Distinctive cytokine profile between acute focal bacterial nephritis and acute pyelonephritis in children ( )

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(1)

Distinctive cytokine profile between acute focal bacterial nephritis and acute pyelonephritis

in children (

)

3 1

(2)
(3)

1.

acute focal bacterial nephritis : AFBN)

(urinary tract infection : UTI)

(acute pyelonephritis : APN) AFBN UTI

AFBN

2009 2016

UTI CT AFBN (n = 17)

APN (n = 21) 38

AFBN APN

AFBN APN

2

AFBN APN IFN (interferon) -

IL (interleukin) -6 IL-10 TNF (tumor necrosis factor) 1

(sTNFR1) ( p < 0.05)

IFN-

IL-6 AFBN APN

AUC= 0.86

4 APN AFBN

IFN- IL-6 AFBN APN

2.

(acute focal bacterial nephritis : AFBN)

(urinary tract infection : UTI) [1]

AFBN (Computed

(4)

Tomography: CT) [2,3]

(acute pyelonephritis : APN) [4,5] AFBN

CT AFBN

AFBN [6,7]

CT AFBN

APN AFBN

[6,7]

AFBN APN

AFBN APN

[8,9]

AFBN APN

[10,11] AFBN APN

AFBN CT

[10,11] AFBN

APN [12]

AFBN APN CT

AFBN (interferon: IFN) -

[13] AFBN APN

AFBN APN

AFBN APN

(procalcitonin : PCT) IFN- (interleukin: IL)-6

. 3-1)

2009 1 2016 4

(5)

15 UTI 52 1

> 38.0

(n = 52) / CT

(n = 23)

5×104 / mL [14]

19 AFBN 33 APN

14 CT

17 AFBN 21 APN ( 1

AFBN) AFBN

(

) 2 (

) 1 APN

2

( 6 2 1

1 1 1 )

(No. 2013-205-3)

3-2)

-20

Sysmex XN-3000 (Sysmex corporation )

C (C-reactive protein : CRP)

2- 2 2MG) 2MG 1-

1 1MG) JCA-BM6070 (

)

D- Coapresta 2000 (Sekisui medical corporation

) PCT Cobas

8000 (Roche Diagnostics K.K. )

(6)

(electro-chemiluminescence immunoassay : ECLIA) N-

NAG) JCA-BM6070

(liver-type fatty acid binding protein : L-FABP) (Lumipulse) G1200

(Fujirebio corporation )

(chemiluminescent enzyme immunoassay : CLEIA) JCA-BM 6070

(creatinine : Cr) CRP < 0.15

mg /dL PCT < 0.05 ng /mL 6.0 80.0 ng /mL 2MG < 2.0

mg /L 2 1 Cr < 0.68 g /L NAG

0.9 2.4 U /gCr

IL-2 IL-4 IL-6 IL-10

BD Cytometric Bead Array Th1 / Th2 II (BD Biosciences San Jose CA USA)

TNF- 1 (soluble TNF-receptor 1 : sTNFR1) sTNFR1 /

TNFR SF1A Quantikine (ELISA) (R D

Systems Minneapolis MN USA)

IL-2 IL-4 2.6 pg /mL IL-6 3.0 pg /mL IL-10 sTNFR1 1.2 pg /mL

3-3)

(

[SD]) [15] UTI 2

(vesicoureteral reflux : VUR) 4

(99mtechnetium dimercaptosuccinic acid renal scan)

[16] 45

3-4)

IL-6 IL-10

(7)

PCT 2MG/ Cr

AFBN APN

sTNFR1

2.5 ( )

AFBN APN

StatFlex Ver6.0 (Artech Co. )

. 4-1)

1 AFBN APN

AFBN APN

(p = 0.013) (p = 0.0032) (p = 0.0003)

(p = 0.019)

(p = 0.0015) (p = 0.0004) (p = 0.039) PCT (p = 0.001) 2MG/ Cr (p = 0.014) APN AFBN

AFBN APN

APN (p = 0.021)

AFBN (p = 0.038) AFBN

AFBN APN

( , 1.85, 1.77 4.48 vs. -0.195, 2.92 1.88, p = 0.016) VUR

UTI 4 AFBN APN

( 63 vs. 32 50 vs. 33 )

AFBN APN

(8)

