Calcium oxalate crystal-induced cytolysis in polymorphonuclear leukocytes and erythrocytes

Proposed mechanisms in renal tubular crystal retention

The production of concentrated urine inevitably leads to the precipitation of poorly soluble waste salts in the renal tubular fluid. These crystallization processes are physiologic and without consequences as long as all crystals are excreted with the urine. The retention of crystals in the renal tubules, however, may lead to tubular nephrocalcinosis. Here, we present a brief survey of the possible mechanisms involved in this process, which seems to depend predominantly on the presence of regenerating/(re)differentiating cells in the renal tubules. Crystal binding to the surface of these cells can be mediated by a number of luminal membrane molecules, including acidic fragment of nucleolin-related protein, annexin-II, osteopontin, and hyaluronan.

Oxalate toxicity in LLC-PK1 cells: role of free radicals

Oxalate, the most common constituent of kidney stones, is an end product of metabolism that is excreted by the kidney. During excretion, oxalate is transported by a variety of transport systems and accumulates in renal tubular cells. This process has been considered benign; however, recent studies on LLC-PK1 cells suggested that high concentrations of oxalate are toxic, inducing morphological alterations, increases in membrane permeability to vital dyes and loss of cells from the monolayer cultures. The present studies examined the basis for oxalate toxicity, focusing on the possibility that oxalate exposure might increase the production/availability of free radicals in LLC-PK1 cells. Free radical production was monitored in two ways, by monitoring the reduction of nitroblue tetrazolium to a blue reaction product and by following the conversion of dihydrorhodamine 123 (DHR) to its fluorescent derivative, rhodamine 123. Such studies demonstrated that oxalate induces a concentration-dependent increase in dye conversion by a process that is sensitive to free radical scavengers. Specifically, addition of catalase or superoxide dismutase blocked the oxalate-induced changes in dye fluorescence/absorbance. Addition of these free radical scavengers also prevented the oxalate-induced loss of membrane integrity in LLC-PK1 cells. Thus it seems likely that free radicals are responsible for oxalate toxicity. The levels of oxalate that induced toxicity in LLC-PK1 cells (350 microM) was only slightly higher than would be expected to occur in the renal cortex. These considerations suggest that hyperoxaluria may contribute to the progression of renal injury in several forms of renal disease.

Mode of activation of the metabolic burst in polymorphonuclear leukocytes by calcium oxalate crystals

Microcrystals of calcium oxalate cause an activation of the metabolic burst in polymorphonuclear leukocytes, measured as NBT reduction. Crystal-induced NBT reduction, which was mainly due to superoxide release, was accompanied by enzyme release. Modulation of calcium oxalate-induced activation by several agents resembles the effect of these agents on activation by opsonized zymosan and by phorbol myristate acetate. Both the activation of the metabolic burst and concomitant enzyme release could be counteracted by certain anions, such as oxalate, pyruvate and citrate, indicating that positive charges on the crystals play an important role in crystal-cell interaction. Removal of the negatively charged sialic acid from the cell surface by neuraminidase did not affect the the action of the crystals. The mechanism, by which calcium oxalate activates polymorphonuclear leukocytes, is discussed.

Enzyme release from polymorphonuclear leukocytes during interaction with calcium oxalate microcrystals

The interaction between polymorphonuclear leukocytes and calcium oxalate crystals results in enzyme release from the cells, due to exocytosis and plasma membrane damage. Positive charges on the crystals apparently play a predominant role in the interaction. Removal of negatively charged sialic acid from the cell surface has little effect on crystal-induced enzyme release. Glucose-loaded liposomes release glucose upon exposure to calcium oxalate crystals when the liposomes are negatively charged but not when the liposomes bear a positive charge. Cytoplasts, which are devoid of granules, are severely damaged by calcium oxalate crystals. As with intact cells the damaging effect of the crystals on liposomes and cytoplasts can be counteracted by a polyanion. The results are consistent with the view that calcium oxalate crystals can cause enzyme release from polymorphonuclear leukocytes, mainly by a direct effect on the plasma membrane. The release might be due to an interaction of positive charges on the crystals with negative countercharges on the cells, possibly located in the phospholipid bilayer.

On the mechanism of histamine release from sodium fluoride-activated mouse mast cells

We have found that sodium fluoride-induced histamine release from mouse mast cells occurs in two separate steps, activation in the presence of fluoride and absence of calcium, and secretion triggered by calcium. The amount of released histamine was dependent either on the time of cell exposure to fluoride or on the final fluoride concentration in the incubation medium. The secretory step depends on the concentration of extracellular calcium; it increased as the concentration of calcium was increased. However, a substantial part of the release was both calcium and energy independent. This part, probably cytotoxic, increased markedly at the highest concentration and with extended times of cell exposure to fluoride. Among other divalent cations tested only strontium could partly substitute calcium to trigger secretion. The activating action of fluoride slowly decayed with time and addition of calcium for up to 2 h caused histamine release. Both steps were dependent on temperature and pH and were inhibited by antimycin A, suggesting that the reaction was enzymatic. The action of fluoride on mouse mast cells closely resembles its action on rat mast cells; however, some differences were also observed.