Pharmacologic Basis for the Treatment of Pyelonephritis

Selective Dependence of Kidney Dendritic Cells on CX3CR1--Implications for Glomerulonephritis Therapy

As central regulators of the adaptive immune response, dendritic cells (DCs) are found in virtually all lymphatic and non-lymphatic organs. A compact network of DCs also spans the kidneys. DCs play a central role in maintenance of organ homeostasis as well as in induction of immune responses against invading pathogens. They can mediate protective or destructive functions in a context-dependent manner.We recently identified CX(3)CR1 as a kidney-specific "homing receptor" for DCs. There was a strong reduction of DCs in the kidneys of CX(3)CR1-deficient mice compared to controls. This reduction was not observed in other organs except the small intestine. As a possible underlying reason we found a strong expression of the CX(3)CR1 ligand fractalkine in the kidneys. Due to this CX(3)CR1-dependent reduction of DCs, especially in the renal cortex, a glomerulonephritis (GN) model was ameliorated in CX(3)CR1-deficient mice. In contrast, the immune defense against the most common renal infection, bacterial pyelonephritis (PN), was not significantly influenced by CX(3)CR1-deficiency. This was explained by the much smaller CX(3)CR1-dependency of medullary DCs, which recruit effector cells into the kidney during PN. Additionally, once neutrophils had been recruited by mechanisms distinct from CX(3)CR1, they carried out some of the functions of DCs.Taken together, we suggest CX(3)CR1 as a therapeutic target for GN treatment, as the absence of CX(3)CR1 selectively influences DCs in the kidney without rendering mice more susceptible towards bacterial kidney infections.

Mouse model for pyelonephritis

This unit describes a simple way to induce pyelonephritis in female mice using uropathogenic Escherichia coli (UPEC). Methods for culturing and preparing working stocks of UPEC are provided. Protocols to measure the bacterial load in the murine kidney following the establishment of pyelonephritis by determining the bacterial colony forming units (CFU) are also included. This assay can be performed with kidney homogenates if the bacterial load is the sole read-out or if cellular intactness is not required for subsequent assays, or from kidney single cell suspensions prepared by enzymatic digestion. A support protocol describes methods for isolating cells for flow cytometry, ex vivo culture, and other assays.