Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 1, January, p. 125–132

doi: 10.17219/acem/94157

Publication type: original article

Language: English

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Preoperative Th1/Th2 and related cytokines: Prediction value in postoperative febrile UTI after ureteroscopy in patients with ureteral calculi

Zhen Li1,A, Kang-Er Wang1,B,C, Xie-Lai Zhou1,C,D, Jin Zhou1,D,E, Chun-Hua Ye1,F

1 Department of Urology, Affiliated Hospital of Hangzhou Normal University, China

Abstract

Background. The topic of whether preoperative Th1/Th2 cells and their related factors have a predictive value for postoperative febrile urinary tract infection (UTI) in patients with ureteral calculi has not been explored.
Objectives. The objective of this study was to investigate the role of preoperative Th1/Th2 cells and related cytokines in the prediction of postoperative febrile UTI after ureteroscopy in patients with ureteral calculi.
Material and Methods. One hundred sixty patients who underwent ureteroscopic pneumatic lithotripsy in the Affiliated Hospital of Hangzhou Normal University (China) were recruited and divided into febrile UTI group (n = 78) and non-UTI group (n = 82). Flow cytometry was used to detect the proportions of Th1 and Th2 cells (Th1% and Th2%). Detection of Th1/Th2 cell-related cytokines was conducted using enzyme-linked immunosorbent assay (ELISA). Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to measure the expression of T-bet and GATA3.
Results. Compared with patients in non-UTI group, those in febrile UTI group had significantly increased proportions of Th2 cells, levels of Th2 cytokines (interleukin (IL)-4, IL-10 and IL-5), and mRNA expression of Th2-associated transcription factor GATA3 (all p < 0.05). In addition, the Th1/Th2 ratio of febrile UTI group was significantly lower than that of non-UTI group (p < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the accuracy rate of Th2%, Th1/Th2 ratio, and IL-4, IL-10 and IL-5 levels for the diagnosis of postoperative febrile UTI in patients with ureteral calculi was 90.63%, 85.00%, 72.50%, 87.50%, and 91.88%, respectively, and their combined diagnostic sensitivity was 97.4% with specificity as high as 100%.
Conclusion. Perioperative Th2 dominance was correlated with the risk of postoperative febrile UTI after ureterscopy in patients with ureteral calculi, which can provide clinical guidance for the development of individualized treatment.

Key words

Th1/Th2, ureteral calculi, febrile urinary tract infection

References (32)

