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Reicherz A, Eltit F, Almutairi K, Mojtahedzadeh B, Herout R, Chew B, Cox M, Lange D. Ureteral Obstruction Promotes Ureteral Inflammation and Fibrosis. Eur Urol Focus 2022; 9:371-380. [PMID: 36244955 DOI: 10.1016/j.euf.2022.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/23/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Hydronephrosis and renal impairment may persist even after relieving an obstruction, particularly in cases of chronic obstruction. Obstruction can cause fibrotic changes of the ureter, potentially contributing to long-term kidney damage. OBJECTIVE To characterise pathophysiological changes of obstructed ureters with focus on inflammatory responses triggering fibrosis and potential impairment of ureteral function. DESIGN, SETTING, AND PARTICIPANTS Eighty-eight mice were randomly assigned to unilateral ureteral obstruction (UUO) for 2 d, UUO for 7 d, and UUO for 7 d followed by 8 d of recovery, or a control group (no prior surgical intervention). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Peristaltic rate was determined over 2 min by direct visualisation with a microscope, while hydronephrosis was assessed by ultrasound. Obstructed and contralateral ureters were harvested, and underwent histopathological evaluation. We quantified 44 cytokines/chemokines, and five matrix metalloproteases using Luminex technology. Cell composition was characterised via immunofluorescence. Statistical significance was assessed using Welch analysis of variance, Kruskal-Wallis test, and Dunnett's T3 multiple comparison test. RESULTS AND LIMITATIONS Obstruction resulted in hydronephrosis and significantly impaired peristalsis. Marked fibrosis was observed in lamina propria, muscle layer, and adventitia. Connective tissue in obstructed ureters showed hyperaemia and leucocyte infiltration. Unsupervised hierarchical clustering demonstrated different cytokine/chemokine patterns between groups. Ureters obstructed for 7 d followed by recovery were notably different from other groups. Inflammatory cytokines, chemoattractants, and matrix metalloproteases increased significantly in obstructed ureters. Contralateral unobstructed ureters showed significantly increased levels of chemokines and matrix metalloproteases. Immunofluorescence confirmed activation of T cells, Th1 and Th2 cells, and M1 macrophages in obstructed and contralateral ureters, and a shift to M2 macrophages following prolonged obstruction. CONCLUSIONS Ureteral obstruction triggers severe inflammation and fibrosis, which may irreversibly impair ureteral functionality. Function of the unobstructed contralateral ureter may be regulated by a systemic immune response as a result of the obstruction. PATIENT SUMMARY Here, we studied in more detail the way the ureter responds to being blocked. We conclude that a strong immune response is activated by the blockage, leading to changes in the structure of the ureter possibly impacting function, which may not be reversible. This immune response also spreads to the opposite ureter, possibly allowing it to change its function to compensate for the reduced functionality of the blocked ureter.
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Srougi V, Bandeira RASDT, Reis ST, dos Santos GA, Andrade HDS, Leite KRM, Hamilton-Cho D, Mitre AI, Arap MA, Srougi M, Duarte RJ. The influence of interstitial cells of Cajal density in the outcomes of pyeloplasty in adults: A prospective analysis. Urologia 2022; 90:30-35. [PMID: 35765765 DOI: 10.1177/03915603221107470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To evaluate if the density of interstitial cells of Cajal (ICC) in the ureteropelvic junction (UPJ) influences the outcomes of pyeloplasty in adults. Methods: Twenty-three patients with the diagnosis of ureteropelvic junction obstruction (UPJO) that underwent laparoscopic dismembered pyeloplasty were included. ICC density was measured using immunohistochemistry reaction for c-KIT expression in the resected UPJ segment. Pyeloplasty outcome was evaluated by patient self-report pain, urinary outflow using DTPA renogram and hydronephrosis assessment using ultrasound (US) at 12 months of follow-up. A logistic regression analysis was performed to assess the association of pyeloplasty outcomes and ICC density. Results: Low, moderate, and high ICC density were present in 17.4%, 30.4%, and 52.2% of the patients, respectively. Complete pain resolution was observed in 100%, 85.7%, and 75% of patients with low, moderate and high ICC density, respectively ( p = 0.791). DTPA renogram improved in 75%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively ( p = 0.739). Hydronephrosis improved in 25%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively ( p = 0.032). Conclusions: Patients with high ICC density have a significant amelioration of hydronephrosis after pyeloplasty. However, ICC density is not associated with functional outcomes.
