Cajal间质细胞自噬参与儿童原发性肾盂输尿管连接部狭窄发病及机制研究

Autophagy of interstitial cells of Cajal in the pathogenesis of primary ureteropelvic junction stenosis in children

目的探究儿童原发性肾盂输尿管连接部狭窄(UPJO)与Cajal间质细胞(interstitial cells of Cajal,ICC)自噬之间的关系。方法随机选择2020年1月-2021年1月初诊为UPJO且入院行肾盂输尿管成形术患者20名(UPJO组),同期选择年龄性别匹配,因肾脏肿瘤行肾切除肾盂输尿管连接部组织的患者15例(对照组)。手术沿纵行方向切取患者的肾盂输尿管连接部组织。酪氨酸激酶受体(tyrosine kinase receptor,c-kit)和Masson染色分析Cajal间质细胞数量和肌纤维变化,免疫印迹法(western blot)和实时荧光定量核酸扩增检测(qPCR)分析自噬相关基因和蛋白变化。结果 Masson染色显示UPJO连接部ICC数量减少,肌纤维明显减少,胶原纤维增多;免疫荧光显示c-kit阳性细胞LC3表达升高;P62基因和蛋白表达降低,LC3基因及蛋白表达升高。结论儿童原发性肾盂输尿管连接部狭窄与Cajal间质细胞自噬水平异常密切相关。

Objective To explore the relationship between primary ureteropelvic junction stenosis and autophagy of interstitial cells of Cajal in children. Methods From January 2020 to January 2021, 20 patients with ureteropelvic junction obstruction(UPJO)who underwent pyeloureteroplasty were randomly selected as UPJO group, and 15 patients who underwent nephrectomy of ureteropelvic junction due to renal tumor were selected as control group. The ureteropelvic junction was excised along the longitudinal direction. C-kit and Masson immunohistochemical staining were used to analyze the changes of interstitial cells and muscle fibers in Cajal. Western blot and qPCR were used to analyze the changes of genes and proteins related autophagy. Results The staining showed that the number of interstitial cells of Cajal(ICC)in UPJO junction decreased, the number of muscle fibers decreased significantly, and the number of collagen fibers increased;immunofluorescence showed that the expression of LC3 in c-kit positive cells increased;P62 gene and protein expression decreased, LC3 gene and protein expression increased. Conclusion Primary ureteropelvic junction stenosis in children is closely related to abnormal autophagy of interstitial cells of Cajal.