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Physiol. Rev. 79: 1157-1191, 1999;
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Physiological Reviews, Vol. 79, No. 4, October 1999, pp. 1157-1191
Copyright ©1999 by the American Physiological Society

Embryonic Renal Epithelia: Induction, Nephrogenesis, and Cell Differentiation

Michael F. Horster, Gerald S. Braun, and Stephan M. Huber

Physiologisches Institut, Universität München, München, Germany

I. INTRODUCTION TO ONTOGENESIS OF THE METANEPHRIC KIDNEY
II. PRINCIPLES IN NEPHROGENESIS
    A.  Metanephrogenesis Proceeds in Defined Morphogenic Stages
    B.  Pronephros and Mesonephros Are Embryonic Precursors of the Metanephros
    C.  Cell Types of the Metanephros Are Derived From Different Lineages
III. URETERIC BUD AND BRANCHING MORPHOGENESIS
    A.  Induction of the Ureteric Bud
    B.  Genes That Control the Ureteric Bud
    C.  Branching Morphogenesis
IV. METANEPHRIC MESENCHYME AND NEPHROGENIC PATHWAY
    A.  Uninduced Mesenchyme is Pluripotent
    B.  Apoptosis is a Regulatory Mechanism for Mesenchymal Stem Cells
    C.  Inductive Signaling Opens the Nephrogenic Pathway
    D.  Postinductive Nephron Formation
V. MESENCHYME-TO-EPITHELIUM TRANSITION AND CELL ADHESION
    A.  MET Requires Profound Changes in Gene Expression
    B.  Cell Adhesion Initiates Cellular Reorganization in MET
    C.  Cell Adhesion Molecules Are Expressed in Cell Type-Specific Patterns
VI. EPITHELIAL CELL POLARIZATION
    A.  Methods to Study Embryonic Renal Epithelia
    B.  Ionic Conductances Are Expressed Before Vectorial Transport
    C.  Membrane Transporters Acquire Their Apicobasal Patterns
VII. GROWTH FACTORS AND EXTRACELLULAR MATRIX
    A.  Growth Factors Are Signaling Molecules in Induction and Differentiation
    B.  Growth Factor Families Are Expressed in Temporospatial Patterns
    C.  ECM and Cells Interact in Epithelial Morphogenesis
VIII. GENES THAT CONTROL RENAL ORGANOGENESIS
    A.  Transcriptional Regulation
    B.  Signaling by Receptor Tyrosine Kinases
IX. GENETIC ERRORS IN NEPHROGENESIS
    A.  Polycystic Kidney Disease
    B.  Wilms Tumor
    C.  Renal Cell Carcinoma
X. CONCLUDING REMARKS AND PERSPECTIVES

    ABSTRACT
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Horster, Michael F., Gerald S. Braun, and Stephan M. Huber. Embryonic Renal Epithelia: Induction, Nephrogenesis, and Cell Differentiation. Physiol. Rev. 79: 1157-1191, 1999.Embryonic metanephroi, differentiating into the adult kidney, have come to be a generally accepted model system for organogenesis. Nephrogenesis implies a highly controlled series of morphogenetic and differentiation events that starts with reciprocal inductive interactions between two different primordial tissues and leads, in one of two mainstream processes, to the formation of mesenchymal condensations and aggregates. These go through the intricate process of mesenchyme-to-epithelium transition by which epithelial cell polarization is initiated, and they continue to differentiate into the highly specialized epithelial cell populations of the nephron. Each step along the developmental metanephrogenic pathway is initiated and organized by signaling molecules that are locally secreted polypeptides encoded by different gene families and regulated by transcription factors. Nephrogenesis proceeds from the deep to the outer cortex, and it is directed by a second, entirely different developmental process, the ductal branching of the ureteric bud-derived collecting tubule. Both systems, the nephrogenic (mesenchymal) and the ductogenic (ureteric), undergo a repeat series of inductive signaling that serves to organize the architecture and differentiated cell functions in a cascade of developmental gene programs. The aim of this review is to present a coherent picture of principles and mechanisms in embryonic renal epithelia.

    I. INTRODUCTION TO ONTOGENESIS OF THE METANEPHRIC KIDNEY
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Most parenchymal epithelial organs follow a fairly simple scheme of embryonic organogenesis. An epithelial sheet or tube that is derived from one of the primordia enters a process of sequential branching (Fig. 1) to generate an arborizing or treelike structure. In the kidney, the epithelial tube is to become the arborizing nephric duct-derived collecting duct system.



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Fig. 1. Histology of early metanephrogenic organization. Section through human kidney (~20.5 mm embryo) showing structures derived from Wolffian duct and metanephrogenic blastema in outermost zone of cortex. Peripheral branch of ureteric tree extends distally into an ampulla (see sect. III). Metanephric blastema has been induced (Fig. 2) to enter nephrogenic pathway (see sect. IV), and nephron anlage has completed mesenchyme-to-epithelium transition (see sect. V). [Modified from Horster (112).]

The particularly complex situation in renal embryonic development is, however, that it has not one but two distinct embryological origins. Most of the nephron, i.e., the structures beginning with the glomerulus and ending at the junction of connecting tubule and collecting tubule, are derived from another primordial tissue, the mesenchymal blastema. These two entirely different tissues interact so that the ureter-derived collecting duct is induced to branch while the mesenchymal blastema is induced to enter the critical process of mesenchyme-to-epithelium conversion or transition (MET). This earliest mesenchyme-derived epithelium follows a structurally well-defined morphogenetic pathway to generate most of the nephron.

Historically, the basic experimental model for work in nephrogenesis had been set up by Grobstein (89-91) some 45 years ago. These pioneering studies, at the National Institutes of Health, demonstrated in an organ system in vitro that 1) kidney rudiments when removed at embryonic day 11 (E11) (mouse) follow an almost normal developmental program in culture, 2) the isolated ureteric bud cannot develop without contact to the metanephric mesenchyme, and 3) the isolated metanephrogenic mesenchyme can be induced to go through the MET by a number of tissues, including the embryonic spinal cord and the ureteric bud. These and later tissue recombination experiments (164, 236, 242, 280) have set the stage for the application of today's molecular biology techniques to nephrogenesis (121, 148, 290).

The two developmental pathways for the two different tissues, the nephrogenic (mesenchymal) and the ductogenic (ureteric), are regulated by transcription factors and protooncogenes, polypeptide growth factors acting as signaling molecules, and their receptors. They are modulated by cell adhesion molecule (CAM) complexes and their associations with the cytoskeleton, by extracellular matrix (ECM) glycoproteins and ECM receptor molecules such as the integrin family, and by ECM degrading proteases. Protooncogenes regulate growth particularly in embryonic organogenesis, and they have the potential to gain tumorigenesis after gene mutations. Some of the protooncogenes that encode for receptor tyrosine kinases are involved in mesenchymal (nephrogenic)-epithelial (ductogenic) interactions, in which the protooncogene encoded tyrosine or serine/threonine kinase is the ureteric receptor (see sect. III) for signaling molecules secreted by the other primordial tissue, the metanephrogenic mesenchyme (see sect. IV).

The entire process is governed by changing gene expression patterns of transcription factors (see sect. VIII) such as Pax-2, of secreted signaling factors such as wnt-4, and of protooncogenes such as c-ret. Through the transfer of techniques from Drosophila to mouse and to human, some of the genes critical in mammalian development have been identified. These genes are part of complex programs that induce and control sequential morphogenetic and differentiation events, i.e., the stages of kidney ontogenesis.