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Affiliation(s)
- Victor Srougi
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Hospital Moriah, Sao Paulo, Brazil
| | | | - Sabrina Thalita Reis
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Minas Gerais State University (UEMG), Campos Passos, Brazil
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gabriel Arantes dos Santos
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- D’Or Institute for Research and Education (IDOR), Sao Paulo, Brazil
| | | | - Katia Ramos Moreira Leite
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - David Hamilton-Cho
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Anuar Ibrahim Mitre
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Marco Antonio Arap
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Hospital Sirio Libanes, Sao Paulo, Brazil
| | - Miguel Srougi
- Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- D’Or Institute for Research and Education (IDOR), Sao Paulo, Brazil
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Iskander SM, Feeney MM, Yee K, Rosenblum ND. Protein Kinase 2 β Is Expressed in Neural Crest-Derived Urinary Pacemaker Cells and Required for Pyeloureteric Contraction. J Am Soc Nephrol 2018; 29:1198-1209. [PMID: 29436516 DOI: 10.1681/asn.2017090951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/10/2018] [Indexed: 01/31/2023] Open
Abstract
Nonobstructive hydronephrosis, defined as dilatation of the renal pelvis with or without dilatation of the ureter, is the most common antenatal abnormality detected by fetal ultrasound. Yet, the etiology of nonobstructive hydronephrosis is poorly defined. We previously demonstrated that defective development of urinary tract pacemaker cells (utPMCs) expressing hyperpolarization-activated cyclic nucleotide-gated channel 3 (HCN3) and the stem cell marker cKIT causes abnormal ureteric peristalsis and nonobstructive hydronephrosis. However, further investigation of utPMC development and function is limited by lack of knowledge regarding the embryonic derivation, development, and molecular apparatus of these cells. Here, we used lineage tracing in mice to identify cells that give rise to utPMCs. Neural crest cells (NCCs) indelibly labeled with tdTomato expressed HCN3 and cKIT. Furthermore, purified HCN3+ and cKIT+ utPMCs were enriched in Sox10 and Tfap-2α, markers of NCCs. Sequencing of purified RNA from HCN3+ cells revealed enrichment of a small subset of RNAs, including RNA encoding protein kinase 2β (PTK2β), a Ca2+-dependent tyrosine kinase that regulates ion channel activity in neurons. Immunofluorescence analysis in situ revealed PTK2β expression in NCCs as early as embryonic day 12.5 and in HCN3+ and cKIT+ utPMCs as early as embryonic day 15.5, with sustained expression in HCN3+ utPMCs until postnatal week 8. Pharmacologic inhibition of PTK2β in murine pyeloureteral tissue explants inhibited contraction frequency. Together, these results demonstrate that utPMCs are derived from NCCs, identify new markers of utPMCs, and demonstrate a functional contribution of PTK2β to utPMC function.
