IMMUNE STATUS IN ACUTE OBSTRUCTIVE AND NONOBSTRUCTIVE PYELONEPHRITIS

The patients with a diagnosis of acute non-obstructive (ANOP) and obstructive pyelonephritis (AOP) (31 and 30 patients respectively) were under observation during treatment at the urological center of the National Healthcare Institution Scientifi c Clinical Center of Russian Railways. The levels of cytokines, complement components and their inhibitors in plasma and the first portion of morning urine, phagocytic and oxygen-dependent activity of circulating blood neutrophils were determined. At the systemic level, in patients with ANOP, to a greater extent in AOP, an increase in the concentration of pro-inflammatory cytokines (TNFα, IL-6, IL-8 and IFNγ), IFNα, IL-4 and IL-10, components of the C₃ and C_5a compliment was established, a decrease in the level of IL-1RA and a regulator of the complement factor H system, a decrease in the activity and intensity of phagocytosis of peripheral blood neutrophils with an increase in the activity of oxygen-dependent systems were also revealed. Before treatment at the local level (in the urine) in patients with ANOP, an increase in the concentration of all studied cytokines, except IL-4, components C₃ and C₅, and a decrease in IL-1RA was established. In AOP, changes were more pronounced, with the exception of a reduced level of factor H and sIgA.