Distinctive cytokine profile between acute focal bacterial nephritis and acute pyelonephritis
in children (
)
3 1
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
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
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. )
(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
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
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
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]
(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
[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
(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
2
* **
*** rs
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).
*
; 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
.
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