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Affiliation(s)
- Samir M Iskander
- Program in Developmental and Stem Cell Biology and.,Departments of Laboratory Medicine and Pathobiology and
| | - Meghan M Feeney
- Program in Developmental and Stem Cell Biology and.,Departments of Laboratory Medicine and Pathobiology and
| | - Kirby Yee
- Program in Developmental and Stem Cell Biology and
| | - Norman D Rosenblum
- Program in Developmental and Stem Cell Biology and .,Departments of Laboratory Medicine and Pathobiology and.,Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada; and.,Paediatrics, University of Toronto, Toronto, Ontario, Canada
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Balikci O, Turunç T, Bal N, Çelik H, Özkardeş H. Comparison of Cajal-like cells in pelvis and proximal ureter of kidney with and without hydronephrosis. Int Braz J Urol 2016; 41:1178-84. [PMID: 26742978 PMCID: PMC4756946 DOI: 10.1590/s1677-5538.ibju.2014.0427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 03/22/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To evaluate effects of Cajal-like cells on human renal pelvis and proximal ureter on peristalsis. MATERIALS AND METHODS 63 patients submitted to nephrectomy due to atrophic non-functional kidney associated with hydroureteronephrosis were included as study group and 30 cases with nephrectomy due to other reasons were included as control group. Samples from renal pelvis and proximal ureters were obtained and sections of 5µ form paraffin blocks of these samples were prepared; layers of lamina propria and muscularis mucosa were examined by immune-histochemistry using CD117 in order to determine count and distribution of Cajal-like cells. RESULTS During immune-histochemical examinations of sections, obtained from renal pelvis and proximal ureter of hydronephrotic kidneys by CD117, Cajal-like cells number determined in lamina propria and muscularis propria was statistically significantly lower compared to control group (p<0.001). Distribution of Cajal-like cells in renal pelvis and proximal tubulus was similar under examination by light microscope, and also both groups were not different from each other regarding staining intensity of Cajal-like cells by c-kit. CONCLUSION Significantly reduced number of Cajal-like cells in study group compared to control group, shows that these cells may have a key role in regulation of peristalsis at level of renal pelvis and proximal ureter in urinary system.
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Affiliation(s)
- Omer Balikci
- Department of Urology, Manisa Alaşehir State Hospital, Manisa, Turkey
| | - Tahsin Turunç
- Department of Urology, School of Medicine, Başkent University, Adana, Turkey
| | - Nebil Bal
- Department of Patology, School of Medicine, Başkent University, Adana, Turkey
| | - Hüseyin Çelik
- Department of Urology, School of Medicine, Inonu University, Malatya, Turkey
| | - Hakan Özkardeş
- Department of Urology, School of Medicine, Başkent University, Adana, Turkey
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Senol C, Onaran M, Gurocak S, Gonul II, Tan MO. Changes in Cajal cell density in ureteropelvic junction obstruction in children. J Pediatr Urol 2016; 12:89.e1-5. [PMID: 26455635 DOI: 10.1016/j.jpurol.2015.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Congenital ureteropelvic junction obstruction is one the most common causes of neonatal hydronephrosis. The etiology of the ureteropelvic junction (UPJ) obstruction has not been clearly established. The presence of a hypoplastic, adynamic ureteral segment is thought to be the major cause of an UPJ obstruction. OBJECTIVE We evaluated the distribution of Cajal cells using immunohistologic methods coupled with light microscopy of the UPJ tissues in obstructed and normal UPJs. STUDY DESIGN The study group consisted of 19 patients who underwent pyeloplasty for UPJ obstruction. Twelve patients who had been operated on for oncological indications constituted the control group. The sections were stained immunohistochemically using CD117 (c-kit) antibody; the numbers of CD117 (+) interstitial cells of Cajal were counted in 10 consecutive high-power fields under the light microscope and the cell density was determined for each case. RESULTS The mean age of the cases who underwent dismembered pyeloplasty and the control group were 116 ± 116 months (14 male, 5 female; 6-420 months) and 279 ± 312 months (9 male, 3 female; 24-948 months) (p = 0.1), respectively. The mean interstitial Cajal cell number in the UPJ obstruction and the control groups were 2.37 ± 2.19 and 24.5 ± 9.73, respectively (p < 0.0001). Thirteen (68.4%) patients had very few, five (26.3%) patients had few, and one (5.3%) patient had many Cajal cells in the UPJ obstruction group. In the control group, all patients had more than seven cells per high-power field. DISCUSSION We found that in cases of UPJ, obstruction the numbers of interstitial Cajal cells were decreased, being either absent or significantly reduced. Although data about the motility are currently not sufficient, the decrease in the number of Cajal cells in patients with UPJ highlights that they might be responsible for the initiation, coordination, and conduction of peristaltic activity along the pelvicalyceal system. Improvement and enhancement of contraction waves arising from the upper urinary system depend on interstitial cells of Cajal, which are the pacemaker cells in smooth muscles. We think that a decreased number of interstitial cells of Cajal have a close relationship with changing ureteral motility when we compare our UPJ obstruction cases with the limited data in the literature. CONCLUSION Further investigations on these cells will probably give detailed information about the neurophysiology of the urinary system and the diseases that cause congenital hydronephrosis.
