Early bladder wall changes after creation of obstructive uropathy in the fetal lamb
Early bladder wall changes after creation of obstructive uropathy in the fetal lamb
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DOI：
10.1007/s00383-006-1755-z
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发表时间：
2006-11-01
影响因子：
1.8
通讯作者：
Nakada, Koonosuke
中科院分区：
文献类型：
--
作者：
Kitagawa, Hiroaki;Pringle, Kevin C.;Nakada, Koonosuke
胎儿羔羊梗阻性尿路病的膀胱羊膜分流术产生了壁厚、顺应性差的膀胱。我们报告了梗阻膀胱壁的早期组织学变化。我们通过结扎尿道和尿尿管，在妊娠 60 天的羔羊身上制造了阻塞性尿路病。 21天后进行膀胱造口术或膀胱羊膜分流管插入和膀胱壁活检。胎儿足月（145 天）分娩，并对肾脏和膀胱进行组织学取样。这些样品使用胶体铁 (Col Fe) 和 α-平滑肌肌动蛋白 (α-SMA) 免疫组织化学染色。当时对 17 个胎儿进行了分流，并进行了 15 个活检。六例（分流失败或错过脐尿管结扎）被排除。分流时进行的所有活检均呈阳性 Col Fe 和 α-SMA。足月羔羊有 5 只患有轻度多囊性发育不良肾 (MCDK)，2 只患有严重 MCDK，4 只患有肾积水。所有膀胱的体积都很小并且严重纤维化。梗阻性尿路病发生后3周进行的胎儿分流手术提供了部分肾脏组织学的保留，但没有保留正常的膀胱组织学。我们认为，分流时扩张的胎儿膀胱壁中透明质酸合成活性高或肌成纤维细胞增生，导致发育中的膀胱肌肉不可逆损伤和纤维化。
Vesico-amniotic shunting of obstructive uropathy in fetal lambs produced a thick-walled, poorly compliant bladder. We report the early histological changes in the obstructed bladder wall. We created an obstructive uropathy in fetal lambs at 60 days gestation by ligating the urethra and urachus. Vesicostomy or vesico-amniotic shunt tube insertion and biopsy of the bladder wall were performed 21 days later. The fetuses were delivered at term (145 days) and the kidneys and bladder sampled for histology. Colloidal iron (Col Fe), and alpha-smooth muscle actin (alpha-SMA) immunohistochemical stains were used for these samples. Seventeen fetuses were shunted with 15 biopsies taken at that time. Six (shunt failure or missed urachal ligation) were excluded. All biopsies taken at shunting had positive Col Fe and alpha-SMA. Term lambs had mild multicystic dysplastic kidney (MCDK) in five, severe MCDK in two, and hydronephrosis in four. All bladders had small volume and were severely fibrotic. Fetal shunt operations 3 weeks after the creation of obstructive uropathy provided partial preservation of renal histology but did not preserve normal bladder histology. We suggest that the high hyaluronic acid synthesis activity or hyperplasia of the myofibroblasts in the dilated fetal bladder wall at the time of shunting results in irreversible damage to the developing bladder muscle and fibrosis.