Interleukin-6 and interleukin-8 as immunological markers of acute pyelonephritis activity in children

Acute pyelonephritis in children is an important issue in pediatrics, pediatric nephrology and clinical immunology, since the disease is associated with the risk of renal parenchymal affection, recurrent course and development of functional renal disorders. The aim of the study was to assess serum levels of IL-6 and IL-8 in children with acute pyelonephritis and to determine their diagnostic significance as immunological markers of infectious/inflammatory process activity. A total of 68 children with acute pyelonephritis aged 3 to 15 years were examined. The control group included 30 apparently healthy children of comparable age who underwent preventive examination. The diagnosis was based on complaints, medical history, clinical manifestations, complete blood counts, urinalysis, bacteriological urine examination and ultrasound examination of the urinary system. Serum levels of IL-6 and IL-8 were determined by ELISA technique. The results were presented as M ± m, and statistical significance was assessed at p 0.05. In children with acute pyelonephritis, fever was observed in 58 patients (85.3%); intoxication syndrome, in 54 patients (79.4%); leukocyturia, in 63 patients (92.6%); bacteriuria, in 49 patients (72.1%). The mean level of IL-6 in the main group was significantly higher than in apparently healthy children being increased to 28.6 ± 2.4 pg/mL versus 7.8 ± 0.9 pg/mL, respectively (p 0.001). The concentration of IL-8 was also significantly increased: 44.3 ± 3.6 pg/mL in the main group versus 12.5 ± 1.4 pg/mL in the control group (p 0.001). In children with pronounced fever and intoxication syndrome, IL-6 and IL-8 levels were higher than in patients with less severe disease activity. The obtained data indicate that acute pyelonephritis in children is accompanied by activation of systemic and local cytokine responses. Increased IL-6 reflects the severity of the systemic inflammatory reaction, whereas increased IL-8 is associated with neutrophilic activation and local inflammation in the urinary system. IL-6 and IL-8 may be considered additional immunological criteria for assessing the activity of acute pyelonephritis in children.

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