To analyze the programs and their downstream effects during embryonic nephrogenesis, a wide spectrum of techniques is increasingly applied at the individual cell level. Single determinants of renal morphogenesis and of epithelial differentiation, uncovered through these techniques, have been presented in a number of excellent in-depth reviews, specifically on MET (16), conversion of mesenchyme to epithelium (66), growth factors (93), renal stem cells (100), gene targeting (147), signaling molecules (201), the transcription factor WT-1 (215), and basement membrane molecules (270).

This review intends to integrate data from these different areas of research. It centers on the progress accomplished over the past 10 years of research in embryonic nephrogenesis, and it intends to provide a comprehensive view of the many diverse aspects of embryonic renal epithelia. Among these, three processes in kidney organogenesis are emphasized, namely, 1) acquisition of functional properties in the collecting duct system, 2) MET, and 3) epithelial cell differentiation from an apolar to an apicobasal polarized phenotype.

    II. PRINCIPLES IN NEPHROGENESIS
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A.  Metanephrogenesis Proceeds in Defined Morphogenic Stages

The development of the metanephric (permanent) mammalian kidney begins at gestational week 4-5 in humans and at E11 in mouse. Organogenesis and its governing principles have been studied mostly in the mouse. Metanephros formation, i.e., organogenesis of the permanent kidney (242), is initiated by the ureteric bud, which sprouts out of the posterior end of the Wolffian duct and invades the metanephrogenic mesenchyme (Fig. 2). The subsequent interaction between the two primordia induces the ureteric bud to branch dichotomously, thus initiating the morphogenesis of the collecting duct system (242). Induced metanephric mesenchyme condenses at the tips of the ureteric buds (Fig. 1), and mesenchymal cells form aggregates (Fig. 3), thus beginning the MET. Each aggregate epithelializes (156) and proceeds in stages to the vesicle stage, comma stage, and S-stage, from where each S-shaped body, after fusion with the ureteric bud-derived collecting duct (Fig. 3F), differentiates into one of the (2 × 106) nephrons of the human kidneys. The architectural pattern, therefore, as a result of the sequential ureteric bud arborization, is designed to proceed from the deep cortex to the periphery in a repeat series of induction, morphogenesis, and differentiation (Fig. 2).



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Fig. 2. Overview of principal events in early nephrogenesis. Ureteric bud, an offspring of Wolffian duct, invades mesenchymal blastema (left) and initiates reciprocal signaling (middle) between epithelial (ductal) and mesenchymal (metanephrogenic) cell types. Receptor tyrosine kinases are expressed almost exclusively in ureteric bud cell, whereas ligands are secreted by adjacent mesenchymal cells. Ligand for c-ros encoded receptor is not yet known. Ligand-receptor signaling activates successive stages shown in Fig. 3, A---F. Mesenchymal-epithelial interactions, in addition to signaling growth factors, involve extracellular matrix (ECM), cell adhesion molecules (CAM), transcription factors, and protooncogene-encoded receptor tyrosine kinases (RTK). Mesenchymal blastema expresses stem cells of several cell lineages; stromogenic and nephrogenic ones are shown. Epithelial S-shaped body connects to ureteric bud-derived collecting duct. HGF, hepatocyte growth factor; GDNF, glial cell-derived neurotrophic factor. [Modified from Horster et al. (113).]



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Fig. 3. Morphogenic stages in early metanephrogenesis. Nephrogenic pathway is initiated by inductive signaling between Wolffian duct-derived ureteric bud and adjacent mesenchymal blastema (Fig. 2). A: induced condensing mesenchymal cells adhere and begin cell remodeling to epithelial phenotype. B: globular aggregates close to tip of ureteric bud express basement membrane proteins and cell adhesion molecules. C: renal vesicle. Lumen of sphere suggests secreted fluid and solutes. D: comma-shaped body representing reorganized sphere and (E) S-shaped body suggest expression of an as yet unknown patterning program. F: junction of upper domain of mesenchymal blastema-derived S-shape body with most peripheral branch of Wolffian duct-derived ureteric bud. Scheme reduces some of morphological features, e.g., not shown is strictly dichotomous branching of ureteric tree, as visible in Fig. 1. [Modified from Horster et al. (113).]

The epithelial segments of the nephron, unlike the ureteric bud-derived collecting duct system, are created from mesenchymal cells by an intricate cascade of events. The early events (Fig. 2) result in the acquisition of an essentially epithelial character by the future nephron cells while these polarized cells form a sphere or vesicle (Fig. 3). The process of modeling the subsequent stages of comma and S-shape (Fig. 3) is not understood, although plenty of morphoregulatory molecules (see sect. VIIC) and transcription factors (see sect. VIIIA) are sequentially and differentially expressed. These stages of morphogenesis are the onset of nephron differentiation, i.e., epithelial segments begin to express their specific properties (112).

The mechanisms directing the segmentation of the nephron have not been identified. Some of the molecules involved in segmental morphogenesis are characteristically regulated in distinct segments, e.g., some members of the integrin family are expressed in the late S-stage (alpha 2 distal; alpha 3 proximal), whereas others are upregulated only in the blastema (alpha 1) or in the vesicle stage (alpha 6) (143).

These stages of nephrogenesis have an ancestry that begins at the blastula stage, which determines the mesoderm; it follows the induction of the pronephros and the directed migration of the pronephric duct to proceed through the stage of the Wolffian duct and to induce the metanephric mesenchyme, which in turn directs branching of the ureteric tree. Cells of the metanephrogenic mesenchyme are induced by ureteric bud cells to become stem cells after rescue from apoptosis (see sect. IVB); they go on to condense and, guided by regulatory circuits of gene expression and repression (see sect. VIIIA), to enter the MET, and to polarize to apicobasal expression patterns (see sect. VI).

B.  Pronephros and Mesonephros Are Embryonic Precursors of the Metanephros

The metanephric kidney is derived from two different early embyronic tissue primordia: the nephric duct and the nephrogenic cord (Fig. 4). The nephric duct becomes the mesonephric duct and continues through the Wolffian duct stage to the ureteric bud. The nephrogenic cord, after inductive signaling with the pronephric duct-derived cells, develops into the nephroi of mesonephros and metanephros. The rudimentary pronephros, the transitory mesonephros, and the permanent metanephros form in sequence during mammalian renal ontogeny (Fig. 4), recapitulating the phylogeny of the excretory system.



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Fig. 4. Embryonic precursors of metanephros. Rudimentary pronephros, transiently functioning mesonephros, and permanent metanephros are sequentially induced and formed, thus recapitulating phylogeny of excretory system. This embryonic continuity also pertains to some transcription factors and signal molecules. [Modified from Horster (112).]

Pronephric tubules are formed around E8 (mouse) from the intermediate mesoderm. In contrast, the primary nephric duct appears to arise from a distinctly different cell population within the intermediate mesoderm (198). The caudal nephric duct (frog) extends along the cranial-caudal axis not by mitotic apposition but through migration of cells from the foremost tip toward their later caudal organ destination where they reassemble into the duct (34). Pronephric (zebrafish) and metanephric (mouse) development, however, are believed to be governed by almost entirely different genetic programs, although the zebrafish Pax-2 and WT-1 homologs appear to be expressed during pronephros differentiation in a pattern similar to that in mouse metanephros (54).

