A highly polarized TH2 bladder response to infection promotes epithelial repair at the expense of preventing new infections.

Journal Article (Journal Article)

Urinary tract infections (UTIs) typically evoke prompt and vigorous innate bladder immune responses, including extensive exfoliation of the epithelium. To explain the basis for the extraordinarily high recurrence rates of UTIs, we examined adaptive immune responses in mouse bladders. We found that, following each bladder infection, a highly T helper type 2 (TH2)-skewed immune response directed at bladder re-epithelialization is observed, with limited capacity to clear infection. This response is initiated by a distinct subset of CD301b+OX40L+ dendritic cells, which migrate into the bladder epithelium after infection before trafficking to lymph nodes to preferentially activate TH2 cells. The bladder epithelial repair response is cumulative and aberrant as, after multiple infections, the epithelium was markedly thickened and bladder capacity was reduced relative to controls. Thus, recurrence of UTIs and associated bladder dysfunction are the outcome of the preferential focus of the adaptive immune response on epithelial repair at the expense of bacterial clearance.

Full Text

Duke Authors

Cited Authors

  • Wu, J; Hayes, BW; Phoenix, C; Macias, GS; Miao, Y; Choi, HW; Hughes, FM; Todd Purves, J; Lee Reinhardt, R; Abraham, SN

Published Date

  • June 2020

Published In

Volume / Issue

  • 21 / 6

Start / End Page

  • 671 - 683

PubMed ID

  • 32424366

Pubmed Central ID

  • PMC7480508

Electronic International Standard Serial Number (EISSN)

  • 1529-2916

Digital Object Identifier (DOI)

  • 10.1038/s41590-020-0688-3


  • eng

Conference Location

  • United States