Novel in vitro model for studying ureteric stent‐induced cell injury

Abstract

OBJECTIVE To develop a novel in vitro model for the study of bladder and kidney epithelial cell injury akin to stent movement, as ureteric stents are associated with urinary tract complications that can significantly add to patient morbidity. These sequelae may be linked to inflammation triggered by stent‐mediated mechanical injury to the urinary tract. MATERIALS AND METHODS T24 bladder and A498 kidney cell line monolayers were damaged mechanically by segments of either Percuflex Plus® (PP) or Triumph® (triclosan‐eluting) stents (both from Boston Scientific Corporation Inc. Natick, MA, USA) and the resulting expression profiles of several pro‐inflammatory cytokines and growth factors were analysed. RESULTS After control injury using the PP stent, supernatants of both cell lines had significantly increased levels of interleukin (IL)‐6, IL‐8, basic fibroblast growth factor and platelet‐derived growth factor BB, and A498 cells also had increased tumour necrosis factor α. In almost all cases, the presence of triclosan within the media abrogated the pro‐inflammatory cytokine increases, while its effects on growth factors varied. CONCLUSION This study suggests that stent‐related symptoms in the bladder and kidney may be partially due to a local inflammatory response to epithelial damage caused by the presence and movement of the stent. Future stent design should take these inflammatory responses, with respect to physical injury, into consideration, using either more biocompatible materials or anti‐inflammatory compounds such as triclosan.

In vivo assessment of a novel biodegradable ureteral stent

“…Similar results were observed by Chew et al demonstrating the ability of BUSs to be less abrading when compared with conventional ureteral stents [5]. It is well documented that the placement of commercial ureteral stents can cause irritation of the ureteral epithelium [16]. The ureteral epithelium after BUS placement and degradation remained intact without any major change compared to the control.…”

“…The thickness of ureter mucosa remained similar and no inflammation or hydronephrosis was observed. In contrast, commercial stent showed to cause some degree of edema and epithelium destruction, as also observed by others [5,16]. Another study on biodegradable stents developed by using different materials showed severe inflammatory reaction, with stent material entrenched in the ureteral wall [4].…”

In Vivo Evaluation of the Third Generation Biodegradable Stent: A Novel Approach to Avoiding the Forgotten Stent Syndrome

“…14 One of the major complications is patient pain and discomfort due to inflammation triggered by stent movement and subsequent irritation of the kidney, ureteral and bladder epithelium. 4,15 As noted histologically, inflammation, bullous edema, irregular surface and increased thickness of the bladder mucosa were absent in biodegradable stented pigs compared to stented controls, suggesting that the biodegradable stent may trigger fewer stent associated symptoms.…”

Cell-penetrating peptide CGKRK mediates efficient and widespread targeting of bladder mucosa following focal injury

“…As seen in Figure 4A, there was no binding of CGKRK to the urothelium in the absence of injury, suggesting that intravesical bleeding alone is unlikely to trigger the enhanced binding. To test whether acute inflammatory response after mechanical urothelium cell injury(20) was responsible for the phenomenon, mice were pretreated with dexamethasone solution in saline by subcutaneous injection (10.55 μg/mouse) 2 h prior to the intravesical injury and CGKRK administration. According to Figure 4B, the delivery of CGKRK to dexamethasone-pretreated mice did not block the widespread binding of the peptide to the injured bladder.…”