Are you experienced? Understanding bladder innate immunity in the context of recurrent urinary tract infection

Valerie P. O'Brien, Thomas J. Hannan, Anthony J. Schaeffer, Scott J. Hultgren

Research output: Contribution to journalReview article

21 Scopus citations

Abstract

Purpose of review: Recurrent urinary tract infection (rUTI) is a serious clinical problem, yet effective therapeutic options are limited, especially against multidrug-resistant uropathogens. In this review, we explore the development of a clinically relevant model of rUTI in previously infected mice and review recent developments in bladder innate immunity that may affect susceptibility to rUTI. Recent findings: Chronic bladder inflammation during prolonged bacterial cystitis in mice causes bladder mucosal remodelling that sensitizes the host to rUTI. Although constitutive defenses help prevent bacterial colonization of the urinary bladder, once infection occurs, induced cytokine and myeloid cell responses predominate and the balance of immune cell defense and bladder immunopathology is critical for determining disease outcome, in both naïve and experienced mice. In particular, the maintenance of the epithelial barrier appears to be essential for preventing severe infection. Summary: The innate immune response plays a key role in determining susceptibility to rUTI. Future studies should be directed towards understanding how the innate immune response changes as a result of bladder mucosal remodelling in previously infected mice, and validating these findings in human clinical specimens. New therapeutics targeting the immune response should selectively target the induced innate responses that cause bladder immunopathology, while leaving protective defenses intact.

Original languageEnglish
Pages (from-to)97-105
Number of pages9
JournalCurrent Opinion in Infectious Diseases
Volume28
Issue number1
DOIs
StatePublished - Feb 13 2015

Keywords

  • cystitis
  • mucosal immunology
  • urinary tract infection
  • uropathogenic Escherichia coli

Fingerprint Dive into the research topics of 'Are you experienced? Understanding bladder innate immunity in the context of recurrent urinary tract infection'. Together they form a unique fingerprint.

  • Cite this