Does intervention in utero preserve the obstructed kidneys of fetal lambs? A histological, cytological, and molecular study.
Ureteropelvic junction obstruction is a common cause of end-stage nephropathy in children. Our aim was to investigate whether relief of obstruction in utero can alleviate the development of nephropathy. A silastic tube was tied around the left superior segment ureter to induce unilateral partial ureteral obstruction in 22 fetal sheep at 75- 85 d of gestation. Three weeks later, the tubes were removed to relieve the obstruction in 10 of the 22 lambs. A sham operation was performed on four fetuses (the control). At birth, the lambs were killed, and their kidneys were removed to study the changes in histology, podocytes, and expression of paired-box 2 (PAX2) and VEGF. In the obstructed kidneys, we observed cysts of various sizes in the cortex, fibrosis in the interstitial tissue, much decreased number of glomeruli, severe podocyte foot process fusion, and markedly increased PAX2 and decreased VEGF expressions. However, relief of obstruction preserved the number of glomeruli, significantly increased VEGF expression, reduced fusion of the podocyte foot processes, andrestored expression of PAX2 to some extent. Thus, relief ofobstruction in utero may prevent or attenuate the development ofnephropathy in lambs.
Fenghua
Wang
W
Department of Pediatric Surgery, First Affiliated Hospital, University of Sun Yat-Sen, Guangzhou, Guangdong 510080, China.
Junjie
Sun
S
Gaoyan
Deng
D
Jiacong
Mo
M
D000818:Animals; D002648:Child; D005260:Female; D005333:Fetus / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000166:cytology / Q000378:metabolism / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology / Q000601:surgery*; D051762:PAX2 Transcription Factor / Q000378:metabolism; D050199:Podocytes / Q000378:metabolism / Q000648:ultrastructure; D011247:Pregnancy; D012756:Sheep; D014517:Ureteral Obstruction / Q000150:complications / Q000151:congenital / Q000196:embryology* / Q000601:surgery*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D051762:PAX2 Transcription Factor; D042461:Vascular Endothelial Growth Factor A