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Adhoni MZU, Nagle A, Ali Z. Radiolucent Matrix Stones in a Transplanted Kidney: A Case Report. Cureus 2023; 15:e38280. [PMID: 37255892 PMCID: PMC10226156 DOI: 10.7759/cureus.38280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2023] [Indexed: 06/01/2023] Open
Abstract
Matrix stones are a rare form of kidney stones, which are composed of mucoproteinaceous material. They are often difficult to diagnose as they are characteristically radiolucent on CT urinary tract. This difficulty is compounded in transplanted kidneys as obstructing stones commonly present without pain and can cause acute kidney injury. Here, we present a case of a 61-year-old female with a live-donor kidney transplant, who was found to develop deranged renal function on routine follow-up investigations. Therefore, a CT urogram was performed and it showed filling defects in the renal pelvis and upper ureter of the transplanted kidney. Therefore, diagnostic ureterorenoscopy was performed and three stones of about 7-8 mm each were found in the renal pelvis, they were treated by Holmium:Yttrium aluminium garnet (YAG) laser fragmentation. This case report describes the challenges in the management of this rare stone in a transplanted kidney.
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Affiliation(s)
| | - Amy Nagle
- Urology, The Royal London Hospital, London, GBR
| | - Zubeir Ali
- Urology, The Royal London Hospital, London, GBR
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2
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Rose J, Basisty N, Zee T, Wehrfritz C, Bose N, Desprez PY, Kapahi P, Stoller M, Schilling B. Comprehensive proteomic quantification of bladder stone progression in a cystinuric mouse model using data-independent acquisitions. PLoS One 2022; 17:e0250137. [PMID: 35771811 PMCID: PMC9246204 DOI: 10.1371/journal.pone.0250137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/03/2022] [Indexed: 11/21/2022] Open
Abstract
Cystinuria is one of various disorders that cause biomineralization in the urinary system, including bladder stone formation in humans. It is most prevalent in children and adolescents and more aggressive in males. There is no cure, and only limited disease management techniques help to solubilize the stones. Recurrence, even after treatment, occurs frequently. Other than a buildup of cystine, little is known about factors involved in the formation, expansion, and recurrence of these stones. This study sought to define the growth of bladder stones, guided by micro-computed tomography imaging, and to profile dynamic stone proteome changes in a cystinuria mouse model. After bladder stones developed in vivo, they were harvested and separated into four developmental stages (sand, small, medium and large stone), based on their size. Data-dependent and data-independent acquisitions allowed deep profiling of stone proteomics. The proteomic signatures and pathways illustrated major changes as the stones grew. Stones initiate from a small nidus, grow outward, and show major enrichment in ribosomal proteins and factors related to coagulation and platelet degranulation, suggesting a major dysregulation in specific pathways that can be targeted for new therapeutic options.
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Affiliation(s)
- Jacob Rose
- Buck Institute for Research on Aging, Novato, CA, United States of America
| | - Nathan Basisty
- Buck Institute for Research on Aging, Novato, CA, United States of America
| | - Tiffany Zee
- Buck Institute for Research on Aging, Novato, CA, United States of America
| | - Cameron Wehrfritz
- Buck Institute for Research on Aging, Novato, CA, United States of America
| | - Neelanjan Bose
- Buck Institute for Research on Aging, Novato, CA, United States of America
| | | | - Pankaj Kapahi
- Buck Institute for Research on Aging, Novato, CA, United States of America
| | - Marshall Stoller
- University of California San Francisco, San Francisco, CA, United States of America
| | - Birgit Schilling
- Buck Institute for Research on Aging, Novato, CA, United States of America
- * E-mail:
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Lee MS, Soyster M, Woloshuk A, Assmus M, Agarwal D, Large T, Krambeck A. Comparison of Perioperative Outcomes and Clinical Characteristics of Calcium, Matrix and Struvite Stones From a Single Institution. Urology 2021; 161:25-30. [PMID: 34848277 DOI: 10.1016/j.urology.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/24/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To define risk factors and perioperative outcomes for matrix stones and compare these outcomes with struvite and calcium stone cohorts. METHODS A retrospective cohort study comparing matrix stones (n=32), struvite stones (n=23) and a matched, calcium stone control group (n=32) was performed. Two-way ANOVA was used to compare the groups for continuous variables. Chi-square tests were used to compare categorical variables. Significance was set at P <.05. All statistical tests were performed using R (v1.73). RESULTS We identified no differences in age, gender, or BMI between the three groups. Matrix and struvite stones were more likely to have a history of prior stone surgery and recurrent UTIs compared to calcium stones (P=.027 and P <.001, respectively). Struvite stones were more likely to present as staghorn calculi compared to matrix or calcium stones (56.5% vs 21.7% vs 18.8%, P=.006). There were no significant differences in postoperative stone free rates (P=.378). No significant differences in postoperative infectious complications were identified. Matrix stones were more likely to have Candida on stone culture compared to the struvite or calcium stones (P <.0001). CONCLUSION Matrix and struvite stones were more likely have a history of stone surgery and preoperative recurrent UTIs. Struvite stones were more likely to present as staghorn calculi. Matrix stones were more likely to have Candida present in stone cultures. However, no difference in postoperative infectious outcomes or stone free rates were identified. Further study with larger cohorts is necessary to distinguish matrix stone postoperative outcomes from struvite and calcium stones.
