Clinical value of determination of epidermal growth factor in the blood and urine of children with pyelonephritis

Abstract

Objective: to study the value of epidermal growth factor (EGF) in the serum and urine of patients with chronic pyelonephritis (CP) depending on the clinical form and features of the disease. Eighty patients aged 6 to 16 years, including 65 who were in clinical and laboratory remission, were examined. In addition to traditional nephrological examination, the serum and urinary levels of EGF, transforming growth factor-Pj (TGF-Pj), insulin-like growth factor-1 (IGF-1), and interleukins (IL)-4, IL-10, and IL-12 were determined by a standard set of solid-phase enzyme immunoassay. There was a statistically significant decrease in serum and urinary EGF level in children having a history of frequent CP exacerbations and a disease duration of more than 5-7 years. An antagonistic relationship was found between of EGF and the profibrotic cytokine TGF-Pj. On the contrary, EGF is strongly related to IGF-1 having antiapoptotic properties. In the patients with latent CP, the serum and urinary EGF levels were significantly lower than in those with recurrent CP. In patients with a history of transient hypoisostenuria, the serum level of EGF did not differ from the normal ones whereas its urinary level was significantly decreased. Conclusion. Significantly low serum and urinary EGF levels were noted in the patients who had an unfavorable disease and were although in clinical and laboratory remission documented by the clinical and laboratory examination traditionally accepted in nephrourological practice.