Pediatric Nephrology

, Volume 29, Issue 7, pp 1139–1149

The innate immune response during urinary tract infection and pyelonephritis

  • John David Spencer
  • Andrew L. Schwaderer
  • Brian Becknell
  • Joshua Watson
  • David S. Hains
Review

Abstract

Despite its proximity to the fecal flora, the urinary tract is considered sterile. The precise mechanisms by which the urinary tract maintains sterility are not well understood. Host immune responses are critically important in the antimicrobial defense of the urinary tract. During recent years, considerable advances have been made in our understanding of the mechanisms underlying immune homeostasis of the kidney and urinary tract. Dysfunctions in these immune mechanisms may result in acute disease, tissue destruction and overwhelming infection. The objective of this review is to provide an overview of the innate immune response in the urinary tract in response to microbial assault. In doing so, we focus on the role of antimicrobial peptides—a ubiquitous component of the innate immune response.

Keywords

Urinary tract infection Pyelonephritis Innate immunity Antimicrobial peptides Toll-like receptors Chemokines Cytokines 

Abbreviations

AMP

Antimicrobial peptides

DC

Dendritic cells

HBD1

Human beta defensin 1

HBD2

Human beta defensin 2

HD5

Human alpha-defensin 5

HNP

Human neutrophil peptides

RNase 7

Ribonuclease 7

SLPI

Secretory leukocyte protease inhibitor

THP

Tamm–Horsfall protein

TLR

Toll-like receptor

UPEC

Uropathogenic Escherichia coli

UTI

Urinary tract infection

VUR

Vesicoureteral reflux

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Copyright information

© IPNA 2013

Authors and Affiliations

  • John David Spencer
    • 1
    • 2
    • 3
  • Andrew L. Schwaderer
    • 1
    • 2
    • 3
  • Brian Becknell
    • 1
    • 2
    • 3
  • Joshua Watson
    • 4
  • David S. Hains
    • 1
    • 2
    • 3
  1. 1.Department of Pediatrics, Division of NephrologyNationwide Children’s HospitalColumbusUSA
  2. 2.Center for Clinical and Translational ResearchThe Research Institute at Nationwide Children’s HospitalColumbusUSA
  3. 3.Kidney Innate Immunity Research GroupThe Research Institute at Nationwide Children’s HospitalColumbusUSA
  4. 4.Department of Pediatrics, Division of Infectious DiseaseNationwide Children’s HospitalColumbusUSA

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