Mediators of fibrosis and apoptosis in obstructive uropathies.
Upper urinary tract obstruction, regardless of its cause, often poses a significant clinical challenge to the urologist. Renal cellular and molecular events that occur in response to upper urinary tract obstruction result in a progressive and permanent loss in renal function when left untreated. These pathologic changes include the development of renal fibrosis, tubular atrophy, interstitial inflammation, and apoptotic renal cell death. Several cytokines and growth factors have been identified as major contributors to obstruction-induced renal fibrosis and apoptotic cell death, most notably transforming growth factor-b1 (TGF-b1), angiotensin II, nuclear factor-kB (NF-kB), and tumor necrosis factor-a (TNF-a). This review examines the challenges of upper urinary tract obstruction and the role of these mediators in obstruction-induced renal injury.
Misseri
Rosalia
R
Riley Hospital for Children, Indiana University, Department of Pediatric Urology, Indianapolis, IN, USA.
Meldrum
Kirstan K
KK
D000804:Angiotensin II / Q000378:metabolism; D017209:Apoptosis / Q000502:physiology; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D005355:Fibrosis / Q000175:diagnosis / Q000378:metabolism; D006801:Humans; D007674:Kidney Diseases / Q000378:metabolism / Q000473:pathology*; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016212:Transforming Growth Factor beta / Q000378:metabolism; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014517:Ureteral Obstruction / Q000378:metabolism / Q000473:pathology*
D015415:Biomarkers; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha; D000804:Angiotensin II
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