The nephron of the mesonephros is functioning (173, 266, 298); it is composed of glomerulus and two segments (proximal/distal) merging in a collecting tubule that empties into the mesonephric or Wolffian duct. Wolffian duct cells appear to induce mesonephric progenitor cells to become differentiation competent (100); this interaction, in the murine mesonephros, occurs around E10.

As the Wolffian duct grows close to a mesenchymal cell population, it is induced to sprout (E10---E11) and to form the ureteric bud, whereupon mesenchymal cells at the bud tip gather and appear to form a cap (Fig. 4). Next, the invading bud is directed to branch dichotomously to form a T-shape (Fig. 1), and this branching mode is maintained sequentially to express the arborizing structure of the collecting duct in the cortex, which establishes the general structure of the kidney.

C.  Cell Types of the Metanephros Are Derived From Different Lineages

1.  Nephric duct-derived ureteric bud

The embryonic kidney has served for almost 50 years (89) as a model system to study inductive interactions between mesenchyme and epithelium. The fact that the kidney is derived from two distinctly different primordia that can be grown to develop in culture has aided the experimental access to signal (growth factor) molecules and their receptors. The very first step in kidney development is the sprouting of the ureteric bud out off the Wolffian duct, followed by signaling from the ureteric bud to the mesenchyme to induce the mesenchyme to become epithelium.

The ductal system after initial sprouting develops by sequential dichotomous branching, and the induction of this repeat process of ureteric bud bifurcation in the kidney appeared to be through interaction with the nephrogenic mesenchyme (90). The nature of some of the inductive signals received by the ureteric bud cell from the mesenchyme has been disclosed, although the cues for the sequence of events remain elusive.

Branching morphogenesis of the collecting duct system, however, requires not only interactions between the embedding mesenchyme and the epithelial duct, but also between basement membrane (ECM) components and the epithelial cells.

The mechanisms of ductal growth and of ductal branching (10, 23, 231, 235) as well as differentiation by expression of plasma membrane transport proteins in the ureteric bud cell (113, 119) have finally come to be investigated.

2.  Mesenchyme-derived stem cell populations

For the metanephric mesenchymal blastema to produce the ~15 epithelial cell types of the metanephric kidney, it must be induced to undergo a conversion to the epithelial phenotype and subsequently differentiate into the highly specialized cell types of the nephron. Hypothetically, this pathway could start from two different points. One starting point would be a homogeneous mesenchymal population consisting of one multipotent cell type from which all nephron epithelial cell types are derived. Alternatively, the primary inductive event is not the conversion to the epithelial phenotype but a commitment of the mesenchymal cell type to different developmental pathways, and the secondary inductive event of phenotypic conversion then destines already committed cells to be recruited for the early nephron (101, 144, 213).

Studies on the temporospatial expression of two transcription factors, BF-2 (97) and Pax-2 (49, 50), have shed some light on this situation. It seems now justified to favor the hypothesis that all peripheral mesenchymal blastema cell types are induced to become stem cells through the first signal interactions. This initial step (see sect. IVA) rescues most of the nephrogenic stem cells now expressing Pax-2 from apoptosis (6, 145), whereas the uninduced mesenchymal cells enter programmed cell death (see sect. IVB).

Induction is a two-step event (6) that had been postulated already from earlier tissue recombination work (243), where it was found that a short-time (hours) exposure of uninduced mesenchyme to the ureteric inductor led to the stem cell phenotype but no further. Nevertheless, this first step to the stem cell phenotype rescues most of the mesenchyme from apoptosis. The second step, however, very likely differs in molecular nature from the first one (6). Two hypotheses, at present, are similarly supported by data, although not yet by complete lineage analysis. In one, the primary inductive interactions between mesenchyme and bud are believed to determine the distinct and final developmental pathways of both stromal and nephrogenic lineage (66). In the other, a bivalent stem cell progenitor population that gathers next to the outermost ureteric bud cells (Fig. 1) is available throughout nephrogenesis, and it may either take the nephrogenic (Pax-2) or the stromogenic (BF-2) pathway (8, 97, 242). It is interesting to note that the endothelial progenitor cell, the angioblast, may derive also from a bipotential (mesodermal) stem cell precursor (218). The further fate of the nephrogenic lineage is also determined by members of the superfamily of signaling peptides, as discussed in section VIIA.

Cell lineage analysis based on classic embryologic work (92, 100) clearly indicates that the definitive kidney is derived from two independent tissue compartments of the intermediate mesoderm, namely, the metanephrogenic mesenchyme and the Wolffian duct. This traditional view has been broadened by a set of data derived from embryonic kidney organ culture (213); when uninduced mesenchyme was isolated and tagged so that cells could be followed to their final destination, and then cocultured with isolated ureteric bud, mesenchymal cells were found to be inserted into the collecting duct, although the majority of collecting duct cells were derived from the ureteric bud.

Organogenesis of the kidney has long become a model system that represents principles in morphogenesis and cell differentiation. The continuous process of morphogenesis is guided by cascades of interactions between two different cell populations (Fig. 2). Regulation involves diverse families of genes and their products, including protooncogene-encoded receptors (see sect. VIIIB) and their polypeptide ligands (see sect. VIIA), transcription factors and their target genes (see sect. VIIIA), and regulating ECM proteins and CAM-mediated signals. All of these diverse systems interact to initiate and guide embryonic renal morphogenesis and cell differentiation. Unraveling the complexity of these interactions, which is described in the following sections, is a major challenge for many outstanding laboratories.

    III. URETERIC BUD AND BRANCHING MORPHOGENESIS
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A.  Induction of the Ureteric Bud

Grobstein, in a classic series of experiments (89-91), had addressed the question of whether or not mesenchyme and epithelium derived from different embryonic organs can induce and maintain ductal morphogenesis and concluded that one common mechanism was not likely. However, there may be families of morphogenic molecules, either signaling via the ECM, as transforming growth factor-beta (TGF-beta ) (230), or mesenchyme derived, as epimorphin (106), or ligands of protooncogene-encoded receptor tyrosine kinases, such as hepatocyte grwoth factor (HGF) (234) that participate in a general pattern governing branching morphogenesis. Several lines of evidence suggest that branching morphogenesis may be viewed within an integrated model system in which cell-matrix receptors (e.g., integrins) and basement membrane components (e.g., laminin-1) on one side and locally secreted signaling molecules [e.g., members of the bone morphogenetic protein (Bmp) and Wnt families] on the other organize budding and branching in different epithelial organs (112, 130, 232). Although specific modes of interactions between ECM and epithelial cells are expressed during organ morphogenesis, the general pattern of signal-directed remodeling of the matrix may apply to branching tubes so diverse as in kidney (232), lung (111), and salivary glands (130).

B.  Genes That Control the Ureteric Bud

1.  WT-1

Several genes are presently believed to be regulated by WT-1. Among those, in addition to Pax-2 (225), is insulin-like growth factor (IGF)-II and its receptor (53, 296) and TGF-beta (47), which are involved in branching morphogenesis, and platelet-derived growth factor (PDGF)-A (292). In the mesonephros, WT-1 is clearly expressed in the mesenchyme, the vesicle, and glomerular structures. In the metanephros, WT-1 is expressed in the uninduced mesenchyme and increasingly in the induced mesenchyme. Importantly, WT-1 is highly expressed in the proximal limb of the S-shaped body (121a), specifically in the future podocytes up to the mature glomerulus (41, 205).

