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

The adhesion of Escherichia coli to human urinary tract epithelial cells was inhibited by commercial gamma globulin, the total immunoglobulin fraction of human breast milk and urine, as well as the isolated immunoglobulin G and secretory immunoglobulin A fractions of urine from patients with acute pyelonephritis. Urinary anti-O6 antibodies reduced the adhesion of several O6 strains. Absorption of antibodies to the lipopolysaccharide of the adhering strain markedly decreased the antiadhesive capacity of all the immunoglobulin preparations, whereas elimination of antibodies to the capsular polysaccharide antigen consistently had a small but not significant effect. When urine was absorbed with whole, live bacteria of the patients' infecting strains, the antiadhesive effect completely disappeared. Absorption with bacteria lacking pili only partially reduced this effect.
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PMID:Secretory immunoglobulin A and G antibodies prevent adhesion of Escherichia coli to human urinary tract epithelial cells. 8 3

The sequential appearance of antibody-coated bacteria in urinary sediment was followed in experimental pyelonephritis produced with Escherichia coli O6:K13:H1. It was possible to determine against which antigen of the organism this antibody was directed. Antibody-coated bacteria appeared by day 11 of infection, a time which coincided with the synthesis of local (intrarenal) antibody. Bacteria coated with antibody more than three days after serum antibody but four days before urinary antibody appeared. Antibody eluted from coated bacteria was directed against the O-antigen of the infecting organism but not the K-antigen. Newly synthesized intrarenal antibody and urinary antibody were directed only against O-antigen, but not against K-antigen; this finding would explain why the antibody that coated the bacteria was antibody to lipopolysaccharide. Thus, a positive test for antibody-coated bacteria indicates that a local immune response to O-antigen has occurred. It is postulated that this immune response could relate to the clinical symptomatology of acute symptomatic pyelonephritis since most patients presenting with acute pyelonephritis have bacteria coated with antibody.
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PMID:Significance of antibody-coated bacteria in urinary sediment in experimental pyelonephritis. 32 77

Vaccination with formalin-treated cells of Escherichia coli serotype O6 protected against unilateral retrograde pyelonephritis due to E. coli O6 in rats with partial ureteral obstruction. This protection was manifested not only by less parenchymal destruction and shrinkage of the pyelonephritic left kidney, but also by less secondary pyelonephritis and compensatory hypertrophy in the opposite right kidney. Vaccinated rats eliminated E. coli from the kidney more rapidly, but even when infection persisted in the kidney, the chronic pyelonephritis was less severe in vaccinated rats. High levels of antibody to E. coli lipopolysaccharide were found in vaccinated animals and may have contributed to protection. These results raise the question of whether vaccination ought to be considered for patients predisposed to chronic bacterial pyelonephritis.
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PMID:Immunization against retrograde pyelonephritis. III. Vaccination against chronic pyelonephritis due to Escherichia coli. 33 1

The response of circulating and infected kidney lymphocytes to the O (lipopolysaccharide) and K (polysaccharide) antigens of an Escherichia coli O6 K 13 H1 strain was determined. Both circulating and kidney lymphocytes showed significant incorporation of [3H-methyl]thymidine into DNA when incubated with the O antigen, whereas neither responded to the K antigen. The lipid moiety of the lipopolysaccharide was required for lymphocyte responsiveness. Upon sequential incubation of O antigen and fluoresceinated homologous antiserum, 24-30 per cent of kidney lymphocytes were shown to have surface receptors for O antigen, whereas none had surface receptors for K antigen. Although the K antigen is an important determinant of invasiveness of the upper urinary tract, it fails to elicit a cellular immune response or attach to lymphocytes from the infected kidney in experimental pyelonephritis.
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PMID:Local immunie response in experimental pyelonephritis in the rabbit. III. Lymphocyte responsivieness to O and K antigens of Escherichia coli. 78 43

