بررسي غلظت ادراري فاكتور مهار كننده مهاجرت ماكروفاژ به عنوان پيشگويي كننده احتمالي پيلونفريت حاد در كودكان مبتلا به عفونت دستگاه ادراري

The Evaluation of Urine Macrophage Migration Inhibitory Factor (MIF) in Children with Urinary Tract Infection: A Possible Predictor of Acute Pyelonephritis

Background: Urinary tract infection is the second most common bacterial infection amongst children which could lead to renal scars. It is supposed that during renal inflammation and all types of renal injury, macrophages infiltrate renal parenchyma, whereas their number is directly correlated with the intensity of inflammation. In fact, macrophage migration inhibitory factor (MIF) is widely expressed and secreted in response to inflammatory stimuli, and plays an important role in renal tissue injury. Yet, the role of MIF was not evaluated in patients with pyelonephritis in any studies. Therefore, the aim of our study was to compare urinary excretion of MIF in acute pyelonephritis, acute cystitis and also control group in order to find a noninvasive and sensitive method to differentiate between them. Materials and Methods: In this analytical cross-sectional study 31 children with urinary tract infection (25 patients with acute pyelonephritis, 8 patients with acute cystitis) and 40 healthy children were recruited. Sterile midstream urine samples were taken to measure MIF concentration in all patients and healthy individuals as well. Urine MIF concentration was determined by ELISA and corrected for urine creatinine. The data were analyzed using SPSS 13 software. Independent t-test, One Way ANOVA, correlation and Receiver Operating Curve (ROC) analysis were performed. Results: The mean ratio of urine MIF/Cr was 66.14(SEM=23.78) pg/|^mol creatinine in acute pyelonephritis patients, 1.58 (SEM=0.59) pg/Mmol creatinine in acute cystitis patients and 1.85 (SEM=0.35) pg/|nmol creatinine in healthy individuals. It was significantly higher in pyelonephritis patients than the ones in acute cystitis patients (P<0.001) and control group (P<0.001), respectively. ROC analysis demonstrated that urine MIF/Cr ratio could be considered as a potentially useful index to detect acute pyelonephritis among both healthy condition [P