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2015 ; 193
(5 Suppl
): 1784-90
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Transcriptional dysregulation in the ureteric bud causes multicystic dysplastic
kidney by branching morphogenesis defect
#MMPMID25301096
Guo Q
; Tripathi P
; Manson SR
; Austin PF
; Chen F
J Urol
2015[May]; 193
(5 Suppl
): 1784-90
PMID25301096
show ga
PURPOSE: The calcineurin-NFAT signaling pathway regulates the transcription of
genes important for development. It is impacted by various genetic and
environmental factors. We investigated the potential role of NFAT induced
transcriptional dysregulation in the pathogenesis of congenital abnormalities of
the kidneys and urinary tract. MATERIALS AND METHODS: A murine model of
conditional NFATc1 activation in the ureteric bud was generated and examined for
histopathological changes. Metanephroi were also cultured in vitro to analyze
branching morphogenesis in real time. RESULTS: NFATc1 activation led to defects
resembling multicystic dysplastic kidney. These mutants showed severe
disorganization of branching morphogenesis characterized by decreased ureteric
bud branching and the disconnection of ureteric bud derivatives from the main
collecting system. The orphan ureteric bud derivatives may have continued to
induce nephrogenesis and likely contributed to the subsequent formation of blunt
ended filtration units and cysts. The ureter also showed irregularities
consistent with impaired epithelial-mesenchymal interaction. CONCLUSIONS: This
study reveals the profound effects of NFAT signaling dysregulation on the
ureteric bud and provides insight into the pathogenesis of multicystic dysplastic
kidney. Our results suggest that the obstruction hypothesis and the bud theory
may not be mutually exclusive to explain the pathogenesis of multicystic
dysplastic kidney. Ureteric bud dysfunction such as that induced by NFAT
activation can disrupt ureteric bud-metanephric mesenchyma interaction, causing
primary defects in branching morphogenesis, subsequent dysplasia and cyst
formation. Obstruction of the main collecting system can further enhance these
defects, producing the pathological changes associated with multicystic
dysplastic kidney.