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Affiliation(s)
- Matthew S Lee
- Department of Urology, From the Feinberg School of Medicine, Northwestern University, Chicago, IL.
| | - Mary Soyster
- Department of Urology, Indiana University School of Medicine, Methodist Hospital, Indianapolis, IN
| | - Andre Woloshuk
- Department of Urology, Indiana University School of Medicine, Methodist Hospital, Indianapolis, IN
| | - Mark Assmus
- Department of Urology, From the Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Deepak Agarwal
- Department of Urology, Indiana University School of Medicine, Methodist Hospital, Indianapolis, IN
| | - Tim Large
- Department of Urology, Indiana University School of Medicine, Methodist Hospital, Indianapolis, IN
| | - Amy Krambeck
- Department of Urology, From the Feinberg School of Medicine, Northwestern University, Chicago, IL
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Yang Y, Hong S, Li C, Zhang J, Hu H, Chen X, Jiang K, Sun F, Wang Q, Wang S. Proteomic analysis reveals some common proteins in the kidney stone matrix. PeerJ 2021; 9:e11872. [PMID: 34395096 PMCID: PMC8323604 DOI: 10.7717/peerj.11872] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022] Open
Abstract
Background Proteins are the most abundant component of kidney stone matrices and their presence may reflect the process of the stone’s formation. Many studies have explored the proteomics of urinary stones and crystals. We sought to comprehensively identify the proteins found in kidney stones and to identify new, reliable biomolecules for use in nephrolithiasis research. Methods We conducted bioinformatics research in November 2020 on the proteomics of urinary stones and crystals. We used the ClusterProfiler R package to transform proteins into their corresponding genes and Ensembl IDs. In each study we located where proteomic results intersected to determine the 20 most frequently identified stone matrix proteins. We used the Human Protein Atlas to obtain the biological information of the 20 proteins and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) analysis to explore their biological functions. We also performed immunohistochemistry to detect the expression of the top five stone matrix proteins in renal tissue. Results We included 19 relevant studies for analysis. We then identified 1,409 proteins in the stone matrix after the duplicates were removed. The 20 most-commonly identified stone matrix proteins were: S100A8, S100A9, uromodulin, albumin, osteopontin, lactotransferrin, vitamin K-dependent protein Z, prothrombin, hemoglobin subunit beta, myeloperoxidase, mannan-binding lectin serine protease 2, lysozyme C, complement C3, serum amyloid P-component, cathepsin G, vitronectin, apolipoprotein A-1, eosinophil cationic protein, fibrinogen alpha chain, and apolipoprotein D. GO and KEGG analysis revealed that these proteins were typically engaged in inflammation and immune response.Immunohistochemistry of the top five stone matrix proteins in renal tissue showed that the expression of S100A8, S100A9, and osteopontin increased, while uromodulin decreased in kidney stone patients. Albumin was rarely expressed in the kidney with no significant difference between healthy controls and kidney stone patients. Conclusion Proteomic analysis revealed some common inflammation-related proteins in the kidney stone matrix. The role of these proteins in stone formation should be explored for their potential use as diagnostic biomarkers and therapeutic targets for urolithiasis.