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Affiliation(s)
- Cem Senol
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
| | - Metin Onaran
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey
| | - Serhat Gurocak
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey
| | - Ipek Isık Gonul
- Department of Pathology, Gazi University School of Medicine, Ankara, Turkey
| | - Mustafa Ozgur Tan
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey
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Kart Y, Karakuş OZ, Ateş O, Hakgüder G, Olguner M, Akgür FM. Altered expression of interstitial cells of Cajal in primary obstructive megaureter. J Pediatr Urol 2013; 9:1028-31. [PMID: 23498667 DOI: 10.1016/j.jpurol.2013.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 02/06/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE A marked decrease in the density of interstitial cells of Cajal (ICC) has been shown in patients with ureteropelvic junction obstruction. ICC may also play a role in primary obstructive megaureter (POM). An immunohistochemical study was conducted to investigate the density of ICC in ureterovesical junction (UVJ) segments resected from patients with POM and from control autopsy specimens. MATERIALS AND METHODS Resected UVJ segments from 11 patients operated for POM comprised the study group. Control UVJs were obtained from autopsy specimens of 7 children who died from causes other than urogenital pathology. The UVJs including the narrowest parts were studied using immunohistochemical staining for C-kit positive cells. RESULTS The number of ICC was significantly lower in the UVJs of the POM compared to the control group. The UVJs of the POM group had 1.75 ± 1.14 ICC (mean ± 1SD), whereas the control group had 5.76 ± 2.99 ICC (mean ± 1SD). CONCLUSION The number of ICC was decreased in the UVJs of the patients with POM compared to the normal control group. As dilation of the ureter during fetal life is a common condition and ureteral dilation is often self limiting, we hypothesize that ureteral peristalsis is a maturational event including the maturational development of ICC.
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Affiliation(s)
- Yeliz Kart
- Clinics of Pediatric Surgery, Private Reyap Hospital, Tekirdag, Turkey
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Eken A, Erdogan S, Kuyucu Y, Seydaoglu G, Polat S, Satar N. Immunohistochemical and electron microscopic examination of Cajal cells in ureteropelvic junction obstruction. Can Urol Assoc J 2013; 7:E311-6. [PMID: 23069698 DOI: 10.5489/cuaj.11293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We examine the ultrastructural configurations of Cajal cells by electron microscopy, as well as the quantitative changes occurring in Cajal cells by light microscopy. METHODS In total, 35 patients with ureteropelvic junction (UPJ) obstruction and 7 patients without obstruction were compared immunohistochemically with c-kit (CD117) to quantify the number of cells. On electron microscopic examination, 7 patients with UPJ obstruction and 3 patients without obstruction were compared to evaluate the changes which occurred in the ultrastructural configuration of the Cajal cells. RESULTS On light microscopic examination, it was determined that the Cajal cells, which demonstrate c-kit (CD117) immunoreactive character, were located near the circular muscle layer and parallel to the muscle cells. The number of Cajal cells in the control group was significantly increased compared to the number of cells in patients with UPJ obstruction (p < 0.001). On electron microscopic examination, the number of interstitial cells was also higher in the control group. A decrease in the number of the caveolae in these cells was seen in the group with UPJ obstruction compared to the control group. CONCLUSION In UPJ obstruction, a decrease in the number of Cajal cells, as well as the changes in the morphologic structure of the Cajal cells, indicates that these cells have a role in the pacemaker system and are associated with ureteral peristalsis.
