Pacemakers in the upper urinary tract.

Abstract:

BACKGROUND:Pacemakers in upper urinary tract (UUT) are still under study. AIM:We reviewed the role of some cells that seem to be involved in the propulsion of urinary bolus from UUT to the bladder. MATERIALS & METHODS:We focuses on evaluating studies on the mechanisms by which the UUT propels urine to the bladder via pacemaker cells. RESULTS:Electric active pacemaker cells generate pyeloureteric autorhythmicity driving adjacent smooth muscle cells (SMCs); it emphasizes the role of the interstitial cells of Cajal-like cells (ICC-LCs) localized in the UUT. Interstitial cells of Cajal (ICCs) are now thought to cooperate in conducting and amplifying pacemaker activity in the UUT. These cells produce electrical slow-wave potentials and determine the propagation of peristaltic activity. Identification of ICC-LCs is facilitated by use of c-kit antibodies. Contraction waves arising from the UUT and the propagation of these waves may require the direct involvement of ICC-LCs, as c-kit immunoreactivity appears developmentally at the same time as coordinated unidirectional peristaltic contraction. ICC-LCs observed in the UUT have morphological features similar to those of c-kitpositive ICCs in the gastrointestinal tract. In addition to gastrointestinal motility, ICCs may also play a significant role in the propagation, coordination, and modulation of ureteropelvic peristalsis. DISCUSSION:Alterations in ICC-LCs are closely associated with a variety of motility disorders and many congenital urological diseases of the UUT such as primary obstructive megaureter, congenital ureteropelvic junction obstruction, and vesicoureteral reflux. CONCLUSION:These observations open the way for further investigations of this cell type.

journal_name

Neurourol Urodyn

authors

Di Benedetto A,Arena S,Nicotina PA,Mucciardi G,Galì A,Magno C

doi

10.1002/nau.22310

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

349-53

issue

4

eissn

0733-2467

issn

1520-6777

journal_volume

32

pub_type

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