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Neira-Carrillo A, Zegers Arce T, Yazdani-Pedram M. Controlled Calcium Oxalate Crystals Obtained by Electrocrystallization on Electrospun Polycaprolactone Fibers Loaded with Zarzaparrilla ( Herreria stellata ). ACS OMEGA 2024; 9:17045-17053. [PMID: 38645337 PMCID: PMC11024939 DOI: 10.1021/acsomega.3c08736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024]
Abstract
Calcium oxalate (CaOx) is known to grow on organic matrices and is often associated with the formation of kidney stones. Therefore, it is crucial to understand the nucleation and growth mechanisms. This study investigates the role of electrospun polycaprolactone (PCL)-loaded zarzaparrilla (ZP) (Herreria stellata) in the electrocrystallization (EC) of CaOx. Electrospinning (ES) was used to prepare PCL meshes with random (R) and aligned (A) fiber orientations. CaOx particles were grown directly on conductive tin indium oxide (ITO) glass modified with electrospun ZP-loaded PCL meshes by EC. The CaOx crystals after EC were measured by chronopotentiometry (CP), optical microscopy (OM), scanning electron microscopy (SEM), and X-ray diffraction (XRD), which showed that the ZP additive and PCL fiber orientations are key factors for CaOx nucleation.
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Affiliation(s)
- Andrónico Neira-Carrillo
- Department
of Biological and Animal Science, Faculty of Veterinary and Animal
Sciences, Universidad de Chile, Santa Rosa 11735, La Pintana, Santiago 1025000, Chile
| | - Tatiana Zegers Arce
- Department
of Biological and Animal Science, Faculty of Veterinary and Animal
Sciences, Universidad de Chile, Santa Rosa 11735, La Pintana, Santiago 1025000, Chile
| | - Mehrdad Yazdani-Pedram
- Department
of Organic and Physical Chemistry, Faculty of Chemical and Pharmaceutical
Sciences, Universidad de Chile, Olivos 1007, Independencia, Santiago 8380492, Chile
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Bourg S, Rakotozandriny K, Lucas IT, Letavernier E, Bonhomme C, Babonneau F, Abou-Hassan A. Confining calcium oxalate crystal growth in a carbonated apatite-coated microfluidic channel to better understand the role of Randall's plaque in kidney stone formation. LAB ON A CHIP 2024; 24:2017-2024. [PMID: 38407354 DOI: 10.1039/d3lc01050c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Effective prevention of recurrent kidney stone disease requires the understanding of the mechanisms of its formation. Numerous in vivo observations have demonstrated that a large number of pathological calcium oxalate kidney stones develop on an apatitic calcium phosphate deposit, known as Randall's plaque. In an attempt to understand the role of the inorganic hydroxyapatite phase in the formation and habits of calcium oxalates, we confined their growth under dynamic physicochemical and flow conditions in a reversible microfluidic channel coated with hydroxyapatite. Using multi-scale characterization techniques including scanning electron and Raman microscopy, we showed the successful formation of carbonated hydroxyapatite as found in Randall's plaque. This was possible due to a new two-step flow seed-mediated growth strategy which allowed us to coat the channel with carbonated hydroxyapatite. Precipitation of calcium oxalates under laminar flow from supersaturated solutions of oxalate and calcium ions showed that the formation of crystals is a substrate and time dependent complex process where diffusion of oxalate ions to the surface of carbonated hydroxyapatite and the solubility of the latter are among the most important steps for the formation of calcium oxalate crystals. Indeed when an oxalate solution was flushed for 24 h, dissolution of the apatite layer and formation of calcium carbonate calcite crystals occurred which seems to promote calcium oxalate crystal formation. Such a growth route has never been observed in vivo in the context of kidney stones. Under our experimental conditions, our results do not show any direct promoting role of carbonated hydroxyapatite in the formation of calcium oxalate crystals, consolidating therefore the important role that macromolecules can play in the process of nucleation and growth of calcium oxalate crystals on Randall's plaque.
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Affiliation(s)
- Samantha Bourg
- Laboratoire Physicochimie des Electrolytes et Nanosystèmes Interfaciaux (PHENIX), CNRS, Sorbonne Université, UMR 8234, Campus Jussieu, 4 place Jussieu, F-75005 Paris, France.
| | - Karol Rakotozandriny
- Laboratoire Physicochimie des Electrolytes et Nanosystèmes Interfaciaux (PHENIX), CNRS, Sorbonne Université, UMR 8234, Campus Jussieu, 4 place Jussieu, F-75005 Paris, France.
- Laboratoire de Chimie de la Matière Condensée de Paris (LCMCP), CNRS, Sorbonne Université, UMR 7574, Campus Jussieu, 4 place Jussieu, F-75005 Paris, France
| | - Ivan T Lucas
- Laboratoire Interfaces et Systèmes Electrochimiques (LISE), CNRS, Sorbonne Université, UMR 8235, Campus Jussieu, 4 place Jussieu, F-75005 Paris, France
| | - Emmanuel Letavernier
- AP-HP, Hôpital Tenon, Explorations Fonctionnelles Multidisciplinaires et Laboratoire des Lithiases, F-75020 Paris, France
| | - Christian Bonhomme
- Laboratoire de Chimie de la Matière Condensée de Paris (LCMCP), CNRS, Sorbonne Université, UMR 7574, Campus Jussieu, 4 place Jussieu, F-75005 Paris, France
| | - Florence Babonneau
- Laboratoire de Chimie de la Matière Condensée de Paris (LCMCP), CNRS, Sorbonne Université, UMR 7574, Campus Jussieu, 4 place Jussieu, F-75005 Paris, France
| | - Ali Abou-Hassan
- Laboratoire Physicochimie des Electrolytes et Nanosystèmes Interfaciaux (PHENIX), CNRS, Sorbonne Université, UMR 8234, Campus Jussieu, 4 place Jussieu, F-75005 Paris, France.
- Institut Universitaire de France (IUF), 75231 Paris Cedex 05, France
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Hou C, Zhong B, Gu S, Wang Y, Ji L. Identification and validation of the biomarkers related to ferroptosis in calcium oxalate nephrolithiasis. Aging (Albany NY) 2024; 16:5987-6007. [PMID: 38536018 PMCID: PMC11042938 DOI: 10.18632/aging.205684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/20/2024] [Indexed: 04/23/2024]
Abstract
Ferroptosis is a specific type of programmed cell death characterized by iron-dependent lipid peroxidation. Understanding the involvement of ferroptosis in calcium oxalate (CaOx) stone formation may reveal potential targets for this condition. The publicly available dataset GSE73680 was used to identify 61 differentially expressed ferroptosis-related genes (DEFERGs) between normal kidney tissues and Randall's plaques (RPs) from patients with nephrolithiasis through employing weighted gene co-expression network analysis (WGCNA). The findings were validated through in vitro and in vivo experiments using CaOx nephrolithiasis rat models induced by 1% ethylene glycol administration and HK-2 cell models treated with 1 mM oxalate. Through WGCNA and the machine learning algorithm, we identified LAMP2 and MDM4 as the hub DEFERGs. Subsequently, nephrolithiasis samples were classified into cluster 1 and cluster 2 based on the expression of the hub DEFERGs. Validation experiments demonstrated decreased expression of LAMP2 and MDM4 in CaOx nephrolithiasis animal models and cells. Treatment with ferrostatin-1 (Fer-1), a ferroptosis inhibitor, partially reversed oxidative stress and lipid peroxidation in CaOx nephrolithiasis models. Moreover, Fer-1 also reversed the expression changes of LAMP2 and MDM4 in CaOx nephrolithiasis models. Our findings suggest that ferroptosis may be involved in the formation of CaOx kidney stones through the regulation of LAMP2 and MDM4.
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Affiliation(s)
- Chao Hou
- Department of Urology, The Affiliated Huai'an First People’s Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu, China
| | - Bing Zhong
- Department of Urology, The Affiliated Huai'an First People’s Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu, China
| | - Shuo Gu
- Department of Urology, The Affiliated Huai'an First People’s Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu, China
| | - Yunyan Wang
- Department of Urology, The Affiliated Huai'an First People’s Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu, China
| | - Lu Ji
- Department of Urology, The Affiliated Huai'an First People’s Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu, China
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De Coninck V, Skolarikos A, Juliebø-Jones P, Joris M, Traxer O, Keller EX. Advancements in stone classification: unveiling the beauty of urolithiasis. World J Urol 2024; 42:46. [PMID: 38244083 DOI: 10.1007/s00345-023-04746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/02/2023] [Indexed: 01/22/2024] Open
Abstract
PURPOSE Urolithiasis has become increasingly prevalent, leading to higher disability-adjusted life years and deaths. Various stone classification systems have been developed to enhance the understanding of lithogenesis, aid urologists in treatment decisions, and predict recurrence risk. The aim of this manuscript is to provide an overview of different stone classification criteria. METHODS Two authors conducted a review of literature on studies relating to the classification of urolithiasis. A narrative synthesis for analysis of the studies was used. RESULTS Stones can be categorized based on anatomical position, size, medical imaging features, risk of recurrence, etiology, composition, and morphoconstitutional analysis. The first three mentioned offer a straightforward approach to stone classification, directly influencing treatment recommendations. With the routine use of CT imaging before treatment, precise details like anatomical location, stone dimensions, and Hounsfield Units can be easily determined, aiding treatment planning. In contrast, classifying stones based on risk of recurrence and etiology is more complex due to dependencies on multiple variables, including stone composition and morphology. A classification system based on morphoconstitutional analysis, which combines morphological stone appearance and chemical composition, has demonstrated its value. It allows for the rapid identification of crystalline phase principles, the detection of crystalline conversion processes, the determination of etiopathogenesis, the recognition of lithogenic processes, the assessment of crystal formation speed, related recurrence rates, and guidance for selecting appropriate treatment modalities. CONCLUSIONS Recognizing that no single classification system can comprehensively cover all aspects, the integration of all classification approaches is essential for tailoring urolithiasis patient-specific management.
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Affiliation(s)
- Vincent De Coninck
- Department of Urology, Augustijnslei 100, Klina, 2930, Brasschaat, AZ, Belgium.
- Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands.
| | - Andreas Skolarikos
- Department of Urology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Manu Joris
- Faculty of Medicine, University Hospitals Leuven, Louvain, Belgium
| | - Olivier Traxer
- GRC N°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Arnhem, The Netherlands
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Arnhem, The Netherlands
| | - Etienne Xavier Keller
- Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Wu M, Liu M, Zhang Y, Wu J, Gao M, Huang F, Chen H, Zhu Z. Serum HDL partially mediates the association between exposure to volatile organic compounds and kidney stones: A nationally representative cross-sectional study from NHANES. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 907:167915. [PMID: 37858818 DOI: 10.1016/j.scitotenv.2023.167915] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
Environmental exposure to volatile organic compounds (VOCs) is ubiquitous, and this study explored whether exposure to VOCs is associated with the risk of kidney stones. We performed a nationally representative US cross-sectional study using data from five survey cycles (2011-2020) of the National Health and Nutrition Examination Survey (NHANES) program. Exposure to VOCs was determined by urine creatinine-corrected metabolites of VOCs (mVOCs). In total 5505 participants and 15 urine mVOCs were included for analysis, and the prevalence of kidney stones was 9.57 % (527/5505). Multivariable logistic regression showed that urine AMCC (parent VOCs (pVOCs): N, N-Dimethylformamide), 3,4-MHA (pVOCs: xylene), MA (pVOCs: ethylbenzene; styrene), DHBMA (pVOCs: 1,3-butadiene), HMPMA (pVOCs: crotonaldehyde) and 2HPMA (pVOCs: propylene oxide) were significantly associated with an increased risk of kidney stones in US general population. Sub-analysis revealed that there was a more pronounced association in women and the overweight/obesity group (body mass index ≥ 25). Moreover, the weighted quantile sum (WQS) regression model and the Bayesian kernel machine regression (BKMR) model consistently identified a positive association between co-exposure to VOCs and the risk of kidney stones, in which AMCC played the most important role among the 15 mVOCs. Mediation analysis further identified serum high-density lipoprotein cholesterol (HDL) as a mediator of the association between VOC co-exposure and kidney stones. Our study draws attention to the previously unknown positive associations between non-occupational VOC exposure and the risk of kidney stones in the general population. However, further studies are required to clarify the existence of such causation.
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Affiliation(s)
- Maolan Wu
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Minghui Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Youjie Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Wu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fang Huang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA.
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6
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Hong SY, Qin BL. The Protective Role of Dietary Polyphenols in Urolithiasis: Insights into Antioxidant Effects and Mechanisms of Action. Nutrients 2023; 15:3753. [PMID: 37686790 PMCID: PMC10490426 DOI: 10.3390/nu15173753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Urolithiasis is a common urological disease with increasing prevalence and high recurrence rates around the world. Numerous studies have indicated reactive oxygen species (ROS) and oxidative stress (OS) were crucial pathogenic factors in stone formation. Dietary polyphenols are a large group of natural antioxidant compounds widely distributed in plant-based foods and beverages. Their diverse health benefits have attracted growing scientific attention in recent decades. Many literatures have reported the effectiveness of dietary polyphenols against stone formation. The antiurolithiatic mechanisms of polyphenols have been explained by their antioxidant potential to scavenge free radicals and ROS, modulate the expression and the activity of endogenous antioxidant and prooxidant enzymes, regulate signaling pathways associated with OS, and maintain cell morphology and function. In this review, we first describe OS and its pathogenic effects in urolithiasis and summarize the classification and sources of dietary polyphenols. Then, we focus on the current evidence defining their antioxidant potential against stone formation and put forward challenges and future perspectives of dietary polyphenols. To conclude, dietary polyphenols offer potential applications in the treatment and prevention of urolithiasis.
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Affiliation(s)
| | - Bao-Long Qin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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7
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Canela VH, Bowen WS, Ferreira RM, Syed F, Lingeman JE, Sabo AR, Barwinska D, Winfree S, Lake BB, Cheng YH, Gaut JP, Ferkowicz M, LaFavers KA, Zhang K, Coe FL, Worcester E, Jain S, Eadon MT, Williams JC, El-Achkar TM. A spatially anchored transcriptomic atlas of the human kidney papilla identifies significant immune injury in patients with stone disease. Nat Commun 2023; 14:4140. [PMID: 37468493 PMCID: PMC10356953 DOI: 10.1038/s41467-023-38975-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 05/24/2023] [Indexed: 07/21/2023] Open
Abstract
Kidney stone disease causes significant morbidity and increases health care utilization. In this work, we decipher the cellular and molecular niche of the human renal papilla in patients with calcium oxalate (CaOx) stone disease and healthy subjects. In addition to identifying cell types important in papillary physiology, we characterize collecting duct cell subtypes and an undifferentiated epithelial cell type that was more prevalent in stone patients. Despite the focal nature of mineral deposition in nephrolithiasis, we uncover a global injury signature characterized by immune activation, oxidative stress and extracellular matrix remodeling. We also identify the association of MMP7 and MMP9 expression with stone disease and mineral deposition, respectively. MMP7 and MMP9 are significantly increased in the urine of patients with CaOx stone disease, and their levels correlate with disease activity. Our results define the spatial molecular landscape and specific pathways contributing to stone-mediated injury in the human papilla and identify associated urinary biomarkers.
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Affiliation(s)
- Victor Hugo Canela
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - William S Bowen
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ricardo Melo Ferreira
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Farooq Syed
- Center for Diabetes and Metabolic Diseases, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James E Lingeman
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Angela R Sabo
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daria Barwinska
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Seth Winfree
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Blue B Lake
- San Diego Institute of Science, Altos Labs, San Diego, CA, USA
| | - Ying-Hua Cheng
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Joseph P Gaut
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
| | - Michael Ferkowicz
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kaice A LaFavers
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kun Zhang
- San Diego Institute of Science, Altos Labs, San Diego, CA, USA
| | - Fredric L Coe
- Department of Medicine, Division of Nephrology, University of Chicago, Chicago, IL, USA
| | - Elaine Worcester
- Department of Medicine, Division of Nephrology, University of Chicago, Chicago, IL, USA
| | - Sanjay Jain
- Department of Medicine, Division of Nephrology, Washington University, St. Louis, MO, USA.
| | - Michael T Eadon
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - James C Williams
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Tarek M El-Achkar
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Medicine, Indianapolis VA Medical Center, Indianapolis, IN, USA.
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Hong SY, Jiang HC, Xu WC, Zeng HS, Wang SG, Qin BL. Bioinformatics analysis reveals the potential role of matrix metalloproteinases in immunity and urolithiasis. Front Immunol 2023; 14:1158379. [PMID: 37006258 PMCID: PMC10050583 DOI: 10.3389/fimmu.2023.1158379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundThe pathogenesis of urolithiasis remains unclear, making the development of medications for treatment and prevention stagnant. Randall’s plaques (RPs) begin as interstitial calcium phosphate crystal deposits, grow outward and breach the renal papillary surface, acting as attachment for CaOx stones. Since matrix metalloproteinases (MMPs) can degrade all components of extracellular matrix (ECM), they might participate in the breach of RPs. Besides, MMPs can modulate the immune response and inflammation, which were confirmed to be involved in urolithiasis. We aimed to investigate the role of MMPs in the development of RPs and stone formation.MethodsThe public dataset GSE73680 was mined to identify differentially expressed MMPs (DEMMPs) between normal tissues and RPs. WGCNA and three machine learning algorithms were performed to screen the hub DEMMPs. In vitro experiments were conducted for validation. Afterwards, RPs samples were classified into clusters based on the hub DEMMPs expression. Differentially expressed genes (DEGs) between clusters were identified and functional enrichment analysis and GSEA were applied to explore the biological role of DEGs. Moreover, the immune infiltration levels between clusters were evaluated by CIBERSORT and ssGSEA.ResultsFive DEMMPs, including MMP1, MMP3, MMP9, MMP10, and MMP12, were identified between normal tissues and RPs, and all of them were elevated in RPs. Based on WGCNA and three machine learning algorithms, all of five DEMMPs were regarded as hub DEMMPs. In vitro validation found the expression of hub DEMMPs also increased in renal tubular epithelial cells under lithogenic environment. RPs samples were divided into two clusters and cluster A exhibited higher expression of hub DEMMPs compared to cluster B. Functional enrichment analysis and GSEA found DEGs were enriched in immune-related functions and pathways. Moreover, increased infiltration of M1 macrophages and enhanced levels of inflammation were observed in cluster A by immune infiltration analysis.ConclusionWe assumed that MMPs might participate in RPs and stone formation through ECM degradation and macrophages-mediated immune response and inflammation. Our findings offer a novel perspective on the role of MMPs in immunity and urolithiasis for the first time, and provide potential biomarkers to develop targets for treatment and prevention.
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Affiliation(s)
- Sen-Yuan Hong
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong-Cheng Jiang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen-Chao Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - He-Song Zeng
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shao-Gang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Shao-Gang Wang, ; Bao-Long Qin,
| | - Bao-Long Qin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Shao-Gang Wang, ; Bao-Long Qin,
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9
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Yang Y, Hong S, Wang Q, Wang S, Xun Y. Exosome-mediated crosstalk between epithelial cells amplifies the cell injury cascade in CaOx stone formation. J Biol Eng 2023; 17:16. [PMID: 36855143 PMCID: PMC9976448 DOI: 10.1186/s13036-023-00324-0] [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] [Received: 10/08/2022] [Accepted: 01/04/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Calcium oxalate (CaOx) stone disease is found worldwide. To explore the role of exosomes as a mediator of intercellular crosstalk during CaOx stone formation, we conducted this study, which may provide a new insight into the treatment and prevention of CaOx stones. METHODS Exosomes derived from HK2 cells with (EXO(S)) or without (EXO(C))CaOx crystal stimulation were cocultured with normal tubular epithelial cells and subcapsularly injected into rat kidneys. Then, oxidative stress levels, the MAPK signalling pathway and osteogenic changes were detected via qPCR, Western blotting, immunofluorescence and immunohistochemical staining. In vivo fluorescence imaging and exosome internalization assays showed the absorption and utilization of exosomes. RESULTS EXO(S) increased the reactive oxygen species (ROS) level and activated the expression of BMP2, OPN and OCN via the MAPK/P-38 pathway both in vivo and in vitro. In vivo experiments showed that preinjection of EXO(S) aggravated, while preinjection of EXO(C) ameliorated, these effects. Crystal depositions were significantly increased in SD rats injected with GAM when they were preinjected with EXO(S), and these effects could be reversed after preinjection with EXO(C). CONCLUSION Our study revealed that exosome-mediated intercellular crosstalk could accelerate the formation of CaOx stones by promoting oxidative stress and the osteogenic cascade in normal tubular epithelial cells. HK2 cells stimulated with CaOx crystals released more exosomal miR-223-3p and S100A8 comparing with normal HK2 cells. These exosomes derived from HK2 cells stimulated with CaOx (EXO(S)) could amplify the oxidative stress and osteogenic changes via MAPK/P-38 pathway, which finally led to the formation of Randall's plaque.
