{"id":382,"date":"2019-07-24T12:48:55","date_gmt":"2019-07-24T12:48:55","guid":{"rendered":"https:\/\/www.nutralabs.it\/area_medici\/?p=382"},"modified":"2026-10-14T12:15:36","modified_gmt":"2026-10-14T10:15:36","slug":"patogenesi-cistite","status":"publish","type":"post","link":"https:\/\/www.nutralabs.it\/area_medici\/patogenesi-cistite\/","title":{"rendered":"PATOGENESI DELLA CISTITE: UNA VISIONE AGGIORNATA"},"content":{"rendered":"\t\t
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La patogenesi della cistite non si esaurisce nella presenza di batteri liberi nelle urine. Gli uropatogeni aderiscono all\u2019urotelio, penetrano nelle cellule e formano colonie o serbatoi intracellulari capaci di persistere dopo la terapia, riattivarsi e contribuire alle recidive anche in presenza di urinocolture negative.<\/em><\/p>

La nostra comprensione della patogenesi della cistite ha subito, negli ultimi 20 anni, una vera e propria rivoluzione<\/strong>, che per\u00f2 stenta ancora a riflettersi in un cambiamento nelle pratiche cliniche.<\/p>

Se classicamente Escherichia coli<\/em>\u2014il batterio responsabile della grande maggioranza delle infezioni urinarie\u2014veniva ritenuto un patogeno esclusivamente extracellulare, siamo arrivati a capire che al contrario la formazione di colonie intracellulari<\/strong> rappresenta con ogni probabilit\u00e0 un passaggio obbligato nel suo ciclo di vita all\u2019interno delle vie urinarie, nonch\u00e9 un fattore imprescindibile affinch\u00e9 possa stabilirsi un\u2019infezione. E, presumibilmente, le cistiti recidive sono dovute non solo al reinoculo di batteri dal serbatoio intestinale, ma anche alla loro persistenza silente all\u2019interno del tessuto della vescica<\/strong>.<\/p>

In questa serie di articoli andiamo alla scoperta dei recenti e fondamentali progressi che la scienza medica ha fatto nella comprensione della patogenesi della cistite. Clicca sui link qui sotto per leggere i capitoli:<\/p>

Capitolo I. La scoperta delle colonie intracellulari e dei serbatoi quiescenti.<\/a>
Capitolo II. Colonie intracellulari, caratteristiche ed evoluzione.<\/a>
Capitolo III. I serbatoi quiescenti si riattivano.<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Bibliografia dei tre capitoli<\/h2>

1: Fukushi, Y., S. Orikasa, and M. Kagayama. “An electron microscopic study of the interaction between vesical epitherlium and E. Coli.” Investigative urology 17.1 (1979): 61-68.<\/p>

2: Mulvey, Matthew A., et al. “Induction and evasion of host defenses by type 1-piliated uropathogenic Escherichia coli.” Science 282.5393 (1998): 1494-1497.<\/p>

3: Mulvey, Matthew A., Joel D. Schilling, and Scott J. Hultgren. “Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection.” Infection and immunity 69.7 (2001): 4572-4579.<\/p>

4: Anderson, Gregory G., et al. “Intracellular bacterial biofilm-like pods in urinary tract infections.” Science301.5629 (2003): 105-107.<\/p>

5: Mysorekar, Indira U., and Scott J. Hultgren. “Mechanisms of uropathogenic Escherichia coli persistence and eradication from the urinary tract.” Proceedings of the National Academy of Sciences103.38 (2006): 14170-14175.<\/p>

6: Justice, Sheryl S., et al. “Differentiation and developmental pathways of uropathogenic Escherichia coli in urinary tract pathogenesis.” Proceedings of the National Academy of Sciences101.5 (2004): 1333-1338.<\/p>

7: Blango, Matthew G., and Matthew A. Mulvey. “Persistence of uropathogenic Escherichia coli in the face of multiple antibiotics.” Antimicrobial agents and chemotherapy 54.5 (2010): 1855-1863.<\/p>

8: Rosen, David A., et al. “Detection of intracellular bacterial communities in human urinary tract infection.” PLoS medicine 4.12 (2007): e329.<\/p>

9: Robino, Luciana, et al. “Detection of intracellular bacterial communities in a child with Escherichia coli recurrent urinary tract infections.” Pathogens and disease 68.3 (2013): 78-81.<\/p>

10: Robino, Luciana, et al. “Intracellular bacteria in the pathogenesis of Escherichia coli urinary tract infection in children.” Clinical Infectious Diseases 59.11 (2014): e158-e164.<\/p>

11: Gilbert, Nicole M., Valerie P. O\u2019Brien, and Amanda L. Lewis. “Transient microbiota exposures activate dormant Escherichia coli infection in the bladder and drive severe outcomes of recurrent disease.” PLoS pathogens 13.3 (2017): e1006238.<\/p>

12: Wright, Kelly J., Patrick C. Seed, and Scott J. Hultgren. “Development of intracellular bacterial communities of uropathogenic Escherichia coli depends on type 1 pili.” Cellular microbiology 9.9 (2007): 2230-2241.<\/p>

13: Silverman, Jennifer A., et al. “From physiology to pharmacy: developments in the pathogenesis and treatment of recurrent urinary tract infections.” Current urology reports 14.5 (2013): 448-456.<\/p>

14: Schilling, Joel D., and Scott J. Hultgren. “Recent advances into the pathogenesis of recurrent urinary tract infections: the bladder as a reservoir for uropathogenic Escherichia coli.” International journal of antimicrobial agents 19.6 (2002): 457-460.<\/p>

15: Pearce, Meghan M., et al. “The female urinary microbiome: a comparison of women with and without urgency urinary incontinence.”\u00a0MBio<\/em>\u00a05.4 (2014): e01283-14.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

La ricerca degli ultimi 20 anni ha rivoluzionato la nostra comprensione della patogenesi delle infezioni urinarie.<\/p>\n","protected":false},"author":2,"featured_media":557,"comment_status":"closed","ping_status":"closed","sticky":true,"template":"","format":"standard","meta":{"_yoast_wpseo_canonical":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":"","_members_access_role":[],"_members_access_error":""},"categories":[10,31],"tags":[57],"class_list":["post-382","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-in-evidenza","category-salute-urinaria","tag-cistiti-ricorrenti"],"_links":{"self":[{"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/posts\/382","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/comments?post=382"}],"version-history":[{"count":4,"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/posts\/382\/revisions"}],"predecessor-version":[{"id":4363,"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/posts\/382\/revisions\/4363"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/media\/557"}],"wp:attachment":[{"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/media?parent=382"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/categories?post=382"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nutralabs.it\/area_medici\/wp-json\/wp\/v2\/tags?post=382"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}