Seyed Mohammad Abedi1, Hamid Mohammadjafari2, Alireza Rafiei3, Sara Bazi4, Pooneh Yazdani5. 1. Department of Radiology, Mazandaran University of Medical Sciences School of Medicine, Pasdaran Avenue Sari, Iran. 2. Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences, Pasdaran Avenue Sari, Iran. 3. Molecular and Cell Biology Research Center, Department of Immunology, Mazandaran University of Medical Sciences School of Medicine, Pasdaran Avenue Sari, Iran. 4. Department of Pediatrics, Mazandaran University of Medical Sciences, School of Medicine, Pasdaran Avenue Sari, Iran. 5. Medical Student, Mazandaran University of Medical Sciences, Sari, Iran.
Abstract
OBJECTIVE: Urinary tract infection occurs in 1.8-6.6% of children under 6 years old. The aim of this study was to assess the urinary concentrations of matrix metalloproteinase 9 (MMP9) and tissue inhibitor of metalloproteinase 1 (TIMP1), in children with acute pyelonephritis (APN) and the potential to develop renal scarring. MATERIAL AND METHODS: Children who had experienced an episode of APN were divided into 2 groups. Group 1 included children with APN who exhibited scarring and group 2 included children with APN who had a normal 99mTechnetium dimercaptosuccinic acid scan. Urinary levels of MMP9 and TIMP1 were measured in the acute phase of infection. A receiver operating characteristic curve was generated to allow calculation of cut-off values. RESULTS: Sixty-one children were enrolled across the 2 groups: group 1 contained 16 patients (all female); group 2, 38 children (36 female and 2 male). Urinary levels of MMP9 and TIMP1 were significantly higher in group 1 than in group 2 (p=0.037 and 0.022 respectively). For comparison of groups 1 and 2, the cut-off values were measured as 75.5 ng/mL (sensitivity 62.5%, specificity 71.1%, positive predictive value, PPV, 48%, negative predictive value, NPV, 82%), 16.1 ng/mL (sensitivity 75%, specificity 55.3%, PPV 41%, NPV 84%), and 1310.7 ng/mL (sensitivity 75% specificity 60.5%, PPV 44%, NPV 85%) for MMP9, TIMP1, and MMP9×TIMP1 levels, respectively. CONCLUSION: Evaluation of urinary MMP9 and TIMP1 levels may help to identify children with APN who are at risk of developing renal scarring.
OBJECTIVE: Urinary tract infection occurs in 1.8-6.6% of children under 6 years old. The aim of this study was to assess the urinary concentrations of matrix metalloproteinase 9 (MMP9) and tissue inhibitor of metalloproteinase 1 (TIMP1), in children with acute pyelonephritis (APN) and the potential to develop renal scarring. MATERIAL AND METHODS: Children who had experienced an episode of APN were divided into 2 groups. Group 1 included children with APN who exhibited scarring and group 2 included children with APN who had a normal 99mTechnetium dimercaptosuccinic acid scan. Urinary levels of MMP9 and TIMP1 were measured in the acute phase of infection. A receiver operating characteristic curve was generated to allow calculation of cut-off values. RESULTS: Sixty-one children were enrolled across the 2 groups: group 1 contained 16 patients (all female); group 2, 38 children (36 female and 2 male). Urinary levels of MMP9 and TIMP1 were significantly higher in group 1 than in group 2 (p=0.037 and 0.022 respectively). For comparison of groups 1 and 2, the cut-off values were measured as 75.5 ng/mL (sensitivity 62.5%, specificity 71.1%, positive predictive value, PPV, 48%, negative predictive value, NPV, 82%), 16.1 ng/mL (sensitivity 75%, specificity 55.3%, PPV 41%, NPV 84%), and 1310.7 ng/mL (sensitivity 75% specificity 60.5%, PPV 44%, NPV 85%) for MMP9, TIMP1, and MMP9×TIMP1 levels, respectively. CONCLUSION: Evaluation of urinary MMP9 and TIMP1 levels may help to identify children with APN who are at risk of developing renal scarring.
Authors: Craig A Peters; Steven J Skoog; Billy S Arant; Hillary L Copp; Jack S Elder; R Guy Hudson; Antoine E Khoury; Armando J Lorenzo; Hans G Pohl; Ellen Shapiro; Warren T Snodgrass; Mireya Diaz Journal: J Urol Date: 2010-07-21 Impact factor: 7.450
Authors: Edyta Tenderenda; Walentyna Zoch-Zwierz; Anna Wasilewska; Tadeusz Porowski; Katarzyna Taranta-Janusz; Zbigniew Kołodziejczyk; Joanna Michaluk-Skutnik Journal: Pol Merkur Lekarski Date: 2009-07
Authors: Alejandro Hoberman; Martin Charron; Robert W Hickey; Marc Baskin; Diana H Kearney; Ellen R Wald Journal: N Engl J Med Date: 2003-01-16 Impact factor: 91.245