Urine Interleukin-1β Can Be Used for Early Prediction of Urinary Tract Infection in Children

Öz

Objective: Interleukin 1 beta (IL-1β) is an essential proinflammatory mediator emerging early in bacterial infection. Urinary tract infections (UTI) are one of the most common bacterial infections during childhood. This prospective study aimed to explore whether urine levels of IL-1β could be used as a biomarker of UTI. The study also aimed to define the optimal cut-off level for urine IL-1β to detect UTI in children. Material and Method: Sixty patients with symptomatic UTI and 29 healthy controls were registered in the study. After taking informed consent, urine culture, urinalysis, serum urea and creatinine, C-reactive protein (CRP) and serum white blood cell count measurements were performed in both groups. Urine IL-1β was analyzed by enzyme-linked immunosorbent assay. Results: The mean urine IL-1β level was significantly greater in the UTI group than in the controls (21.14 pg/ml vs 2.60 pg/ml, p=0.0001), and using a cut-off of 6.11 pg/ml for urine IL-1β for early prediction of UTI, sensitivity and specificity were 100% and 93.1%, respectively (AUC: 0.971). The mean urine IL-1β/creatinine ratio (uIL-1β /Cr) was also significantly greater in the UTI group (46.87 pg/mgCr vs 3.29 pg/mgCr; p=0.0001), and using a cut-off of 9.45 pg/mgCr for uIL-1β/Cr for early prediction of UTI, sensitivity, and specificity were 96.7% and 89.7%, respectively (AUC: 0.963). Conclusion: Both urine IL-1β and uIL-1β/Cr can be used as a sensitive biomarker for early prediction of UTI. Further research with larger groups is necessary to support our results.

Anahtar Kelimeler

• Interleukin 1 beta (IL-1β)
• urinary tract infections (UTI)
• biomarker

İdrar İnterlökin-1β Düzeyi Çocuklarda İdrar Yolu Enfeksiyonun Erken Belirteci Olarak Kullanılabilir

Öz

Amaç: İnterlökin 1 beta (IL-1β) bakteriyel enfeksiyon sırasında erken görülen önemli bir proinflamatuar mediatördür. İdrar yolu enfeksiyonları (İYE), çocuklarda görülen en yaygın bakteriyel enfeksiyonlardan biridir. Bu prospektif çalışmanın amacı, idrar IL-1β seviyelerinin İYE’ nin güvenilir bir belirleyicisi olarak kullanılıp kullanılamayacağını araştırmak ve çocuklarda İYE’nin erken teşhisinde, idrar IL-1β için optimum kestirim seviyesini belirlemektir. Gereç ve Yöntem: Semptomatik İYE olan 60 hasta ve 29 sağlıklı kontrol çalışmaya dahil edildi. Bilgilendirilmiş onam alındıktan sonra her iki grupta idrar kültürü, idrar tahlili, serum üre ve kreatinin, C-reaktif protein (CRP) ve serum beyaz küre sayımı analizleri yapıldı. İdrar IL-1β, enzim bağlı immünosorbent (ELISA) analizi ile ölçüldü. İYE hastalarında, dimerkaptosüksinik asit (DMSA) radyonüklid taraması yapıldı. Bulgular: Ortalama idrar IL-1β seviyesi İYE grubunda kontrol grubundan anlamlı derecede yüksekti (21,14 pg/ml’ye karşı 2,60 pg/ml, p=0,0001) ve idrar IL-1β için 6,11 pg/ml’lik bir kestrim kullanılarak İYE’nin erken tanısında duyarlılık ve özgüllük sırasıyla %100 ve %93,1 idi (AUC:0,971). Ortalama idrar IL-1β/kreatinin oranı (uIL-1β/Cr) de İYE grubunda anlamlı şekilde daha yüksekti (46,87 pg/mgCr - 3,29 pg/mgCr; p=0,0001) ve uIL1β/Cr için mgCr için 9,45 pg/mg kestirim kullanılarak, İYE’nin erken tanısında, duyarlılık ve özgüllük sırasıyla %96,7 ve %89,7 idi (AUC: 0,963). Sonuç: Hem idrar IL-1β hem de uIL-1β/Cr, İYE’nin erken tanısı için hassas bir belirteç olarak kullanılabilir. Sonuçlarımızı doğrulamak için daha büyük hasta grupları ile daha fazla araştırma yapılması gerekmektedir.

Anahtar Kelimeler

• İnterlökin1 beta (IL-1β)
• idrar yolu enfeksiyonları (İYE)
• biyobelirteç

Kaynakça

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