The urinary tract functions in close proximity to the outside environment, yet must remain free of microbial colonization to avoid disease. The mechanisms for establishing an antimicrobial barrier in this area are not completely understood. Here, we describe the production and function of the cathelicidin antimicrobial peptides LL-37, its precursor hCAP-18 and its ortholog CRAMP in epithelial cells of human and mouse urinary tract, respectively. Bacterial contact with epithelial cells resulted in rapid production and secretion of the respective peptides, and in humans LL-37/hCAP-18 was released into urine. Epithelium-derived cathelicidin substantially contributed to the protection of the urinary tract against infection, as shown using CRAMP-deficient and neutrophil-depleted mice. In addition, clinical E. coli strains that were more resistant to LL-37 caused more severe urinary tract infections than did susceptible strains. Thus, cathelicidin seems to be a key factor in mucosal immunity of the urinary tract.
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http://dx.doi.org/10.1038/nm1407 | DOI Listing |
JAMA Intern Med
January 2025
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Importance: Evidence on cardiovascular benefits and safety of sodium-glucose cotransporter 2 (SGLT-2) inhibitors is mainly from placebo-controlled trials. Therefore, the comparative effectiveness and safety of individual SGLT-2 inhibitors remain unknown.
Objective: To compare the use of canagliflozin or dapagliflozin with empagliflozin for a composite outcome (myocardial infarction [MI] or stroke), heart failure hospitalization, MI, stroke, all-cause death, and safety outcomes, including diabetic ketoacidosis (DKA), lower-limb amputation, bone fracture, severe urinary tract infection (UTI), and genital infection and whether effects differed by dosage or cardiovascular disease (CVD) history.
Int Urogynecol J
January 2025
Department of Urogynecology and Reconstructive Pelvic Surgery, Atlantic Health System, 435 South Street, Suite 370, Morristown, NJ, 07960, USA.
Introduction And Hypothesis: The objective of our study was to evaluate the need for antibiotic prophylaxis for urinary tract infection (UTI) prevention before Onabotulinum toxin A injection for overactive bladder (OAB). We hypothesize that the lack of antibiotic prophylaxis might not be inferior to administering prophylaxis.
Methods: This was a multi-centered, nonblinded, randomized controlled trial conducted between August 2022 and September 2024.
Clin Infect Dis
January 2025
Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark.
The recent US Food and Drug Administration approval of pivmecillinam-an oral prodrug of the amidinopenicillin antibiotic mecillinam-presents a valuable opportunity to address the need for new treatments for uncomplicated urinary tract infection (uUTI). We report findings of a systematic literature review of the safety profile of pivmecillinam/mecillinam based on more than 40 years' experience, mainly in Europe and Canada, to describe its tolerability profile and identify any important safety signals. In total, 110 eligible publications were identified describing use of pivmecillinam/mecillinam as monotherapy or in combination, for treatment of uUTI or other infectious conditions.
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March 2025
Virology Department, Hôpital Paul Brousse, INSERM U1193, AP-HP, Université Paris Saclay, Paris, France.
Objectives: BK virus (BKV) is highly seroprevalent in humans. After primary infection, it remains latent in the urinary tract and can reactivate in immunocompromised individuals, leading to interstitial nephropathy or hemorrhagic cystitis. The BKV viral load (VL) in plasma correlates with the occurrence of nephropathy and can be monitored in kidney graft recipients; the early detection of BKV viremia can enable an early reduction of immunosuppressant drug doses and the prevention of BKV-associated nephropathy.
View Article and Find Full Text PDFFront Neurol
January 2025
Unidade Local de Saúde de São João, Porto, Portugal.
Background: Anti-CD20 monoclonal antibodies are a class of immunosuppressive drugs widely used in the treatment of central nervous system (CNS) inflammatory diseases, with well-established efficacy and safety. Although rare, these therapies can be associated with serious adverse events including hematological and infectious complications. This study aims to evaluate their safety and tolerability profile in real-world clinical practice.
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