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Affiliation(s)
- Yuanyuan Yang
- grid.33199.310000 0004 0368 7223Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei China
| | - Senyuan Hong
- grid.33199.310000 0004 0368 7223Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei China
| | - Qing Wang
- grid.443382.a0000 0004 1804 268XDepartment of Urology, Guizhou Provincial People’s Hospital, Guizhou University, Guiyang, 550000 Guizhou China ,grid.443382.a0000 0004 1804 268XDepartment of Research Laboratory Center, Guizhou Provincial People’s Hospital, Guizhou University, Guiyang, 550000 Guizhou China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
| | - Yang Xun
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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10
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Yu L, Li G, Jin S, Su J, Li S. Identification of the core genes in Randall's plaque of kidney stone and immune infiltration with WGCNA network. Front Genet 2023; 14:1048919. [PMID: 36816033 PMCID: PMC9931196 DOI: 10.3389/fgene.2023.1048919] [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] [Received: 09/20/2022] [Accepted: 01/13/2023] [Indexed: 02/04/2023] Open
Abstract
Background: Randall's plaque is regarded as the precursor lesion of lithiasis. However, traditional bioinformatic analysis is limited and ignores the relationship with immune response. To investigate the underlying calculi formation mechanism, we introduced innovative algorithms to expand our understanding of kidney stone disease. Methods: We downloaded the GSE73680 series matrix from the Gene Expression Omnibus (GEO) related to CaOx formation and excluded one patient, GSE116860. In the RStudio (R version 4.1.1) platform, the differentially expressed genes (DEGs) were identified with the limma package for GO/KEGG/GSEA analysis in the clusterProfiler package. Furthermore, high-correlated gene co-expression modules were confirmed by the WGCNA package to establish a protein-protein interaction (PPI) network. Finally, the CaOx samples were processed by the CIBERSORT algorithm to anchor the key immune cells group and verified in the validation series matrix GSE117518. Results: The study identified 840 upregulated and 1065 downregulated genes. The GO/KEGG results revealed fiber-related or adhesion-related terms and several pathways in addition to various diseases identified from the DO analysis. Moreover, WGCNA selected highly correlated modules to construct a PPI network. Finally, 16 types of immune cells are thought to participate in urolithiasis pathology and are related to hub genes in the PPI network that are proven significant in the validation series matrix GSE117518. Conclusion: Randall's plaque may relate to genes DCN, LUM, and P4HA2 and M2 macrophages and resting mast immune cells. These findings could serve as potential biomarkers and provide new research directions.
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Affiliation(s)
- Lingyun Yu
- Department of Urology, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Gefei Li
- Department of Cardiovascular Surgery, Shenzhen, Guangdong, China
| | - Shiyao Jin
- Department of Urology, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Jiahong Su
- Department of Urology, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Shoulin Li
- Department of Urology, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China,*Correspondence: Shoulin Li,
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11
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Luo Y, Zhu D, Fang JH. Editorial: Gene regulation mediated by competing RNA: From benchside to bedside. Front Genet 2022; 13:1085155. [PMID: 36506324 PMCID: PMC9727387 DOI: 10.3389/fgene.2022.1085155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Yumei Luo
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Guangzhou Laboratory, Guangzhou, China,Institute of Biological Products, National Institutes for Food and Drug Control, Beijing, China,*Correspondence: Yumei Luo, ; Detu Zhu,
| | - Detu Zhu
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, United States,*Correspondence: Yumei Luo, ; Detu Zhu,
| | - Jian-Hong Fang
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
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12
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Bazin D, Bouderlique E, Tang E, Daudon M, Haymann JP, Frochot V, Letavernier E, Van de Perre E, Williams JC, Lingeman JE, Borondics F. Using mid infrared to perform investigations beyond the diffraction limits of microcristalline pathologies: advantages and limitation of Optical PhotoThermal IR spectroscopy. CR CHIM 2022. [DOI: 10.5802/crchim.196] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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13
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Deffert C, Stoermann Chopard C, Lambeng N. 10,000 urinary stones for 10 years of analysis: a retrospective study in western Switzerland. CR CHIM 2022. [DOI: 10.5802/crchim.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Bazin D, Daudon M, Frochot V, Haymann JP, Letavernier E. Foreword to microcrystalline pathologies: combining clinical activity and fundamental research at the nanoscale. CR CHIM 2022. [DOI: 10.5802/crchim.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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15
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Bazin D, Bouderlique E, Daudon M, Frochot V, Haymann JP, Letavernier E, Tielens F, Weil R. Scanning electron microscopy—a powerful imaging technique for the clinician. CR CHIM 2022. [DOI: 10.5802/crchim.101] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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16
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Daudon M, Frochot V, Bazin D, Haymann JP, Letavernier E. Medullary sponge kidney: what kind of stones? CR CHIM 2022. [DOI: 10.5802/crchim.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Van de Perre E, Bazin D, Estrade V, Bouderlique E, Wissing KM, Daudon M, Letavernier E. Randall’s plaque as the origin of idiopathic calcium oxalate stone formation: an update. CR CHIM 2022. [DOI: 10.5802/crchim.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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18
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Khan SR. Inflammation and injury: what role do they play in the development of Randall’s plaques and formation of calcium oxalate kidney stones? CR CHIM 2022. [DOI: 10.5802/crchim.93] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Arce TZ, Yazdani-Pedram M, Neira-Carrillo A. Electrocrystallization of Calcium Oxalate on Electrospun PCL Fibers Loaded with Phytic Acid as a Template. Polymers (Basel) 2022; 14:polym14153190. [PMID: 35956705 PMCID: PMC9371010 DOI: 10.3390/polym14153190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023] Open
Abstract
Crystallization occurs widely in living organisms where different organs could associate with the calcification process, such as the formation of calcium oxalate (CaOx) calculi in the urinary tract. However, the pathogenesis and the role of an inhibitor in the pathological processes involved in urolithiasis is poorly understood. Therefore, the use of phytic acid (PA) as an inhibitor for the organic fibrillar matrix is a novel approach to inhibit the formation of pathological CaOx crystals. Herein, electrospun polymer fiber meshes of polycaprolactone (PCL) with random (R) and aligned (A) fiber orientations containing PA were prepared by electrospinning, and their role as a 3D organic template in in vitro CaOx crystallization was investigated. CaOx crystals were generated on conductive tin indium oxide (ITO)-modified glass with R-PCL and A-PCL fibers in the presence of PA through an electrocrystallization (EC) procedure. This study provides a simple electrochemical approach to evaluate the role of PA as an inhibitor in the nucleation of pathological CaOx crystals. The resulting CaOx crystals were analyzed by chrono-potentiometry, optical microscopy (OM), scanning electron microscopy (SEM), and X-ray diffraction (XRD). We found that PA and the fiber orientations are key factors in the nucleation and crystal growth of CaOx, achieving the stabilization of healthy CaOx crystal and the inhibition of the pathological crystal form.
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Affiliation(s)
- Tatiana Zegers Arce
- Department of Biological and Animal Sciences, Faculty of Veterinary and Animal Sciences, University of Chile, Santiago, Santa Rosa 11735, La Pintana, Santiago 8820808, Chile
| | - Mehrdad Yazdani-Pedram
- Department of Organic and Physical Chemistry, University of Chile, Olivos 1007, Independencia, Santiago 8380544, Chile
| | - Andrónico Neira-Carrillo
- Department of Biological and Animal Sciences, Faculty of Veterinary and Animal Sciences, University of Chile, Santiago, Santa Rosa 11735, La Pintana, Santiago 8820808, Chile
- Correspondence: ; Tel.: +562-29785674
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20
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Sun P, Liao SG, Yang RQ, Lu CL, Ji KL, Cao DH, Hu HB, Lu JM, Song XZ, Wu M, Jia HZ, Xiao CF, Ma ZW, Xu YK. Aspidopterys obcordata vine inulin fructan affects urolithiasis by modifying calcium oxalate crystallization. Carbohydr Polym 2022; 294:119777. [DOI: 10.1016/j.carbpol.2022.119777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 11/02/2022]
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21
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Xia Y, Zhou X, Ye Z, Yu W, Ning J, Ruan Y, Yuan R, Lin F, Ye P, Zheng D, Rao T, Cheng F. Construction and Analysis of Immune Infiltration-Related ceRNA Network for Kidney Stones. Front Genet 2021; 12:774155. [PMID: 34938320 PMCID: PMC8686191 DOI: 10.3389/fgene.2021.774155] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/17/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose: Kidney stones is a common medical issue that mediates kidney injury and even kidney function loss. However, the exact pathogenesis still remains unclear. This study aimed to explore the potential competing endogenous RNA (ceRNA)-related pathogenesis of kidney stones and identify the corresponding immune infiltration signature. Methods: One mRNA and one long non-coding RNA (lncRNA) microarray dataset was obtained from the GEO database. Subsequently, we compared differentially expressed mRNAs (DE-mRNAs) and lncRNAs between Randall's plaques in patients with calcium oxalate (CaOx) stones and controls with normal papillary tissues. lncRNA-targeted miRNAs and miRNA-mRNA pairs were predicted using the online databases. lncRNA-related DE-mRNAs were identified using the Venn method, and GO and KEGG enrichment analyses were subsequently performed. The immune-related lncRNA-miRNA-mRNA ceRNA network was developed. The CIBERSORT algorithm was used to estimate the rate of immune cell infiltration in Randall's plaques. The ceRNA network and immune infiltration were validated in the glyoxylate-induced hyperoxaluric mouse model and oxalate-treated HK-2 cells. Results: We identified 2,340 DE-mRNAs and 929 DE-lncRNAs between Randall's plaques in patients with CaOx stones and controls with normal papillary tissues. lncRNA-related DE-mRNAs were significantly enriched in extracellular matrix organization and collagen-containing extracellular matrix, which were associated with kidney interstitial fibrosis. The immune-related ceRNA network included 10 lncRNAs, 23 miRNAs, and 20 mRNAs. Moreover, we found that M2 macrophages and resting mast cells were differentially expressed between Randall's plaques and normal tissues. Throughout kidney stone development, kidney tubular injury, crystal deposition, collagen fiber deposition, TGF-β expression, infiltration of M1 macrophages, and activation of mast cells were more frequent in glyoxylate-induced hyperoxaluric mice compared with control mice. Nevertheless, M2 macrophage infiltration increased in early stages (day 6) and decreased as kidney stones progressed (day 12). Furthermore, treatment with 0.25 and 0.5 mM of oxalate for 48 h significantly upregulated NEAT1, PVT1, CCL7, and ROBO2 expression levels and downregulated hsa-miR-23b-3p, hsa-miR-429, and hsa-miR-139-5p expression levels in the HK-2 cell line in a dose-dependent manner. Conclusion: We found that significant expressions of ceRNAs (NEAT1, PVT1, hsa-miR-23b-3p, hsa-miR-429, hsa-miR-139-5p, CCL7, and ROBO2) and infiltrating immune cells (macrophages and mast cells) may be involved in kidney stone pathogenesis. These findings provide novel potential therapeutic targets for kidney stones.