2. c-ret

As a member of the family of growth factor receptors characterized by an extraordinarily large extracellular binding domain, c-ret is a protooncogene required for ureteric bud branching and proliferation. The Ret receptor is first expressed in the Wolffian duct (E8---E11.5), and as ureteric arborization proceeds (E13.5---E17.5), c-ret is expressed only in ureteric bud (Fig. 5) tip cells (200). It is thus not surprising that in homozygous mutant mice (RET-k-) the ureteric bud does not outgrow from the Wolffian duct (247) while the mesenchyme from RET-k- mice maintains branching and growth of a wild-type ureter in vitro. Moreover, mesenchymal differentiation appears normal when induced with spinal cord, whereas the ureteric bud from RET-k- mice did not interact with wild-type mesenchyme (247). This impressive work indicated that 1) the Ret receptor response to an inductive signal is independent of the cell type, and 2) the Ret ligand glial cell-derived neurotrophic factor (GDNF) activates ureteric cell proliferation and branching very early (Fig. 5), beginning with the first visible Wolffian duct outgrowth.



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Fig. 5. Temporospatial expression of signaling systems in nephrogenic and ureteric bud morphogenic pathways. Receptor tyrosine kinases (Ret, Met, Ros) are encoded by protooncogenes. Growth factor signaling molecules are expressed and secreted as indicated. Relative abundance of expression is specified by bold or normal type. Induced precondensing mesenchyme is shown on top; other stages of metanephric nephrogenesis correspond to those depicted highly schematically in Fig. 3, A, C, and E. PDGF, platelet-derived growth factor.

3.  Limb deformity

Limb deformity (ld) encodes a group of phosphoproteins, the formins, generated by alternative splicing of mRNA that are all expressed in the kidney. The ld mutation in the mouse results in defects of limb formation and urogenital development that, interestingly, are expressed with differing degrees of anomaly (167). The five known alleles of ld and the formin isoforms are expressed in the ureteric bud (Fig. 5) and in the mesenchyme. The primary defect in ld -/- mutant is a failure of the ureteric bud to induce the mesenchyme because outgrowth of the ureteric bud is either arrested or delayed or incomplete (167). Because formins are believed to operate in intracellular protein-protein interactions (27, 279), they might be part of a signaling pathway downstream of the ligand-receptor interaction in the ureteric bud tip cell. The epithelial cell at the tip of the invading ureteric bud (Fig. 1) faces the interspace between the two signaling tissues. When this cell (Fig. 11) was analyzed by the combined techniques of electronmicroscopy, electrophysiology, and molecular biology (119, 121), it was found that it differs functionally from the cells in deeper parts of the branching ureteric tree, and it undergoes the epithelial polarization and differentiation process in situ. An alternative hypothesis (100), however, postulates that the bud tip cell exhibits a mesenchymal phenotype that is capable to delaminate from the ureteric bud and to be incorporated into all segments of the mesenchyme-derived nephron. Ureteric bud cell differentiation, i.e., how this cell acquires the polar organization of apical and basolateral plasma membrane characteristic for the collecting duct cell, is discussed in section VI.

C.  Branching Morphogenesis

1.  Multiple controls regulate the arborizing duct system

The embryonic development of several organs, such as lung, mammary gland, pancreas, tooth, salivary glands, and kidney, depends decisively on branching morphogenesis. In all of these organs, a small epithelial rudiment is initially surrounded by mesenchymal cells. In the metanephric kidney (Fig. 2), a sequence of different events is initiated after reciprocal induction that leads to the formation of dichotomous duct branches. Two processes result in the arborizing collecting duct system starting from the first bifurcation of the ureteric bud, namely, the longitudinal growth of duct epithelia and the branching process. There is now accumulating evidence that both of these are regulated separately (40). In fact, a recent model for renal branching morphogenesis (229-231) proposes that a local ratio, at the branching point, of branch-promoting to branch-inhibiting factors might account for the architecture of the collecting duct system, and it was demonstrated for the first time that growth (ductogenesis) and branching are regulated by separate mechanism. Whereas HFG and TGF-alpha are branching morphogens, TGF-beta is inhibitory to branching but not to ductogenesis. Nevertheless, HGF/scatter factor (SF) and its c-met receptor are the primary signaling system for branching and for ductal growth in nephrogenesis. Moreover, this inducing action on ductal morphogenesis is paralleled by HGF effects on its mesenchyme-based Met receptor, and antibodies to HGF/SF perturb branching morphogenesis and the early phase of MET (301).

2.  Signaling by GDNF through Ret is branch promoting

Ureteric bud cells express high-affinity receptors for growth factors (see sect. VIIIB) and among them are the receptor tyrosine kinases Met, Ret, and Ros (Fig. 5). The polypeptide ligand of Ret, GDNF, is a branch-promoting growth factor, since GDNF -/- mice suffer from delayed or absent ureteric branching (186, 208, 232). Expression of GDNF (99) is high in wild-type condensing mesenchymal cells (E11.5) and downregulated after MET (Fig. 5) to maintain the arborizing morphology. Importantly, expression is maintained high in the outer cortical mesenchymal cell population, which might enable GDNF to organize the treelike patterning possibly by radial concentration gradients of GDNF along extracellular matrix components. Glial cell-derived neurotrophic factor binds to the receptor GDNFR-alpha (127, 273), and the receptor-ligand complex binds to Ret (276, 285). Indeed, GDNF and Ret are a specific ligand-receptor entity, since GDNF when added to wild-type kidney cultures increased the number of (aberrant) ureteric branches (285). Ureteric growth and branching are also dependent on the intact Ret receptor, which is part of the GDNF signaling system (200, 247). Among the regulatory genes (Fig. 5) expressed in the ureteric bud cell, in addition to Pax-2, is ld, and its mutation inhibits ureteric growth (275). The intracellular signal systems, however, that link the ligand-dependent RTK activation to the ureteric bud effector systems for growth and branching remain undefined.

3.  Local growth factors interact with the basement membrane

Extracellular matrix molecules are secreted and localized in complex temporospatial patterns (66, 141), and they have signaling roles particularly in early nephrogenesis, followed by regulation of basement membrane components and their receptors during epithelial polarization. When the peptide growth factors IGF-I or IFG-II (220) or nerve growth factor (NGF) (237) are blocked selectively by molecular or immunotechniques, mesenchyme and ureteric bud development is perturbed. On the other hand, renal morphogenesis is overall normal in mice with homozygous null mutations of the IGF-II (42) and the NGF (155) receptors. These apparently contradictory observations are not unusual in polypeptide signaling and suggest functional redundancy.

