This article further investigates the molecular environment of the pediatric ureteropelvic junction and possible changes associated with obstruction. The compliance of the ureteral wall is multifactorial, including the muscular structure, the composition of the extracellular matrix, and the density of neural input. Previous studies have implicated poorly functioning muscle cells and a decreased distribution of nerves (References 1 and 4 in the article). The current authors now demonstrate an increase in the expression of local matrix metalloproteinases in obstructed ureters compared with normals. We will likely find that the true etiology of obstruction is also muitifactorial with multiple markers at play.
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