Dextranomer/Hyaluronic Acid Copolymer Implant for Vesicoureteral Reflux: Role of Myofibroblast Differentiation
被引:10
作者:
Arena, Salvatore
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Univ Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, ItalyUniv Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
Arena, Salvatore
[1
]
Fazzari, Carmine
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Univ Messina, Policlin, Unit Histopathol Diagnosis, Dept Human Pathol, Messina, ItalyUniv Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
Fazzari, Carmine
[2
]
Implatini, Alessandra
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Univ Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, ItalyUniv Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
Implatini, Alessandra
[1
]
Torre, Santo
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Univ Messina, Policlin, Unit Histopathol Diagnosis, Dept Human Pathol, Messina, ItalyUniv Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
Torre, Santo
[2
]
Villari, Daniela
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Univ Messina, Policlin, Unit Histopathol Diagnosis, Dept Human Pathol, Messina, ItalyUniv Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
Villari, Daniela
[2
]
Arena, Francesco
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Univ Messina, Policlin, Dept Pediat Med & Surg Sci, Unit Pediat Surg, Messina, ItalyUniv Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
Arena, Francesco
[3
]
Di Benedetto, Vincenzo
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Univ Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, ItalyUniv Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
Di Benedetto, Vincenzo
[1
]
机构:
[1] Univ Catania, Vittorio Emanuele Hosp, Unit Pediat Surg, Dept Pediat Surg, I-95124 Catania, Italy
[2] Univ Messina, Policlin, Unit Histopathol Diagnosis, Dept Human Pathol, Messina, Italy
[3] Univ Messina, Policlin, Dept Pediat Med & Surg Sci, Unit Pediat Surg, Messina, Italy
Purpose: Dextranomer/hyaluronic acid implantation is associated with a granulomatous inflammatory reaction, replaced by fibrosis. Appearance of myofibroblasts is considered a crucial event in fibrosis, and CD68 positive cells and other factors are implied in their activation. Mast cells are a source of these factors and tryptase can induce fibroblast to express a-smooth muscle actin, which is characteristic of myofibroblasts. We evaluated histological changes in refluxing ureters treated with dextranomer/hyaluronic acid and immunolocalized CD68 positive cells, tryptase mast cells and myofibroblasts. Materials and Methods: We performed histological, histochemical and immunohistochemical analyses in 22 refluxing ureters treated with dextranomer/hyaluronic acid in comparison with 17 refluxing ureters who underwent ureteral reimplantation but did not receive endoscopic bulking agent. We used CD68 antibody for monocytes/macrophages and epithelioid cells, mast cell tryptase mouse antibody for mast cells, and a-smooth muscle actin and vimentin antibodies for myofibroblasts. The area of the ureteral lumen in dextranomer/hyaluronic acid treated and untreated ureteral endings was measured. Results: Sirius red documented a major grade of histological lesions in dextranomer/hyaluronic acid treated refluxing ureters. CD68 and tryptase mast cell staining showed a significant enhancement of positive cells in dextranomer/hyaluronic acid treated refluxing ureters. Immunostaining for a-smooth muscle actin and vimentin displayed a myofibroblastic invasion in dextranomer/hyaluronic acid. Measurement of surface in treated refluxing ureters was significantly less than in untreated refluxing ureters. Conclusions: Our data documented a recruitment of CD68 and tryptase positive cells, abnormal accumulation of collagenous stroma and successive extracellular matrix remodeling through differentiation of myofibroblasts. Myofibroblasts might provoke tissue contraction, decreasing the ureteral diameter and modifying the ureteral length-to-diameter ratio, preventing urine reflux.
机构:
Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, IsraelTel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Leor, Jonathan
Rozen, Liat
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Rozen, Liat
Zuloff-Shani, Adi
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Zuloff-Shani, Adi
Feinberg, Micha S.
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Feinberg, Micha S.
Amsalem, Yoram
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Amsalem, Yoram
Barbash, Israel M.
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Barbash, Israel M.
Kachel, Erez
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Kachel, Erez
Holbova, Radka
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Holbova, Radka
Mardor, Yael
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Mardor, Yael
Daniels, Dianne
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Daniels, Dianne
Ocherashvilli, Aharon
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Ocherashvilli, Aharon
Orenstein, Arie
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Orenstein, Arie
Danon, David
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
机构:
Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, IsraelTel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Leor, Jonathan
Rozen, Liat
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h-index: 0
机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Rozen, Liat
Zuloff-Shani, Adi
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h-index: 0
机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Zuloff-Shani, Adi
Feinberg, Micha S.
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h-index: 0
机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Feinberg, Micha S.
Amsalem, Yoram
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h-index: 0
机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Amsalem, Yoram
Barbash, Israel M.
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Barbash, Israel M.
Kachel, Erez
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Kachel, Erez
Holbova, Radka
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Holbova, Radka
Mardor, Yael
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Mardor, Yael
Daniels, Dianne
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Daniels, Dianne
Ocherashvilli, Aharon
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Ocherashvilli, Aharon
Orenstein, Arie
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
Orenstein, Arie
Danon, David
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机构:Tel Aviv Univ, Neufeld Cardiac Res Inst, Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel