Abstract
We evaluated the protective effects of probiotic administration as a prophylaxis treatment and immediately after fever onset in increasing the immune response and decreasing the renal scarring in a rat model of acute pyelonephritis. Twenty-four rats were apportioned to three groups. In GI (n = 8), the rats were injected with direct inoculation of Escherichia coli into the right kidney. In GII (n = 8), the rats received a probiotic regimen 1 month before E. coli injection and the probiotic regimen was continued for the next 2 months. In GIII (n = 8), the probiotic regimen was started just after E. coli injection and was continued for 2 months. Technetium-99m-DMSA renal scan, histopathological evaluations, concentrations of CA19-9, IgA, blood urea nitrogen (BUN), and creatinine were assessed 1 and 2 months post-injection. It took an average of 4.2 ± 1.1 h between the injection and onset of fever in GI and GII. In GIII, this period was longer (7.5 ± 1.4). Probiotic administration resulted in reduction of interstitial fibrosis and tubular and glomerular atrophy in GII in all follow-ups. Technetium-99m-DMSA renal scan showed that the right kidney reached near the normal cortical integrity (47%) in GII compared to GI (32%) after 2 months of injection. However, the renal integrity did not improve significantly in GIII (41%). In GII, CA19-9 was lower (p < 0.05), while the levels of serum and fecal IgA were higher (p < 0.05). Administration of the probiotic regimen in the rat model may decrease renal damage in pyelonephritis. In spite of better results in the prophylactic group compared to the treatment group, no strong evidence was found to prove the advantage of its prophylactic application over the treatment administration.
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Abbreviations
- APN:
-
Acute pyelonephritis
- UTI:
-
Urinary tract infection
- E. coli :
-
Escherichia coli
- IgA:
-
Immunoglobulin A
- BUN:
-
Blood urea nitrogen
References
Wassner S, Baum M (1999) Physiology and management. Pediatric Nephrology Lippincott Williams Wilkins, Baltimore, pp 1155–1182
LeBrun M, Grenier L, Gourde P, Bergeron MG, Labrecque G, Beauchamp D (1999) Effectiveness and toxicity of gentamicin in an experimental model of pyelonephritis: effect of the time of administration. Antimicrob Agents Chemother 43(5):1020–1026
Koch VH, Zuccolotto SM (2003) Urinary tract infection: a search for evidence. J Pediatr 79(Suppl 1):S97–106. https://doi.org/10.1590/S0021-75572003000700011
Tekgül S (2015) A snapshot of the guidelines on vesicoureteral reflux in children. Eur Urol Suppl 14(1):9–11. https://doi.org/10.1016/j.eursup.2015.01.005
Celik S, Gorur S, Aslantas O, Erdogan S, Ocak S, Hakverdi S (2007) Caffeic acid phenethyl ester suppresses oxidative stress in Escherichia coli-induced pyelonephritis in rats. Mol Cell Biochem 297(1–2):131–138. https://doi.org/10.1007/s11010-006-9337-x
Kaur A, Garg U, Sethi A, Gorowara S, Sharma S, Ganguly N (1988) Effect of various oxygen free radical scavengers in preventing tissue injury caused by Escherichia coli in pyelonephritic mice. Biochem Int 16(6):1083–1093
Sadeghi Z, Kajbafzadeh AM, Tajik P, Monajemzadeh M, Payabvash S, Elmi A (2008) Vitamin E administration at the onset of fever prevents renal scarring in acute pyelonephritis. Pediatr Nephrol 23(9):1503–1510. https://doi.org/10.1007/s00467-008-0853-7
Reid G, Chan RC, Bruce AW, Costerton JW (1985) Prevention of urinary tract infection in rats with an indigenous Lactobacillus casei strain. Infect Immun 49(2):320–324
Cadieux PA, Burton J, Devillard E, Reid G (2009) Lactobacillus by-products inhibit the growth and virulence of uropathogenic Escherichia coli. J Physiol Pharmacol 60 Suppl 6(Suppl 6):13–18
Kaye D (1971) The effect of water diuresis on spread of bacteria through the urinary tract. J Infect Dis 124(3):297–305. https://doi.org/10.1093/infdis/124.3.297
Rushton HG (1997) The evaluation of acute pyelonephritis and renal scarring with technetium 99m-dimercaptosuccinic acid renal scintigraphy: evolving concepts and future directions. Pediatr Nephrol 11(1):108–120. https://doi.org/10.1007/s004670050243
Chen SM, Mukoyama T, Sato N, Yamagata S, Arai Y, Satoh N, Ueda S (2002) Induction of nephrotoxic serum nephritis in inbred mice and suppressive effect of colchicine on the development of this nephritis. Pharmacol Res 45(4):319–324. https://doi.org/10.1006/phrs.2002.0948
Katouli M (2010) Population structure of gut Escherichia coli and its role in development of extra-intestinal infections. Iran J Microbiol 2(2):59–72
Montini G, Tullus K, Hewitt I (2011) Febrile urinary tract infections in children. N Engl J Med 365(3):239–250. https://doi.org/10.1056/NEJMra1007755