The response of circulating and kidney lymphocytes from rabbits with experimental haematogenous pyelonephritis to somatic (O) antigen (lipopolysaccharide) from the infecting organism was evaluated. Lymphocytes were cultured for 3 days in the presence and absence of lipopolysaccharide from the infecting organism, Escherichia coli O75 and a heterologous organism. Circulating lymphocytes showed a significant response to the homologous lipopolysaccharide by day 5 of infection, and kidney lymphocytes responded by day 19 of infection but failed to respond after day 33. The lipid moiety of somatic antigen was required for the stimulation of lymphocytes since antigen preparations in which lipid was low or absent did not activate lymphocytes. B lymphocytes from kidney were stimulated by this antigen whereas both T and B circulating lymphocytes responded. Thus, pyelonephritis in rabbits is associated with the activation of a subpopulation of circulating cells which have specific receptors for the homologous antigen. B lymphocytes that are specifically activated by the homologous or O antigen then localize to the infected site.
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PMID:Local immune response in experimental pyelonephritis in the rabbit. II. Lymphocyte stimulation by lipopolysaccharide of infecting organism. 110 73

A BALB/c mouse model of nonobstructive, ascending Proteus mirabilis pyelonephritis was characterized bacteriologically, histologically, and serologically from 3 to 28 days. Intravesicular administration of 2 X 10(8) P. mirabilis K7 resulted in the septic death of 9 (16%) of 57 mice by day 15. Among the survivors, K7 colonized the kidneys in great numbers until day 21. Histological examination of the kidneys revealed acute inflammation which was characterized by neutrophil infiltration by day 3, renal necrosis by day 7, and fibroblastic infiltration by day 14 which persisted at least until day 28. The immunoglobulin G response to the outer membrane proteins (OMP) was assessed by enzyme-linked immunosorbent assay and Western blotting (immunoblotting). Anti-OMP immunoglobulin G antibodies were detected as early as day 7, and the reciprocals of their titers rose progressively up to day 28 (i.e., greater than or equal to 500). This model was also used to assess the efficacy of OMP and lipopolysaccharide (LPS) immunization in preventing renal infection. K7 OMP or LPS (100 micrograms) preparations were administered intramuscularly in Freund's complete adjuvant. After 2 weeks, mice were intravesicularly challenged with 2 X 10(8) bacteria of the homologous K7 strain or one of four heterologous strains. Compared with the saline-immunized control group and K7 LPS-immunized mice, K7 OMP recipients were protected from death when challenged by homologous or heterologous strains. In addition, K7 OMP recipients were protected (P less than 0.003) from subsequent renal infection when challenged by the K7 strain and had more rapid bacterial renal clearance when challenged by three of four heterologous strains. OMP recipients produced antibodies which bound major OMP moieties (viz., 36- to 39-kDa cell wall constituents) as assessed by Western blotting. These results support the concept that immunization with selected bacterial protein surface coat constituents can prevent uromucosal infection by interfering with colonization or renal injury.
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PMID:Efficacy of a Proteus mirabilis outer membrane protein vaccine in preventing experimental Proteus pyelonephritis in a BALB/c mouse model. 189 76

Anemia develops in about a fourth of women whose pregnancy is complicated by pyelonephritis, although its exact mechanism has not been defined clearly. In this study of 18 women with antepartum pyelonephritis, although only a third had anemia (hematocrit less than 30 vol/dl), there was evidence for hemolysis in all 18. Specifically there was a mean decrease in hematocrit of 5 vol/dl from admission to discharge. With scanning electron microscopy, we compared erythrocyte morphologic aberrations that were found in women with renal infection with those of normally pregnant women, and the former had significantly increased proportions of echinocytes in particular, but schistocytes and spherocytes were increased also (total 10.3% vs 1.4%, p less than 0.0001). These changes, especially echinocytosis, have been induced in vitro by lipopolysaccharide, and they are known to lead to premature red blood cell destruction in vivo. We conclude that hemolysis with subsequent anemia in pregnant women with pyelonephritis is caused by lipopolysaccharide-induced red blood cell membrane damage.
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PMID:Mechanisms of hemolysis and anemia associated with acute antepartum pyelonephritis. 199 6

