Saratov JOURNAL of Medical and Scientific Research

The diagnostic value of biomarkers of inflammation, angiogenesis and fibrogenesis to assess the severity of urodynamic obstruction in children with congenital megaureter

Year: 2012, volume 8 Issue: №4 Pages: 996-1001
Heading: Urology Article type: Original article
Authors: Morozov D.A., Krasnova E.I., Deryugina LA., Zakharova N.B., H'icheva Yu.A.
Organization: Saratov State Medical University, Clinical hospital n.a. S. R. Mirotvortsev SSMU, Moscow Research Institute of Pediatrics and Pediatric Surgery

The aim of the study is to determine the diagnostic value of urine biomarkers of inflammation (interleukin-1p, tumor necrosis factor-a), angiogenesis (vascular endothelial growth factor) and fibrogenesis (monocyte chemoattractant protein-1, matrix metalloproteinase-9) to assess the severity of urodynamic obstruction of the ureter. Materials and Methods — Complex investigation of 47 children with congenital nonrefluxing megaureter at the age from 1 month till 11 years is carried. Results. The correlation between the urine level of IL-1p and main laboratory criteria of inflammation occurred, so IL-1p as an integrative indicator of pyelonephritis activity was appeared. The relation between levels of VEGF and MCP-1 and indicators of renal hemodynamics allowed to consider increased levels of these factors as markers of irreversible nephrosclerosis. The urine level of MMP-9 was strongly correlated with parameters of peristalyic activity of the ureter. The group of children with lower peristalyic activity of the megaureter was significantly different from group with normal ureteral peristalsis by the high urine level of MMP-9. We do not have reliable data about the diagnostic value of determination of the urine level of TNF-a in children with congenital megaureter. Conclusion: The urine level of biological markers investigations are very important for clinical practice for determination of pyelonephritis activity (IL-1p), severity of ischemic deterioration of renal parenchyma (VEGF, MCP-1). Further studies are needed to clarify the pathogenic role of MMP-9 in the regulation of peristalyic activity of the ureter during embryonic and postnatal development in patients with congenital nonrefluxing megaureter.

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