Cathelicidin, a natural antimicrobial peptide produced by urinary tract cells, shows promise as an early UTI diagnostic biomarker, a predictor of recurrence risk, and a potential therapeutic target for treatment.
Single gene, multiple rolesCathelicidin, encoded by just one gene (CAMP) in humans, serves as bactericidal agent, immune cell recruiter, and cytokine inducer — making it a versatile target for UTI diagnosis, prognosis, and treatment
What the researchers found
Cathelicidin is rapidly produced by uroepithelial cells upon pathogen contact, making it a potential early UTI biomarker. Post-UTI cathelicidin levels lower than healthy controls suggest a risk factor for recurrence. Cathelicidin also shows promise as a biomarker for severe vesicoureteral reflux and renal scarring. Multiple therapeutic agents that upregulate cathelicidin expression are under investigation.
Why it matters
With antibiotic resistance rising, leveraging the body's own antimicrobial defenses is increasingly important. Cathelicidin-based diagnostics could enable faster UTI detection than traditional culture methods, while cathelicidin-boosting therapies could reduce antibiotic dependence. Identifying patients with low cathelicidin levels could also enable preventive strategies for those prone to recurrent UTIs.
The numbers in context
Cathelicidin is encoded by a single gene in humans (CAMP gene). UTIs are one of the most common infectious diseases worldwide.
How the study worked
Comprehensive review searching Scopus, Medline, and Web of Science databases for all published studies on cathelicidin in urinary tract diseases, covering diagnostic, prognostic, and therapeutic applications.
Who was studied
Patients with urinary tract infections (preclinical and clinical evidence)
What this study cannot tell us
Review format inherently depends on the quality and quantity of available studies, which varies considerably across the different clinical applications discussed. Most cathelicidin biomarker studies have been relatively small. Therapeutic cathelicidin upregulation is still in early stages with limited clinical data. Standardization of cathelicidin measurement methods across studies remains a challenge.
How to read the evidence
Moderate evidence overall — multiple studies support cathelicidin's diagnostic utility, but most are relatively small. Therapeutic applications remain in early research stages.
When this study was published
Published in 2024, providing a comprehensive up-to-date synthesis of two decades of cathelicidin research in urinary tract diseases.
The bigger picture
Antimicrobial peptides represent the evolutionary frontline of immune defense, predating antibiotics by hundreds of millions of years. Understanding and enhancing these natural defenses is a major strategy for combating antibiotic resistance. Cathelicidin's role in the urinary tract is just one example of how innate immune peptides could transform infectious disease management.
Questions still open
- Can urinary cathelicidin measurement be developed into a rapid point-of-care test for UTI diagnosis?
- Would prophylactic cathelicidin supplementation or upregulation reduce recurrent UTI rates in high-risk populations?
Common questions
What is cathelicidin?
Could this help prevent recurrent UTIs?
Read the original research
Cathelicidin in Urinary Tract Diseases: Diagnostic, Prognostic and Therapeutic Potential of an Evolutionary Conserved Antimicrobial Protein.
Medicina (Kaunas, Lithuania), 60(12)
Citation
Sorić Hosman, Iva; Cvitković Roić, Andrea; Vuković Brinar, Ivana; Gulin, Tonko; Ćorić, Marijana; Rogić, Dunja; Lončar Vrančić, Ana; Lamot, Lovro. (2024). Cathelicidin in Urinary Tract Diseases: Diagnostic, Prognostic and Therapeutic Potential of an Evolutionary Conserved Antimicrobial Protein.. Medicina (Kaunas, Lithuania), 60(12). https://doi.org/10.3390/medicina60122015