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Affiliation(s)
- Yuanyuan Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Senyuan Hong
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Cong Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiaqiao Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Henglong Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaolong Chen
- Department of Urology, Guizhou Provincial People's Hospital, Guizhou University, Guiyang, Guizhou, China
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People's Hospital, Guizhou University, Guiyang, Guizhou, China
| | - Fa Sun
- Department of Urology, Guizhou Provincial People's Hospital, Guizhou University, Guiyang, Guizhou, China
| | - Qing Wang
- Department of Urology, Guizhou Provincial People's Hospital, Guizhou University, Guiyang, Guizhou, China.,Department of Research Laboratory Center, Guizhou Provincial People's Hospital, Guizhou University, Guiyang, Guizhou, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Abstract
Urolithiasis, which is the presence of stones in the urinary tract, has long been linked with a
higher risk of causing chronic kidney diseases and associated illnesses, such as diabetes-affecting 12%
of the world population. This clinical condition arises due to the supersaturation of urine and alterations
in the expression of cellular and urinary proteins. The renal stone mineral composition has been
well understood and incorporated as a routine part of stone removal, however, the protein composition,
an essential fraction of the stone matrix has been inadequately understood and not adeptly established.
Stone proteomics consists of a number of techniques including crystal analysis using X-ray diffractometry
and IR spectroscopy, sample purification, identification and characterization of proteins using
high throughput mass spectrometric methods. However, not many studies have utilized the data obtained
from these experiments to assign functional significance to associated identified proteins. Protein
network analysis using bioinformatic tools such as STRING to study protein-protein interactions
will enable researchers to get better insight into stone formation mechanics. Hence, a comprehensive
proteomic study of kidney stone matrix will help in deciphering protein-crystal pathways generating
novel information useful for clinical application.
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Affiliation(s)
- Manavi Jain
- Department of Biotechnology, Jaypee Institute of Information Technology, Noida, India
| | - Paramveer Yadav
- Department of Biotechnology, Jaypee Institute of Information Technology, Noida, India
| | - Priyadarshini
- Department of Biotechnology, Jaypee Institute of Information Technology, Noida, India
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Elawdy MM, El-Halwagy S, Razek YA, Alsenani AR, Almazroui S. A Case of Pure Matrix Ureteral Stone: A rare type of urinary calculi that may be overlooked. Sultan Qaboos Univ Med J 2019; 18:e557-e559. [PMID: 30988982 DOI: 10.18295/squmj.2018.18.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/13/2018] [Accepted: 09/27/2018] [Indexed: 11/16/2022] Open
Abstract
Matrix stones are a rare form of urinary calculi with a low mineral content. We report a 63-year-old female patient who presented to the Sohar Hospital, Sohar, Oman, in 2018 with unexplained left flank pain and constipation. She had a history of chronic renal failure (CRF) and had previously undergone haemodialysis (HD). Non-contrast computed tomography (CT) did not show any renal or urinary stones. However, a left-sided ureteroscopy revealed a yellow-coloured stone that was soft in consistency occupying the proximal 5 cm section of the ureter. Many attempts at forceps extraction were required for complete clearance. A global quantitative composition analysis revealed the extracted stone to be composed entirely of protein-matrix material. Matrix stones require a high index of suspicion as they are sometimes radiolucent and cannot be visualised on CT scans. Risk factors include being female and a history of urinary tract infections, CRF and HD.
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Kaneko K, Kabeya M, Kondo H, Fukuuchi T, Yamaoka N, Yasuda M, Yamaguchi S. Proteomic analysis of a urinary stone with two layers composed of calcium oxalate monohydrate and uric acid. NUCLEOSIDES NUCLEOTIDES & NUCLEIC ACIDS 2018; 37:717-723. [PMID: 30587091 DOI: 10.1080/15257770.2018.1478095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We examined the mechanism of urinary stone formation by analyzing the matrix proteins in a urinary stone with two layers composed of different crystals. Micro-area X-ray spectrometry and infrared spectroscopy revealed calcium oxalate monohydrate in the outside and uric acid in the inside. We also examined the interface. After the outside, inside, and interface parts were separated, proteomic analysis identified 48, 7, and 4 matrix proteins, respectively. Urinary stones with two layers are considered to have grown under different conditions. The matrix proteins in each part differed among the crystal components and may reveal the stone-generating process. The proteins in the interface likely function to enlarge the stone via the addition of different crystals.