4-2) AFBN APN

AFBN APN

( 2) AFBN APN IL-6 ( 162 vs. 63.7 pg /mL

p < 0.001) IL-10 (18.7 vs. 3.7 pg /mL p = 0.004)

p = 0.005) sTNFR1 (4,100 vs. 3,400 pg /mL p = 0.006)

AFBN IL-6 (p = 0.023) IL-10

(p = 0.0068) sTNFR1 (p = 0.0002)

IL-2 IL-4 3

UTI 4

8 1

2 AFBN APN

( 3) IL-6 sTNFR1 IL-6

5 (5/12 = 0.42; PCT

sTNFR1) 5 (5/12 = 0.42;

2MG/ Cr sTNFR1) sTNFR1

7 (7/12 = 0.58; 2MG/ Cr IL-6

IL-10 )

4-3) AFBN APN

AFBN APN

(multiple logistic regression analysis : MLRA)

IL-6 AFBN APN

95

(confidence interval : CI) (odds ratio : OR) 1.87 (1.11

3.16) IL-6 OR 2.64 (1.22 5.74) ( 2)

p AFBN IL-6

AFBN (area under the

curve : AUC) 0.86 2 IL-6

(9)

AUC 0.77 0.82 ( 4)

.

IL-6 IL-10 sTNFR1

AFBN APN

IL-6 AFBN APN

IL-6 AFBN APN

AFBN 2

Kashiwagi AFBN IL-6 IL-10

[13] Kometani (mild encephalopathy with reversible splenial lesion : MERS) 2 AFBN

IL-6 [17]

AFBN APN

APN AFBN

IL-6 IL-10 sTNFR1

AFBN APN

[8,10] [3]

PCT

2MG/ Cr APBN APN

AFBN

3 ( )

sTNFR1 IL-10

[18,19]

AFBN APN

PCT

Tahar APN

PCT [20]

(10)

(LPS) IL-1 IL-6

[21] UTI PCT IL-6

(human leukocyte antigen : HLA) I

2MG 2MG

[22,23] 2MG 4.5 mg/ L

2MG [24] 2MG

2MG [25] AFBN

APN 1MG/Cr NAG/Cr L-FABP/Cr

AFBN

2MG

AFBN APN

UTI

AFBN

UTI [26-28]

IL-6 IL-10

[29] AFBN APN

IL-6 [30]

IL-10 [31,32]

AFBN

[33]

CD8+ T

[34] CD8+ T

[35,36]

CD4 CD8

(major histocompatibility complex : MHC) I II

(11)

[37]

APN AFBN

AFBN CT APN 81 (17 )

CT

.

IL-6 IL-10 sTNFR1 UTI

IL-6 APN AFBN

( 2) UTI IL-6

AFBN APN

AFBN AFBN

(12)
(13)

(IL-6; < 3.0 pg / mL; IL-10; < 2.8 pg / mL;

sTNFR1; < 1.2 pg / mL)

AFBN APN (pg / mL) IL-6

162, 23.4- 591 (n = 17) vs 63.7, 15.2- 362 (n = 21) vs 23.8, 2.4- 648 (n = 12) IL-10 18.7, 1.60- 377 (n = 17) vs 3.7, 2.70- 109 (n = 21) vs 2.8, 1.9- 27 (n = 12)

94.0, 8.7- 1,510 (n = 17) vs 27.1, 0- 307 (n = 21) vs 12.8, 4- 43.6 (n = 12) sTNFR1 4,760, 2,710- 8,420 (n = 16) vs 3,420, 1,960- 6,590 (n = 21) vs 2,640, 1,670- 4,130 (n = 12)

AFBN APN

(14)

2

* **

*** rs

(15)

AUC: area under the curve.

: (AUC 0.77 ± SD 0.077).

: IL-6 (AUC 0.82 ± SD 0.075).

: & IL-6 (AUC 0.86 ± SD 0.059).

(16)

*

; AFBN: APN: ; 16:21:8

16:20:8 17:20:12 13:17:12 17:20:12

17:11:11 D 17:21:10 9:8:0 2 MG 8:7:0

b 2 MG 13:12:0 1 MG 7:7:0 NAG 13:11:0 L-FABP 6:6:0

17:8:0 14:15:0

(17)

.

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