**Author details**

levels were significantly higher in patients with UPJ obstruction. They also expressed that

Although it is a highly investigated area, role of ECM proteins in the development of UPJ obstruction and their impact on treatment success is still controversial. Current literature lacks a study that compares child and adult patient populations, which could give us a clearer picture for the progression of UPJ obstruction thought the life. Such information could help

Similar to UPJ studies, UVJ shows decreased muscle density and increased ECM components in diseased patients. In a study published in 2004, 36 UVJ segments were evaluated and MMP1 production was found significantly higher in the group with an obstructed junction. This study also found that an increased level of CD68+ macrophages was found in obstructed junctions and as a result there was an increase in cytokines and growth factors and ECM is secreted at

Oswald et al. have shown that markers of smooth muscle structure decrease in UVJ pathologies whereas collagen concentration increases significantly by examining tissue specimens of 29

Studies showing changes in ECM composition in UVJ-related disease gives us a picture of what happens after pathological process starts. In most conditions, our knowledge lacks the information of what really starts these changes on subcellular level. There is a need for more detailed and larger studies to get a clear picture of the conditions and develop better treatment

With advancement in the technology and increased data on ECM components, it was realized that many diseases have a close relation with the composition of ECM in the affected tissue.

ECM composition, in some conditions, gives us a view about the prognosis and progression of disease whereas in others it can give information about the cause and pathophysiology of the disease. With better understanding of ECM one can develop new treatment and follow-up models. Also better knowledge of ECM is essential for tissue engineering. Although there is a lot of data on ECM subject there are still needs for well-planned clinical trials, which can change

patients with a refluxing ureter and comparing them with nonrefluxing tissues.

the physician to decide the timing of the surgery with more objective data.

apoptosis was higher in UPJ obstruction group [34].

230 Composition and Function of the Extracellular Matrix in the Human Body

**7. ECM on UVJ**

elevated levels [23].

strategies.

**8. Conclusion**

our perspective on this subject.

Cevdet Kaya1\* and Bahadır Şahin<sup>2</sup>