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Affiliation(s)
- Kiyoko Kaneko
- a Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science , Teikyo University , Tokyo , Japan
| | - Mizuho Kabeya
- a Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science , Teikyo University , Tokyo , Japan
| | - Hirokazu Kondo
- a Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science , Teikyo University , Tokyo , Japan
| | - Tomoko Fukuuchi
- a Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science , Teikyo University , Tokyo , Japan
| | - Noriko Yamaoka
- a Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science , Teikyo University , Tokyo , Japan
| | - Makoto Yasuda
- b Laboratory of Analytical Chemistry, Faculty of Pharma-Science , Teikyo University , Tokyo , Japan
| | - Satoshi Yamaguchi
- c Department of Urology , Asahikawa Medical College , Asahikawa , Japan
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8
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Martelli C, Marzano V, Iavarone F, Huang L, Vincenzoni F, Desiderio C, Messana I, Beltrami P, Zattoni F, Ferraro PM, Buchholz N, Locci G, Faa G, Castagnola M, Gambaro G. Characterization of the Protein Components of Matrix Stones Sheds Light on S100-A8 and S100-A9 Relevance in the Inflammatory Pathogenesis of These Rare Renal Calculi. J Urol 2016; 196:911-8. [DOI: 10.1016/j.juro.2016.04.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 12/23/2022]
Affiliation(s)
- Claudia Martelli
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Italy
| | - Valeria Marzano
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Italy
| | - Federica Iavarone
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Italy
| | - Liling Huang
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Italy
| | - Federica Vincenzoni
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Italy
| | - Claudia Desiderio
- Institute of Chemistry of Molecular Recognition, Italian National Research Council, Rome, Italy
| | - Irene Messana
- Department of Life and Environmental Sciences, Cagliari University, Cagliari, Italy
| | - Paolo Beltrami
- Urology Clinic, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Filiberto Zattoni
- Urology Clinic, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Pietro Manuel Ferraro
- Nephrology Division, Institute of Internal Medicine, Catholic University, Rome, Italy
| | - Noor Buchholz
- U-merge (Urology in Emerging Countries), London, United Kingdom
| | - Giorgia Locci
- Pathology Division, Department of Surgery, Cagliari University, Cagliari, Italy
| | - Gavino Faa
- Pathology Division, Department of Surgery, Cagliari University, Cagliari, Italy
| | - Massimo Castagnola
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Italy
- Institute of Chemistry of Molecular Recognition, Italian National Research Council, Rome, Italy
| | - Giovanni Gambaro
- Nephrology Division, Institute of Internal Medicine, Catholic University, Rome, Italy
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Guaifenesin stone matrix proteomics: a protocol for identifying proteins critical to stone formation. Urolithiasis 2016; 45:139-149. [PMID: 27435233 DOI: 10.1007/s00240-016-0907-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/06/2016] [Indexed: 01/22/2023]
Abstract
Drug-related kidney stones are a diagnostic problem, since they contain a large matrix (protein) fraction and are frequently incorrectly identified as matrix stones. A urine proteomics study patient produced a guaifenesin stone during her participation, allowing us to both correctly diagnose her disease and identify proteins critical to this drug stone-forming process. The patient provided three random midday urine samples for proteomics studies; one of which contained stone-like sediment with two distinct fractions. These solids were characterized with optical microscopy and Fourier transform infrared spectroscopy. Immunoblotting and quantitative mass spectrometry were used to quantitatively identify the proteins in urine and stone matrix. Infrared spectroscopy showed that the sediment was 60 % protein and 40 % guaifenesin and its metabolite guaiacol. Of the 156 distinct proteins identified in the proteomic studies, 49 were identified in the two stone-components with approximately 50 % of those proteins also found in this patient's urine. Many proteins observed in this drug-related stone have also been reported in proteomic matrix studies of uric acid and calcium containing stones. More importantly, nine proteins were highly enriched and highly abundant in the stone matrix and 8 were reciprocally depleted in urine, suggesting a critical role for these proteins in guaifenesin stone formation. Accurate stone analysis is critical to proper diagnosis and treatment of kidney stones. Many matrix proteins were common to all stone types, but likely not related to disease mechanism. This protocol defined a small set of proteins that were likely critical to guaifenesin stone formation based on their high enrichment and high abundance in stone matrix, and it should be applied to all stone types.
