This review aims to assist in the categorization of inherited, developmental, and acquired cystic disease of the kidney as well as to provide a pertinent, up-to-date bibliography. The conditions included are autosomal-dominant polycystic kidney disease, autosomal-recessive polycystic kidney disease, unilateral renal cystic disease (localized cystic disease), renal simple cysts, multicystic dysplastic kidney, pluricystic kidney of the multiple malformation syndromes, juvenile nephronophthisis and medullary cystic disease, medullary sponge kidney, primary glomerulocystic kidney disease, and glomerulocystic kidney associated with several systemic disorders mainly of genetic or chromosomal etiology, cystic kidney in tuberous sclerosis, and in von Hippel-Lindau syndrome, cystic nephroma, cystic variant of congenital mesoblastic nephroma, mixed epithelial stromal tumor of the kidney, renal lymphangioma, pyelocalyceal cyst, peripylic cyst and perinephric pseudocyst, acquired renal cystic disease of long-term dialysis, and cystic renal cell carcinoma and sarcoma. Whereas the gross and histologic appearance of some of these conditions may be diagnostic, clinical and sometimes molecular studies may be necessary to define other types.
Low PlGF identifies small fetuses with significant underlying placental pathology and is a promising tool for antenatal discrimination of FGR from fetuses who are constitutionally-small.
Interleukin-1β (IL-1β) production is impaired in cord blood monocytes. However, the mechanism underlying this developmental attenuation remains unclear. Here, we analyzed the extent of variability within the Toll-like receptor (TLR)/NLRP3 inflammasome pathways in human neonates. We show that immature low CD14 expressing/CD16 pos monocytes predominate before 33 weeks of gestation, and that these cells lack production of the pro-IL-1β precursor protein upon LPS stimulation. In contrast, high levels of pro-IL-1β are produced within high CD14 expressing monocytes, although these cells are unable to secrete mature IL-1β. The lack of secreted IL-1β in these monocytes parallels a reduction of NLRP3 induction following TLR stimulation resulting in a lack of caspase-1 activity before 29 weeks of gestation, whereas expression of the apoptosisassociated speck-like protein containing a CARD and function of the P2×7 receptor are preserved. Our analyses also reveal a strong inhibitory effect of placental infection on LPS/ATP-induced caspase-1 activity in cord blood monocytes. Lastly, secretion of IL-1β in preterm neonates is restored to adult levels during the neonatal period, indicating rapid maturation of these responses after birth. Collectively, our data highlight important developmental mechanisms regulating IL-1β responses early in gestation, in part due to a downregulation of TLR-mediated NLRP3 expression. Such mechanisms may serve to limit potentially damaging inflammatory responses in a developing fetus.Keywords: Human r Inflammasome r Interleukin-1 beta (IL-1β) r Neonate r Toll-like receptor Additional supporting information may be found in the online version of this article at the publisher's web-site Correspondence: Dr. Pascal M. Lavoie e-mail: plavoie@cw.bc.ca * These authors contributed equally to this work.C 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim www.eji-journal.eu Eur. J. Immunol. 2015. 45: 238-249 Innate immunity 239 IntroductionNewborns are at high risk of infections, in part due to attenuated innate immune defenses [1]. The cytokine interleukin-1β (IL-1β) is an important inflammatory mediator in response to infections [2]. Mice lacking IL-1β display impaired acute phase and pyrogenic responses [3], and increased susceptibility to pathogens commonly encountered in the neonatal period [4,5]. In contrast, high levels of IL-1β in a fetus can result in autoimmune organ damage [2], as well as lethal metabolic disturbances including severe weight loss and hypoglycemia [6]. Together, these data illustrate the evolutionary importance of a tight regulation of IL-1β in order to avoid inflammation-mediated organ damage, neurological injury [7], or even premature birth in a developing human [2,8].Monocytes are primarily responsible for the production of IL-1β in circulating blood [9,10]. Three subsets predominate in humans: "Classical" monocytes express CD14, but lack expression of the immunoglobulin receptor CD16. These CD14 high /CD16 neg monocytes make up the majority of monocytes in peripheral adult bloo...
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