ReviewPediatric nephrology (Berlin, Germany)2012
Susceptibility to acute pyelonephritis or asymptomatic bacteriuria: host-pathogen interaction in urinary tract infections.
Review in Pediatric nephrology (Berlin, Germany), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 109 citations in OpenAlex.
- The effect of vitamin A on renal damage following acute pyelonephritis in children: a meta-analysis of randomized controlled trials.Pediatric nephrology (Berlin, Germany) · 2016Pooled it
- Trial
- Why Does Prevention of Recurrent Urinary Tract Infection not Result in Less Renal Scarring? A Deeper Dive into the RIVUR Trial.The Journal of urology · 2019Trial
- Trial
- Development of a PapG-AcmA surface-associated antigen on Lactobacillus reuteri as a vaccine strategy against uropathogenic Escherichia coli.Archives of microbiology · 2026Article
- Temporal trends and geographical variations in pediatric urinary tract infections: a comprehensive analysis using the global burden of disease study 2021.Tropical medicine and health · 2025Article
- Infant urinary tract infection in Sweden - A national study of current diagnostic procedures, imaging and treatment.Pediatric nephrology (Berlin, Germany) · 2024Article
- Vesicoureteral Reflux and Innate Immune System: Physiology, Physiopathology, and Clinical Aspects.Journal of clinical medicine · 2023Review
- Effects of aging on urinary tract epithelial homeostasis and immunity.Developmental biology · 2023Review
- Febrile Urinary Tract Infections in Children: The Role of High Mobility Group Box-1.Children (Basel, Switzerland) · 2022Article
- The Impact of Lactobacillus Plantarum PCS26 Supplementation on the Treatment and Recurrence of Urinary Tract Infections in Children-A Pilot Study.Journal of clinical medicine · 2022Article
- Recurrent cystitis: patients' needs, expectations and contribution to developing an information leaflet - a qualitative study.BMJ open · 2022Article
- Ammonium chloride-induced acidosis exacerbates cystitis and pyelonephritis caused by uropathogenic E. coli.Physiological reports · 2022Article
- Urinary microRNAome in healthy cats and cats with pyelonephritis or other urological conditions.PloS one · 2022Article
- Naturopathic Management of Urinary Tract Infections: A Retrospective Chart Review.Journal of alternative and complementary medicine (New York, N.Y.) · 2021Article
- Metabolic acidosis exacerbates pyelonephritis in mice prone to vesicoureteral reflux.Physiological reports · 2020Article
- Innate immunity and urinary tract infection.Pediatric nephrology (Berlin, Germany) · 2020Review
- Serum and Urine Interleukin-6 and Interleukin-8 Levels Do Not Differentiate Acute Pyelonephritis from Lower Urinary Tract Infections in Children.Journal of inflammation research · 2020Article
- P2XPurinergic signalling · 2019Article
- Urinary tract infections (UTIs) or genital tract infections (GTIs)? It's the diagnostics that count.GMS hygiene and infection control · 2019Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Our knowledge of the molecular mechanisms of urinary tract infection (UTI) pathogenesis has advanced greatly in recent years. In this review, we provide a general background of UTI pathogenesis, followed by an update on the mechanisms of UTI susceptibility, with a particular focus on genetic variation affecting innate immunity. The innate immune response of the host is critically important in the antibacterial defence mechanisms of the urinary tract, and bacterial clearance normally proceeds without sequelae. However, slight dysfunctions in these mechanisms may result in acute disease and tissue destruction. The symptoms of acute pyelonephritis are caused by the innate immune response, and inflammation in the urinary tract decreases renal tubular function and may give rise to renal scarring, especially in paediatric patients. In contrast, in children with asymptomatic bacteriuria (ABU), bacteria persist without causing symptoms or pathology. Pathogenic agents trigger a response determined by their virulence factors, mediating adherence to the urinary tract mucosa, signalling through Toll-like receptors (TLRs) and activating the defence mechanisms. In ABU strains, such virulence factors are mostly not expressed. However, the influence of the host on UTI severity cannot be overestimated, and rapid progress is being made in clarifying host susceptibility mechanisms. For example, genetic alterations that reduce TLR4 function are associated with ABU, while polymorphisms reducing IRF3 or CXCR1 expression are associated with acute pyelonephritis and an increased risk for renal scarring. It should be plausible to "individualize" diagnosis and therapy by combining information on bacterial virulence and the host response.
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