INVESTIGATION OF TLR4 POLYMORPHISM IN CHILDREN WITH VESICOURETERAL REFLUX AND RENAL SCARRING
Sav NM1*, Eroz R2, Kalay Duran N3, Kilicaslan O4, Erisen Karaca S5
*Corresponding Author: *Corresponding Author: Nadide Melike SAV, Address: Duzce Universitesi Araştırma Uygulama Hastanesi, Pediatrik Nefroloji B.D, Merkez, DUZCE, TURKEY; Phone: +905378683281; Fax:+903805421390; e-mail address: savmelike@gmail.com
page: 41
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Abstract
Vesicoureteral reflux (VUR) is an important factor in
the etiology of recurrent urinary tract infections (UTIs).
Permanent kidney damage may develop in children with
high-grade VUR in the long term. This damage may prog-
ress with the development of scar tissue in some patients.
The TLR4 gene is an important resistance mechanism,
especially against UTIs. TLR4 gene polymorphism is asso-
ciated with recurrent UTIs and kidney scar development in
the long term. This study aimed to examine the relationship
between scar development and TLR4 gene polymorphism
in children with VUR. This cross-sectional study included
49 patients with recurrent UTIs and primary vesicoureteral
reflux. Patients were divided into two groups (26 patients
with the scar, and 23 patients without scar) according to the
presence of scar tissue. TLR4 gene polymorphisms of the
patients were evaluated by Next Generation Sequencing.
The TLR4 gene polymorphism was significantly higher in
the compound heterozygous group with scarring than in
the group without scarring (p=0.03). Gene polymorphisms,
c.958T>C, c.942A>G, c.776A>G, c.1076C>T, c.896AT, c.1078C>T were presented more commonly in
the group with scarring. Moreover, gene polymorphisms
c.942A>G and c.776A>G were defined for the first time
in this study among patients with scar tissue. The higher
incidence of some TLR4 gene polymorphisms in patients
with scarring suggested that these variations might cause
permanent kidney damage. In addition to genetic predis-
position, environmental factors such as untreated UTIs
might also contribute to scar formation.
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