Nephron Number is Variable and Declines with Age

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Unilateral Renal Hypoplasia

Renal Dysplasia



Hypoplasia and Dysplasia Account for 50% of Abdominal Masses of the Newborn
(Prevalence 0.5% of all Pregnancies)

Kidney Development<<>>Urological Development
How to make a nephron
How to make 106 nephrons.
How to connect nephrons from kidney to bladder.
How nephron formation is related to hypoplasia and dysplasia and how these are related to abnormalities of the urinary track.

Concepts
Lineage marker
Epiboly and experiments that investigated the “duct”.
The plasticity of the duct systems.
Induction and Reciprocal Induction
Mesenchymal to epithelial conversion
Monopodial & dipodial branching
Stephen’s Hypothesis and the “shared molecule hypothesis”

The Central Mechanism of Kidney Development is
the Conversion of
Mesenchyme into Epithelia
MET: Kidney and Testis
EMT: Neural Crest, Endocardial cushion, Carcinoma, Damage to Tubules.
Mesenchyme Epithelia
Motile, migratory Sessile
Few Cellular Contacts Tightly Adherent
NCAM E-cadherin, ZO-1
Diffuse Extracellular Matrix Localized Matrix (basal)
Collagen I III Collagen IV
Polarity by leading edge Polarity Apical-Basal
Vimentin IF Cytokeratin IF

The Intermediate Mesoderm
“TheCord”

Wolffian Duct Forms in One Day

How Does the Wolffian Duct Form So Quickly?
H:A tubule forms in the cranial part of the cord and then the epithelial cells proliferate and migrate caudally.
Exp: Coherent growth of an epithelial cord; very high replication rate in these cells.
H: A wave of Mesenchymal to Epithelial Conversion. 1.Cells could incorporate along the length of the cord as they convert into epithelia.
Exp: the tubule to be a mosaic of cells.
2.Cord is formed and then converts in situ in a two step process.
Exp: We could dissociate cord formation and epithelialization.

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How Does the Wolffian Duct Form So Quickly?
H:A tubule forms in the cranial part of the cord and then the epithelial cells proliferate and migrate caudally.
Exp: Coherent growth of an epithelial cord; very high replication rate in these cells.
H: A wave of Mesenchymal to Epithelial Conversion. 1.Cells could incorporate along the length of the cord as they convert into epithelia.
Exp: the tubule to be a mosaic of cells.
2.Cord is formed and then converts in situ in a two step process.
Exp: We could dissociate cord formation and epithelialization.

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Concepts
Lineage marker
Epiboly and experiments that investigated the “duct”.
The plasticity of the duct systems.
Mesenchymal to epithelial conversion
Induction and Reciprocal Induction
Monopodial & dipodial branching
Stephen’s Hypothesis and the “shared molecule hypothesis”

Wolffian Duct>>?
Changes the surrounding duct cells to express Pax-2.
Pax-2 is required for all subsequent steps.
As the Wolffian duct advances caudally, nephrons appear on either side of the duct. The nephrons form perpendicular to the cord. The are called ‘mesonephric tubules’. 20-30 tubules form. It is functional in amphibia and fish, but in mammals only the cranial 4-6 attach to the Wolffian duct, and the rest will degenerate.

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Concepts
Lineage marker
Epiboly and experiments that investigated the “duct”.
The plasticity of the duct systems.
Mesenchymal to epithelial conversion
Induction and Reciprocal Induction
Monopodial & dipodial branching
Stephen’s Hypothesis and the “shared molecule hypothesis”

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Reciprocal Induction
Mutual Dependency
Implies that factors made in Mesenchyme>>Ureteric bud>>Mesenchyme
Hence any interruption of the signaling between these compartments must affect both compartments.
Determination of targeting and downstream signaling is complex because a factor may come from the mesenchyme to instruct the ureteric bud to synthesize a factor important in the mesenchyme.

Reciprocal Induction
Ureteric Bud>Mesenchyme
Wnt6, Wnt9a,Wnt-11, FGF-2,9,18, TIMP, IL-6 Cytokines, BMP-7.
Mesenchyme>Ureteric Bud
GDNF, FGF-7, pleiotrophin,  BMP-4, HGF, amphiregulin.
Stroma>Ureteric Bud
RA dependent factor, BMP-4, BMP-6.
Ureteric Bud>Stroma
Unknown signal.
Mesenchyme>Stroma
BMP-7.
Stroma>Mesenchyme
Unknown Signal.

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Concepts
Lineage marker
Epiboly and experiments that investigated the “duct”.
The plasticity of the duct systems.
Mesenchymal to epithelial conversion
Induction and Reciprocal Induction
Monopodial & dipodial branching
Stephen’s Hypothesis and the “shared molecule hypothesis”

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RET

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Two Pathways to Form Epithelia
in the Metanephric Kidney
Mesenchymal Cells into Epithelial Cells-Nephron, A Sequence
1. Proliferation of mesenchymal cells.
2. De novo expression of competency factors (Pax-2, WT-1).
3. De novo expression of conversion factors (Wnt-4).
4. De novo expression of junctional proteins (NCAM>Cad6>E-cadherin>ZO-1).
5. De novo expression of matrix proteins (collagen I/III, Fn >laminin alpha5, collagen IV).
6. De novo expression of cytoskeletal proteins (vimentin>cytokeratin).
Branching Morphogenesis- Ureteric Bud, A Sequence
1. Proliferation of epithelia
2. Transient loss of epithelial organizers such as E-cadherin
3. But retention of other components of polarity such as Zo-1
4. Coherent growth of the tubule.
5. Distinct populations of tip cells which can act as pathfinders, or have different rates of replication. Ret+
6. 3 types of branching-terminal bifid, arcade and cortical lateral-Regulatory events?

Concepts
Lineage marker
Epiboly and experiments that investigated the “duct”.
The plasticity of the duct systems.
Mesenchymal to epithelial conversion
Induction and Reciprocal Induction
Monopodial & dipodial branching
Stephen’s Hypothesis and the “shared molecule hypothesis”

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Kidney Development<<>>Urological Development
How to make a nephron
How to make 106 nephrons.
How to make the connection from kidney to bladder.
How nephron formation is related to hypoplasia and dysplasia and how these are related to abnormalities of the urinary track.

Concepts
Nephron number is variable, hypolasia, dysplasia
Mesenchymal to epithelial conversion
Lineage marker
Epiboly and experiments that investigated the “duct”.
The plasticity of the duct systems.
Induction and Reciprocal Induction
Monopodial & dipodial branching
Stephen’s Hypothesis and the “shared molecule hypothesis”

Epithelia
Mesenchymal to Epithelial Conversion
Tubule elongation and branching
Tubules-sheets of cells
Tubules being used for multiple purposes.