Karl-Erik Andersson led the peer-review process as the Associate Editor responsible for the paper
Article first published online: 21 SEP 2012
Copyright © 2012 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 32, Issue 4, pages 349–353, April 2013
How to Cite
Di Benedetto, A., Arena, S., Nicotina, P. A., Mucciardi, G., Galì, A. and Magno, C. (2013), Pacemakers in the upper urinary tract. Neurourol. Urodyn., 32: 349–353. doi: 10.1002/nau.22310
Conflict of interest: None.
- Issue published online: 15 APR 2013
- Article first published online: 21 SEP 2012
- Manuscript Accepted: 16 AUG 2012
- Manuscript Received: 8 MAY 2012
- interstitial cells of Cajal;
- ureteral obstruction;
- urinary tract;
- vesicoureteral reflux
Pacemakers in upper urinary tract (UUT) are still under study.
We reviewed the role of some cells that seem to be involved in the propulsion of urinary bolus from UUT to the bladder.
Materials & Methods
We focuses on evaluating studies on the mechanisms by which the UUT propels urine to the bladder via pacemaker cells.
Electric active pacemaker cells generate pyeloureteric autorhythmicity driving adjacent smooth muscle cells (SMCs); it emphasizes the role of the interstitial cells of Cajal-like cells (ICC-LCs) localized in the UUT. Interstitial cells of Cajal (ICCs) are now thought to cooperate in conducting and amplifying pacemaker activity in the UUT. These cells produce electrical slow-wave potentials and determine the propagation of peristaltic activity. Identification of ICC-LCs is facilitated by use of c-kit antibodies. Contraction waves arising from the UUT and the propagation of these waves may require the direct involvement of ICC-LCs, as c-kit immunoreactivity appears developmentally at the same time as coordinated unidirectional peristaltic contraction. ICC-LCs observed in the UUT have morphological features similar to those of c-kitpositive ICCs in the gastrointestinal tract. In addition to gastrointestinal motility, ICCs may also play a significant role in the propagation, coordination, and modulation of ureteropelvic peristalsis.
Alterations in ICC-LCs are closely associated with a variety of motility disorders and many congenital urological diseases of the UUT such as primary obstructive megaureter, congenital ureteropelvic junction obstruction, and vesicoureteral reflux.
These observations open the way for further investigations of this cell type. Neurourol. Urodynam. 32: 349–353, 2013. © 2012 Wiley Periodicals, Inc.