Recent retrospective surveys have supported previous investigations in demonstrating the incidence of UTI during infancy; 0.3% to 1.2% of infants develop symptomatic UTI during the first year of life. Boys are more commonly infected during the first 3 months of life. After the first year, symptomatic UTI is much more frequent among girls. Similarly, asymptomatic bacteriuria is more frequently detected in boys than in girls during the first 12 months of life. Thereafter, the incidence decreases markedly in boys but increases in girls. Recent investigations indicate that lack of circumcision is a risk factor for UTI among male infants. Recurrent UTI is common and frequently asymptomatic. The most important microbiologic factor that is associated with E. coli causing acute pyelonephritis is adherence mediated by P fimbriae. Other factors, such as capsule, lipopolysaccharide, aerobactin production, and serum resistance, also determine the invasiveness of E. coli. Vesicoureteral reflux appears to be an important host factor predisposing to UTI. Microbiologic and host factors that are determinants of renal scarring are under investigation.
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PMID:Epidemiology and natural history of urinary tract infections in children. 199 34

Sixty-three Escherichia coli strains isolated from neonatal sepsis or meningitis were studied and compared with previous data on fecal or urinary pyelonephritis-associated isolates from children. Characteristics significantly associated with neonatal infection were capsular type K1 (54%), O group 18 (27%), rough-type lipopolysaccharide together with K1 capsule (19%), and S fimbriae (29%). Within the neonatal infection group, the K1 capsule and rough lipopolysaccharide were most common among the youngest infants (0 to 21 days old) and in meningitis. Hemolysin production, P fimbriae, and X adhesions (adhesions not identifiable as type 1, P, or S) were significantly more common in the two materials from infections as compared with the fecal isolates. One large clone of 11 strains (O18:K1:H7, with both type 1 and S fimbriae) and three smaller ones (O7:K1:H1 and O6:K2:H1, both with type 1 and P fimbriae and X adhesions; and R:K1:H33 with no adhesions) were identified among the strains from neonatal infections. Only O6:K2:H1 strains were also common among the strains from pyelonephritis.
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PMID:Serotypes, hemolysin production, and receptor recognition of Escherichia coli strains associated with neonatal sepsis and meningitis. 258 Jul 92

Most human pyelonephritis Escherichia coli isolates express both mannose (MS)- and globoside (Gal-Gal)-binding pili. An ascending E. coli urinary tract infection model was established in the 16-wk-old female BALB/c mouse to compare the pathogenic significance of MS and Gal-Gal pili and their efficacy as vaccines for the prevention of pyelonephritis. The distribution and density of pilus receptor compounds in urogenital tissues and as soluble compounds in urine were determined with antibodies to the synthetic receptor analogues, alpha D-Gal(1----4) beta D-Gal and alpha D-Man(1----2) alpha D-Man. Both carbohydrates were detected in vagina, bladder, ureter, and renal pelvis epithelium and in collecting duct and tubular cells. A pilus receptor compound also was detected in urine. It competitively inhibited the binding capacity of MS pili and was found to be physically, chemically, and immunologically related to Tamm-Horsfall uromucoid. Infectivity and invasiveness were quantitatively and histologically characterized for four E. coli strains: J96, a human pyelonephritis strain that expresses both MS and Gal-Gal pili; two recombinant strains prepared from J96 chromosomal DNA encoding MS pili or Gal-Gal pili; and the nonpiliated K12 recipient. Intravesicular administration of J96 (10(6) colony-forming units [CFU]) resulted in renal colonization and invasion in each of nine mice. The Gal-Gal clone (10(6) CFU) colonized the kidneys in each of 10 mice but did not invade. In contrast, the MS clone (10(6) CFU) did not colonize renal epithelium or invade. This effect was superceded when larger doses (greater than or equal to 10(10) CFU) of the MS clone were administered in volumes that cause acute vesicoureteric reflux. The efficacy was determined of vaccines composed of pure MS or Gal-Gal pili or the lipopolysaccharide containing O somatic antigen of the challenge strain, J96. The Gal-Gal pilus vaccine blocked renal colonization in 19 of 22 mice and renal invasion in 10 of 11 mice. Gal-Gal pili may be useful immunogens for the prevention of pyelonephritis in anatomically normal urinary tracts.
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PMID:Molecular basis of Escherichia coli colonization of the upper urinary tract in BALB/c mice. Gal-Gal pili immunization prevents Escherichia coli pyelonephritis in the BALB/c mouse model of human pyelonephritis. 285 30


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