BERKELEY, CA (UroToday.com) - The ideal approach for urologic tissue regeneration consists of autologous cells, biocompatible matrices, and the right niche. Autologous cell therapy enhances functional tissue regeneration and effective cell fusion into host tissue, in vivo, without immunologic rejection. Bladder tissue is the most commonly used autologous cell source for urologic tissue regeneration. However, autologous cells have limited proliferation capacity and cannot be used in patients with bladder cancer or end-stage bladder disease. Furthermore, the harvest of bladder tissue requires invasive procedures and has potential complications, including infection, bleeding, and patient discomfort. To overcome these limitations, various stem cell sources, including bone marrow stem cells, skeletal muscle-derived cells, adipose stem cells, and embryonic stem or germ cells, have been investigated. Although some have shown successful results, these approaches also require an invasive procurement procedure, and morbidity is inevitable.
Recently, cells isolated from voided urine (VUCs) have been proposed as an alternative stem cell source for urologic tissue reconstruction. VUCs have mesenchymal stem cell characteristics and the capacity to differentiate into a variety of urologic cell lineages. However, VUCs cannot be used in patients with bladder cancer because of the potential risk of tumor recurrence. Therefore, cells isolated from upper urinary tract urine (UTCs) have been proposed as a new source, because these cells are most often normal, even in patients with bladder cancer.
Bharadwaj et al. have shown that UTCs have characteristics similar to those of VUCs. Although they showed no malignant potential with UTCs, the urine samples used in their study were from patients with ureteropelvic junction obstruction, not from patients with bladder cancer. For the use of bladder tissue engineering for patients with bladder cancer who require cystoplasty, it is necessary to confirm the efficiency and safety of UTCs from patients with bladder cancer.
In the present study, urine obtained from the upper urinary tract seems to have more progenitor cells than voided urine in the same volume of urine. The UTCs were similar to the VUCs in terms of morphology, growth characteristics, marker expression profile, and differentiation potential, except that UTCs had a greater growth rate than the VUCs. Moreover, the UTCs of patients with bladder cancer had no chromosomal abnormality or tumorigenicity in vivo. Therefore, UTCs could be a useful cell source for urologic tissue engineering in patients with bladder cancer.
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Hyun Tae Kim, MDa and Tae Gyun Kwon, MD, PhDb as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
a Assistant professor, Department of Urology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700-721, Korea. Tel: 82-53-420-5855, Fax: 82-53-421-9618. Email:
b Professor, Department of Urology, Chilgok Kyungpook National University Hospital, 474 Hakjeongdong, Buk-gu, Daegu 702-210, Korea. Tel: 82-53-200-3516, HP: 82-10-9049-5855. Email: