Urinary antimicrobial peptides and cytokines as biomarkers for recurrent urinary tract infection in children and adolescents
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By
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Guillermo Yepes
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Hancong Chloe Tang
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Natalie Holdsworth
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Kristin Salamon
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Laura Schwartz
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Christina Ching
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Steve Rust
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John David Spencer
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June 15, 2026
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Clinical Scorecard: Urinary Cytokines and Antimicrobial Peptides as Potential Biomarkers for Recurrent Urinary Tract Infections in Pediatric Patients
At a Glance
| Category | Detail |
|---|
| Condition | Recurrent Urinary Tract Infection (rUTI) |
| Key Mechanisms | Dysregulated innate immune responses, including antimicrobial peptides and cytokines |
| Target Population | Asymptomatic girls and adolescent females with a history of rUTI |
| Care Setting | Pediatric outpatient clinics |
Key Highlights
- Participants with rUTI exhibited distinct urinary immune profiles.
- Lower concentrations of beta-defensin 1, cathelicidin, and ribonuclease 7 in rUTI group.
- Higher concentrations of alpha-defensins 1-3, lipocalin 2, and secretory leukocyte protease inhibitor in rUTI group.
- Elevated cytokine levels (IL-1β, IL-6, IL-8, TNFα) in rUTI participants.
- High discriminatory performance of the classification model (AUC 0.97).
Guideline-Based Recommendations
Diagnosis
- Utilize urinary biomarkers and clinical features to classify rUTI status.
Management
- Consider management of bowel and bladder dysfunction, circumcision, and evaluation of sexual activity.
Monitoring & Follow-up
- Monitor urinary cytokine and antimicrobial peptide levels in patients with rUTI.
Risks
- Recurrent UTI is associated with repeated antibiotic exposure, compromised kidney function, and reduced quality of life.
Patient & Prescribing Data
Asymptomatic girls and adolescent females with a history of rUTI.
Biomarkers may improve risk stratification for rUTI.
Clinical Best Practices
- Integrate urinary biomarkers with clinical features for better classification of rUTI.
- Conduct thorough evaluations for patients with recurrent UTI.
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