Decoding epithelial-immune cell crosstalk in uropathogenic Escherichia coli urinary tract infections.

Urinary tract infections (UTIs) pose a significant global health burden, characterized by a spectrum of clinical outcomes shaped by intricate epithelial-immune interactions. Uropathogenic Escherichia coli (UPEC) is the predominant etiological agent, accounting for the majority of cystitis cases. Upon breaching urothelial barriers, UPEC triggers a robust innate immune response involving cytokine secretion, antimicrobial peptide production, and recruitment of neutrophils and other immune cells. This review synthesizes current understanding of the dynamic crosstalk between urothelial and immune cells-highlighting mechanisms of bacterial recognition, phagocytosis, inflammatory mediation, and tissue repair-while addressing the limited adaptive immunity, which underlies the high recurrence rates. Elucidating these interactions provides a framework for developing targeted immunomodulatory therapies against UTIs.