Uropathogens express common virulence factors that enable them to successfully establish infection in the urinary tract ( BOX 1). The majority of urinary tract infections (UTIs) in healthy individuals are caused by uropathogenic Escherichia coli (UPEC) that originate from the gut 3. NK, natural killer TLR, Toll-like receptor. These cells are located underneath the basal epithelium and function as sentinels to sense infection and recruit neutrophils and LY6C + macrophages from the bladder. The major resident immune cells in the bladder include mast cells and LY6C − macrophages. The ureters, urethra and bladder constitute the lower urinary tract, and several layers of stratified epithelial cells that line the bladder function as the first line of defence. In addition, there is a large network of lymphatic vessels in these organs, which connects to the renal lymph nodes. Many of the immune-competent cells, including dendritic cells (DCs) and macrophages, are aggregated in the interstitium in close proximity to both the tubular epithelium and blood vessels. The upper urinary tract is comprised primarily of the kidneys, and the filtration function of the kidneys is performed by hundreds of thousands of nephrons, each of which is composed of a glomerulus and a double hairpin-shaped tubule. Organization of immune-competent cells along the urinary tractĪ variety of cell types are responsible for initiating immune responses along the urinary tract.
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