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Affiliation(s)
- Alper Eken
- Cukurova University, Faculty of Medicine, Department of Urology, Adana, Turkey
| | - Seyda Erdogan
- Cukurova University, Faculty of Medicine, Department of Pathology, Adana, Turkey
| | - Yurdun Kuyucu
- Cukurova University, Faculty of Medicine, Department of Histology and Embryology, Adana, Turkey
| | - Gulsah Seydaoglu
- Cukurova University, Faculty of Medicine, Department of Biostatistics, Adana, Turkey
| | - Sait Polat
- Cukurova University, Faculty of Medicine, Department of Histology and Embryology, Adana, Turkey
| | - Nihat Satar
- Cukurova University, Faculty of Medicine, Department of Urology, Adana, Turkey
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Apoznanski W, Koleda P, Wozniak Z, Rusiecki L, Szydelko T, Kalka D, Pilecki W. The distribution of interstitial cells of Cajal in congenital ureteropelvic junction obstruction. Int Urol Nephrol 2013; 45:607-12. [PMID: 23632879 PMCID: PMC3689466 DOI: 10.1007/s11255-013-0454-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 04/18/2013] [Indexed: 01/19/2023]
Abstract
Purpose The authors analysed the distribution of c-kit-positive interstitial cells of Cajal (ICCs) in obstructed ureteropelvic junction (UPJ) and its age-related changes. Methods Twenty specimens were obtained from children with intrinsic ureteropelvic junction obstruction (UPJO), at the average age of 8.1 years (8 months–16.8 years), fixed in formalin and embedded in paraffin. Five control samples were taken from children at the average age of 2.3 years (2.4 months–7.4 years). All specimens were analysed by the immunohistochemistry test with light microscopy with respect to c-kit expression. The distribution of c-kit-positive ICCs in the two groups was compared and the correlation between the distribution of c-kit-positive ICCs and the patients’ age in UPJO cases was analysed. The results were examined by Yates’ χ2 test, Mann–Whitney U test, and t test for Pearson’s correlation coefficient. A P value < 0.05 was considered as statistically significant. Results No statistically significant differences were found in the distribution of c-kit-positive ICCs between UPJO and the control group. No correlation was established between the age of patients with UPJO and the distribution of c-kit-positive ICCs. Conclusion No distributional difference found in obstructed and unobstructed UPJ seems to indicate that UPJO is not associated with anomalous distribution of c-kit-positive ICCs. Age-related changes in the expression of c-kit-positive ICCs are equally distributed in obstructed UPJ.
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Affiliation(s)
- Wojciech Apoznanski
- Department and Clinic of Paediatric Surgery and Urology, Wroclaw Medical University, ul. M.Sklodowskiej-Curie 50/52, 50-369, Wrocław, Poland
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Koleda P, Apoznanski W, Wozniak Z, Rusiecki L, Szydelko T, Pilecki W, Polok M, Kalka D, Pupka A. Changes in interstitial cell of Cajal-like cells density in congenital ureteropelvic junction obstruction. Int Urol Nephrol 2011; 44:7-12. [PMID: 21547467 PMCID: PMC3253995 DOI: 10.1007/s11255-011-9970-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 04/12/2011] [Indexed: 11/02/2022]
Abstract
PURPOSE The authors examined the number of interstitial cells of Cajal-like cells (ICC-LCs) in obstructed ureteropelvic junction (UPJ) in comparison with normal UPJ specimens and age-related changes. MATERIALS AND METHODS A total of 20 human formalin fixed, paraffin-embedded specimens of intrinsic UPJO from children at the mean age of 8.1 years (age range: 8 months-16.8 years) and 5 control samples from children at the mean age of 2.3 years (range 2.4 months-7.4 years) were investigated immunohistochemically for the expression of c-kit proto-oncogene by light microscopy with computerized image analysis. The results were examined by Fisher's exact test, Yates' chi-square test, and t test for Pearson's correlation coefficient. A P value less than 0.05 was considered statistically significant. RESULTS The number of ICC-LCs-dense fields was significantly higher in UPJO specimens in comparison with the normal group (P = 0.0004). The number of ICC-LCs-sparse fields was significantly lowered in UPJO specimens in comparison with the normal group (P = 0.0122). There was no significant difference in the number of ICC-LCs-medium fields in obstructed and normal UPJ specimens. The number of ICC-LCs was decreasing significantly with increasing age of the patients with UPJO (P = 0.0038). CONCLUSIONS The higher density of c-kit-positive ICC-LCs in UPJ may manifest the compensation of altered peristalsis in UPJO. The number of ICC-LCs-dense fields decreasing with age may show the failure of compensation and regression of the compensatory changes.
