The Effect of 6-Hydroxydopamine on Nerves in the Rat Upper Urinary Tract

Pacemaker Mechanisms Driving Pyeloureteric Peristalsis: Modulatory Role of Interstitial Cells

The peristaltic pressure waves in the renal pelvis that propel urine expressed by the kidney into the ureter towards the bladder have long been considered to be 'myogenic', being little affected by blockers of nerve conduction or autonomic neurotransmission, but sustained by the intrinsic release of prostaglandins and sensory neurotransmitters. In uni-papilla mammals, the funnel-shaped renal pelvis consists of a lumen-forming urothelium and a stromal layer enveloped by a plexus of 'typical' smooth muscle cells (TSMCs), in multi-papillae kidneys a number of minor and major calyces fuse into a large renal pelvis. Electron microscopic, electrophysiological and Ca²⁺ imaging studies have established that the pacemaker cells driving pyeloureteric peristalsis are likely to be morphologically distinct 'atypical' smooth muscle cells (ASMCs) that fire Ca²⁺ transients and spontaneous transient depolarizations (STDs) which trigger propagating nifedipine-sensitive action potentials and Ca²⁺ waves in the TSMC layer. In uni-calyceal kidneys, ASMCs predominately locate on the serosal surface of the proximal renal pelvis while in multi-papillae kidneys they locate within the sub-urothelial space. 'Fibroblast-like' interstitial cells (ICs) located in the sub-urothelial space or adventitia are a mixed population of cells, having regional and species-dependent expression of various Cl^-, K⁺, Ca²⁺ and cationic channels. ICs display asynchronous Ca²⁺ transients that periodically synchronize into bursts that accelerate ASMC Ca²⁺ transient firing. This review presents current knowledge of the architecture of the proximal renal pelvis, the role Ca²⁺ plays in renal pelvis peristalsis and the mechanisms by which ICs may sustain/accelerate ASMC pacemaking.

Identification of c-kit-positive cells in the mouse ureter: the interstitial cells of Cajal of the urinary tract

The existence of a pacemaker system in the urinary tract capable of orchestrating the movement of filtrated urine from the ureteral pelvis to the distal ureter and lower urinary tract seems intuitive. The coordinated activity necessary for such movement or "peristalsis" would likely require an intricate network of cells with pacemaker-like activity, as is the case with the interstitial cells of Cajal (ICC) of the gut. We investigated whether these putative pacemaker cells of the urinary tract are antigenically similar to ICC of the gut by using immunofluorescence staining for c-kit, a cell-surface marker specific for ICC. Ureteral, urinary bladder, and urethral tissues were harvested from female mice of the WBB6F1 strain, and fixed sections were prepared and stained for c-kit. Cell networks composed of stellate-appearing, c-kit-positive, ICC-like cells were found in the lamina propria and at the interface of the inner longitudinal and outer circular muscle layers of the ureteral pelvis but not in the urinary bladder or urethra. Thus, like in the gut, c-kit-positive, ICC-like cells are present in the urinary tract but appear to be restricted to the proximal ureter of this murine species.

Ultrastructural evidence for adrenergic and cholinergic innervation of the human ureter

Electron microscopic study of the autonomic innervation of the human ureter demonstrated the existence of adrenergic and cholinergic nerve terminals. The 2 types of nerves were observed in the adventitia, smooth muscle layer and submucosa. The presence of adrenergic and cholinergic nerves was confirmed with the aid of 5-hydroxydopamine, a false sympathetic neurotransmitter that may be used as a specific marker for adrenergic nerve endings at the ultrastructural level. Adrenergic and cholinergic nerves were observed to run in close contact with each other in the same nerve fiber, providing ultramorphological evidence for a possible interaction between the 2 components of the autonomic nervous system in the human ureter.