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Affiliation(s)
- Yuqi Xia
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiangjun Zhou
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zehua Ye
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Weimin Yu
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jinzhuo Ning
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuan Ruan
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Run Yuan
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fangyou Lin
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Peng Ye
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Di Zheng
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ting Rao
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fan Cheng
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
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22
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Canela VH, Bledsoe SB, Worcester EM, Lingeman JE, El-Achkar TM, Williams JC. Collagen fibrils and cell nuclei are entrapped within Randall's plaques but not in CaOx matrix overgrowth: A microscopic inquiry into Randall's plaque stone pathogenesis. Anat Rec (Hoboken) 2021; 305:1701-1711. [PMID: 34825513 DOI: 10.1002/ar.24837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 01/28/2023]
Abstract
Calcium oxalate (CaOx) stones can grow attached to the renal papillary calcification known as Randall's plaque. Although stone growth on Randall's plaque is a common phenomenon, this mechanism of stone formation is still poorly understood. The objective of this study was to investigate the microenvironment of mature Randall's plaque, explore its molecular composition and differentiate plaque from CaOx overgrowth using multimodal imaging on demineralized stone sections. Fluorescence imaging showed consistent differences in autofluorescence patterns between Randall's plaque and calcium oxalate overgrowth regions. Second harmonic generation imaging established the presence of collagen only in regions of decalcified Randall's plaque but not in regions of CaOx overgrowth matrix. Surprisingly, in these stone sections we observed cell nuclei with preserved morphology within regions of mature Randall's plaque. These conserved cells had variable expression of vimentin and CD45. The presence of nuclei in mature plaque indicates that mineralization is not necessarily associated with cell death. The markers identified suggest that some of the entrapped cells may be undergoing dedifferentiation or could emanate from a mesenchymal or immune origin. We propose that entrapped cells may play an important role in the growth and maintenance of Randall's plaque. Further characterization of these cells and thorough analyses of the mineralized stone forming renal papilla will be fundamental in understanding the pathogenesis of Randall's plaque and CaOx stone formation.
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Affiliation(s)
- Victor Hugo Canela
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sharon B Bledsoe
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - James E Lingeman
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tarek M El-Achkar
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - James C Williams
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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23
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Yaykasli KO, Schauer C, Muñoz LE, Mahajan A, Knopf J, Schett G, Herrmann M. Neutrophil Extracellular Trap-Driven Occlusive Diseases. Cells 2021; 10:2208. [PMID: 34571857 PMCID: PMC8466545 DOI: 10.3390/cells10092208] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
The enlightenment of the formation of neutrophil extracellular traps (NETs) as a part of the innate immune system shed new insights into the pathologies of various diseases. The initial idea that NETs are a pivotal defense structure was gradually amended due to several deleterious effects in consecutive investigations. NETs formation is now considered a double-edged sword. The harmful effects are not limited to the induction of inflammation by NETs remnants but also include occlusions caused by aggregated NETs (aggNETs). The latter carries the risk of occluding tubular structures like vessels or ducts and appear to be associated with the pathologies of various diseases. In addition to life-threatening vascular clogging, other occlusions include painful stone formation in the biliary system, the kidneys, the prostate, and the appendix. AggNETs are also prone to occlude the ductal system of exocrine glands, as seen in ocular glands, salivary glands, and others. Last, but not least, they also clog the pancreatic ducts in a murine model of neutrophilia. In this regard, elucidating the mechanism of NETs-dependent occlusions is of crucial importance for the development of new therapeutic approaches. Therefore, the purpose of this review is to address the putative mechanisms of NETs-associated occlusions in the pathogenesis of disease, as well as prospective treatment modalities.
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Affiliation(s)
- Kursat Oguz Yaykasli
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (K.O.Y.); (L.E.M.); (A.M.); (J.K.); (G.S.); (M.H.)
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Christine Schauer
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (K.O.Y.); (L.E.M.); (A.M.); (J.K.); (G.S.); (M.H.)
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Luis E. Muñoz
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (K.O.Y.); (L.E.M.); (A.M.); (J.K.); (G.S.); (M.H.)
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Aparna Mahajan
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (K.O.Y.); (L.E.M.); (A.M.); (J.K.); (G.S.); (M.H.)
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Jasmin Knopf
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (K.O.Y.); (L.E.M.); (A.M.); (J.K.); (G.S.); (M.H.)
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (K.O.Y.); (L.E.M.); (A.M.); (J.K.); (G.S.); (M.H.)
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (K.O.Y.); (L.E.M.); (A.M.); (J.K.); (G.S.); (M.H.)
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
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Peerapen P, Thongboonkerd V. Kidney stone proteomics: an update and perspectives. Expert Rev Proteomics 2021; 18:557-569. [PMID: 34320328 DOI: 10.1080/14789450.2021.1962301] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Main problems of kidney stone disease are its increasing prevalence and high recurrence rate after calculi removal in almost all areas around the globe. Despite enormous efforts in the past, its pathogenic mechanisms remain unclear and need further elucidations. Proteomics has thus become an essential tool to unravel such sophisticated disease mechanisms at cellular, subcellular, molecular, tissue, and whole organism levels. AREAS COVERED This review provides abrief overview of kidney stone disease followed by updates on proteomics for investigating urinary stone modulators, matrix proteins, cellular responses to different types/doses of calcium oxalate (CaOx) crystals, sex hormones and other stimuli, crystal-cell interactions, crystal receptors, secretome, and extracellular vesicles (EVs), all of which lead to better understanding of the disease mechanisms. Finally, the future challenges and translation of these obtained data to the clinic are discussed. EXPERT OPINION Knowledge from urinary proteomics for exploring the important stone modulators (either inhibitors or promoters) will be helpful for early detection of asymptomatic cases for prompt prevention of symptoms, complications, and new stone formation. Moreover, these modulators may serve as the new therapeutic targets in the future for successful treatment and prevention of kidney stone disease by medications or other means of intervention.
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Affiliation(s)
- Paleerath Peerapen
- Medical Proteomics Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Visith Thongboonkerd
- Medical Proteomics Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Almeras C, Pradere B, Estrade V, Meria P, French Urological Association OBOTLCOT. Endoscopic Papillary Abnormalities and Stone Recognition (EPSR) during Flexible Ureteroscopy: A Comprehensive Review. J Clin Med 2021; 10:jcm10132888. [PMID: 34209668 PMCID: PMC8267668 DOI: 10.3390/jcm10132888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction: The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the stone and the papillary abnormalities endoscopically (endoscopic papillary recognition (EPR) and endoscopic stone recognition (ESR)). Our objective was to evaluate the value for those endoscopic descriptions. Methods: The MEDLINE and EMBASE databases were searched in February 2021 for studies on endoscopic papillary recognition and endoscopic stone recognition. Results: If the ESR provided information concerning the main crystallization process, EPR provided information concerning the origin of the lithogenesis and its severity. Despite many actual limitations, those complementary descriptions could support the preventive care of the stone formers in improving the diagnosis of the lithogenesis mechanism and in identifying high-risk stone formers. Conclusion: Until the development of an Artificial Intelligence recognition, the endourologist has to learn EPSR to minimize the distortion effect of the new lasers on the stone analysis and to improve care efficiency of the stone formers patients.
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Affiliation(s)
- Christophe Almeras
- Department of Urology, La Croix du Sud Clinic-RGDS, UroSud, 52 bis Chemin de Ribaute, Boite 301, 31130 Quint Fonsegrives, France
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Correspondence: ; Tel.: +33-53-202-7202; Fax: +33-53-202-7203
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria;
| | - Vincent Estrade
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Department of Urology, CHU Pellegrin, 33300 Bordeaux, France
| | - Paul Meria
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Department of Urology, Saint Louis Hospital, Denis Diderot University, 75010 Paris, France
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Wang Z, Zhang Y, Zhang J, Deng Q, Liang H. Recent advances on the mechanisms of kidney stone formation (Review). Int J Mol Med 2021; 48:149. [PMID: 34132361 PMCID: PMC8208620 DOI: 10.3892/ijmm.2021.4982] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022] Open
Abstract
Kidney stone disease is one of the oldest diseases known to medicine; however, the mechanisms of stone formation and development remain largely unclear. Over the past decades, a variety of theories and strategies have been developed and utilized in the surgical management of kidney stones, as a result of recent technological advances. Observations from the authors and other research groups suggest that there are five entirely different main mechanisms for kidney stone formation. Urinary supersaturation and crystallization are the driving force for intrarenal crystal precipitation. Randall's plaques are recognized as the origin of calcium oxalate stone formation. Sex hormones may be key players in the development of nephrolithiasis and may thus be potential targets for new drugs to suppress kidney stone formation. The microbiome, including urease-producing bacteria, nanobacteria and intestinal microbiota, is likely to have a profound effect on urological health, both positive and negative, owing to its metabolic output and other contributions. Lastly, the immune response, and particularly macrophage differentiation, play crucial roles in renal calcium oxalate crystal formation. In the present study, the current knowledge for each of these five aspects of kidney stone formation is reviewed. This knowledge may be used to explore novel research opportunities and improve the understanding of the initiation and development of kidney stones for urologists, nephrologists and primary care.