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Affiliation(s)
- Piotr Koleda
- Department of Pathophysiology, Wroclaw Medical University, ul. Marcinkowskiego 1, 50-368 Wroclaw, Poland.
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Abstract
Interstitial cells of Cajal (ICC)-like cells (ICC-LCs) have been identified in many regions of the urinary tract and male genital organs by immunohistochemical studies and electron microscopy. ICC-LCs are characterized by their spontaneous electrical and Ca2+ signalling and the cellular mechanisms of their generation have been extensively investigated. Spontaneous activity in ICC-LCs rises from the release of internally stored Ca2+ and the opening of Ca2+-activated Cl− channels to generate spontaneous transient depolarizations (STDs) in a manner not fundamentally dependent on Ca2+ influx through L-type voltage-dependent Ca2+ channels. Since urogenital ICC-LCs have been identified by their immunoreactivity to Kit (CD117) antibodies, the often-used specific marker for ICC in the gastrointestinal tract, their functions have been thought likely to be similar. Thus ICC-LCs in the urogenital tract might be expected to act as either electrical pacemaker cells to drive the smooth muscle wall or as intermediaries in neuromuscular transmission. However, present knowledge of the functions of ICC-LCs suggests that their functions are not so predetermined, that their functions may be very region specific, particularly under pathological conditions. In this review, we summarize recent advances in our understanding of the location and function of ICC-LCs in various organs of the urogenital system. We also discuss several unsolved issues regarding the identification, properties and functions of ICC-LCs in various urogenital regions in health and disease.
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Affiliation(s)
- Hikaru Hashitani
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Yang X, Zhang Y, Hu J. The expression of Cajal cells at the obstruction site of congenital pelviureteric junction obstruction and quantitative image analysis. J Pediatr Surg 2009; 44:2339-42. [PMID: 20006022 DOI: 10.1016/j.jpedsurg.2009.07.061] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2009] [Accepted: 07/31/2009] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The study aimed to analyze the expression and significance of interstitial cells of Cajal (ICC) at the obstruction site of congenital pelviureteric junction obstruction (PUJO). METHODS Specimens of the strictured segment of the PUJ were obtained from 24 patients who were diagnosed to have PUJO (without aberrant vessels and adhesive band compression of ureteral junction) intraoperatively. In the control group, PUJ specimens were taken from 21 patients who had Wilms' tumor. Pelviureteric junction tissues were confirmed to be free of tumor invasion by histology. Immunohistochemistry with c-kit antibody was performed to detect the expression of ICC in specimens of the 2 groups. Quantitative analysis was made using image analysis technique and statistical analysis was carried out. RESULTS Immunoreactivity to ICC was predominantly detected in the muscle layers of PUJ. The mean area of ICC expression in the PUJO group was 14.86 +/- 1.37 x 10(4)microm(2) , which was lower than that in the control group (16.80 +/- 1.68) x 10(4)microm(2) (P < .01). The mean density of ICC expression in the PUJO was 0.207 +/- 0.020, which was also lower than that in the control group (0.262 +/- 0.026) (P < .05). CONCLUSIONS A reduction of the number of ICC may play an important role in the etiology and pathogenesis of PUJO.
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Affiliation(s)
- Xinghai Yang
- Department of Pediatric Surgery, Hubei Women and Children's Hospital, Wuhan 430070, People's Republic of China.
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