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    Protein deficiency may be marker for recurrent UTIs

    Low urinary NGAL concentration in children appears to be marker for susceptibility

    Editor's note: This article has been updated since its original publication to include additional study data and commentary from the author/presenter.

    Orlando, FL—Local deficiency in neutrophil gelatinase-associated lipocalin (NGAL) may be a contributing pathogenic factor for recurrent urinary tract infections (rUTIs) in some children, according to research from Boston Children’s Hospital reported at the AUA annual meeting in Orlando, FL.

    Urinary NGAL concentration was evaluated in a case-control study that included 15 pediatric patients (ages 1 month to 18 years) seen for rUTI in the department of urology at Boston Children’s Hospital, and 15 children who presented to the emergency department who served as normal controls. The cases were selected based on having a history of at least two UTI episodes and absence of a current UTI or features predisposing them to UTI. Controls had no history of UTI or renal abnormalities and were not affected with any acute conditions associated with NGAL elevation.

    Using immunoblotting, urinary NGAL was measurable in all of the rUTI patients. However, the mean NGAL concentration was significantly lower in the case group compared with the controls (21±10 ng/mL vs. 69±97 ng/mL). Similarly, the median NGAL concentration was also significantly lower among cases when compared with the controls (30 ng/mL vs. 60 ng/mL).

    “NGAL is upregulated within the uroepithelium in patients with UTI, and it is a critical component of the innate immune system that exhibits bacteriostatic activity through iron sequestration. Therefore, we hypothesized that localized NGAL deficiency within the uroepithelium may contribute to the development of rUTI by increasing environmental iron that is required for bacterial growth,” said first author Catherine S. Forster, MD, a pediatrics resident at Boston Children’s Hospital.

    Continue to the next page for more.

    Cheryl Guttman Krader
    Cheryl Guttman Krader is a contributor to Dermatology Times, Ophthalmology Times, and Urology Times.

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