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Affiliation(s)
- Zhu Wang
- Department of Urology, People's Hospital of Longhua, Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Ying Zhang
- Department of Urology, People's Hospital of Longhua, Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Jianwen Zhang
- Department of Urology, People's Hospital of Longhua, Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Qiong Deng
- Department of Urology, People's Hospital of Longhua, Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Hui Liang
- Department of Urology, People's Hospital of Longhua, Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
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Sun XY, Zhang H, Chen JY, Zeng GH, Ouyang JM. Porphyra yezoensis polysaccharide and potassium citrate synergistically inhibit calcium oxalate crystallization induced by renal epithelial cells and cytotoxicity of the formed crystals. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 119:111448. [DOI: 10.1016/j.msec.2020.111448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/19/2020] [Accepted: 08/25/2020] [Indexed: 02/08/2023]
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Zhu Z, Huang F, Xia W, Zeng H, Gao M, Li Y, Zeng F, He C, Chen J, Chen Z, Li Y, Cui Y, Chen H. Osteogenic Differentiation of Renal Interstitial Fibroblasts Promoted by lncRNA MALAT1 May Partially Contribute to Randall's Plaque Formation. Front Cell Dev Biol 2021; 8:596363. [PMID: 33505960 PMCID: PMC7829506 DOI: 10.3389/fcell.2020.596363] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/10/2020] [Indexed: 12/29/2022] Open
Abstract
Background The current belief is that Randall's plaques (RP) constitute a nidus for the formation of idiopathic calcium oxalate stones, but the upstream events in RP formation remain unclear. The present study aimed to investigate whether RP formation shares similarities with biomineralization and to illustrate the potential role played by the lncRNA MALAT1 in osteogenic differentiation of human renal interstitial fibroblasts (hRIFs). Materials and Methods Biomineralization and MALAT1 expression were assessed in RP, and hRIFs were isolated and induced under osteogenic conditions for further experiments. The transcription initiation and termination sites in MALAT1 were identified by 5' and 3' RACE. RNA immunoprecipitation assays and luciferase assays were used to validate the interactions among MALAT1, Runx2 and miRNAs. Results Upregulated expression of osteogenic markers and MALAT1 was observed in RP and hRIFs induced with osteogenic medium. Biomineralization in RP and calcium phosphate (CaP) deposits in induced hRIFs were further verified by electron microscopy. Furthermore, overexpression of MALAT1 promoted the osteogenic phenotype of hRIFs, while treatment with a miR-320a-5p mimic and knockdown of Runx2 significantly suppressed the osteogenic phenotype. Further analysis showed that MALAT1 functioned as a competing endogenous RNA to sponge miR-320a-5p, leading to upregulation of Runx2 and thus promoting osteogenic differentiation of hRIFs. Conclusion Ectopic calcification and MALAT1 partially contributed to the formation of RP, in which MALAT1 might promote Runx2 expression to regulate osteogenic differentiation of hRIFs by sponging miRNA-320a-5p. The current study sheds new light on the lncRNA-directed mechanism of RP formation via a process driven by osteogenic-like cells.
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Affiliation(s)
- Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Fang Huang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Weiping Xia
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Huimin Zeng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yongchao Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Feng Zeng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Cheng He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhiyong Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu Cui
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
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Kletzmayr A, Bigler M, Montanari E, Kuro-o M, Hayashi H, Ivarsson ME, Leroux JC. Development of a Kidney Calcification Inhibitor Employing Image-Based Profiling: A Proof-of-Concept Study. ACS Pharmacol Transl Sci 2020; 3:1339-1351. [DOI: 10.1021/acsptsci.0c00153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Anna Kletzmayr
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Melina Bigler
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Elita Montanari
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Makoto Kuro-o
- Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Hirosaka Hayashi
- Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | | | - Jean-Christophe Leroux
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
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Wang Q, Sun Y, Yang Y, Li C, Zhang J, Wang S. Quantitative proteomic analysis of urinary exosomes in kidney stone patients. Transl Androl Urol 2020; 9:1572-1584. [PMID: 32944520 PMCID: PMC7475656 DOI: 10.21037/tau-20-41] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Increased urinary exosomes are associated with kidney stones but how they work is unknown. In this study, we aim to identify dysregulated proteins in urinary exosomes from kidney stone patients and to explore the potential role of exosomal proteins in nephrolithiasis. Methods First morning voids were collected from participants. Urinary exosomes were isolated via ultracentrifugation. Label free liquid chromatography-tandem mass spectrometry was performed to analyze the proteome of urine exosomes from three kidney stone patients and three age-/sex-matched healthy controls. Bioinformatics analysis was conducted to identify dysregulated proteins associated with stone formation. Results of proteomic analysis were verified by Western blotting in other three kidney stone patients and three healthy controls. Results Nine hundred and sixty proteins were identified with proteomic analysis, of which 831 were identified in the control group and 879 in the stone group. Sixteen proteins in urinary exosomes were found most significantly different between kidney stone patients and healthy controls. Gene ontology (GO) analysis showed that dysregulated proteins were enriched in innate immune response, defense response to bacterium and calcium-binding. S100A8, S100A9 and S100A12 were common in above three GO terms and were chosen for further study. Western blotting confirmed that the expression of these three S100 proteins was higher in urinary exosomes from kidney stone patients. In addition, S100 proteins were aggregated in urinary exosomes and it was difficult to detect them in urine. Conclusions Urinary exosomes from kidney stone patients are rich in S100 proteins and play a role in innate immune response, defense response to bacterium and calcium-binding.
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Affiliation(s)
- Qing Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Sun
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cong Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaqiao Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sun XY, Chen JY, Rao CY, Ouyang JM. Size-Dependent Cytotoxicity of Hydroxyapatite Crystals on Renal Epithelial Cells. Int J Nanomedicine 2020; 15:5043-5060. [PMID: 32764935 PMCID: PMC7369374 DOI: 10.2147/ijn.s232926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 06/09/2020] [Indexed: 12/05/2022] Open
Abstract
Background Hydroxyapatite (HAP) is a common component of most idiopathic calcium oxalate (CaOx) stones and is often used as a nidus to induce the formation of CaOx kidney stones. Methods This work comparatively studies the cytotoxicity of four kinds of HAP crystals with different sizes (40 nm to 2 μm), namely, HAP-40 nm, HAP-70 nm, HAP-1 μm, and HAP-2 μm, on human renal proximal tubular epithelial cells (HK-2). Results HAP crystals reduce the viability and membrane integrity of HK-2 cells in a concentration-dependent manner and consequently cause cytoskeleton damage, cell swelling, increased intracellular reactive oxygen species level, decreased mitochondrial membrane potential, increased intracellular calcium concentration, blocked cell cycle and stagnation in G0/G1 phase, and increased cell necrosis rate. HAP toxicity to HK-2 cells increases with a decrease in crystal size. Conclusion Cell damage caused by HAP crystals increases the risk of kidney stone formation.
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Affiliation(s)
- Xin-Yuan Sun
- Department of Chemistry, Institute of Biomineralization and Lithiasis Research, Jinan University, Guangzhou 510632, People's Republic of China
| | - Jia-Yun Chen
- Department of Chemistry, Institute of Biomineralization and Lithiasis Research, Jinan University, Guangzhou 510632, People's Republic of China
| | - Chen-Ying Rao
- Department of Chemistry, Institute of Biomineralization and Lithiasis Research, Jinan University, Guangzhou 510632, People's Republic of China
| | - Jian-Ming Ouyang
- Department of Chemistry, Institute of Biomineralization and Lithiasis Research, Jinan University, Guangzhou 510632, People's Republic of China
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Sabaté Arroyo XA, Grases Freixedas F, Bauzà Quetglas JL, Guimerà Garcia J, Pieras Ayala E. Relationship of endoscopic lesions of the renal papilla with type of renal stone and 24 h urine analysis. BMC Urol 2020; 20:46. [PMID: 32334600 PMCID: PMC7183647 DOI: 10.1186/s12894-020-00615-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/13/2020] [Indexed: 01/24/2023] Open
Abstract
Background Our purpose was to study the relationship of the 3 different types of endoscopic calcifications of the renal papilla (Randall’s plaque, intratubular calcification, papillary crater) with the type of stone and urine analysis. Methods This prospective study examined 41 patients (age range: 18 to 80 years) who received retrograde intrarenal surgery (RIRS) for renal lithiasis (mean stone size: 15.3 ± 7.2 mm). The renal papilla injuries were endoscopically classified as Randall’s plaque, intratubular calcification, or papillary crater. Calculi were classified as uric acid, calcium oxalate monohydrate (COM; papillary and cavity), calcium oxalate dihydrate (COD), or calcium phosphate (CP). A 24 h urine analysis of calcium, oxalate, citrate, phosphate, and pH was performed in all patients. The relationship of each type of papillary injury with type of stone and urine chemistry was determined. Fisher’s exact test and Student’s t-test were used to determine the significance of relationships, and a p value below 0.05 was considered significant. Results The most common injury was tubular calcification (78%), followed by Randall’s plaque (58%), and papillary crater (39%). There was no significant relationship of Randall’s plaque with type of stone. However, endoscopic intratubular calcification (p = 0.025) and papillary crater (p = 0.041) were more common in patients with COD and CP stones. There were also significant relationships of papillary crater with hypercalciuria (p = 0.036) and hyperoxaluria (p = 0.024), and of Randall’s plaque with hypocitraturia (p = 0.005). Conclusions There are certain specific relationships between the different types of papillary calcifications that were endoscopically detected with stone chemistry and urine analysis. COD and CP stones were associated with endoscopic tubular calcifications and papillary craters. Hypercalciuria was associated with tubular calcification, and hypocitraturia was associated with Randall’s plaque.
