest in adult nephrology; but antibody production is a well-characterised event in pyelonephritis (PN), the study of which seems to be the best indirect procedure for localising the site of UTI. We have analysed the production of urinary and humoral antibodies, and their correlation with E.Coli serotypes in patients with E.Coli UTI.
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PMID:Antibodies in Escherichia coli urinary tract infection. 34 Nov 44

In 138 adults with monomicrobial E. coli urinary tract infections, IgG coated bacteriuria (ACB) are found in 9/10 acute pyelonephritis, 21/24 chronic pyelonephritis, 2/5 acute prostatitis, and in only 6/99 lower UTI. These urinary antibodies are synthetised localy because IgA-S are found in 75%, in the kidney because humoral IgG antibodies are detected in only 40% of the ACB + patients. O6, O18, O22, O75, are the four most frequent O antigens (47,5%) and no difference were found in the distribution of O serotypes according to ACB production or clinical signs. But rough strains are significantly more frequent in pyelonephritis, suggesting a modification of the bacterial wall. The use of ACB test and O serotyping allows a better follow-up of patients, but relapses with ACB- and reinfection with ACB+ show the complexity of the relation host-E. coli.
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PMID:[Production of O antigens and antibodies during urinary tract infections due to Escherichia coli (author's transl)]. 37 88

Patients with ileal conduits frequently have bacteruria, and some have pyelonephritis with associated renal deterioration. We attempted to find a noninvasive technique that could be used to define the source of the bacteria in such patients. Neither the antibody-coated bacteria test nor the selective immunofluorescent antibody studies made this distinction. Quantitative immunoglobulin determinations performed on urine from ileal conduits containing either less or greater than 10(5) bacteria per ml showed IgA to be the predominant immunoglobulin. Urine from patients with permanent nephrostomy drainage who had known chronic upper urinary tract infection contained predominantly IgG. Inasmuch as several studies have shown that both normal urine and urine from patients with pyelonephritis contain more IgG than IgA, we conclude that the conduit added IgA to the urine. However, even this quantitative immunoglobulin technique is unable to identify the source of the bacteria. To do so would have required an invasive collection of upper tract urine. The occurrence of acute symptomatic pyelonephritis was rare during the 18 months of the study, but the urine of the one ileal conduit patient with acute pyelonephritis studied contained more IgG than IgA.
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PMID:Immunoglobulin in urine from ileal conduit and nephrostomy patients. 37 82

To investigate the presence of intraglomerular immunoprotein deposition in chronic pyelonephritis (CPN), 29 renal specimens from patients with various urological diseases were examined by immunofluorescence. The relationship between immunohistological findings and types of glomerular changes which were classified according to Heptinstall's criteria was studied. Only type 2 glomeruli, which were considered to be ischemic changes, demonstrated granular and globular depositions of IgM and C3 in the collapsed and solidified shrunken tufts. IgM was positive in 117 of 258 (45.3%), and C3 in 122 of 264 (46.2%) type 2 glomeruli. The distribution patterns of IgM and C3 were much the same. IgG and IgA were rarely observed and neither fibrinogen nor albumin was observed in the tufts of type 2 glomeruli. Normal glomeruli and other types of glomerular changes in CPN showed few or no intraglomerular immunoprotein deposition.
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PMID:Immunopathology of the glomerular changes in chronic pyelonephritis. 38 7

Using the fluorescent antibody test, the presence of antibody-coated bacteria in 10 out of 17 urine sediment samples from cattle infected with Corynebacterium renale is described. These antibodies were mainly of the immunoglobulin class IgG, and to a lesser extent IgA. This finding is characteristic for infections of the upper urinary tract (pyelonephritis). In seven samples no antibody coating of the bacterial surface was detected. In these cases an infection of the lower urinary tract (cystitis) is suggested.
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PMID:Antibody coated bacteria in urine sediment from cattle infected with Corynebacterium renale. 39 Aug 48

In the serum of patients with chronic pyelonephritis IgG, IgM, IgA, IgD and autoantibodies against organ- and species-specific renal antigens were determined. Clinical questions concerned relations to the activity of the disease and the renal function. The Ig-mean-values lying within the biological norm could be precised by taking into consideration individual biological boundary titres and relative ratio values. Pictures of tendency led to the estimation that increases of IgG and IgD appear in severely restricted renal function in normal or decreased IgM. Increases may be a criterion of activity in diseases with normal or slightly restricted renal function. IgA determinations remained without any evidence.-- Autoantibodies were found in 32,5%, increased titres were a sign of deteriorated renal function. The apparently given possibility of a humoral immunogramme for the chronic pyelonephritis is discussed, in which case a combination with other test parameters seems to be necessary.
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PMID:[The clinical value of unspecific humoral immune parameters. Attempt at an immunogram. 1. Quantitative determination of IgG, IgM, IgA and IgD and demonstration of antibodies against cell and tissue bound antigens in patients with chronic pyelonephritis]. 46 56

Girls with various forms of urinary tract infections and a reference material were analyzed for autoantibodies in serum to the Tamm-Horsfall glycoprotein. Such antibodies could be detected in all sera analyzed. In the control subjects cord blood contained very low IgA and IgM anti-TH, which increased significantly up to the age of 8 months. The IgG anti-TH levels in cord blood correlated with maternal levels. After the age of 2 months the IgG anti-TH followed the anti-TH levels of the other immunoglobulin classes. Among the infants aged 2 to 7 months with acute UTI, no anti-TH increases were found. In girls more than one year of age with acute nonobstructive UTI, IgG and IgA anti-TH levels were significantly higher in those with acute pyelonephritis and reflux, with or without parenchymal reduction, than in those with acute pyelonephritis and normal radiologic findings. The latter group had significantly higher levels of IgG and IgA but not IgM anti-TH than did those with acute cystitits. In contrast, girls with renal parenchymal reduction but no signs of infection at the time of testing had significantly depressed anti-TH levels compared to control values.
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PMID:Autoantibodies to Tamm-Horsfall protein associated with urinary tract infections in girls. 48 12

Although the systemic and local immune response to the O antigen of Escherichia coli has been well characterized, little information is available on the immune response to K anigen. Experimental hematogenous pyelonephritis was produced with Escherichia coli 06 K13 H1 and the serum and local (intrarenal) antibody response to O and K antigens was determined with the enzyme-linked immunosorbent assay. Both local and serum antibody responses to the K antigen were significantly less than that to the O antigen. The K antigen induced low titer IgM and IgG antibody responses in fewer than one-half of the animals and did not induce a local IgA response in any animal. In contrast, the O antigen induced local antibody responses in each of the immunoglobulin classes in all animals from day 9 of infection. Similarly, the serum IgM and IgG antibody titers to the K antigen were significantly less than those evoked in response to the O component of the Escherichia coli. No serum IgA anti-K antibodies were detected. These observations helf clarify the roles of these two antigens in pyelonephritis. Although the K antigen of Escherichia coli functions as a virulence factor in upper urinary tract infections, this antigen does not elicit a significant immune response, whereas the O antigen does induce a significant antibody response which could be of protective or diagnostic benefit.
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PMID:The local immune response to Escherichia coli O and K antigen in experimental pyelonephritis. 78 96


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