Laminin-1, a basement membrane constitutent, acts during cell differentiation in a dual way, namely, as a signaling molecule and as a structural component. The extracellular glycoprotein is a member of a large family present in basement membranes, and it has several biologically active domains including the proteolytic fragments E3 and E8 (72); importantly, the laminin alpha 1-chain is expressed at the onset of epithelial polarization (65). Antisera against the E8 and E3 domains inhibited the MET in embryonic renal organ culture (141). The role of laminin-1 in early branching morphogenesis was further demonstrated by monoclonal antibodies against the E3 fragment in organ culture of embryonic salivary gland, which inhibited branching morphogenesis, suggesting a role for the laminin E3 fragment in structuring basement membranes (130). Dystroglycan is the high-affinity receptor for laminin-1 and laminin-2, and alpha -dystroglycan, the receptor for the E3 fragment, probably links the basement membrane to the cytoskeleton (70), and an antibody against alpha -dystroglycan inhibits the embryonic epithelial polarization process (60). In addition to alpha -dystroglycan, a second receptor specific for the E8 fragment of laminin-1, the alpha 6beta 1-integrin, is expressed on nephrogenic cells during MET (255). The alpha 6-integrin receptor, therefore, might participate in signal transmission during cell differentiation, and the alpha 6-integrin subunit associates with the beta 1-subunit during the early nephrogenic process (65). The structural role of the laminins is within the two major complex networks of laminin and collagen IV that are probably linked by nidogen that binds to type IV collagen and to a domain in the laminin gamma 1-chain (174). The crucial role of nidogen as a link protein has been proven by perturbation experiments (67), demonstrating that interfering with the link between nidogen and laminin-1 inhibits ureteric bud branching morphogenesis. It is of interest in this context that an unexpected heterogeneity at the histochemical level (142) was demonstrated for the embryonic collecting duct, and a monoclonal antibody of the IgG-1 subclass was shown elegantly to react with an epitope at the basolateral side of the ampullar collecting duct epithelium (259). The roles of antibody and epitope in nephrogenesis remain to be elucidated.

4.  Local proteolysis coregulates ductal morphogenesis

Local proteolysis remodels the extracellular matrix during branching. Matrix proteolysis can be attributed to secreted matrix metalloproteinases (157) and to plasma membrane-bound proteases. Matrix metalloproteases and their regulation thus have a complementary role to the branch-promoting (157) and branch-inhibiting growth factors. This function implies that inhibitors of proteases block branching morphogenesis. Proteases can be secreted by epithelial or by adjacent stromal cells. Although almost all details of the design for collecting duct architecture are unknown, it might be permitted to speculate that stromally secreted proteases, after binding to epithelial receptors, could guide directed proteolysis along tissue gradients of proteases.

    IV. METANEPHRIC MESENCHYME AND NEPHROGENIC PATHWAY
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A.  Uninduced Mesenchyme is Pluripotent

The classic studies of kidney organogenesis had established (89-91) that a signal, although its nature and mechanism could not be identified, must initiate outgrowth and branching of the ureteric bud, and another signal originating from the ureteric bud must induce MET. Today, some of the signals essential for interactive early nephrogenesis have been identified (and many more have been shown to exist), but the meaning of their temporospatial expression patterns and their precise downstream roles still remain poorly defined.

The discovery of BF-2 as an embryonic stromal gene (97) in the mesenchyme, i.e., in the intermediate mesoderm, has rekindled the debate of whether or not two cell populations are present in the uninduced mesenchyme whose final destination is either stromal or epithelial. This view requires that the uninduced mesenchyme had already received a signal, presumably from the early invading outgrowth of the Wolffian duct which is essential for the continuity of the nephrogenic process, since uninduced mesenchyme goes apoptotic (145). Alternatively, the decision would be made through molecules of the inductive interactions within a homogeneous mesenchymal cell type. A case for the latter was made by the observation (213) that induced ureteric bud cells can delaminate and incorporate themselves into the mesenchyme to become part of the epithelia-generating cell population.

1.  Intermediate mesoderm differentiation is regulated: Pax-2

The family of Pax genes encodes transcription factors expressed in various embryonic tissues, including the kidney (50). Two Pax genes are expressed in renal organogenesis, Pax-2 and Pax-8. Pax-2 is central for renal development, since it appears to specify all epithelial phenotypes derived from the intermediate mesoderm. It is first expressed in the nephric duct and in mesonephric tubules, extending caudally to the ureteric bud (49, 50). Pax-2 is expressed only in mesenchyme that has been induced by signaling from the ureteric bud, but not in the uninduced mesenchyme (207), and Pax-2 becomes the first indicator of the nephrogenic cell lineage at this early stage (Fig. 5). Pax-2 continues to be expressed throughout condensation and polarized vesicle formation (Fig. 15), and expression is downregulated in the proximal loop of the S-shaped body that is the site of the podocyte precursor cells. This repression of Pax-2 transcription is related to the expression of WT-1 (215) and its interaction with the first exon of the Pax-2 gene (225).

2.  Pax-2 and WT-1

The regulatory loop between WT-1 and Pax-2 (Fig. 15) may provide clues for further analysis of those renal diseases in which epithelial cell proliferation continues. The Pax-2 gene is a member of a family that also includes genes involved in severe abnormalities as Waardenburg syndrome (264) and human aniridia (271). Pax-2 is essential for the MET (223), since interference with gene function inhibits mesenchymal condensation and the subsequent steps in nephrogenesis. The complete loss of Pax-2 function, by homologous recombination (272), resulted in abolished formation of nearly all of the epithelial components derived from the intermediate mesoderm. The central role of Pax-2 was further illustrated in a transgenic mouse model (52) where the deregulated gene produced severe abnormalities such as cystic kidney and undifferentiated glomerular epithelia, reminiscent of features in congenital nephrotic syndrome. In conclusion, the nephrogenic stem cell is characterized by a new pattern of gene expression, such as Pax-2, both at the level of transcription and of signaling molecules (Fig. 5).

B.  Apoptosis is a Regulatory Mechanism for Mesenchymal Stem Cells

Apoptosis or programmed cell death is a crucial regulated event in renal morphogenesis, since a large number of (blastemal) cells are produced and only a few are guided to follow a developmental program because they have been rescued from programmed cell death by induction. Cell death occurs by two distinct mechanisms. In one, necrosis, cellular ATP concentration declines immediately (as in renal ischemia) followed by a sequence of events, such as cellular swelling, leading to cell lysis. In the other, apoptosis, the primary event is a regulated breakdown of DNA into small, 200-bp fragments by the activation of a calcium-sensitive endonuclease. The cell constituents condense and ultimately break into fragments that are taken up mostly by macrophages. Mesenchymal cells are destined for apoptosis, as shown in transfilter culture of rat E13 isolated renal tissue (145, 295), unless they are induced to survive by signaling interactions with the ureteric bud. Apoptosis is a normal event in development, and apoptotic cells are frequently observed next to condensing aggregates and to vesicles (32, 116). Apoptosis is more prominent in mesenchymal cells of the nephrogenic outer cortex where cell death may serve to remove those mesenchymal cells that have not been chosen for MET. This implies that inductive signaling may be a two-step event (6) in which rescue from apoptosis is followed by conversion to the epithelial phenotype. Although the rescue or survival signal remains to be disclosed, a hint to a putative pathway may have come from the observation that LiCl (15 mM), added to the medium of isolated mouse (E11) mesenchyme in the absence of an inducing signal, was able to rescue these cells from entering programmed cell death; morphogenesis after the LiCl rescue was initiated up to the expression of the cell adhesion molecule N-CAM in the comma stage, but no further (39). In addition, some growth factors, such as epidermal growth factor (EGF) (295) or basic fibroblast growth factor (FGF) (206) are able to rescue cultured mesenchyme from apoptosis.

The tumor suppressor gene p53 is believed to not only act as controller in the cell cycle but also in apoptosis (211). However, wild-type p53 expression in comma- and S-shaped body does not provide a clue to its function (245), and a p53 loss-of-function mutation does not dramatically alter organogenesis (48), whereas a gain-of-function mutation induces ureteric alterations and small kidneys with a reduced number of nephrons and, notably, accelerated apoptosis (82). Of interest in this context are the findings that WT-1 binds the p53 protein, thus inhibiting p53-mediated apoptosis (169, 170), and p53 expression can be repressed by Pax-2 (260).

