Urinary prostaglandin E2 as a biomarker for recurrent UTI in postmenopausal women.
Tahmineh Ebrahimzadeh, Amy Kuprasertkul, Michael L Neugent, Kevin C Lutz, Jorge L Fuentes, Jashkaran Gadhvi, Fatima Khan, Cong Zhang, Belle M Sharon, Kim Orth, Qiwei Li, Philippe E Zimmern, Nicole J De Nisco
Author Information
Tahmineh Ebrahimzadeh: Department of Biological Sciences, University of Texas at Dallas, Richardson, TX, USA.
Amy Kuprasertkul: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Michael L Neugent: Department of Biological Sciences, University of Texas at Dallas, Richardson, TX, USA.
Kevin C Lutz: Depatment of Mathematics, University of Texas at Dallas, Richardson, TX, USA.
Jorge L Fuentes: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jashkaran Gadhvi: Department of Biological Sciences, University of Texas at Dallas, Richardson, TX, USA. ORCID
Fatima Khan: Department of Biological Sciences, University of Texas at Dallas, Richardson, TX, USA.
Cong Zhang: Depatment of Mathematics, University of Texas at Dallas, Richardson, TX, USA.
Belle M Sharon: Department of Biological Sciences, University of Texas at Dallas, Richardson, TX, USA.
Kim Orth: Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Qiwei Li: Depatment of Mathematics, University of Texas at Dallas, Richardson, TX, USA.
Philippe E Zimmern: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Nicole J De Nisco: Department of Biological Sciences, University of Texas at Dallas, Richardson, TX, USA nicole.denisco@utdallas.edu. ORCID
Urinary tract infection (UTI) is one of the most common adult bacterial infections and exhibits high recurrence rates, especially in postmenopausal women. Studies in mouse models suggest that cyclooxygenase-2 (COX-2)-mediated inflammation sensitizes the bladder to recurrent UTI (rUTI). However, COX-2-mediated inflammation has not been robustly studied in human rUTI. We used human cohorts to assess urothelial COX-2 production and evaluate its product, PGE, as a biomarker for rUTI in postmenopausal women. We found that the percentage of COX-2-positive cells was elevated in inflamed versus uninflamed bladder regions. We analyzed the performance of urinary PGE as a biomarker for rUTI in a controlled cohort of 92 postmenopausal women and PGE consistently outperformed all other tested clinical variables as a predictor of rUTI status. Furthermore, time-to-relapse analysis indicated that the risk of rUTI relapse was 3.6 times higher in women with above median urinary PGE levels than with below median levels. Taken together, these data suggest that urinary PGE may be a clinically useful diagnostic and prognostic biomarker for rUTI in postmenopausal women.