Amdekar S, Singh V, Singh DD (2011) Probiotic therapy: immunomodulating approach toward urinary tract infection. Curr Microbiol 63(5):484–490. https://doi.org/10.1007/s00284-011-0006-2
Serlachius E, Sundelin B, Eklof AC, Jahnke M, Laestadius A, Aperia A (1997) Pyelonephritis provokes growth retardation and apoptosis in infant rat renal cortex. Kidney Int 51(6):1855–1862. https://doi.org/10.1038/ki.1997.253
Rachmilewitz D, Katakura K, Karmeli F, Hayashi T, Reinus C, Rudensky B, Akira S, Takeda K, Lee J, Takabayashi K, Raz E (2004) Toll-like receptor 9 signaling mediates the anti-inflammatory effects of probiotics in murine experimental colitis. Gastroenterology 126(2):520–528. https://doi.org/10.1053/j.gastro.2003.11.019
Hopkin M (2004) Probiotic bacteria health boon. Nature 432:427
Hsieh MH, Versalovic J (2008) The human microbiome and probiotics: implications for pediatrics. Curr Probl Pediatr Adolesc Health Care 38(10):309–327. https://doi.org/10.1016/j.cppeds.2008.09.001
Asahara T, Nomoto K, Watanuki M, Yokokura T (2001) Antimicrobial activity of intraurethrally administered probiotic Lactobacillus casei in a murine model of Escherichia coli urinary tract infection. Antimicrob Agents Chemother 45(6):1751–1760. https://doi.org/10.1128/AAC.45.6.1751-1760.2001
Uehara S, Monden K, Nomoto K, Seno Y, Kariyama R, Kumon H (2006) A pilot study evaluating the safety and effectiveness of Lactobacillus vaginal suppositories in patients with recurrent urinary tract infection. Int J Antimicrob Agents 28:30–34. https://doi.org/10.1016/j.ijantimicag.2006.05.008
Kontiokari T, Laitinen J, Jarvi L, Pokka T, Sundqvist K, Uhari M (2003) Dietary factors protecting women from urinary tract infection. Am J Clin Nutr 77(3):600–604
Lee SJ, Shim YH, Cho SJ, Lee JW (2007) Probiotics prophylaxis in children with persistent primary vesicoureteral reflux. Pediatr Nephrol 22(9):1315–1320. https://doi.org/10.1007/s00467-007-0507-1
Mohseni MJ, Aryan Z, Emamzadeh-Fard S, Paydary K, Mofid V, Joudaki H, Kajbafzadeh AM (2013) Combination of probiotics and antibiotics in the prevention of recurrent urinary tract infection in children. Iran J Pediatr 23(4):430–438
Grin PM, Kowalewska PM, Alhazzan W, Fox-Robichaud AE (2013) Lactobacillus for preventing recurrent urinary tract infections in women: meta-analysis. Can J Urol 20(1):6607–6614
Schwenger EM, Tejani AM, Loewen PS (2015) Probiotics for preventing urinary tract infections in adults and children. Cochrane Database Syst Rev 12:CD008772. https://doi.org/10.1002/14651858.CD008772.pub2
Bedi M, Gandhi M, Jacob G, Lekha V, Venugopal A, Ramesh H (2009) CA 19-9 to differentiate benign and malignant masses in chronic pancreatitis: is there any benefit? Indian J Gastroenterol 28(1):24–27. https://doi.org/10.1007/s12664-009-0005-4
Aybek H, Aybek Z, Sinik Z, Demir S, Sancak B, Tuncay L (2006) Elevation of serum and urinary carbohydrate antigen 19-9 in benign hydronephrosis. Int J Urol 13(11):1380–1384. https://doi.org/10.1111/j.1442-2042.2006.01593.x
Kajbafzadeh AM, Elmi A, Talab SS, Emami H, Esfahani SA, Saeedi P (2010) Urinary and serum carbohydrate antigen 19-9 as a biomarker in ureteropelvic junction obstruction in children. J Urol 183(6):2353–2358. https://doi.org/10.1016/j.juro.2010.02.031
Majd M, Rushton HG, Jantausch B, Wiedermann BL (1991) Relationship among vesicoureteral reflux, P-fimbriated Escherichia coli, and acute pyelonephritis in children with febrile urinary tract infection. J Pediatr 119(4):578–585. https://doi.org/10.1016/S0022-3476(05)82407-2
Linné T, Fituri O, Escobar-Billing R, Karlsson A, Wikstad I, Aperia A, Tullus K (1994) Functional parameters and99mtechnetium-dimercaptosuccinic acid scan in acute pyelonephritis. Pediatr Nephrol 8(6):694–699. https://doi.org/10.1007/BF00869092
Acknowledgements
The authors acknowledge Miss Shahnaz Halimi of the Department of Microbiology, School of Medicine, Tehran University of Medical Sciences for bacterial culture. The authors thank the authorities in charge of R&D department of Iran Dairy Industries Co. (Pegah).
Funding
The authors would like to thank Tehran University of Medical Sciences for funding this study (Grant Number 29548).
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The local ethics committee approved the experimental protocol. The principles of laboratory animal care (NIH publication no. 85–23, revised 1985) were respected for animal treatment.
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Sabetkish, N., Sabetkish, S., Mohseni, M.J. et al. Prevention of Renal Scarring in Acute Pyelonephritis by Probiotic Therapy: an Experimental Study. Probiotics & Antimicro. Prot. 11, 158–164 (2019). https://doi.org/10.1007/s12602-017-9363-x
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DOI: https://doi.org/10.1007/s12602-017-9363-x