A protooncogene with death repressor activity, bcl-2, is expressed in nephrogenesis (197, 253). The bcl-2-encoded protein is on the outer mitochondrial membrane, in the endoplasmic reticulum and the nuclear envelope, and it is involved probably in an antioxidant pathway (286) to protect cells from oxidative damage (110). The bcl-2 gene is highly expressed in condensing mesenchyme and in the ureteric bud, and it is downregulated, as in most mature cells, in terminal epithelia and in glomerular cells (154, 253); bcl-2-deficient mice develop hypoplastic polycystic kidneys (286). In addition, they have abnormal postinductive nephrogenesis either after E13 (193) or weeks after birth (253, 286), associated with fulminant mesenchymal apoptosis (194).

WT-1 binds to p53, and WT-1-deficient mice show increased mesenchymal apoptosis (148). Also, when c-myc is constitutively expressed in cell lines, the ensuing apoptosis can be inhibited by coexpression of bcl-2 (17). Clearly, bcl-2-regulated apoptosis is a basic mechanism in nephrogenesis, and bcl-2 is an intrinsic negative regulator of the cell death pathway even beyond the inductive phase of morphogenesis.

C.  Inductive Signaling Opens the Nephrogenic Pathway

Mesenchymal-to-epithelial transition of the metanephrogenic mesenchyme is the center event in early nephrogenesis. Mesenchymal cells are nonpolarized, loosely associated, and apolar cells embedded in ECM with a fibroblast-like shape and high mobility. Epithelial cells, in contrast, are asymmetric or polarized, form continuous sheets, express a basement membrane, have a cuboidal or "cobblestone" shape, and are generally little mobile. The phenotypic conversion of metanephrogenic mesenchymal to nephron epithelial cells (Fig. 6) mirrors changes in the expression of different gene families (121a), encoding transmembrane receptors, cell adhesion molecules, growth factors, ECM components, and specific basement membrane constituents. As discussed, one or more genes of the Pax family are expressed in each of the tissues that undergoes MET, and pro-, meso-, and metanephros are all formed through these interactions. The nature of the inductive signals that were postulated in the classic embryologic recombination experiments (86, 89) is now being uncovered. The inductive process is multifactorial and multiphasic. Although much effort has been invested in studying single factors (e.g., Refs. 37, 39, 102, 206, 295), these single factors appear to address and express only parts of the developmental program, i.e., their effects either have not induced tubulogenesis (39, 206, 295), or the inducing factor has activated another messenger system that in fact induced tubulogenesis (102, 133).



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Fig. 6. Functional complexes in transition of mesenchymal to epithelial cells (MET). Nephrogenic mesenchymal cells (top) are induced to enter MET whereby several systems with signaling functions are activated. CAM-mediated signals and ECM-mediated signals interact with secreted growth factors to express epithelial phenotype (bottom).

1.  Genes in mesenchyme induction

The early stages of kidney organogenesis are governed by four different control genes (Fig. 5). These are WT-1 (148), Pax-2 (49, 51), Wnt-4 (258), and Bmp7 (55, 165). Their primary roles, as deduced from knockout experiments, suggest that they are local mediators in signaling interactions between the ureteric bud and the nephrogenic blastema.

WT-1 is expressed in the metanephrogenic mesenchyme but not in the ureteric bud cells (4), and the expression of WT-1 (191) is the earliest sign of commitment in the intermediate mesoderm-derived metanephric blastema that contains the nephron lineage(s). WT-1 is essential for mesenchymal competence to later respond to other inductive signals (148); it directs the genesis of the first ureteric bud off the Wolffian duct, and it interacts with Pax-2 in the nephrogenic stem cells at the transcriptional level (Fig. 15).

Another of the control genes in early nephrogenesis is Bmp-7, which encodes the bone morphogenetic protein-7 (55, 165). Bmp proteins belong to the TGF-beta family of secreted signaling molecules generally involved in morphogenesis (261). Bmp-7 loss-of-function kidneys differentiate up to the comma- and S-shaped stage, but further epithelial development is defective (56), and the mesenchymal cells undergo rapid apoptosis (165). Consequently, genes of early induction and transition stages are expressed in Bmp-7-deficient mutants, albeit mostly in aberrant patterns, such as Pax-2, Wnt-4, WT-1, Ret, and even Pax-8. Bmp-7 transcripts are seen in the mesonephric kidney, in the metanephric condensates, in comma and S-stage, and in the collecting duct (166). In line with the expression pattern of Bmp-7 and the mutant phenotype is the finding that Bmp-7 induces cultured metanephric mesenchyme to differentiate, and antibodies or antisense oligonucleotides inhibit Bmp-7 and tubulogenesis (288).

The homeobox gene lim1 is expressed in the intermediate mesoderm, mesonephric tubules, Wolffian duct, and induced mesenchymal cells (9, 75). Lim1 -/- mice have a complete defect of kidneys and gonads (249) probably due to premetanephric defects, suggesting that lim1 has a primary role in intermediate mesoderm specification. The gene that is expressed in the progeny of the Wolffian duct appears to have an important role after the initial signaling events (183). Metanephric mesenchyme and ureteric bud of Emx2 -/- mutants correctly expressed transcribed marker molecules of the the first signaling stage; the ureteric bud invaded the metanephric mesenchyme and induced Pax-2 expression. After this initial phase, however, signaling was discontinued, and the expression of Lim-1, c-ret, and Pax-2 in ureteric bud, as well as that of GDNF in the mesenchyme, was greatly reduced; the ureteric tip did not dilate and branch, Wnt-4 was not expressed, and MET was not initiated. The control experiment showed that wild-type ureteric bud or spinal cord was capable to induce the mesenchyme of the mutants, suggesting that Emx2 is required in early ureteric bud cells subsequent to the induction of mesenchymal Pax-2 expression.

Condensed mesenchymal cells, in addition to their shift from mesenchymal to epithelial surface proteins (Fig. 7), express a protein encoded by Wnt-4, a member of a family of genes that encode signaling molecules regulating early embryonic tissues (258). The Wnt-4 protein is secreted by induced metanephrogenic mesenchyme (138), and the Wnt-4 gene is expressed in condensates very soon after induction by tip ureteric bud cells, and expression persists in the vesicle, comma, and S-stages (Fig. 5). In mutant Wnt-4 -/- mice, mesenchymal cells condense next to the ureteric buds, Pax-2 is normally expressed (258), but Pax-8 that is normally expressed immediately after the condensation stage (Fig. 15) was not expressed. The failure of nephrogenesis to proceed beyond the condensation stage suggests that the cascade of signaling molecules directing the induction process was interrupted at the Wnt-4 plateau. The Wnt family (77) indeed has some characteristics of the putative mesenchymal inducer molecule(s), e.g., they are postulated to associate with secreted matrix or with basement membrane domains. Another Wnt family member, Wnt-1, was demonstrated to have properties comparable to Wnt-4 (102). In an elegant and important study, Wnt-1-secreting NIH 3T3 fibroblasts (transfected with Wnt-1 cDNA) were cocultured with isolated nephrogenic mesenchyme and shown to induce tubule formation after an initially increased proliferation of induced mesenchymal cells. It is of interest that Wnt-4 has a temporal expression pattern very similar to Bmp-7 (166, 288) and that sonic hedgehog (Shh) genes are coexpressed with Bmp genes (18), but nothing is known about interactions between these families of morphogens.



