Abstract

Objective: We aimed to assess the impact of obstructive uropathy and its revision on renal apoptotic and inflammatory activity in an experimental model in rabbits. Methods: Twenty-four rabbits were separated into four different groups. Ureteropelvic junction (UPJ) obstruction model was performed in Group 1 and 2. Ureterovesical junction (UVJ) obstruction model was performed in Group 3 and 4. Thirty days after the operations, bilateral nephrectomy was performed in Group 1 and 3. Thirty days after the initial surgery, the obstruction was revised in Group 2 and 4. Thirty days after the revision surgeries, bilateral nephrectomy was performed in Group 2 and 4. The apoptotic and inflammatory activity was measured at the protein level and nephrectomy specimens were examined histologically. Results: Caspase 3 levels were significantly higher in operated left kidneys than the levels obtained in the right counterparts. The increase in procaspase 9 and caspase 3 activities in the UVJ obstruction group was less than those of the UPJ obstruction group (p 0.05, p>0.05, respectively). Conclusion: The rabbits with a UVJ obstruction had lower apoptotic indexes as compared to those with a UPJ obstruction. The apoptotic activity decreased to almost normal levels following an adequate revision of the obstruction in both groups, but this improvement was more significant in animals with a UVJ obstruction.

Highlights

  • Physiological turnover of the cell including both cell proliferation and programmed cell death is essential for preserving the functional integrity of the kidney

  • When we gave a statistical score of 1 to the procaspase9 and cleaved caspase-3 levels in ureteropelvic junction (UPJ) obstruction, we found that scores for procaspase-9 and cleaved caspase-3 levels were 0.84 and 0.82 respectively (Figure 3)

  • COX-2 expression levels decreased insignificantly both in UPJ and ureterovesical junction (UVJ) obstruction models. These results show that the inflamatory burden reached in UPJ obstruction is much more as compared to the UVJ obstruction, and their revision provides a reasonable recovery

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Summary

Introduction

Physiological turnover of the cell including both cell proliferation and programmed cell death is essential for preserving the functional integrity of the kidney. Obstructive uropathy (OU), a major cause of chronic renal failure in childhood, is characterized by the decreased cell proliferation and increased apoptosis [1]. The ureteropelvic junction (UPJ) and ureterovesical junction (UVJ) obstruction are among the most common known causes of the obstructive uropathy in children [2]. Both the pelvicalyceal system and the ureter are dilated in the UVJ obstruction as compared to the UPJ obstruction. The interstitial inflammation is an important factor contributing to the early damage of nephrons and the renal failure in OU. The inflammation leads to the generation of reactive oxygen species (ROS) [5]. The overproduction of ROS has been identified as a key component of apoptotic pathways involving the activation of endogenous endonucleases and the direct DNA fragmentation [6]

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