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Witzmann FA, Evan AP, Coe FL, Worcester EM, Lingeman JE, Williams JC. Label-free proteomic methodology for the analysis of human kidney stone matrix composition. Proteome Sci 2016; 14:4. [PMID: 26924944 PMCID: PMC4769560 DOI: 10.1186/s12953-016-0093-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/19/2016] [Indexed: 11/10/2022] Open
Abstract
Background Kidney stone matrix protein composition is an important yet poorly understood aspect of nephrolithiasis. We hypothesized that this proteome is considerably more complex than previous reports have indicated and that comprehensive proteomic profiling of the kidney stone matrix may demonstrate relevant constitutive differences between stones. We have analyzed the matrices of two unique human calcium oxalate stones (CaOx-Ia and CaOx-Id) using a simple but effective chaotropic reducing solution for extraction/solubilization combined with label-free quantitative mass spectrometry to generate a comprehensive profile of their proteomes, including physicochemical and bioinformatic analysis.` Results We identified and quantified 1,059 unique protein database entries in the two human kidney stone samples, revealing a more complex proteome than previously reported. Protein composition reflects a common range of proteins related to immune response, inflammation, injury, and tissue repair, along with a more diverse set of proteins unique to each stone. Conclusion The use of a simple chaotropic reducing solution and moderate sonication for extraction and solubilization of kidney stone powders combined with label-free quantitative mass spectrometry has yielded the most comprehensive list to date of the proteins that constitute the human kidney stone proteome. Electronic supplementary material The online version of this article (doi:10.1186/s12953-016-0093-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Frank A Witzmann
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, 635 Barnhill Drive, Room 362A, Indianapolis, IN 46202-5120 USA
| | - Andrew P Evan
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN USA
| | - Fredric L Coe
- Department of Medicine, Nephrology Section, University of Chicago, Chicago, IL USA
| | - Elaine M Worcester
- Department of Medicine, Nephrology Section, University of Chicago, Chicago, IL USA
| | - James E Lingeman
- International Kidney Stone Institute, Methodist Hospital, Indianapolis, IN USA
| | - James C Williams
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN USA
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KANEKO K, NISHII SI, IZUMI Y, YASUDA M, YAMANOBE T, FUKUUCHI T, YAMAOKA N, HORIE S. Proteomic Analysis after Sequential Extraction of Matrix Proteins in Urinary Stones Composed of Calcium Oxalate Monohydrate and Calcium Oxalate Dihydrate. ANAL SCI 2015; 31:935-42. [DOI: 10.2116/analsci.31.935] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kiyoko KANEKO
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science, Teikyo University
| | - Shin-ichiro NISHII
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science, Teikyo University
| | - Yoko IZUMI
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science, Teikyo University
| | - Makoto YASUDA
- Laboratory of Bioanalytical Chemistry, Faculty of Pharma-Science, Teikyo University
| | - Tomoyo YAMANOBE
- Central Laboratory of Analytical Biochemistry, Teikyo University
| | - Tomoko FUKUUCHI
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science, Teikyo University
| | - Noriko YAMAOKA
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science, Teikyo University
| | - Shigeo HORIE
- Department of Urology, School of Medicine, Teikyo University
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12
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Khan SR, Canales BK. Unified theory on the pathogenesis of Randall's plaques and plugs. Urolithiasis 2014; 43 Suppl 1:109-23. [PMID: 25119506 DOI: 10.1007/s00240-014-0705-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 07/23/2014] [Indexed: 01/19/2023]
Abstract
