Departments of Urology; Genetics and Development and Pathology; Columbia University; New York, New York USA.
Organogenesis. 2009 Jan;5(1):306-14. doi: 10.4161/org.8173.
Removal of toxic substances from the blood depends on patent connections between the kidneys, ureters and bladder that are established when the ureter is transposed from its original insertion site in the Wolffian duct, to the bladder, its final insertion site. The Ureteral Bud Theory of Mackie and Stephens suggests that repositioning of the ureter orifice occurs as the trigone forms from the common nephric duct (CND), the caudal-most Wolffian duct segment. According to this model, insertion of the CND into the bladder and its expansion into the trigone both repositions the ureter in the bladder and enables it to separate from the Wolffian duct. The availability of new mouse models has enabled to re-examine this hypothesis using morphological analysis and lineage studies to follow the fate of the ureter and CND during the maturation process. We find that in contrast to what has been previously thought, the CND does not differentiate into the trigone but instead, undergoes apoptosis, a step that enables the ureter to separate from the Wolffian duct. Apoptosis occurs as the CND and ureter merge with the urogenital sinus positioning the ureter orifice at a site close to the Wolffian duct. Finally, expansion of the bladder moves the ureter orifice which is now fused with epithelium to its final position which is at the bladder neck. Interestingly, CND apoptosis appears to depend on close proximity to the bladder, suggesting that the bladder may be a source of signals that induce cell death. Together, these studies provide new insights into the normal process of ureter maturation, and shed light on possible causes of obstruction and reflux, ureteral abnormalities that affect 1-2% of the human population.
从血液中清除有害物质取决于肾脏、输尿管和膀胱之间的通畅连接,这些连接是在输尿管从其在沃弗氏管的原始插入部位转移到膀胱(其最终插入部位)时建立的。Mackie 和 Stephens 的输尿管芽理论表明,输尿管口的重新定位发生在中肾管(CND)从最尾端的沃弗氏管段形成三角区时。根据该模型,CND 插入膀胱并扩展到三角区,这两个过程都将输尿管重新定位到膀胱中,并使其与沃弗氏管分离。新的小鼠模型的出现使得能够使用形态分析和谱系研究重新检验这一假说,以追踪输尿管和 CND 在成熟过程中的命运。我们发现,与之前的想法相反,CND 不会分化成三角区,而是会发生凋亡,这一步骤使输尿管能够与沃弗氏管分离。凋亡发生在 CND 和输尿管与尿生殖窦融合时,将输尿管口定位在靠近沃弗氏管的位置。最后,膀胱的扩张将输尿管口(现在与上皮融合)移动到最终位置,即膀胱颈部。有趣的是,CND 凋亡似乎取决于与膀胱的接近程度,这表明膀胱可能是诱导细胞死亡的信号源。这些研究共同为输尿管成熟的正常过程提供了新的见解,并揭示了梗阻和反流、输尿管异常(影响人类人口的 1-2%)的可能原因。