{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:21:26Z","timestamp":1785410486425,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science, Technological Development and Innovation of the Republic of Serbia","award":["451-03-34\/2026-03\/200113"],"award-info":[{"award-number":["451-03-34\/2026-03\/200113"]}]},{"award":["451-03-34\/2026-03\/200113"],"award-info":[{"award-number":["451-03-34\/2026-03\/200113"]}],"id":[{"id":"https:\/\/ror.org\/01znas443","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This study evaluated serum and urinary extracellular matrix (ECM)-related biomarkers in pediatric patients with vesicoureteral reflux (VUR) and their association with disease severity and renal scarring. Children with VUR and control subjects were included. Serum and urinary concentrations of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinases-1 (TIMP-1), CD147, transforming growth factor-\u03b2 (TGF-\u03b2), and monocyte chemoattractant protein-1 (MCP-1) were analyzed, with urinary values normalized to creatinine. Serum MCP-1 levels were higher in patients with VUR (p &lt; 0.001), whereas other serum biomarkers showed no significant differences. Creatinine-normalized urinary TIMP-1 and TGF-\u03b2 levels were significantly elevated (p = 0.006 and p = 0.008, respectively), while CD147 levels were reduced (p = 0.011) in VUR patients. Receiver operating characteristic analysis demonstrated moderate discriminative performance for uTIMP-1\/Cr (AUC = 0.74), uTGF-\u03b2\/Cr (AUC = 0.73), and uCD147\/Cr (AUC = 0.72). Higher urinary levels of MMP-9 (p = 0.014), TIMP-1 (p = 0.003), and MCP-1 (p = 0.015) were associated with high-grade VUR and with bilateral renal scarring (p = 0.048, p = 0.041, and p = 0.025, respectively). These findings suggest that urinary ECM-related biomarkers may reflect intrarenal inflammatory and fibrotic processes in VUR. However, their clinical applicability remains limited and requires validation in larger, longitudinal studies.<\/jats:p>","DOI":"10.3390\/ijms27114815","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:31:56Z","timestamp":1779885116000},"page":"4815","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inflammation\u2013Matrix Crosstalk in Vesicoureteral Reflux: Serum and Urinary ECM-Related Biomarkers and Renal Scarring"],"prefix":"10.3390","volume":"27","author":[{"given":"Marija","family":"Ratkovi\u0107-Jankovi\u0107","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"},{"name":"Clinic of Pediatrics, University Clinical Center Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9221-561X","authenticated-orcid":false,"given":"Jelena","family":"Ba\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Jevtovi\u0107-Stoimenov","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilija","family":"Golubovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"},{"name":"Clinic of Pediatrics, University Clinical Center Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2010-2648","authenticated-orcid":false,"given":"Ljiljana","family":"Pej\u010di\u0107","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"},{"name":"Clinic of Pediatrics, University Clinical Center Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Nikoli\u0107","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Clinic \u201cNarodni Front\u201d, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bojko","family":"Bjelakovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"},{"name":"Clinic of Pediatrics, University Clinical Center Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1016\/j.juro.2010.05.066","article-title":"Pediatric vesicoureteral reflux guidelines panel summary report: Clinical practice guidelines for screening siblings of children with vesicoureteral reflux and neonates\/infants with prenatal hydronephrosis","volume":"184","author":"Skoog","year":"2010","journal-title":"J. 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