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Fig. 7. MET-associated shift in gene expression. Relative abundance (symbol size) of gene expression or protein production of some CAM and ECM proteins, and their shift in process of mesenchymal (top left) to epithelial (top right) cell transition (MET), is shown. Reference numbers are given in parentheses.

To summarize, Wnt-4, in contrast to Wnt-11, which is expressed exclusively at the very tip of the ureteric bud (Fig. 5), appears to be essential, possibly as an autoactivator, for the transitional step from the induced mesenchyme to epithelia and most likely in subsequent early stages of tubulogenesis, but it is not required for the initial step(s) leading to the induced nephrogenic mesenchymal cells. This emerging role of Wnt as a regulator of E-cadherin-mediated cell-cell adhesion (105) denotes a further very important point along the multistep induction process.

D.  Postinductive Nephron Formation

The inductive process between nephrogenic mesenchyme and ureteric bud ultimately results in aggregates of induced cells that now express adhesion molecules (Fig. 6). Wnt-4 is expressed in these aggregates, and it is repressed upon completion of the nephron. In Wnt-4 -/- mice, condensations of induced mesenchymal cells appear, but few only express markers of epithelialization or Pax-8 (258), indicating that Wnt-4 is an essential regulator of MET, probably by controlling the expression of cell adhesion molecules (105, 281, 287). Control mechanisms in the subsequent stage of cell polarization are unknown, although some putative control genes, such as members of the Hox family and WT-1, are upregulated during the transition process. As the mesenchymal-to-epithelial program continues, tenascin is expressed in polarizing mesenchymal cells (5) together with SGP-2 (94).

The MET is completed when cells display the basic features of an epithelium, e.g., the asymmetry of apicobasal membrane proteins. The condensed and converted cells form a round body which, by as yet undefined mechanisms of fluid secretion, develops a small lumen and proceeds to the vesicle stage (Fig. 3C). The subsequent stage, some hours later, is reached by reorganization of the sphere into a longitudinally curved epithelial body, the "comma shape" (Fig. 3D). The mechanisms responsible for this rearrangement and for the intricate pattern formations that follow are unknown. The comma stage develops to the "S-shaped body" by a cleft involution at both curving ends (Fig. 3E). It is very likely by now that the S-stage expresses a proximal-distal profile of cell properties (121a) characteristic of the evolving proximal and distal nephron segments. Nevertheless, in situ hybridization and immunohistochemical work have already demonstrated that some transcription factors are repressed (e.g., WT-1, Pax-2, N-myc) while others are expressed (e.g., Pax-8; LFB-1) during this and the subsequent stages of nephron formation (4, 50, 223, 188, 153, 210). Their state of molecular differentiation is only now beginning to be explored (Fig. 12). The most proximal end of the S-shape enters angiogenesis (218), whereas adjacent tubular parts express a few apical membrane markers (7). In the most distal part of the S-shape, membrane fusion ultimately must connect the mesenchyme-derived nephron segments with those originating from the epithelial ureteric bud (Fig. 3F). Other cells of the distal tail of the S-body are to express the cell types of the distal convoluted tubule and of the macula densa. The importance of apoptosis at this stage, regulated by bcl-2 (110, 154), is clearly demonstrated by the fact that bcl-2 -/- mice, in addition to high apoptotic rates, have polycystic kidneys (286). Further development into nephron segments is accompanied by basement membrane scaffolding (68) and by signaling of a wide variety of growth factors (93). Collecting duct growth, in addition, is directed by IGF/R-mediated actions, since antisense oligonucleotides against the receptor inhibit growth of the collecting duct in organ culture (291). The repression of Pax-2 at the S-shape stage is a prerequisite for further cell differentiation; it is as essential here as is the expression of Pax-2 in previous stages for completion of MET (Fig. 15). Finally, the junction of the mesenchyme-derived segments of the nephron with those derived from the Wolffian duct has not been investigated, and it involves most likely mechanisms of plasma membrane reorganization similar to those supposed to take place in branching morphogenesis (229-231).

    V. MESENCHYME-TO-EPITHELIUM TRANSITION AND CELL ADHESION
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A.  MET Requires Profound Changes in Gene Expression

Conversion of the induced mesenchymal cell to its epithelial cell phenotype, i.e., MET, requires extensive alterations in gene expression. Regulatory genes and morphogenic molecules known to participate are considered.

The first step of induction rescues part of the mesenchyme from apoptosis and leaves these mesenchymal stem cell populations committed for further induction to enter either the nephrogenic or the stromogenic pathway (see sect. IIC). Condensing cells transiently express the surface glycoprotein syndecan (281, 282), and they begin to express a new set of regulatory genes and of morphogenic molecules, whereas typical mesenchymal markers are repressed. Mesenchymal vimentin and N-CAM disappear, and epithelial E-cadherin, the alpha -chain of laminin, and the alpha 6beta 1-integrins that act as transmembrane receptors for laminin A (66, 65, 139, 255) appear, to mention only some of them (Fig. 7). In an attempt to identify additional surface molecules expressed in the transitional process, monoclonal antibodies were raised against induced mesenchymal cells (83); their ability to inhibit tubule formation in culture and their expression patterns should promote further search for the corresponding antigens involved in epitheliogenesis. In conclusion, the conversion to the epithelial phenotype involves several levels of cellular, protein, and genetic changes (121a). Most of the putative interactions between these levels have not yet been defined.

B.  Cell Adhesion Initiates Cellular Reorganization in MET

Cell adhesion appears to be regulated through an interplay of several molecular species in which the cadherin family of adhesion molecules (171), the catenin family of intracellular adhesive junction proteins, and the product of the protooncogenes Wnt-1 and src participate (21, 105). Cadherins and catenins are fundamental molecules in embryonic epitheliogenesis, and changes in cadherin expression patterns designate events in morphogenesis, such as MET. The cadherins E-, N-, and P-, the classic cadherins, are able to form complexes with specific catenins, i.e., with alpha -, beta -, and gamma -catenin (plakoglobin) (21, 199). Cadherins are linked to the actin filament network by catenins, and cadherin-catenin complexes may interact with other cytoplasmic or transmembrane proteins (115, 214). Cadherins thus acquire a critical role in early epithelial polarization (152). The alpha - and beta -catenins colocalize with E-cadherin at the zonula adherens (195), and interactions between the zonula adherens complex, as for beta -catenin/E-cadherin, and the actin filaments may participate in morphogenetic changes such as from the comma to S-shape. E-cadherin expression increases early at the contact site between two cells, ~1 h after contact has been made (176, 177). The next stage is characterized by interactions between E-cadherin and cytoskeletal proteins that result in the polar distribution of membrane proteins (176). Truncated N-cadherin lacking the extracellular domain and expressed in Xenopus embryos results in disruption of cell adhesion and abnormal development (137). Furthermore, epithelial cells deprived of alpha -catenin are unable to adhere, although they express beta -catenin and E-cadherin; cells that lack cadherins but express alpha - and beta -catenins can be induced to express an epithelial adhesive phenotype by the introduction of E-cadherin or N-cadherin, indicating that different cadherins can interact with one catenin subtype (107). E-cadherin is essential early in embryogenesis, since mice lacking this gene expression are unable to form a trophoectoderm epithelium and die from this preimplantation defect (217). The final phenotypic step in the polarization process, some 1.5 days after the first inductive step (mouse), is the gain of expression of cytokeratin components of the intermediate filament system (Fig. 7) and the loss of vimentin.

