Urothelial Dysfunction and Increased Suburothelial Inflammation of Urinary Bladder Are Involved in Patients with Upper Urinary Tract Urolithiasis – Clinical and Immunohistochemistry StudyReport as inadecuate




Urothelial Dysfunction and Increased Suburothelial Inflammation of Urinary Bladder Are Involved in Patients with Upper Urinary Tract Urolithiasis – Clinical and Immunohistochemistry Study - Download this document for free, or read online. Document in PDF available to download.

Objectives

To investigate the urothelial dysfunction and inflammation of urinary bladder in patients with upper urinary tract UUT urolithiasis through the results of cystoscopic hydrodistension and immunohistochemistry study.

Methods

Ninety-one patients with UUT urolithiasis underwent cystoscopic hydrodistension before the stone surgery. Immunofluorescence staining of E-cadherin, zonula occludens-1 ZO-1, tryptase mast cell activation, and TUNEL urothelial apoptosis were performed in 42 patients with glomerulations after hydrodistension, 10 without glomerulations, and 10 controls.

Results

Of the 91 patients, 62 68.2% developed glomerulations after hydrodistension. Lower urinary tract symptoms LUTS were present in 53.8% patients, in whom significantly smaller maximal anesthetic bladder capacity MBC was noted. Patients with middle or lower 1-3 ureteral stones had a significantly higher glomerulation rate 88.6% vs. 55.4%, p<0.01 and lower MBC 618.4±167.6 vs. 701.2±158.4 ml, p = 0.027 than those with upper 1-3 ureteral or renal stones. Patients with UUT urolithiasis had significantly lower expression of E-cadherin 26.2±14.8 vs. 42.4±16.7 and ZO-1 5.16±4.02 vs. 11.02±5.66; and higher suburothelial mast cell 13.3±6.8 vs. 1.3±1.2 and apoptotic cell 2.6±2.5 vs. 0.1±0.3 numbers than in controls all p<0.01.

Conclusions

Urothelial dysfunction and increased suburothelial inflammation and apoptosis are highly prevalent in the bladders of UUT urolithiasis patients, indicating inflammation cross-talk between UUT and urinary bladder. Patients with UUT urolithiaisis concomitant with LUTS had a smaller MBC, which may explain the presence of irritative bladder symptoms.



Author: Yuan-Hong Jiang, Hann-Chorng Kuo

Source: http://plos.srce.hr/



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