Romih R, Korosec P, Jezernik K, Sedmak B, Trsinar B, Deng F-M, Liang F-X, Sun T-T
Institute of Cell Biology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
BJU Int. 2003 Apr;91(6):507-12. doi: 10.1046/j.1464-410x.2003.03052.x.
To assess the expression and distribution of uroplakins, protein subunits of the asymmetric unit membrane (AUM), and inducible nitric-oxide synthase (iNOS) in the urinary bladder urothelium of patients with bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia (BPH).
Urinary bladder urothelium samples from 15 men (mean age 69 years) with BOO secondary to BPH were processed for light and electron immunocytochemistry. Uroplakins and iNOS were detected, and areas of apical surface covered with AUM were compared with those of iNOS-positive urothelial cells.
Areas of superficial urothelial cells with no AUM were found in all obstructed bladder samples. The immuno-electron microscopy showed that the uroplakin-positive cells had the characteristic appearance of terminally differentiated umbrella cells, whereas cells from the uroplakin-negative regions were undifferentiated, typically showing microvilli on their apical surface. iNOS was not detected in areas with continuous AUM staining, but was readily detected in the uroplakin-negative areas. There was an inverse correlation between the intensity of uroplakin and iNOS staining.
In patients with BOO associated with BPH, some superficial urothelial cells lacked the AUM, suggesting focal compromise of the blood-urine permeability barrier. In such relatively undifferentiated urothelial zones there was an accompanying increase in the expression of iNOS, which marks perturbed urothelial differentiation and may modulate bladder response to the outlet obstruction.
评估在良性前列腺增生（BPH）所致膀胱出口梗阻（BOO）患者膀胱尿路上皮中尿板蛋白（不对称单位膜的蛋白质亚基）和诱导型一氧化氮合酶（iNOS）的表达及分布情况。
对15例继发于BPH的BOO男性患者（平均年龄69岁）的膀胱尿路上皮样本进行光镜和电镜免疫细胞化学处理。检测尿板蛋白和iNOS，并比较覆盖不对称单位膜的顶端表面区域与iNOS阳性尿路上皮细胞的区域。
在所有梗阻性膀胱样本中均发现无不对称单位膜的浅表尿路上皮细胞区域。免疫电镜显示，尿板蛋白阳性细胞具有终末分化伞细胞的特征性外观，而来自尿板蛋白阴性区域的细胞未分化，其顶端表面通常可见微绒毛。在不对称单位膜连续染色区域未检测到iNOS，但在尿板蛋白阴性区域很容易检测到。尿板蛋白和iNOS染色强度之间呈负相关。
在与BPH相关的BOO患者中，一些浅表尿路上皮细胞缺乏不对称单位膜，提示血 - 尿渗透屏障存在局灶性损害。在这些相对未分化的尿路上皮区域，iNOS表达随之增加，这标志着尿路上皮分化受到干扰，并可能调节膀胱对出口梗阻的反应。