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Affiliation(s)
- X A Sabaté Arroyo
- Hospital Universitari Son Espases, Ctra. Valldemossa, 79, Palma de Mallorca, Spain.
| | - F Grases Freixedas
- Universitat de les Illes Balears. IUNICS, Ctra. de Valldemossa, Km. 7.5, Palma de Mallorca, Spain
| | - J L Bauzà Quetglas
- Hospital Universitari Son Espases, Ctra. Valldemossa, 79, Palma de Mallorca, Spain
| | - J Guimerà Garcia
- Hospital Universitari Son Espases, Ctra. Valldemossa, 79, Palma de Mallorca, Spain
| | - E Pieras Ayala
- Hospital Universitari Son Espases, Ctra. Valldemossa, 79, Palma de Mallorca, Spain
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Almeras C, Daudon M, Estrade V, Gautier JR, Traxer O, Meria P. Classification of the renal papillary abnormalities by flexible ureteroscopy: evaluation of the 2016 version and update. World J Urol 2020; 39:177-185. [PMID: 32193654 PMCID: PMC7858204 DOI: 10.1007/s00345-020-03149-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 02/26/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction To assess the use of the 2016 proposed classification of the renal papillary abnormalities during flexible ureteroscopy that aims to standardize their description. Patients and methods We performed a prospective monocentric single operator collection of the data using this classification during 88 consecutive flexible ureteroscopies required for renal stones treatment. Outcome measurements and statistical analysis: data of stones analysis (microscopy and infrared spectrophotometry) and of serum and urines biochemical samples have been compared with the results of the classified endoscopic descriptions. Results Mean duration of description was 81.4 s. We reported that 83% of the patients had Randall plaques (RP), as only 4.5% of the patients had no abnormality. Concerning the papillary stones and anchored stones were observed in 30.7% and aspect of intraductal crystallization (Sc) in 15.9%. Erosions were present in 55.7% and extrophic papillae in 8%. Sa1 and Pa2 were significantly correlated to RP, anchored stones (Sa) to papillary erosions and calcium phosphate stones to intraductal crystallization. Hypercalciuria was significantly higher in Sa2 than Sa1 stones. Conclusions The different descriptions in the 2016 classification were confirmed by the results of this study. Papillary abnormalities are consequences of stones development. Their descriptions could also improve the follow-up and the diagnosis of a metabolic lithogenesis. We recommend their systematic description during ureteroscopy. Some improvements are proposed to update this classification.
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Affiliation(s)
- Christophe Almeras
- Department of Urology, La Croix du Sud Clinic, 52 chemin de Ribaute, 31130, Quint Fonsegrives, France.
| | - Michel Daudon
- Unit of Functional Explorations, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | | | - Jean Romain Gautier
- Department of Urology, La Croix du Sud Clinic, 52 chemin de Ribaute, 31130, Quint Fonsegrives, France
| | - Olivier Traxer
- Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | - Paul Meria
- Department of Urology, Saint-Louis Hospital, Denis Diderot University, Paris, France
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Kuliasha CA, Rodriguez D, Lovett A, Gower LB. In situ flow cell platform for examining calcium oxalate and calcium phosphate crystallization on films of basement membrane extract in the presence of urinary 'inhibitors'. CrystEngComm 2020; 22:1448-1458. [PMID: 32256199 PMCID: PMC7111463 DOI: 10.1039/c9ce01587f] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A significant portion of the population suffers from idipoathic calcium oxalate (CaOx) kidney stones, and current clinical treatments of stones have limited lasting success with a high rate of patients suffering from reoccurring stones. Understanding the role of physiologically relevant urinary species on the formation, aggregation, and growth of CaOx crystals can allow for better understanding of this complex biomineralization process and lead to more effective clinical treatments. Our prior work has focused on developing a two-stage model system, where the first stage emulates the formation of Randall's plaque, and the second stage examines the influence of the plaque on overgrowth of CaOx into a stone. Herein, we report on the development of an easy-to-use flow-cell platform that utilizes basement membrane extract (BME) as a biologically relevant crystallization substrate to study the influence of urinary 'inhibitors' on the in situ formation and growth of CaOx on BME under flow conditions. Magnesium, citrate, and osteopontin were studied because of their known ability to inhibit CaOx formation, but their influence also led to interesting modifications to the terminal crystal habit. Magnesium had little to no effect on the CaOx crystallization, but both citrate and osteopontin resulted in significant changes to the crystallization kinetics and the terminal crystal habits. Triply inhibited artificial urine solutions resulted in CaOx monohydrate formations that resembled physiological stones, and the in situ platform allowed for morphogenesis to be dynamically monitored. The BME was also used in a two-stage model system to first grow CaP that mimicked Randall's plaques, whereby the impact of the CaP crystallizing surface on CaOx formation could be studied. It was found that the CaP surface did not result in any significant changes in CaOx crystal formation or growth indicating that the urinary inhibitors and the basement membrane substrate were the dominant factors in modulating CaOx crystallization. It was also found that the basement membrane surface promoted the attachment and/or nucleation and growth of both CaOx and CaP crystals compared to bare glass surfaces, thereby enabling easy study of the urinary inhibitors. The work presented here has elucidated the terminal growth habit of different COM structures and has provided an easy to use platform that can be widely adopted by the kidney stone and other crystallization communities.
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Affiliation(s)
- Cary A. Kuliasha
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL, USA
| | - Douglas Rodriguez
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL, USA
| | - Archana Lovett
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL, USA
| | - Laurie B. Gower
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL, USA
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Gay C, Letavernier E, Verpont MC, Walls M, Bazin D, Daudon M, Nassif N, Stéphan O, de Frutos M. Nanoscale Analysis of Randall's Plaques by Electron Energy Loss Spectromicroscopy: Insight in Early Biomineral Formation in Human Kidney. ACS NANO 2020; 14:1823-1836. [PMID: 31909991 DOI: 10.1021/acsnano.9b07664] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Idiopathic kidney stones originate mainly from calcium phosphate deposits at the tip of renal papillae, known as Randall's plaques (RPs), also detected in most human kidneys without stones. However, little is known about the mechanisms involved in RP formation. The localization and characterization of such nanosized objects in the kidney remain a real challenge, making their study arduous. This study provides a nanoscale analysis of the chemical composition and morphology of incipient RPs, characterizing in particular the interface between the mineral and the surrounding organic compounds. Relying on data gathered from a calculi collection, the morphology and chemical composition of incipient calcifications in renal tissue were determined using spatially resolved electron energy-loss spectroscopy. We detected microcalcifications and individual nanocalcifications found at some distance from the larger ones. Strikingly, concerning the smaller ones, we show that two types of nanocalcifications coexist: calcified organic vesicles and nanometric mineral granules mainly composed of calcium phosphate with carbonate in their core. Interestingly, some of these nanocalcifications present similarities with those reported in physiological bone or pathological cardiovascular biominerals, suggesting possible common formation mechanisms. However, the high diversity of these nanocalcifications suggests that several mechanisms may be involved (nucleation on a carbonate core or on organic compounds). In addition, incipient RPs also appear to present specific features at larger scales, revealing secondary calcified structures embedded in a fibrillar organic material. Our study proves that analogies exist between physiological and pathological biominerals and provides information to understand the physicochemical processes involved in pathological calcification formation.
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Affiliation(s)
- Clément Gay
- Laboratoire de Physique des Solides, CNRS UMR 8502 , Université de Paris-Saclay , F-91405 , Orsay , France
| | - Emmanuel Letavernier
- Sorbonne Université , UPMC Univ Paris 06, UMR S 1155, F-75020 , Paris , France
- INSERM , UMR S 1155, F-75020 , Paris , France
- Physiology Unit, APHP , Hôpital Tenon , F-75020 , Paris , France
| | - Marie-Christine Verpont
- Sorbonne Université , UPMC Univ Paris 06, UMR S 1155, F-75020 , Paris , France
- INSERM , UMR S 1155, F-75020 , Paris , France
| | - Michael Walls
- Laboratoire de Physique des Solides, CNRS UMR 8502 , Université de Paris-Saclay , F-91405 , Orsay , France
| | - Dominique Bazin
- Laboratoire de Chimie Physique, UMR 8000-CNRS , Université de Paris-Saclay , F-91405 , Orsay , France
| | - Michel Daudon
- Sorbonne Université , UPMC Univ Paris 06, UMR S 1155, F-75020 , Paris , France
- INSERM , UMR S 1155, F-75020 , Paris , France
- Physiology Unit, APHP , Hôpital Tenon , F-75020 , Paris , France
| | - Nadine Nassif
- Sorbonne Université , CNRS, Collège de France, Laboratoire de Chimie de la Matière Condensée de Paris (LCMCP), 4 Place Jussieu , F-75005 , Paris , France
| | - Odile Stéphan
- Laboratoire de Physique des Solides, CNRS UMR 8502 , Université de Paris-Saclay , F-91405 , Orsay , France
| | - Marta de Frutos
- Laboratoire de Physique des Solides, CNRS UMR 8502 , Université de Paris-Saclay , F-91405 , Orsay , France
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Pseudoxanthoma Elasticum, Kidney Stones and Pyrophosphate: From a Rare Disease to Urolithiasis and Vascular Calcifications. Int J Mol Sci 2019; 20:ijms20246353. [PMID: 31861118 PMCID: PMC6940945 DOI: 10.3390/ijms20246353] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/11/2022] Open
Abstract
Pseudoxanthoma elasticum is a rare disease mainly due to ABCC6 gene mutations and characterized by ectopic biomineralization and fragmentation of elastic fibers resulting in skin, cardiovascular and retinal calcifications. It has been recently described that pyrophosphate (a calcification inhibitor) deficiency could be the main cause of ectopic calcifications in this disease and in other genetic disorders associated to mutations of ENPP1 or CD73. Patients affected by Pseudoxanthoma Elasticum seem also prone to develop kidney stones originating from papillary calcifications named Randall’s plaque, and to a lesser extent may be affected by nephrocalcinosis. In this narrative review, we summarize some recent discoveries relative to the pathophysiology of this mendelian disease responsible for both cardiovascular and renal papillary calcifications, and we discuss the potential implications of pyrophosphate deficiency as a promoter of vascular calcifications in kidney stone formers and in patients affected by chronic kidney disease.
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Zhao YW, Guo D, Li CY, Ouyang JM. Comparison of the adhesion of calcium oxalate monohydrate to HK-2 cells before and after repair using tea polysaccharides. Int J Nanomedicine 2019; 14:4277-4292. [PMID: 31239679 PMCID: PMC6559723 DOI: 10.2147/ijn.s198644] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/21/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Kidney stone formation is closely related to renal epithelial cell damage and the adhesion of calcium oxalate crystals to cells. Methods: In this research, the adhesion of human kidney proximal tubular epithelial cells (HK-2) to calcium oxalate monohydrate crystals with a size of approximately 100 nm was studied. In addition, the inhibition of crystal adhesion by four tea polysaccharides (TPS0, TPS1, TPS2, and TPS3) with the molecular weights of 10.88, 8.16, 4.82, and 2.31 kDa, respectively were compared. Results: When oxalic acid-damaged HK-2 cells were repaired, cell viability increased. By contrast, reactive oxygen species level, phosphatidylserine eversion, and osteopontin expression decreased, thus indicating that tea polysaccharides have a repairing effect on damaged HK-2 cells. Moreover, after repairing the damaged cells, the amount of adherent crystals was reduced. The repair effect of tea polysaccharides is closely related to molecular weight, and TPS2 with the moderate molecular weight displayed the best repair effect. Conclusion: These results suggest that tea polysaccharides, especially TPS2, may inhibit the formation and recurrence of calcium oxalate kidney stones.
