Amplifying renal immunity

The role of antimicrobial peptides in pyelonephritis

Brian Becknell, Andrew Schwaderer, David Hains, John David Spencer

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

Urinary tract infections (UTIs), including pyelonephritis, are among the most common and serious infections encountered in nephrology practice. UTI risk is increased in selected patient populations with renal and urinary tract disorders. As the prevalence of antibiotic-resistant uropathogens increases, novel and alternative treatment options will be needed to reduce UTI-associated morbidity. Discoveries over the past decade demonstrate a fundamental role for the innate immune system in protecting the urothelium from bacterial challenge. Antimicrobial peptides, an integral component of this urothelial innate immune system, demonstrate potent bactericidal activity toward uropathogens and might represent a novel class of UTI therapeutics. The urothelium of the bladder and the renal epithelium secrete antimicrobial peptides into the urinary stream. In the kidney, intercalated cells - a cell-type involved in acid-base homeostasis - have been shown to be an important source of antimicrobial peptides. Intercalated cells have therefore become the focus of new investigations to explore their function during pyelonephritis and their role in maintaining urinary tract sterility. This Review provides an overview of UTI pathogenesis in the upper and lower urinary tract. We describe the role of intercalated cells and the innate immune response in preventing UTI, specifically highlighting the role of antimicrobial peptides in maintaining urinary tract sterility.

Original languageEnglish (US)
Pages (from-to)642-655
Number of pages14
JournalNature Reviews Nephrology
Volume11
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Pyelonephritis
Urinary Tract Infections
Immunity
Urinary Tract
Kidney
Peptides
Urothelium
Infertility
Immune System
Nephrology
Innate Immunity
Urinary Bladder
Homeostasis
Epithelium
Anti-Bacterial Agents
Morbidity
Acids
Therapeutics
Infection
Population

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Amplifying renal immunity : The role of antimicrobial peptides in pyelonephritis. / Becknell, Brian; Schwaderer, Andrew; Hains, David; Spencer, John David.

In: Nature Reviews Nephrology, Vol. 11, No. 11, 01.11.2015, p. 642-655.

Research output: Contribution to journalReview article

Becknell, Brian ; Schwaderer, Andrew ; Hains, David ; Spencer, John David. / Amplifying renal immunity : The role of antimicrobial peptides in pyelonephritis. In: Nature Reviews Nephrology. 2015 ; Vol. 11, No. 11. pp. 642-655.
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