Identification of the cells underlying pacemaker activity in the guinea‐pig upper urinary tract

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Abstract
1 The varying profile of cell types along the muscle wall of the guinea-pig upper urinary tract was examined electrophysiologically, using intracellular microelectrodes, and morphologically, using both electron and confocal microscopy. 2 Simple ‘pacemaker’ oscillations (frequency of 8 min−1) of the membrane potential were recorded in both the pelvi-calyceal junction (83 % of cells) and the proximal renal pelvis (15 % of cells), but never in the distal renal pelvis or ureter. When filled with the cell marker, neurobiotin, ‘pacemaker’ cells were spindle shaped and ≈160 μm in length. 3 In most cells of the ureter (100 %) and in both the proximal (75 %) and distal (89 %) renal pelvis, spontaneous action potentials (frequency of 3-5 min−1) consisted of an initial spike, followed by a number of potential oscillations superimposed on a plateau phase. When filled with neurobiotin, cells firing these ‘driven’ action potentials, were spindle shaped and > 250 μm in length. 4 Greater than 80 % of smooth muscle cells in the pelvi-calyceal junction were ‘atypical’, having < 40 % of their sectional areas occupied by loosely packed contractile filaments. Most of the smooth muscle cells in the ureter (99.7 %) and both the proximal (83 %) and distal (97.5 %) renal pelvis were of ‘typical’ appearance in that they contained cytoskeletal and contractile elements occupying > 60 % of cross-sectional area. 5 A third type of spontaneously discharging cell fired ‘intermediate’ action potentials (3-4 min−1), consisting of a single spike followed by a quiescent plateau and an abrupt repolarization. These cells were morphologically similar to interstitial cells of Cajal (ICC). However, these ‘ICC-like’ cells were not immuno-reactive for c-Kit, the proto-oncogene for tyrosine kinase. 6 In summary, ‘atypical’ smooth muscle cells were predominant in the pelvi-calyceal junction and fired ‘pacemaker’ potentials at a frequency significantly higher than ‘driven’ action potentials recorded in ‘typical’ smooth muscle cells throughout the renal pelvis and ureter. ‘Intermediate’ action potentials were recorded in ‘ICC-like’ cells in both the pelvi-calyceal junction and renal pelvis. We suggest that these ‘ICC-like’ cells act as a preferential pathway, conducting and amplifying pacemaker signals to initiate action potential discharge in the driven areas of the upper urinary tract.