Kidney stones develop attached to sub-epithelial plaques of calcium phosphate (CaP) crystals (termed Randall's plaque) and/or form as a result of occlusion of the openings of the Ducts of Bellini by stone-forming crystals (Randall's plugs). These plaques and plugs eventually extrude into the urinary space, acting as a nidus for crystal overgrowth and stone formation. To better understand these regulatory mechanisms and the pathophysiology of idiopathic calcium stone disease, this review provides in-depth descriptions of the morphology and potential origins of these plaques and plugs, summarizes existing animal models of renal papillary interstitial deposits, and describes factors that are believed to regulate plaque formation and calcium overgrowth. Based on evidence provided within this review and from the vascular calcification literature, we propose a "unified" theory of plaque formation-one similar to pathological biomineralization observed elsewhere in the body. Abnormal urinary conditions (hypercalciuria, hyperoxaluria, and hypocitraturia), renal stress or trauma, and perhaps even the normal aging process lead to transformation of renal epithelial cells into an osteoblastic phenotype. With this de-differentiation comes an increased production of bone-specific proteins (i.e., osteopontin), a reduction in crystallization inhibitors (such as fetuin and matrix Gla protein), and creation of matrix vesicles, which support nucleation of CaP crystals. These small deposits promote aggregation and calcification of surrounding collagen. Mineralization continues by calcification of membranous cellular degradation products and other fibers until the plaque reaches the papillary epithelium. Through the activity of matrix metalloproteinases or perhaps by brute physical force produced by the large sub-epithelial crystalline mass, the surface is breached and further stone growth occurs by organic matrix-associated nucleation of CaOx or by the transformation of the outer layer of CaP crystals into CaOx crystals. Should this theory hold true, developing an understanding of the cellular mechanisms involved in progression of a small, basic interstitial plaque to that of an expanding, penetrating plaque could assist in the development of new therapies for stone prevention.
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Affiliation(s)
- Saeed R Khan
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, 32610, USA,
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Coker-Gürkan A, Arisan S, Arisan ED, Unsal NP. Lack of evidence for the association of ornithine decarboxylase (+316 G>A), spermidine/spermine acetyl transferase (-1415 T>C) gene polymorphisms with calcium oxalate stone disease. Biomed Rep 2013; 2:69-74. [PMID: 24649071 DOI: 10.3892/br.2013.184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 09/20/2013] [Indexed: 12/19/2022] Open
Abstract
Urolithiasis is a complex and multifactorial disorder characterized by the presence of stones in the urinary tract. Urea cycle is an important process involved in disease progression. L-ornithine is a key amino acid in the urea cycle and is converted to putrescine by ornithine decarboxylase (ODC). Putrescine, spermidine and spermine are natural polyamines that are catabolized by a specific enzyme, spermidine/spermine acetyltransferase (SSAT). The single-nucleotide polymorphisms (SNPs) in the intron region of ODC (+316 G>A) and promoter region of SSAT (-1415 T>C) genes have been found to be associated with the polyamines expression levels. The aim of this study was to examine whether the ODC (+316 G>A) intron 1 region gene polymorphism and SAT-1 promoter region (-1415 T>C) gene polymorphisms are potential genetic markers for susceptibility to urolithiasis. A control group of 104 healthy subjects and a group of 65 patients with recurrent idiopathic calcium oxalate stone disease were enrolled into this study. Polymerase chain reaction (PCR)-based restriction analysis was performed for the ODC intron 1 (+316 G>A) region and SAT-1 (-1415 T>C) promoter gene polymorphisms by PstI and MspI restriction enzyme digestion, respectively. The genotype distribution of polymorphisms studied in the ODC intron 1 region (+316 G>A) and SAT-1 -1415 T>C promoter region did not reveal a significant difference between urolithiasis and the control groups (P=0.713 and 0.853), respectively. Furthermore, no significant difference was observed between the control and patient groups for ODC +316 G>A and SAT-1 -1415 T>C allele frequencies (P=0.877 and 0.644), respectively. In conclusion, results of the present study suggest that ODC + 316 G>A and SAT-1 -1415 T>C gene polymorphisms might not be a risk factor for urolithiasis.
