Circulating inflammatory cytokine levels in hemolytic uremic syndrome

Catherine Litalien, François Proulx, Michelle M. Mariscalco, Pierre Robitaille, Jean P. Turgeon, Elaine Orrbine, Peter C. Rowe, Peter N. McLaine, Ernest Seidman

Research output: Contribution to journalArticlepeer-review

Abstract

Experimental data suggest that the host's inflammatory response is involved in the pathophysiology of verotoxin-producing Escherichia coli (VTEC)-associated hemolytic uremic syndrome (HUS). We compared the circulating levels of pro- [interleukin (IL)-6, IL-8] and anti-inflammatory [IL-10 and IL-1 receptor antagonist (Ra)] mediators on enrollment among children with HUS due to E. coli O157:H7, according to the severity of renal dysfunction. The latter was evaluated by the occurrence of oligoanuria, the requirement for dialysis, and a glomerular filtration rate (GFR) ≤ 80 ml/min per 1.73 m2 measured 1 year later. Increased levels of IL-6 (P < 0.0001), IL-10 (P < 0.0001), and IL-1Ra (P < 0.07) were found among patients with HUS compared with normal controls. Children with severe renal dysfunction also had tenfold increased levels of IL-6 and higher concentrations of IL-10 and IL-1Ra. Both the IL-6/IL-10 (4.9 ± 8.3 vs. 0.5 ± 0.4, P = 0.01) and the IL-6/IL-1Ra ratios (0.10 ± 0.20 vs. 0.01 ± 0.01, P = 0.04) were significantly increased. GFR correlated well with IL-6 levels, IL-6/IL-10 and IL-6/IL-1Ra ratios. Our data demonstrate that the inflammatory response of the host is associated with the severity of renal dysfunction during classic HUS. An imbalance between the pro- and the anti-inflammatory responses may be involved in the pathophysiology of VTEC-associated HUS.

Original languageEnglish (US)
Pages (from-to)840-845
Number of pages6
JournalPediatric Nephrology
Volume13
Issue number9
DOIs
StatePublished - Nov 1999

Keywords

  • Escherichia coli
  • Hemolytic uremic syndrome
  • Interleukin
  • Renal function

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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