Estimation of Interleukin 6, IL- 23 and GM-CSF concentration levels in adult and adolescent patients with urinary tract infections in Sulaymaniyah city, Iraq

Abstract

Background

Urinary tract infections (UTIs) are classified as one of the most common infectious diseases worldwide and represent a significant public health problem. Recurrent infection is one of the major challenges associated with this disease in adults and adolescents.

Aim

This study aims to estimate the concentration levels of interleukin 6, IL-1β and 23 (IL-23) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in the urine of adult and adolescent patients with acute and recurrent urinary tract infections in the city of Sulaymaniyah Iraq.

Materials and Method

This study was conducted in Sulaymaniyah on patients with acute and recurrent urinary tract infections (UTIs) who visited private clinics and were diagnosed by a specialist physician between January 2023 and July 2023. A total of 68 samples were collected, comprising 26 males and 42 females, with patient ages ranging from 22 to 76 years for adults and 15 to 21 years for adolescents. Fifteen samples were also taken as a control group. Information was accurately recorded for each sample on a questionnaire, selected based on established criteria. Interleukin-6, IL-1β and IL-23 and GM-CSF levels were measured in the urine of patients with acute and recurrent UTIs using enzyme-linked immunosorbent assay (ELISA(.

Results

In the current study, the number of females with urinary tract infections was 61.3% including adult and adolescent females, while the number of males was 38.7%. The results of the current study showed that the number of samples from patients with acute urinarytract infections was higher than from those with recurrent infections, while the rate of recurrent UTI in adolescent females were higher.  A significant elevated levels of IL-6 and IL-1β was found in acute UTI, while a low levels of IL-6 recorded in recurrent adults and adolescents compared to acute UTI inversely to IL-1β which scored values of 268.19± 32 ng/ml for recurrent UTI patients and 284.27 ± 40 ng/ml for those with adolescent UTI. Regarding the concentration of IL--23 in the urine of patients with acute urinary tract infections, the results showed a significant difference (P ≤ 0.05) between the patient group and the control group, with concentration levels of (42.66 ± 10.13) and (16.03 ± 5.51) pg/ml, respectively. Similarly, in recurrent cases, there were significant differences at a probability level of (P ≤ 0.05), with concentration levels of (35.07±8.60) and (16.0±5.51) pg/ml, respectively. As for GM-CSF, the results showed an increase, but it was not statistically significant between patients and the control group in patients with acute urinary tract infections. .Regarding GM-CSF in recurrent cases, the results showed a significant increase (p < 0.05) recording 39.16 ± 8.23 pg/ml.

Conclusions

The study results showed that urinary tract infections (UTIs) are more common in females, and that acute cases are more prevalent than recurrent ones. Significantly elevated levels of interleukin – 6, IL-1β  and  IL-23  were observed in both acute  cases , while was low in recurrent regarding IL-6 and high IL-1β valeus . Furthermore, significantly elevated levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) were observed in recurrent cases, suggesting that these two factors may contribute to the inflammatory response associated with UTIs and potentially to recurrent infection.