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Affiliation(s)
- Ajda Coker-Gürkan
- Department of Molecular Biology and Genetics, Science and Letter Faculty, Istanbul Kultur University, Atakoy Campus, 34156 Istanbul, Turkey
| | - Serdar Arisan
- 1st Urology Clinics, Şişli Etfal Research and Training Hospital, Sisli, 34377 Istanbul, Turkey
| | - Elif Damla Arisan
- Department of Molecular Biology and Genetics, Science and Letter Faculty, Istanbul Kultur University, Atakoy Campus, 34156 Istanbul, Turkey
| | - Narçin Palavan Unsal
- Department of Molecular Biology and Genetics, Science and Letter Faculty, Istanbul Kultur University, Atakoy Campus, 34156 Istanbul, Turkey
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Kaneko K, Matsuta Y, Moriyama M, Yasuda M, Chishima N, Yamaoka N, Fukuuchi T, Miyazawa K, Suzuki K. Proteomic analysis of a rare urinary stone composed of calcium carbonate and calcium oxalate dihydrate: a case report. Int J Urol 2013; 21:341-6. [PMID: 24118610 DOI: 10.1111/iju.12282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 08/18/2013] [Indexed: 01/07/2023]
Abstract
The objective of the present study was to investigate the matrix protein of a rare urinary stone that contained calcium carbonate. A urinary stone was extracted from a 34-year-old male patient with metabolic alkalosis. After X-ray diffractometry and infrared analysis of the stone, proteomic analysis was carried out. The resulting mass spectra were evaluated with protein search software, and matrix proteins were identified. X-ray diffraction and infrared analysis confirmed that the stone contained calcium carbonate and calcium oxalate dihydrate. Of the identified 53 proteins, 24 have not been previously reported from calcium oxalate- or calcium phosphate-containing stones. The protease inhibitors and several proteins related to cell adhesion or the cytoskeleton were identified for the first time. We analyzed in detail a rare urinary stone composed of calcium carbonate and calcium oxalate dihydrate. Considering the formation of a calcium carbonate stone, the new identified proteins should play an important role on the urolithiasis process in alkaline condition.
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Affiliation(s)
- Kiyoko Kaneko
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma Sciences, Teikyo University, Tokyo, Japan
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Reid DG, Duer MJ, Jackson GE, Murray RC, Rodgers AL, Shanahan CM. Citrate occurs widely in healthy and pathological apatitic biomineral: mineralized articular cartilage, and intimal atherosclerotic plaque and apatitic kidney stones. Calcif Tissue Int 2013; 93:253-60. [PMID: 23780351 DOI: 10.1007/s00223-013-9751-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 05/14/2013] [Indexed: 11/25/2022]
Abstract
There is continuing debate about whether abundant citrate plays an active role in biomineralization of bone. Using solid state NMR dipolar dephasing, we examined another normally mineralized hard tissue, mineralized articular cartilage, as well as biocalcifications arising in pathological conditions, mineralized intimal atherosclerotic vascular plaque, and apatitic uroliths (urinary stones). Residual nondephasing ¹³C NMR signal at 76 ppm in the spectra of mineralized cartilage and vascular plaque indicates that a quaternary carbon atom resonates at this frequency, consistent with the presence of citrate. The presence, and as yet unproven possible mechanistic involvement, of citrate in tissue mineralization extends the compositional, structural, biogenetic, and cytological similarities between these tissues and bone itself. Out of 10 apatitic kidney stones, five contained NMR-detectable citrate. Finding citrate in a high proportion of uroliths may be significant in view of the use of citrate in urolithiasis therapy and prophylaxis. Citrate may be essential for normal biomineralization (e.g., of cartilage), play a modulatory role in vascular calcification which could be a target for therapeutic intervention, and drive the formation of apatitic rather than other calcific uroliths, including more therapeutically intractable forms of calcium phosphate.
