Vogt Benoît, Chokri Ilham
Department of Urology, Polyclinique de Blois, La Chaussée Saint-Victor, 41260, France.
Laboratory of Anatomocytopathology, Laboratoire Léonard de Vinci, Chambray-lès-Tours, 37170, France.
Res Rep Urol. 2021 Jul 26;13:529-533. doi: 10.2147/RRU.S324192. eCollection 2021.
The Sonic Hedgehog/Gli1 signal is involved in smooth muscle activity. An experiment showed that the double-pigtail stent caused ureteral inflammation and decreased Gli1 expression in smooth muscle cells. The innovative pigtail-suture stent (JFil or MiniJFil) with a thin 0.3F suture thread significantly decreased stent-related symptoms. Fortuitously, a dilation of the ureter containing the sutures was discovered, and a previous study confirmed that the sutures caused less ureteral inflammation than the double-pigtail stent. However, the mechanisms involved in the ureteral dilation are still unknown. In this study, we assessed ureteral Gli1 expression in the human ureter when it was un-stunted or when fitted with a double-pigtail stent or a suture thread.
After consent and inclusion of patients in the protocol, nine segments of ureters were collected during cystectomy procedures for bladder cancers. There was no selection or exclusion, and patients with large tumors were included. Gli1 expression was assessed on the histological section to control the reflection of an active hedgehog signal. The expression of Gli1 in smooth muscle cells of the stented ureter was subjectively compared to un-stented ureter.
A decrease in the intensity of Gli1 expression of smooth muscle cells was observed in all cases of ureter fitted with a double-pigtail stent. For the un-stunted ureters and the ureters fitted with the thin 0.3F suture thread, Gli1 staining of smooth muscle cells was heterogeneous, and the small number of cases did not allow us to conclude.
Apart from the cases of ureters fitted with the double-pigtail stent, Gli1 expression of smooth muscle was heterogeneous. The Shh/Gli1 pathway may not be involved in ureteral dilation by the thread. A broader exploration of molecular mechanisms could make it possible to obtain the mechanisms involved in the dilation of the ureter by the thread.
音猬因子/ Gli1信号参与平滑肌活动。一项实验表明，双猪尾支架会引发输尿管炎症并降低平滑肌细胞中Gli1的表达。创新的带缝线猪尾支架（JFil或MiniJFil）配有一根细的0.3F缝线，可显著减轻支架相关症状。偶然发现，含有缝线的输尿管出现了扩张，并且先前的一项研究证实，与双猪尾支架相比，缝线引发的输尿管炎症更少。然而，输尿管扩张所涉及的机制仍然未知。在本研究中，我们评估了人输尿管在未置入支架、置入双猪尾支架或缝线时的Gli1表达情况。
在患者同意并纳入研究方案后，在膀胱癌膀胱切除术中收集了9段输尿管。没有进行选择或排除，包括患有大肿瘤的患者。在组织学切片上评估Gli1表达，以控制活跃的刺猬信号的反映情况。将置入支架的输尿管平滑肌细胞中Gli1的表达与未置入支架的输尿管进行主观比较。
在所有置入双猪尾支架的输尿管病例中，均观察到平滑肌细胞Gli1表达强度降低。对于未置入支架的输尿管和置入细0.3F缝线的输尿管，平滑肌细胞的Gli1染色是异质性的，且病例数量较少，无法得出结论。
除了置入双猪尾支架的输尿管病例外，平滑肌的Gli1表达是异质性的。Shh / Gli1通路可能不参与缝线导致的输尿管扩张。对分子机制进行更广泛的探索可能有助于了解缝线导致输尿管扩张的机制。
