TY - JOUR
T1 - The unexplored relationship between urinary tract infections and the autonomic nervous system
AU - Hibbing, Michael E.
AU - Conover, Matt S.
AU - Hultgren, Scott J.
N1 - Funding Information:
We would like to thank Jennifer Silverman, Karen Dodson, and Henry Schreiber for critical reading and helpful discussions. MEH and SJH were supported by the National Institutes of Health and the Office of Research on Women's Health Specialized Center of Research ( P50 DK064540 , RO1 DK051406 , RO1 AI1087489 , UO1 AI095542 , and RO1 AI048689 ) awarded to SJH. MSC was also supported by the National Institutes of Health ( F32 DK101171 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Urinary tract infections (UTIs), the majority of which are caused by uropathogenic E. coli (UPEC), are extremely common infections that preferentially effect women. Additional complicating factors, such as catheterization, diabetes, and spinal cord injuries can increase the frequency and severity of UTIs. The rise of antimicrobial resistant uropathogens and the ability of this disease to chronically recur make the development of alternative preventative and therapeutic modalities a priority. The major symptoms of UTIs, urgency, frequency, and dysuria, are readouts of the autonomic nervous system (ANS) and the majority of the factors that lead to complicated UTIs have been shown to impact ANS function. This review summarizes the decades’ long efforts to understand the molecular mechanisms of the interactions between UPEC and the host, with a particular focus on the recent findings revealing the molecular, bacteriological, immunological and epidemiological complexity of pathogenesis. Additionally, we describe the progress that has been made in: i) generating vaccines and anti-virulence compounds that prevent and/or treat UTI by blocking bacterial adherence to urinary tract tissue and; and ii) elucidating the mechanism by which anti-inflammatories are able to alleviate symptoms and improve disease prognosis. Finally, the potential relationships between the ANS and UTI are considered throughout. While these relationships have not been experimentally explored, the known interactions between numerous UTI characteristics (symptoms, complicating factors, and inflammation) and ANS function suggest that UTIs are directly impacting ANS stimulation and that ANS (dys)function may alter UTI prognosis.
AB - Urinary tract infections (UTIs), the majority of which are caused by uropathogenic E. coli (UPEC), are extremely common infections that preferentially effect women. Additional complicating factors, such as catheterization, diabetes, and spinal cord injuries can increase the frequency and severity of UTIs. The rise of antimicrobial resistant uropathogens and the ability of this disease to chronically recur make the development of alternative preventative and therapeutic modalities a priority. The major symptoms of UTIs, urgency, frequency, and dysuria, are readouts of the autonomic nervous system (ANS) and the majority of the factors that lead to complicated UTIs have been shown to impact ANS function. This review summarizes the decades’ long efforts to understand the molecular mechanisms of the interactions between UPEC and the host, with a particular focus on the recent findings revealing the molecular, bacteriological, immunological and epidemiological complexity of pathogenesis. Additionally, we describe the progress that has been made in: i) generating vaccines and anti-virulence compounds that prevent and/or treat UTI by blocking bacterial adherence to urinary tract tissue and; and ii) elucidating the mechanism by which anti-inflammatories are able to alleviate symptoms and improve disease prognosis. Finally, the potential relationships between the ANS and UTI are considered throughout. While these relationships have not been experimentally explored, the known interactions between numerous UTI characteristics (symptoms, complicating factors, and inflammation) and ANS function suggest that UTIs are directly impacting ANS stimulation and that ANS (dys)function may alter UTI prognosis.
KW - Autonomic nervous system
KW - Complicated UTI
KW - Therapeutics
KW - Urinary tract infection
KW - Uropathogenic E. coli
UR - http://www.scopus.com/inward/record.url?scp=84995617562&partnerID=8YFLogxK
U2 - 10.1016/j.autneu.2015.06.002
DO - 10.1016/j.autneu.2015.06.002
M3 - Review article
C2 - 26108548
AN - SCOPUS:84995617562
VL - 200
SP - 29
EP - 34
JO - Autonomic Neuroscience: Basic and Clinical
JF - Autonomic Neuroscience: Basic and Clinical
SN - 1566-0702
ER -