Human Nephrogenesis can Persist Beyond 40 Postnatal Days in Preterm Infants.
Human Nephrogenesis can Persist Beyond 40 Postnatal Days in Preterm Infants.
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早产儿的人类肾发生可以持续 40 天以上。
DOI：
10.1016/j.ekir.2023.10.032
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发表时间：
2024
影响因子：
6
通讯作者：
Schuh,MeredithP
中科院分区：
文献类型：
--
作者：
Carpenter,James;Yarlagadda,Sunitha;VandenHeuvel,KatherineA;Ding,Lili;Schuh,MeredithP
人类肾脏发育通常在妊娠36周左右完成，然而，它受到早产的影响。早期研究表明，早产儿的肾发生持续≤40天。然而，存活>40天的早产儿的经后年龄（PMA）是不确定的。在这项研究中，我们试图重新检查出生后的肾脏发育的早产儿存活>40 days.MethodsHuman肾脏样本从一个机构的生物银行。如果出生后存活≤4天且PMA为30至≤36周，则将样本视为对照。将出生后存活>40天且PMA为30至≤36周的早产新生儿的肾脏与对照组进行比较。我们计数肾小球代数，测量肾生成带宽度（NZW），并用SIX1和RET进行免疫荧光（IF）。我们比较肾脏重量和量化的横截面积近端（莲花凝集素[LTL]，SL22A2），远端（SLC12A3，KCNJ10），肾小球（nephrin）标记使用IF.Results7早产儿生存>40天和8个对照进行了分析。7例早产儿中有4例有肾发生的组织学和分子学证据。早产儿的肾发生停止发生2周前比PMA匹配的对照组与减弱的SIX1和RET的表达。我们发现增加肾脏重量与体重的比例，增加远端肾小管横截面染色的浅表肾单位，和远端肾小管肥大和增生的早产儿kidney.ConclusionOur研究支持，在早产儿的肾发生持续时间比以前认为的早期肾单位应激的证据，重视新生儿的环境。
IntroductionHuman nephrogenesis is typically completed by 36 weeks gestation; however, it is impacted by preterm birth. Early studies suggested that nephrogenesis persisted for ≤40 postnatal days in preterm infants. However, the postmenstrual age (PMA) of the preterm infants who survived >40 days was uncertain. In this study, we sought to reexamine postnatal kidney development in preterm infants surviving >40 days.MethodsHuman kidney samples were obtained from an institutional biobank. Samples were considered controls if survival was ≤4 days after birth with PMA of 30 to ≤36 weeks. Kidneys from preterm neonates with postnatal survival >40 days and PMA of 30 to ≤36 weeks were compared to controls. We counted glomerular generations, measured nephrogenic zone widths (NZW), and performed immunofluorescence (IF) with SIX1 and RET. We compared kidney weights and quantified the cross-sectional area of proximal (lotus tetragonolobus lectin [LTL], SL22A2), distal (SLC12A3, KCNJ10), and glomerular (nephrin) markers using IF.ResultsSeven preterm infants surviving >40 days and 8 controls were analyzed. Four of 7 preterm infants had histologic and molecular evidence of nephrogenesis. Cessation of nephrogenesis in preterm infants occurred 2 weeks earlier than PMA-matched controls with attenuated expression of both SIX1 and RET. We found increased kidney weight-to-body weight ratio, increased distal tubular cross-sectional staining in the superficial nephrons, and distal tubular hypertrophy and hyperplasia in the preterm infant kidneys.ConclusionOur study supports that nephrogenesis in preterm infants persists longer than previously thought with evidence of early nephron stress, placing importance on the neonatal environment.