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International Journal of Nephrology
Volume 2012 (2012), Article ID 681473, 15 pages
Review Article

Role of Uropathogenic Escherichia coli Virulence Factors in Development of Urinary Tract Infection and Kidney Damage

1Witold Stefanski Institute of Parasitology of the Polish Academy of Sciences, 51/55 Twarda Street, 00818 Warsaw, Poland
2Institute of Experimental Internal Medicine, Otto von Guericke University, Leipziger Straße 44, 39120 Magdeburg, Germany
3Department of Internal Medicine I, Faculty of Medicine, University of Tübingen, Otfried-Müller-Straße 10, 72076 Tübingen, Germany

Received 1 August 2011; Revised 2 November 2011; Accepted 1 December 2011

Academic Editor: Lucia Andrade

Copyright © 2012 Justyna Bien et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Uropathogenic Escherichia coli (UPEC) is a causative agent in the vast majority of urinary tract infections (UTIs), including cystitis and pyelonephritis, and infectious complications, which may result in acute renal failure in healthy individuals as well as in renal transplant patients. UPEC expresses a multitude of virulence factors to break the inertia of the mucosal barrier. In response to the breach by UPEC into the normally sterile urinary tract, host inflammatory responses are triggered leading to cytokine production, neutrophil influx, and the exfoliation of infected bladder epithelial cells. Several signaling pathways activated during UPEC infection, including the pathways known to activate the innate immune response, interact with calcium-dependent signaling pathways. Some UPEC isolates, however, might possess strategies to delay or suppress the activation of components of the innate host response in the urinary tract. Studies published in the recent past provide new information regarding how virulence factors of uropathogenic E. coli are involved in activation of the innate host response. Despite numerous host defense mechanisms, UPEC can persist within the urinary tract and may serve as a reservoir for recurrent infections and serious complications. Presentation of the molecular details of these events is essential for development of successful strategies for prevention of human UTIs and urological complications associated with UTIs.