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Affiliation(s)
- David G Reid
- Department of Chemistry, University of Cambridge, UK
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Yang Y, Chen N, Xu W. Matrix stone in ureter and bladder simultaneously. Jpn J Radiol 2012; 30:762-5. [DOI: 10.1007/s11604-012-0110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 07/16/2012] [Indexed: 10/28/2022]
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Nosocomial and community acquired uropathogenic isolates of Proteus mirabilis and antimicrobial susceptibility profiles at a university hospital in Sub–Saharan Africa. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2012. [DOI: 10.1016/s2222-1808(12)60003-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Reid DG, Jackson GJ, Duer MJ, Rodgers AL. Apatite in kidney stones is a molecular composite with glycosaminoglycans and proteins: evidence from nuclear magnetic resonance spectroscopy, and relevance to Randall's plaque, pathogenesis and prophylaxis. J Urol 2010; 185:725-30. [PMID: 21168873 DOI: 10.1016/j.juro.2010.09.075] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Indexed: 11/26/2022]
Abstract
PURPOSE We characterized the biomacromolecular composition of phosphatic urinary stones using solid state nuclear magnetic resonance spectroscopy. We identified possible parallels between the nature of the organic matrix-mineral interface in stones and that in other mineralized tissue using nuclear magnetic resonance spectroscopy rotational echo double resonance. MATERIALS AND METHODS We analyzed 28 phosphatic (apatite and mixed apatite-struvite) surgically removed stones by nuclear magnetic resonance spectroscopy using (31)P, (13)C and a 9.4 Tesla magnetic field. Ten samples had sufficient signal from biomacromolecular organic material to characterize the mineral/organic interface by (13)C{(31)P} rotational echo double resonance. RESULTS Biomacromolecular organic material was most abundant in phosphatic stones in which apatite predominated. Nuclear magnetic resonance spectroscopy detected variable proportions of protein, glycosaminoglycan, lipid and carbonate. Rotational echo double resonance revealed strong interaction between mineral and glycosaminoglycan molecules, and to a lesser extent protein molecules, on the sub-nm length scale, implying that glycosaminoglycan and protein are composited into or onto the mineral lattice by strong physicochemical interactions. Carbonate ions substituted into apatite crystal lattices also showed the expected strong (13)C{(31)P} rotational echo double resonance effects. Conversely when present, lipid, calcium oxalate hydrates and uric acid showed no rotational echo double resonance effects, proving that they exist as deposits or crystals distinct from phosphatic mineral/biomacromolecular composites. CONCLUSIONS The intimate coexistence of biomacromolecules, especially glycosaminoglycan, with apatite in phosphatic stones supports the notion that they may have a key role in stone pathogenesis. The underlying intermolecular relationships may reflect those governing the formation of Randall's plaque in nascent stones.
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Affiliation(s)
- David G Reid
- Department of Chemistry, University of Cambridge, Cambridge, United Kingdom
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Thurgood LA, Ryall RL. Proteomic analysis of proteins selectively associated with hydroxyapatite, brushite, and uric acid crystals precipitated from human urine. J Proteome Res 2010; 9:5402-12. [PMID: 20795672 DOI: 10.1021/pr1006312] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to compare the intracrystalline protein profiles of hydroxyapatite (HA), brushite (BR), and uric acid (UA) crystals precipitated from the same urine samples. HA, BR, and UA crystals were precipitated on two different occasions from the same pooled healthy urine. Crystals were washed to remove surface-bound proteins, and their composition was confirmed using Fourier transform infrared spectroscopy (FTIR) and field emission scanning electron microscopy (FESEM) coupled with energy dispersive X-ray analysis (EDAX). SDS-PAGE was used for visual comparison of the protein content of the demineralised crystal extracts, which were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). HA comprised nanosized particles interspersed with organic material, which was absent from the BR and UA crystals. The number and type of individual proteins differed between the 3 minerals: 45 proteins were detected in the HA crystal extracts and 77 in the BR crystals, including a number of keratins, which were regarded as methodological contaminants. After excluding the keratins, 21 proteins were common to both HA and BR crystals. Seven nonkeratin proteins were identified in the UA extracts. Several proteins consistently detected in the HA and BR crystal extracts have been previously implicated in kidney stone disease, including osteopontin, prothrombin, protein S100A9 (calgranulin B), inter-α-inhibitor, α1-microglobulin bikunin (AMBP), heparan sulfate proteoglycan, and Tamm-Horsfall glycoprotein, all of which are strong calcium binders. We concluded that the association of proteins with HA, BR, and UA crystals formed in healthy urine is selective and that only a few of the numerous proteins present in healthy urine are likely to play any significant role in preventing stone pathogenesis.
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Affiliation(s)
- Lauren A Thurgood
- Urology Unit, Department of Surgery, Flinders Medical Centre and Flinders Clinical and Molecular Medicine, School of Medicine, Flinders University, Bedford Park, South Australia, Australia.
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