C.  Cell Adhesion Molecules Are Expressed in Cell Type-Specific Patterns

When mesenchymal cells aggregate next to the tip cells of ureteric buds to form packed condensates, this is considered the first visible morphological indication of transformation. Syndecan-1 (14) and N-CAM (196) are upregulated at the onset of this stage, as is Wnt-4, and they may therefore be involved in organizing the mesenchymal condensate. N-cell adhesion molecule coexpresses with the low-affinity receptor (p75NGFR) of NGF (297) and with NGF (237); this fact suggests an early role for N-CAM and NGF in the predetermined nephrogenic stem cell (140) even before epithelial polarization is expressed. N-cell adhesion molecule probably is a target gene for regulation by Pax and Hox gene products (64, 128); it may turn out that these homeobox and paired-box gene products are an important functional link between patterning genes and morphoregulatory CAM genes. A-cell adhesion molecule has a similar pattern except that its expression persists in the lower limb of the S-shaped body during later stages, whereas L-CAM is expressed in ureteric bud, collecting duct, and the limb of the S-shaped body that is to become the distal nephron where L-CAM continues to be expressed in the neonatal kidney (196). These segment-specific patterns for L-CAM and for A-CAM as early as in the S-stage may contribute to the expression of characteristic nephron segmental properties. In conclusion, upregulation of both syndecan (283) and N-CAM (140) denotes the onset of epithelial morphogenesis in the mesenchyme. However, it should be mentioned that neither the mechanism of aggregate formation within the condensations nor the regulation of cell polarization is currently understood. Answers to these open questions may come from studies on the "reverse" process in which epithelial cells revert to mesenchymal cells, a phenomenon also seen in carcinogenesis (16).

Syndecan-1 associates with the actin-containing cytoskeleton via its intracellular domain (14), and it is expressed highly in condensing (induced) mesenchymal cells only, i.e., it appears to be involved in the ligand-induced clustering of the committed mesenchymal cells (281). The proteoglycan is later reexpressed in bud-derived epithelia, while nephrogenic mesenchymal cells lose the expression of syndecan-1 with differentiation. Tenascin-C, a mesenchymal ECM glycoprotein, is transiently expressed close to the condensing (induced) stem cells and later next to the early epithelia (mouse E13), suggesting that its expression is upregulated by cortical epithelial signals, whereas in newborn kidney, tenascin C expression declines in the cortex and persists in medullary mesenchymal cells (5). Epimorphin, a 150-kDa protein, is expressed with syndecan (130) on the surface of condensing mesenchymal cells, but antibody interference with the protein had no effect on morphogenesis.

    VI. EPITHELIAL CELL POLARIZATION
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A.  Methods to Study Embryonic Renal Epithelia

1.  The classic system to study tissue interactions

The embryonic kidney, when taken in organ culture (mouse E11.5), continues with its tubulogenic developmental program (68, 86, 90, 92, 243, 280). When mesenchymal blastema and ureteric bud are separated before the inductive interactions, the ureteric bud can be induced to branching morphogenesis only by the renal mesenchyme, whereas the mesenchyme can be induced not only by the ureteric bud but also by other embryonic tissues (see sect. II). The fact that the induced metanephrogenic mesenchyme continues its differentiation in vitro to a certain stage of tubulogenesis provides an indispensable system to study early nephrogenesis because 1) each embryonic stage can be identified by its characteristic morphogenetic event, e.g., the comma shape (Fig. 13C), 2) immunolocalization and in situ hybridization (60) can be applied directly to the embryonic epithelia to resolve temporospatial expression patterns (227) of defined molecules, and 3) the in vitro situation provides direct access for mRNA analysis in single embryonic epithelial cells (121).

2.  Generating knock-out mutations with defective renal phenotypes

Functions of genes and their successive expression in the cascade of kidney development are being analyzed using either transgenic mice or mutants generated by loss of function/gain of function, i.e., by gene targeting (147). Mutation or modification of a gene at its chromosomal site ("knock-out gene") can be achieved by gene targeting in embryonic stem cells in culture; subsequently, these genetically manipulated cells are reimplantanted into the mouse, and the mutation can then be investigated in the whole (embryonic) mouse. In this way, mutations with a defective kidney phenotype have been created (Table 1), and their renal phenotype can be compared with the temporospatial expression pattern of the wild-type gene. Another approach is to identify gene families and their role in development by their homology of motifs with Drosophila genes, since many of the Drosophila melanogaster genes known as developmental control genes are conserved with evolution, e.g., in mice and humans. This pertains to the sequence elements of paired box (Pax) and homeobox (Hox) that are available to search for gene family members in other species. Ultimately, however, to understand the developmental (downstream) role of a gene, it is mandatory to define its function in the whole embryo under the conditions of constructed misregulation or of absent regulation of the gene under study. By the loss-of-function (targeted disruption) strategy, WT-1 was shown to prepare the mesenchyme for the inductive process (148), Pax-2 (272) to control multiple steps in nephrogenesis downstream of WT-1, Wnt-4 (258) to participate in the transformation from aggregate to epithelial tubule, Bmp-7 (55, 165) to be involved in stem cell conservation, c-ret (247) to regulate collecting duct branching and growth, and BF-2 (97) to advance the differentiation of aggregates.


                              
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Table 1. Gene mutations influencing nephrogenesis

3. Cell culture of ureteric bud and of induced metanephrogenic mesenchyme

A) MONOLAYER CELL CULTURE OF NEPHRIC DUCT-DERIVED EPITHELIA. The introduction of techniques for primary culture of single nephron segments (112) opened the in vitro access not only to most cell types of the nephron (114), but moreover to the apical plasma membrane (Fig. 8) for ion channel evaluation (119). In addition, this culture system (114) was modified to evaluate ion channel expression in the particular cell population covering the ureteric bud (Fig. 9) by applying the reverse transcription (RT)-PCR (Fig. 10) to monolayers and to the single cell (Fig. 11). These cells at the tip of the ureteric bud express specific properties, such as ClC-2 mRNA consistent with the notion that this channel is widely expressed in embryonic cells (see sect. VIC). In a newborn kidney culture system (259), significantly, a novel antigen, termed PCDAmp1, was found by immunohistochemical techniques on the basal aspect of ampullar collecting duct only in embryonic but not in differentiated collecting duct cells derived from cortical explants of newborn rabbit cortex (259). This important finding may point to a role of the antigen in nephrogenesis.



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Fig. 8. Morphology of ureteric bud cells in culture. Scanning electron microscopy of apical cell side in monolayer (A) suggests that these cells express a principal cell-like phenotype, as indicated by central cilium (B).



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Fig. 9. Scheme of single ureteric bud cell analysis. Ureteric duct with ureteric buds is microdissected and transferred on collagen matrix in culture dish. Patch-clamp recording is followed by mRNA harvesting into patch pipette. mRNA encoding housekeeper and ion channels are reverse transcribed and amplied by PCR, similar to protocol in Fig. 10.



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Fig. 10. Scheme of quantitative RT-PCR in analysis of embryonic ion channel expression. Quantitative reverse transcriptase-PCR was applied to monolayer cultures of ureteric bud cells (Fig. 8) at different stages of embryonic and postembryonic cell differentiation (Fig. 14).



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