Relation between ureteral telocytes and the hydronephrosis development in children.

INTRODUCTION: Hydronephrosis is an actual pediatric problem, affecting children in the ante- and neonatal periods. Intrinsic stenosis is due to external obstruction and creates a pathophysiological basis of this urological pathology. Co-localization of ureter with a renal vasculature also could not be omitted from this point of view. Mesenchymal cells, partially telocytes, are important for local fibrosis development and hydronephrosis formation as well. In the current study, we focused on identification of telocytes in the human ureters to hypothesize their role in hydronephrosis pathophysiology. MATERIAL AND METHODS: the samples were taken from 18 surgically treated patients with hydronephrosis (due to ureteral obstruction and crossing renal vessel). The control group consisted of 10 patients suffered from a non-obstructive disease of the urinary tract - predominantly renal tumors. Tissue samples from a ureter were stained for c-kit, tryptase, CD34 and PDGFRα to identify telocytes. Routine histology was performed to analyze tissue morphology, collagen deposits and mast cell's profile. RESULTS: Telocytes were detected in the ureteral wall. In patients with hydronephrosis we revealed decreasing density of telocytes, the prevalence of collagen, rise in mast cells amount and the ureteral wall thickening. In ureters with crossing renal vessels as a primary etiologic factor more telocytes have been observed in comparison with the obstructive hydronephrosis. CONCLUSIONS: A declined density of telocytes accompanied hydronephrosis development. Increased number of mast cells in the ureteral wall reflects a local inflammation, while detailed observation of collagen/muscle deposits and density of telocytes reveal a difference depended on etiologic factor (obstruction or crossing vessel) in patients with hydronephrosis.