Intestinal colonization resistance is associated with hyperoxaluria in the patients with recurrent pyelonephritis
| Main Authors: | Natalia Stepanova, Natalia Stashevska, Victoria Driianska, Mykola Kolesnyk |
|---|---|
| Format: | Proceeding eJournal |
| Bahasa: | eng |
| Terbitan: |
, 2017
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| Subjects: | |
| Online Access: |
https://zenodo.org/record/3345001 |
Daftar Isi:
- INTRODUCTION & OBJECTIVES: Hyperoxaluria and the violation of intestinal colonization resistance can be trigger factors in the formation of recurrent pyelonephritis. The aim of our study was to investigate the intestinal colonization resistance in the patients with recurrent pyelonephritis and hyperoxaluria. MATERIAL & METHODS: The observational cross-sectional study involved 64 women with recurrent pyelonephritis; the mean age was 31.6±7.7 years. According to the presence of hyperoxaluria, the women were allocated into two groups: the first group of the patients (n=35) had hyperoxaluria (˃44 mg in 24 hours) and the second one (n=29) didn’t have any hyperoxaluria. The control group consisted of 15 conditionally healthy donors. The state of the patients’ intestinal colonization resistance was evaluated by bacteriological study of feces, determination of sIgA and IgA against lipopolysaccharide (LPS) of gram-negative bacteria in saliva and levels of interleukins (IL) -4 - 17, -23 and monocytic chemotactic protein-1 (MCP-1) in the serum. The cytokines concentrations were analyzed using ELISA and STAT FAX-303 PLUS (Diaclon, France; DRG, Germany; Ukrmedservice, Ukraine). For the statistical analysis, we used the Student's t-test, nonparametric (U-test) Mann-Whitney and Pearson's rank correlation test. All the statistical analyses were performed using MedCalc. RESULTS: There were observed dysbiotic disorders of feces in all studied patients: 61 (95.3%) of the patients had a decrease in the number of indigenous microflora of the colon mucosa, and 20 (31.5%) of the women had the contamination opportunistic and pathogenic microorganisms. The comparative analysis of the composition of the microflora identified a significant decrease in the composition of bifidobacteria (p = 0.03) and lactobacteria (p = 0.0001) in the women with hyperoxaluria. Moreover, the level of daily urinary oxalate excretion was significantly correlated with the quantitative content of Lactobacillus spp. in the intestine of the patients (R= -0.57; P<0.0001). All the patients increased synthesis of sIg A and IgA against LPS of gram-negative bacteria in the saliva, as well as the concentration of the MSP-1, ІL-4, ІL-17 and IL-23 in the serum. The blood levels of IL-4, IL-17 and IL-23 in the women with hyperoxaluria were significantly higher compared with the nonhyperoxaluria patients: 62.2 [52.8-74.1] vs 44.5 [35.8-67] pg/ml (P=0.019), and 130.7 [101.3-231.2] vs 103.4 [77.5-133.9] (P=0.03), and 123.2±17.1 vs 80.98±29.4 (P=0.03), respectively. CONCLUSIONS: The status of intestinal colonization resistance of the patients with recurrent pyelonephritis and hyperoxaluria is characterized by a decrease in the content of indigenous microflora.