Survivin expression in the ureteral wall of high degree vesicoureteral reflux in children.
BACKGROUND
Survivin is a member of inhibitor of apoptosis protein family which suppresses apoptosis and regulates cell division. Survivin was not found to be expressed in normal differentiated tissues. CD95 is a cell surface receptor, and it is believed to induce cell death in a variety of cells. The goal of this study is to evaluate the survivin and CD95 expression in bladder and uerters of children operated for vesicoureteral reflux (VUR).


METHODS
Sixteen paraffine embeded ureteral units of 11 children with vecico ureterl reflux were treated immunohistochemicaly with survivin and CD95. At operation the distal margins of the ureters were send to histologic exam and a full thickness biopsy from the anterior bladder wall including muscle and mucosa were performed. The control was taken from a urologically normal 9 days old baby who died from myocarditis. The sections were stained with the antibody in the regular method and the degree of staining was graded from 0 to 3, by a single uropathologist.


RESULTS
Immunohistochemistry staining with survivin was positive in all ureters. We had 13 high grade (grade 3-5) and 3 low grade (grade 1-2) vesicoureteral reflux. The average survivin degree of staining in the low grade reflux was 1.33 compared to 2.3 (P = 0.019) in the high grade refluxing ureters. The staining of the control sample was graded 1. The average degree of staining was 1.2 in the bladder wall compared to 2.125 in the ureters. CD95 stained mast cells in ureters and bladders.


CONCLUSIONS
Possitive staining of survivin was found in both ureters and urinary bladders of children that underwent surgical repair of vesicoureteral reflux. The degree of survivin staining was significantly higher in the high grade refluxing ureters compared to low grade reflux and to the bladder wall in the same patients.
Joseph
Binyamini
B
Urology, Ichilov-Tel Aviv Medical Center, 6 Weizmann st, Tel Aviv 64239, Israel. orel100@yahoo.com
Letizia
Schreiber
S
Grisaru
Dan
D
Bar-Yosef
Yuval
Y
Matzkin
Haim
H
Ben-Chaim
Jacob
J
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008407:Mast Cells / Q000378:metabolism; D008869:Microtubule-Associated Proteins / Q000378:metabolism*; D009363:Neoplasm Proteins / Q000378:metabolism*; D000077022:Survivin; D014513:Ureter / Q000378:metabolism* / Q000473:pathology; D001743:Urinary Bladder / Q000378:metabolism / Q000473:pathology; D014718:Vesico-Ureteral Reflux / Q000378:metabolism*; D019014:fas Receptor / Q000378:metabolism
C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D019014:fas Receptor