A DMBT protein, labeled fluorescent green, in the human kidney
INDIANAPOLIS – Indiana University School of Medicine researchers worked in collaboration with an international team of scientists to uncover why certain children get recurring urinary tract infections (UTIs) and others do not. The group took the research one step further to uncover a genetic variation in some children that when present – if treated with preventative antibiotics – can help prevent recurring UTIs. The findings are published in the scientific journal Clinical and Translational Medicine.
Together, the team conducted a genetic study comparing children with a condition known as vesicoureteral reflux (VUR) to those children without this condition. VUR is common among infants and young children and characterized by the flow of urine in the wrong direction. In the case of VUR, urine travels upward from the bladder to the kidney. Some children with VUR experience recurrent UTIs which can lead to permanent kidney damage.
The team studied each of the children’s genetic information, including children with VUR treated with a daily antibiotic to prevent UTIs versus a placebo. They compared the information and what they found was a low number of copies of the genetic marker known as DMBT1 in children with VUR and recurring UTIs. When treated with preventative antibiotics, children with a low copy number of DMBT1 and VUR overcame the UTI risk. Patients with VUR and a high copy number had similarly low rates of recurrent UTIs with and without preventive antibiotics, indicating that the antibiotics may not be helpful in these children.
“While more and more people of all ages are developing antibiotic resistance, this is the first study that I’m aware of that shows which children will benefit from the utilization of preventative antibiotics and which ones won’t,” said Andrew Schwaderer, MD, professor of pediatrics at IU School of Medicine and senior author of the study.
Working with geneticists from the United Kingdom and DMBT1 experts from Denmark, the team created a protein that modeled a high copy number and a low copy number. When they bound the protein at a high copy number, it showed more efficient at binding bacteria.
“Data from the research study showed a high prevalence of UTIs in children with VUR and a low DMBT1 copy number. If they had a low copy number, they were four times more likely to have UTIs when treated with placebo,” added Schwaderer.
About IU School of Medicine IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.