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Immune System Overreaction May Enable Recurrent Urinary Tract Infections

The immune system may open the door to recurrent urinary tract infections (UTIs) by overdoing its response to an initial infection, researchers at Washington University School of Medicine in St. Louis have found.

Researchers showed in mice that severe inflammatory responses to an initial UTI cause bladder damage and allow infection to persist longer. After one to two weeks of infection, the bladder wall undergoes additional changes that leave mice more vulnerable to later infection. Suppressing the immune system during initial infection decreases these vulnerabilities, they report Aug. 12 in PLoS Pathogens.

"We found markers in the mice that may one day help us identify patients vulnerable to recurrent infection and refine our treatment strategies," says lead author Thomas J. Hannan, DVM, PhD. "There were infection-fighting elements in the immune responses of some mice that we may, for example, one day be able to trigger with vaccines for vulnerable patients."

The research was conducted at the Center for Women's Infectious Disease Research at the School of Medicine.

UTIs affect millions of people each year. Although antibiotics are the primary treatment, antibiotic resistance is a growing concern, according to Scott Hultgren, PhD, the center's director. Symptoms include frequent, painful urination, blood or cloudiness in the urine and fatigue.

"Women and infants are at greatest risk for UTIs, and chronic and recurrent infections are common," says Hultgren, the Helen L. Stoever Professor of Molecular Microbiology. "The diagnosis and treatment of UTIs in the United States is estimated to cost $1.6 billion annually."

Hultgren's lab has shown that bacteria can cause multiple bouts of UTI symptoms by going into a dormant state in the host and reactivating months later.
 
 

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