title: Distribution of Cajal like cells and innervation in intrinsic ureteropelvic junction obstruction.
abstract: OBJECTIVE
  C-kit positive interstitial cells of Cajal (ICC)-like cells are defined as pacemaker cells in the ureter, which produce and coordinate peristaltic motility. To investigate the changes in ICC-like cells and innervation in segments of intrinsic uretero-pelvic junction (UPJ) obstruction.
  
  
  METHODS
  Full thickness specimens obtained from UPJ segments (n = 77) were divided into 3 groups. Group I included 32 intrinsic UPJ obstruction segments, separated into 3 subgroups: Group Ia (proximal), Group Ib (obstruction, intermediate) and Group Ic (distal segments). Group II included 30 normal UPJ segments derived from the nephrectomy specimens. In Group III, 15 UPJ segments of chronic obstruction were analyzed. Formalin fixed, paraffin embedded specimens from UPJs were analyzed immunohistochemically for CD117, S100 and synaptophysin protein expression in nerve plexus and ganglionic cells in the neuromuscular junction.
  
  
  RESULTS
  Group Ib showed significantly decreased (p < 0.05) positive staning with c-kit protooncogene protein (CD117), S100 and synaptophysin proteins compared with Group Ia and Group Ic. ICC-like cells were observed in increased number (p < 0.05) in Group Ia compared to Groups II and III. Group Ib had lower synaptophysin positivity compared to Group II.
  
  
  CONCLUSIONS
  The findings support the hypothesis of decreased innervation in the etiopathogenesis of intrinsic UPJ obstruction. Increased number of ICC-like cells in Group Ia suggests that peristaltic activity is higher in pelvicalyceal region.
authors.affiliation: Urology II Clinics, Kartal Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Kuvel
authors.forename: Onder
authors.initials: O
authors.lastname: Canguven
authors.forename: Medine
authors.initials: M
authors.lastname: Murtazaoglu
authors.forename: Selami
authors.initials: S
authors.lastname: Albayrak
mesh_terms: D000465:Algorithms; D015415:Biomarkers / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D056885:Interstitial Cells of Cajal / Q000378:metabolism*; D007682:Kidney Pelvis / Q000294:innervation* / Q000378:metabolism* / Q000473:pathology; D010528:Peristalsis; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D009418:S100 Proteins / Q000378:metabolism; D016708:Synaptophysin / Q000378:metabolism; D014517:Ureteral Obstruction / Q000473:pathology
chemical_list: D015415:Biomarkers; D009418:S100 Proteins; D016708:Synaptophysin; D019009:Proto-Oncogene Proteins c-kit