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Affiliation(s)
- Yao-Wang Zhao
- Department of Urology, Hunan Children's Hospital, Changsha 410007, People's Republic of China
| | - Da Guo
- Institute of Biomineralization and Lithiasis Research, Jinan University, Guangzhou 510632, People's Republic of China
| | - Chuang-Ye Li
- Department of Urology, Hunan Children's Hospital, Changsha 410007, People's Republic of China
| | - Jian-Ming Ouyang
- Institute of Biomineralization and Lithiasis Research, Jinan University, Guangzhou 510632, People's Republic of China
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Gomes DL, Melo KRT, Queiroz MF, Batista LANC, Santos PC, Costa MSSP, Almeida-Lima J, Camara RBG, Costa LS, Rocha HAO. In Vitro Studies Reveal Antiurolithic Effect of Antioxidant Sulfated Polysaccharides from the Green Seaweed Caulerpa cupressoides var flabellata. Mar Drugs 2019; 17:md17060326. [PMID: 31159355 PMCID: PMC6628234 DOI: 10.3390/md17060326] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 12/21/2022] Open
Abstract
Urolithiasis affects approximately 10% of the world population and is strongly associated with calcium oxalate (CaOx) crystals. Currently, there is no efficient compound that can be used to prevent this disease. However, seaweeds' sulfated polysaccharides (SPs) can change the CaOx crystals surface's charge and thus modify the crystallization dynamics, due to the interaction of the negative charges of these polymers with the crystal surface during their synthesis. We observed that the SPs of Caulerpa cupressoides modified the morphology, size and surface charge of CaOx crystals. Thus, these crystals became similar to those found in healthy persons. In the presence of SPs, dihydrate CaOx crystals showed rounded or dumbbell morphology. Infrared analysis, fluorescence microscopy, flow cytometry (FITC-conjugated SPs) and atomic composition analysis (EDS) allowed us to propose the mode of action between the Caulerpa's SPs and the CaOx crystals. This study is the first step in understanding the interactions between SPs, which are promising molecules for the treatment of urolithiasis, and CaOx crystals, which are the main cause of kidney stones.
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Affiliation(s)
- Dayanne Lopes Gomes
- Laboratory of Natural Polymer Biotechnology (BIOPOL), Department of Biochemistry, Center of Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte- RN 59078-970, Brazil.
- Federal Institute of Education, Science and Technology of Piauí (IFPI), São Raimundo Nonato Campus, São Raimundo Nonato-PI 64.770-000, Brazil.
| | - Karoline Rachel Teodosio Melo
- Laboratory of Natural Polymer Biotechnology (BIOPOL), Department of Biochemistry, Center of Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte- RN 59078-970, Brazil.
| | - Moacir Fernandes Queiroz
- Laboratory of Natural Polymer Biotechnology (BIOPOL), Department of Biochemistry, Center of Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte- RN 59078-970, Brazil.
| | - Lucas Alighieri Neves Costa Batista
- Laboratory of Natural Polymer Biotechnology (BIOPOL), Department of Biochemistry, Center of Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte- RN 59078-970, Brazil.
| | - Pablo Castro Santos
- State University of Rio Grande do Norte (UERN), Mossoró-RN 59.610-210, Brazil.
| | | | - Jailma Almeida-Lima
- Laboratory of Natural Polymer Biotechnology (BIOPOL), Department of Biochemistry, Center of Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte- RN 59078-970, Brazil.
| | - Rafael Barros Gomes Camara
- Laboratory of Natural Polymer Biotechnology (BIOPOL), Department of Biochemistry, Center of Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte- RN 59078-970, Brazil.
| | - Leandro Silva Costa
- Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN), Canguaretama-RN 59.190-000, Brazil.
| | - Hugo Alexandre Oliveira Rocha
- Laboratory of Natural Polymer Biotechnology (BIOPOL), Department of Biochemistry, Center of Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte- RN 59078-970, Brazil.
- Federal Institute of Education, Science and Technology of Piauí (IFPI), São Raimundo Nonato Campus, São Raimundo Nonato-PI 64.770-000, Brazil.
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Prevention of Calcium Nephrolithiasis: The Influence of Diuresis on Calcium Oxalate Crystallization in Urine. Adv Prev Med 2019; 2019:3234867. [PMID: 31016047 PMCID: PMC6448328 DOI: 10.1155/2019/3234867] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/28/2019] [Accepted: 02/06/2019] [Indexed: 12/13/2022] Open
Abstract
A high fluid intake is still the most evidence-based measure for the prevention of idiopathic stone disease. The recommendation of current guidelines on urolithiasis to increase diuresis to 2-2.5 L/day is mainly based on a single clinical study. The present paper shows the influence of diuresis on calcium oxalate (CaOx) crystallization and especially aggregation (AGN) which can explain the initial development of Ca stones on papillary calcifications as well as stone growth in the renal pelvic system. Diuresis determines the urinary transit time (UT) through the kidney and together with the afflux of Ca and Ox the state of urinary saturation with respect to CaOx being the most frequent stone mineral. High supersaturation inducing crystallization during UT and a high urinary ion concentration interfering with the inhibition of crystal AGN by urinary macromolecules seem to be critical parameters for stone formation. Using data from the literature the influence of diuresis on these parameters is evaluated for short-term recurrent stone formers (RSF), idiopathic stone patients, and healthy controls, the latter two collectives with and without excessive oxalate ingestion. This investigation suggests that a diuresis of 2 L/day may protect from stone formation even after dietary Ox excesses and in RSF. However, in RSF with a continuously high Ca and Ox afflux into urine a permanent high diuresis is required which is difficult to sustain over 24 hours.
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40
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Zhang J, Wang L, Putnis CV. Underlying Role of Brushite in Pathological Mineralization of Hydroxyapatite. J Phys Chem B 2019; 123:2874-2881. [PMID: 30840456 DOI: 10.1021/acs.jpcb.9b00728] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The majority of human kidney stones are composed of multiple calcium oxalate crystals with variable amounts of brushite [dicalcium phosphate dihydrate (DCPD)] and hydroxyapatite (HAP) as a nucleus, in which fluid-mediated dissolution and reprecipitation may result in the phase transformation of DCPD to HAP. However, the underlying mechanisms of the phase transition and its modulation by natural inhibitors, such as osteopontin (OPN) proteins, remain poorly understood. Here, the in vitro formation of new phases on the DCPD (010) surface is observed in situ using atomic force microscopy in a simulated hypercalciuria milieu. We demonstrate the presence of an acidic amorphous calcium phosphate (ACP) phase with a characteristic Raman band of ν1HPO42- and the octacalcium phosphate (OCP)-like phase during the transformation process. High-resolution transmission electron microscopy analyses also confirm the existence of OCP and HAP within an amorphous matrix phase. In support of clinical observations, we further demonstrate the inhibitory effect of OPN peptide segments on the dissolution of DCPD and reprecipitation of acidic ACP. The definition of respective roles of DCPD and OPN thereby provides insights into the control of nucleus formation and subsequent inhibition of pathological mineralization.
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Affiliation(s)
- Jing Zhang
- College of Resources and Environment , Huazhong Agricultural University , Wuhan 430070 , China
| | - Lijun Wang
- College of Resources and Environment , Huazhong Agricultural University , Wuhan 430070 , China
| | - Christine V Putnis
- Institut für Mineralogie , University of Münster , Münster 48149 , Germany.,Department of Chemistry , Curtin University , Perth 6845 , Australia
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41
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Zhai H, Wang L, Putnis CV. Inhibition of Spiral Growth and Dissolution at the Brushite (010) Interface by Chondroitin 4-Sulfate. J Phys Chem B 2019; 123:845-851. [PMID: 30615454 DOI: 10.1021/acs.jpcb.8b11531] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Modulation of mineralization and demineralization of calcium phosphates (Ca-Ps) with organic macromolecules is a critical process which prevents human kidney stone disease. As a long unbranched polysaccharide of urinary glycosaminoglycans, chondroitin 4-sulfate (Ch4S) has been shown to play an essential role in inhibiting the formation of kidney stones. However, the mechanism of the role of Ch4S remains poorly understood. Here, we used in situ atomic force microscopy to observe the growth and dissolution of spirals on brushite (CaHPO4·2H2O) (010) surfaces. The results show that Ch4S preferentially inhibits the [101]Cc step growth/dissolution by step pinning. This step-specific effect appears to be related to specific binding of Ch4S to Ca sites, as the observed inhibition is not seen in other crystallographic directions where there are fewer Ca terminations. Moreover, Ch4S promotes an increase in the terrace width of [101̅]Cc by the modification of the interfacial energies of the step edge. These in vitro direct observations of Ch4S modulating brushite mineralization and demineralization reveal a dual control of both step kinetics and interfacial energy.
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Affiliation(s)
- Hang Zhai
- College of Resources and Environment , Huazhong Agricultural University , Wuhan 430070 , China
| | - Lijun Wang
- College of Resources and Environment , Huazhong Agricultural University , Wuhan 430070 , China
| | - Christine V Putnis
- Institut für Mineralogie , University of Münster , 48149 Münster , Germany.,Department of Chemistry , Curtin University , Perth 6845 , Australia
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42
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Abstract
Calcium kidney stones are common worldwide. Most are idiopathic and composed of calcium oxalate. Calcium phosphate is present in around 80% and may initiate stone formation. Stone production is multifactorial with a polygenic genetic contribution. Phosphaturia is found frequently among stone formers but until recently received scant attention. This review examines possible mechanisms for the phosphaturia and its relevance to stone formation from a wide angle. There is a striking lack of clinical data. Phosphaturia is associated, but not correlated, with hypercalciuria, increased 1,25 dihydroxy-vitamin D [1,25 (OH)2D], and sometimes evidence of disturbances in proximal renal tubular function. Phosphate reabsorption in the proximal renal tubules requires tightly regulated interaction of many proteins. Paracellular flow through intercellular tight junctions is the major route of phosphate absorption from the intestine and can be reduced therapeutically in hyperphosphatemic patients. In monogenic defects stones develop when phosphaturia is associated with hypercalciuria, generally explained by increased 1,25 (OH)2D production in response to hypophosphatemia. Calcification does not occur in disorders with increased FGF23 when phosphaturia occurs in isolation and 1,25 (OH)2D is suppressed. Candidate gene studies have identified mutations in the phosphate transporters, but in few individuals. One genome-wide study identified a polymorphism of the phosphate transporter gene SLC34A4 associated with stones. Others did not find mutations obviously linked to phosphate reabsorption. Future genetic studies should have a wide trawl and should focus initially on groups of patients with clearly defined phenotypes. The global data should be pooled.
