Genetic susceptibility to uncomplicated urinary tract infections and refractory overactive bladder in women

The cystitis is a consequence of the prevalence of infectious agent virulence over the defence capabilities of the bladder mucosa. Uropathogenic strains of E. coli could form biofilms (microcolonies) on the surface of the bladder mucosa and within the epithelial layer. As it usually happens, development and intensity of infection is a complex fusion of the virulence of bacterial species and the state of the defence of the human body. E. coli species present with the virulence factors by means of which they can overcome defence potential of the bladder mucosa in women and spread upwards in the urinary tract. It was shown in some investigations that 27-44% women who had one episode of cystitis showed recurrence further. Nevertheless, in many women social, functional or anatomical factors predisposing to urinary tract infection cannot be identified. This situation rises a big question, whether if genetic susceptibility has any role in the development of infection. Among adult women 65.5% of mothers, 60.7% of their daughters and 48.6% of their sisters with recurrent urinary tract infection share common history of disease. It is also important to account for infectious origin of overactive bladder which is intensively investigated in the literature. Nowadays, there is a big amount of evidence showing genetic susceptibility to the different types of urinary tract infections and overactive bladder, especially underlining the role of genetic variability in toll-like receptors type 4 and IRF-3.