EVALUATION OF URINARY IL-1-ALPHA AND IL-1-BETA IN GRAVID FEMALES AND PATIENTS WITH BACTERIAL CYSTITIS AND MICROSCOPIC HEMATURIA

Objectives: to determine IL-1 alpha and IL-1 beta levels in patients w ith bacterial cystitis, microscopic hematuria, and gravid females rela tive to a control group of normal subjects. Methods: enzyme immunoassa ys were used to measure concomitantly urinary IL-1 alpha and IL-1 beta in clean catch urine samples from normal subjects (n = 31) and study patients (n = 46). All normal subjects and patients underwent urinalys is, urine culture, and urine creatinine level determination. Since the IL-1 alpha assay was developed for serum, the utility of the assay fo r urine specimens was unknown. The key parameters of urine collection, processing and sample storage for IL-1 alpha were evaluated in detail . Results. mean values +/- SEM (pg/mg) for IL-1 alpha/Cr and IL-1 beta /Cr were control group (0.25 +/- 0.10 and 0.17 +/- 0.06), bacterial cy stitis (9.97 +/- 1.15 and 42.45 +/- 1.86), and microscopic hematuria ( 2.81 +/- 0.65 and 2.82 +/- 0.70). Differences in cytokine levels betwe en the control group and patients with either bacterial cystitis or mi croscopic hematuria were statistically significant for both IL-1 alpha /Cr (P < 0.026; P < 0.007, respectively) and IL-1 beta/Cr (P < 0.0004; P < 0.014, respectively). IL-1 beta/Cr correlates better with pyuria than IL-1 alpha/Cr (P = 0.02 vs P = 0.44).In gravid females, only IL-1 alpha was significantly elevated relative to non-pregnant females (IL -1 beta elevation approached statistical significance). Gravid females with positive urine cultures could not be distinguished from those wi th negative cultures based on either interleukin (P > 0.05). Conclusio ns: Significant elevations of IL-1 alpha and IL-1 beta occur in patien ts with bacterial cystitis and microscopic hematuria. Correlation betw een pyuria and cytokine elevation was stronger for IL-1 beta than for IL-1 alpha. Changes in IL-1 alpha a may reflect changes in the bladder epithelium rather than in the inflammatory leukocytes. The ability of IL-1 alpha and IL-1 beta to serve as markers for bacterial cystitis i n gravid females is diminished due to high basal levels during pregnan cy.