The promoter region (G-800A and C-509T) polymorphisms of transforming growth factor-β1 gene among young women with recurrent urinary tract infection

Chronic Kidney Disease, Urinary Tract Infections and Antibiotic Nephrotoxicity: Are There Any Relationships?

Chronic kidney disease (CKD) has been a constant burden worldwide, with a prevalence of more than 10% of the population and with mortality reaching 1.2 million deaths and 35.8 million disability-adjusted life years (DALYs) in 2017, as it is claimed by the Global Burden of Diseases. Moreover, an increase in its prevalence is expected in the next years due to a rise in the number of people suffering from obesity, diabetes mellitus and hypertension. On the other hand, with cardiovascular morbidity and mortality showing a downward trend, maybe it is time to focus on CKD, to minimize the preventable risk factors involved in its progression toward end-stage kidney disease (ESKD) and to offer a better quality of life. Another major health burden is represented by infectious diseases, particularly urinary tract infections (UTIs), as it is considered that approximately 40-50% of women and 5% of men will have at least one episode during their lifetime. Additionally, CKD consists of a constellation of immunological and metabolical disturbances that lead to a greater risk of UTIs: increased apoptosis of lymphocytes, elevated levels of tumor necrosis factor α and interleukin 6, which lower the function of neutrophils and increased levels of uremic toxins like p-cresyl sulfate and indoxyl sulfate, which alter the adherence and migration of leukocytes to the sites of injury. Moreover, UTIs can lead to a more rapid decline of kidney function, especially in stages G3-G5 of CKD, with all the complications involved. Last, but not least, antibiotherapy is often complicated in this category of patients, as antibiotics can also negatively affect the kidneys. This review will try to focus on the particularities of the urinary microbiome, asymptomatic bacteriuria and UTIs and the subtle balance between the risks of them and the risks of antibiotherapy in the evolution of CKD.

IL-10 Promoter -592 Polymorphism may Influence Susceptibility to HIV Infection in South Indian Population

BACKGROUND

Genetic factors play an important role in the development of disease susceptibility or protection. Cytokine gene polymorphisms are reported to be associated with altered levels of cytokine production that can impact disease progression in HIV and TB.

OBJECTIVE

In this study, we studied IL-10 -592(C/A) and TGF-β -509 (C/T) promoter polymorphisms to understand their role in susceptibility or resistance to HIV and TB in a South Indian population.

METHOD

Genomic DNA was isolated from healthy controls, pulmonary tuberculosis patients (n=122) and HIV positive individuals (n=100) and used for genotyping by polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) method.

RESULTS

Results revealed that under dominant model (CC vs CA+AA), IL-10 -592 'A' allele either 'CA' or 'AA' combinations significantly associated with susceptibility to HIV compared to healthy controls (OR: 1.88(1.05-3.35); p=0.030). However, we found no significant association with TB. TGF-β -509 polymorphism did not associate with either HIV or TB under overdominant model. Neither of the promoter polymorphisms associated with sex in either HIV or TB. However, a trend towards higher risk to HIV was found in females compared with males in IL-10 -592 'AA' genotype.

CONCLUSION

This study suggests the association of IL-10 -592 "AA" genotype with susceptibility to HIV under dominant model in the Southern Indian population. Future studies are needed with a larger sample size in order to confirm the observations made in this study.