  1. Cheng Y, Liu GL. Current state and advance of flexible ureteroscope in the treatment of upper urinary calculi. J Mod Urol. 2014;5:285–288.
  2. Cavildak IK, Nalbant I, Tuygun C, et al. Comparison of flexible ureterorenoscopy and laparoscopic ureterolithotomy methods for proximal ureteric stones greater than 10 mm. Urol J. 2016;13(1):2484–2489.
  3. Korkes F, Gomes SA, Heilberg IP. Diagnosis and treatment of ureteral calculi. J Bras Nefrol. 2009;31:55–61.
  4. El-Qadhi M. Outcome of ureteroscopy for the management of distal ureteric calculi: 5-years’ experience. Afr J Urol. 2015;21(1):67–71.
  5. de la Rosette J, Denstedt J, Geavlete P, et al; CROES URS Study Group. The clinical research office of the endourological society ureteroscopy global study: Indications, complications, and outcomes in 11,885 patients. J Endourol. 2014;28(2):131–139.
  6. Krowka JF, Singh B, Fotedar A, Mosmann T, Giedlin MA, Pilarski LM. A requirement for physical linkage between determinants recognized by helper molecules and cytotoxic T cell precursors in the induction of cytotoxic T cell responses. J Immunol. 1986;136(10):3561–3566.
  7. Feng Y, Tian J, Xie HQ, et al. Effects of acute low-dose exposure to the chlorinated flame retardant dechlorane 602 and Th1 and Th2 immune responses in adult male mice. Environ Health Perspect. 2016; 124(9):1406–1413.
  8. Ebrahimian M, Hashemi M, Maleki M, et al. Induction of a balanced Th1/Th2 immune responses by co-delivery of PLGA/ovalbumin nanospheres and CpG ODNs/PEI-SWCNT nanoparticles as TLR9 agonist in BALB/c mice. Int J Pharm. 2016;515(1–2):708–720.
  9. Miyake K, Akahoshi M, Nakashima H. Th subset balance in lupus nephritis. J Biomed Biotechnol. 2011;2011:1–7.
  10. Yuan D, Yuan Q, Cui Q, et al. Vaccine adjuvant ginsenoside Rg 1 enhances immune responses against hepatitis B surface antigen in mice. Can J Physiol Pharm. 2016;94(6):676–681.
  11. Behfarjam F, Sanati MH, Nasseri Moghaddam S, Ataei M, Nikfam S, Jadali Z. Role of Th1/Th2 cells and related cytokines in autoimmune hepatitis. Turk J Gastroenterol. 2017;28(2):110–114.
  12. Wintrob ZA, Hammel JP, Nimako GK, et al. TH1 and TH2 cytokines dataset in insulin users with diabetes mellitus and newly diagnosed breast cancer. Data Brief. 2017;11:331–348.
  13. Kang W, Li Y, Zhuang Y, Zhao K, Huang D, Sun Y. Dynamic analysis of Th1/Th2 cytokine concentration during antiretroviral therapy of HIV-1/HCV co-infected patients. BMC Infect Dis. 2012;12:102.
  14. Tang Y, Liao C, Xu X, et al. Evaluation of Th1/Th2 cytokines as a rapid diagnostic tool for severe infection in paediatric haematology/oncology patients by the use of cytometric bead array technology. Clin Microbiol Infect. 2011;17(11):1666–1673.
  15. Chen J, Zhang Y, Deng Z. Imbalanced shift of cytokine expression between T helper 1 and T helper 2 (Th1/Th2) in intestinal mucosa of patients with post-infectious irritable bowel syndrome. BMC Gastroenterol. 2012;12:91.
  16. Wang Y, Wang W, Gong F, et al. Evaluation of intravenous immunoglobulin resistance and coronary artery lesions in relation to Th1/Th2 cytokine profiles in patients with Kawasaki disease. Arthritis Rheum. 2013;65(3):805–814.
  17. Bădărău DO. Declaration of Helsinki. Phys Ther. 2013;45:1418–1419.
  18. Mitsuzuka K, Nakano O, Takahashi N, Satoh M. Identification of factors associated with postoperative febrile urinary tract infection after ureteroscopy for urinary stones. Urolithiasis. 2016;44(3):257–262.
  19. Yoon SJ, Kim SJ, Lee SM. Overexpression of HO-1 contributes to sepsis-induced immunosuppression by modulating the Th1/Th2 balance and regulatory T-cell function. J Infect Dis. 2017;215(10):1608–1618.
  20. Rubbo PA, Tuaillon E, Bollore K, et al. The potential impact of CD4+ T cell activation and enhanced Th1/Th2 cytokine ratio on HIV-1 secretion in the lungs of individuals with advanced AIDS and active pulmonary infection. Clin Immunol. 2011;139(2):142–154.
  21. Matsuda A, Furukawa K, Suzuki H, et al. Does impaired TH1/TH2 balance cause postoperative infectious complications in colorectal cancer surgery? J Surg Res. 2007;139(1):15–21.
  22. Del Prete G, Maggi E, Romagnani S. Human Th1 and Th2 cells: Functional properties, mechanisms of regulation, and role in disease. Lab Invest. 1994;70(3):299–306.
  23. Romagnani S. The Th1/Th2 paradigm. Immunol Today. 1997;18(6):263.
  24. Tatsumi H, Ura H, Ikeda S, et al. Surgical influence on TH1/TH2 balance and monocyte surface antigen expression and its relation to infectious complications. World J Surg. 2003;27(5):522–528.
  25. Ishikawa M, Nishioka M, Hanaki N, et al. Hepatic resection leads to predominance of the T helper-2 lymphocyte phenotype. Hepatol Res. 2004;30:96–103.
  26. de Sá KS, Santana BB, de Souza Ferreira TC, et al. IL28B gene polymorphisms and Th1/Th2 cytokine levels might be associated with HTLV-associated arthropathy. Cytokine. 2016;77:79–87.
  27. Koguchi Y, Kawakami K. Cryptococcal infection and Th1-Th2 cytokine balance. Int Rev Immunol. 2002;21(4–5):423–438.
  28. Suzuki D, Furukawa K, Kimura F, et al. Effects of perioperative immunonutrition on cell-mediated immunity, T helper type 1 (Th1)/Th2 differentiation, and Th17 response after pancreaticoduodenectomy. Surgery. 2010;148(3):573–581.
  29. Nosko A, Kluger MA, Diefenhardt P, et al. T-Bet enhances regulatory T cell fitness and directs control of th1 responses in crescentic GN. J Am Soc Nephrol. 2017;28(1):185–196.
  30. Hercor M, Anciaux M, Denanglaire S, Debuisson D, Leo O, Andris F. Antigen-presenting cell-derived IL-6 restricts the expression of GATA3 and IL-4 by follicular helper T cells. J Leukoc Biol. 2017;101(1):5–14.
  31. Hafez SF, Sallam MM, Ibraheem SA. Local expression of IL-4 and IL-5 in perennial allergic rhinitis and their modulation by topical corticosteroid therapy. Egypt J Immunol. 2004;11(1):111–121.
  32. Kato Y, Koseki T, Mastsutani R, et al. MP33-01 risk factors for febrile urinary tract infection after ureteroscopic stone removal. J Urol. 2016; 195(4):e436–e436.
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