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Affiliation(s)
- Valerie Walker
- Department of Clinical Biochemistry, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
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43
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Daudon M, Jungers P, Bazin D, Williams JC. Recurrence rates of urinary calculi according to stone composition and morphology. Urolithiasis 2018; 46:459-470. [PMID: 29392338 PMCID: PMC6711148 DOI: 10.1007/s00240-018-1043-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/24/2018] [Indexed: 12/13/2022]
Abstract
Few studies have examined the relative risk of recurrence of different stone types. The object of the present study was to evaluate the tendency for stone recurrence as a function of major mineral composition of the stones and morphological characteristics of the stones. This study was carried out using 38,274 stones for which we had data available to specify if the stone was from the first or a subsequent urinary stone episode. Stones were analyzed for morphology by stereomicroscope and for composition by infrared spectroscopy. Overall, 42.7% of stones were from patients who had had a previous stone event, with these being more frequent in men (44.4%) than in women (38.9%, p < 0.0001). Age of first stone occurrence was lowest for dihydroxyadenine (15.7 ± 16.6 years) and highest for anhydrous uric acid (62.5 ± 14.9 years), with the average age of first stones of calcium oxalate falling in the middle (40.7 ± 14.6 years for calcium oxalate dihydrate, and 48.4 ± 15.1 years for calcium oxalate monohydrate, COM). By composition alone, COM was among the least recurrent of stones, with only 38.0% of COM stones coming from patients who had had a previous episode; however, when the different morphological types of COM were considered, type Ic-which displays a light color, budding surface and unorganized section-had a significantly greater rate of recurrence, at 82.4% (p < 0.0001), than did other morphologies of COM. Similarly, for stones composed of apatite, morphological type IVa2-a unique form with cracks visible beneath a glossy surface-had a higher rate of recurrence than other apatite morphologies (78.8 vs. 39-42%, p < 0.0001). Stone mineral type alone is insufficient for identifying the potential of recurrence of the stones. Instead, the addition of stone morphology may allow the diagnosis of highly recurrent stones, even among common mineral types (e.g., COM) that in general are less recurrent.
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Affiliation(s)
- Michel Daudon
- Laboratoire des Lithiases, Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, APHP, 4, rue de la Chine, 75970, Paris Cedex 20, France.
- Unité INSERM UMRS 1155, UPMC, Hôpital Tenon, Paris, France.
| | - Paul Jungers
- Département de Néphrologie, Hôpital Necker, APHP, Paris, France
| | - Dominique Bazin
- LCMCP, UPMC, CNRS, Collège de France, Paris, France
- Laboratoire de Physique des Solides, Université Paris Sud, Orsay, France
| | - James C Williams
- Department of Anatomy and Cell Biology, Indiana University, Indianapolis, IN, USA
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44
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Letavernier E, Kauffenstein G, Huguet L, Navasiolava N, Bouderlique E, Tang E, Delaitre L, Bazin D, de Frutos M, Gay C, Perez J, Verpont MC, Haymann JP, Pomozi V, Zoll J, Le Saux O, Daudon M, Leftheriotis G, Martin L. ABCC6 Deficiency Promotes Development of Randall Plaque. J Am Soc Nephrol 2018; 29:2337-2347. [PMID: 29991491 DOI: 10.1681/asn.2017101148] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 05/28/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Pseudoxanthoma elasticum (PXE) is a genetic disease caused by mutations in the ABCC6 gene that result in low pyrophosphate levels and subsequent progressive soft tissue calcifications. PXE mainly affects the skin, retina, and arteries. However, many patients with PXE experience kidney stones. We determined the prevalence of this pathology in patients with PXE and examined the possible underlying mechanisms in murine models. METHODS We conducted a retrospective study in a large cohort of patients with PXE and analyzed urine samples and kidneys from Abcc6-/- mice at various ages. We used Yasue staining, scanning electron microscopy, electron microscopy coupled to electron energy loss spectroscopy, and Fourier transform infrared microspectroscopy to characterize kidney calcifications. RESULTS Among 113 patients with PXE, 45 (40%) had a past medical history of kidney stones. Five of six computed tomography scans performed showed evidence of massive papillary calcifications (Randall plaques). Abcc6-/- mice spontaneously developed kidney interstitial apatite calcifications with aging. These calcifications appeared specifically at the tip of the papilla and formed Randall plaques similar to those observed in human kidneys. Compared with controls, Abcc6-/- mice had low urinary excretion of pyrophosphate. CONCLUSIONS The frequency of kidney stones and probably, Randall plaque is extremely high in patients with PXE, and Abcc6-/- mice provide a new and useful model in which to study Randall plaque formation. Our findings also suggest that pyrophosphate administration should be evaluated for the prevention of Randall plaque and kidney stones.
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Affiliation(s)
- Emmanuel Letavernier
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France; .,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Department of Physiology, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Gilles Kauffenstein
- Institut des maladies mitochondriales, du coeur et des vaisseaux-MITOVASC, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Angers University, Angers, France
| | - Léa Huguet
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France.,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Nastassia Navasiolava
- Department of Dermatology, PseudoXanthoma Elasticum Consultation center, Reference Center for rare skin diseases, Angers University Hospital, France
| | - Elise Bouderlique
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France.,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Ellie Tang
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France.,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Léa Delaitre
- Department of Dermatology, PseudoXanthoma Elasticum Consultation center, Reference Center for rare skin diseases, Angers University Hospital, France
| | - Dominique Bazin
- Unité Mixte de Recherche 8502, Laboratoire de Physique des Solides, Centre National de la Recherche Scientifique, Université Paris Sud XI, Orsay, France
| | - Marta de Frutos
- Unité Mixte de Recherche 8502, Laboratoire de Physique des Solides, Centre National de la Recherche Scientifique, Université Paris Sud XI, Orsay, France
| | - Clément Gay
- Unité Mixte de Recherche 8502, Laboratoire de Physique des Solides, Centre National de la Recherche Scientifique, Université Paris Sud XI, Orsay, France
| | - Joëlle Perez
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France.,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Marie-Christine Verpont
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France.,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Jean-Philippe Haymann
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France.,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Department of Physiology, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Viola Pomozi
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; and
| | - Janna Zoll
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; and
| | - Olivier Le Saux
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; and
| | - Michel Daudon
- Unité Mixte de Recherche S 1155, Sorbonne Universités, Université Pierre et Marie Curie-Paris 06, Paris, France.,Unité Mixte de Recherche S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Department of Physiology, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Georges Leftheriotis
- Department of Physiology and Molecular Medicine, Unité Mixte de Recherche 7370, Centre National de la Recherche Scientifique, University of Nice, Nice, France
| | - Ludovic Martin
- Institut des maladies mitochondriales, du coeur et des vaisseaux-MITOVASC, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Angers University, Angers, France.,Department of Dermatology, PseudoXanthoma Elasticum Consultation center, Reference Center for rare skin diseases, Angers University Hospital, France
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Mediators of the Effects of Gender on Uric Acid Nephrolithiasis: A Novel Application of Structural Equation Modeling. Sci Rep 2018; 8:6077. [PMID: 29666405 PMCID: PMC5904184 DOI: 10.1038/s41598-018-24485-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/04/2018] [Indexed: 11/08/2022] Open
Abstract
Numerous epidemiological studies have shown that male patients with uric acid nephrolithiasis outnumber female patients. To our knowledge, no research exists evaluating the reasons gender affects the development of uric acid nephrolithiasis. We hereby used a novel application of structural equation modeling to analyze the mediators of the effects of gender on uric acid nephrolithiasis. In 1,098 patients with nephrolithiasis between 2012 and 2016, male gender was found to have a statistically significant positive indirect effect on the development of uric acid nephrolithiasis, which was mediated by lower urine pH (estimate: 0.010, standard error: 0.005, critical ratio: 2.135, 95% confidence interval: 0.002–0.023, P = 0.017), lower estimated glomerular filtration rate (estimate: 0.014, standard error: 0.005, critical ratio: 2.993, 95% confidence interval: 0.006–0.025, P < 0.001), and higher incidence rate of gout (estimate: 0.009, standard error: 0.005, critical ratio: 2.028, 95% confidence interval: 0.002–0.021, P = 0.009). We conclude that low urine pH, impaired renal function, and gout are the mediators of the effect of male gender on the development of uric acid nephrolithiasis. The survey, treatment, and follow-up of kidney diseases, acidic urine, and uric acid metabolism disorders should be considered in men with uric acid nephrolithiasis.
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46
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Vitamin D, Hypercalciuria and Kidney Stones. Nutrients 2018; 10:nu10030366. [PMID: 29562593 PMCID: PMC5872784 DOI: 10.3390/nu10030366] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 01/30/2023] Open
Abstract
The estimated lifetime risk of nephrolithiasis is growing nowadays, and the formation of kidney stones is frequently promoted by hypercalciuria. Vitamin D, and especially its active metabolite calcitriol, increase digestive calcium absorption—as urinary calcium excretion is directly correlated with digestive calcium absorption, vitamin D metabolites could theoretically increase calciuria and promote urinary stone formation. Nevertheless, there was, until recently, low evidence that 25-hydroxyvitamin D serum levels would be correlated with kidney stone formation, even if high calcitriol concentrations are frequently observed in hypercalciuric stone formers. Low 25-hydroxyvitamin D serum levels have been associated with a broad spectrum of diseases, leading to a huge increase in vitamin D prescription in the general population. In parallel, an increased frequency of kidney stone episodes has been observed in prospective studies evaluating vitamin D alone or in association with calcium supplements, and epidemiological studies have identified an association between high 25-hydroxyvitamin D serum levels and kidney stone formation in some groups of patients. Moreover, urinary calcium excretion has been shown to increase in response to vitamin D supplements, at least in some groups of kidney stone formers. It seems likely that predisposed individuals may develop hypercalciuria and kidney stones in response to vitamin D supplements.
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47
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Abstract
Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of human health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal failure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at Randall's plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary crystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of renal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein kinase pathways. Currently, there is no satisfactory drug to cure and/or prevent kidney stone recurrences. Thus, further understanding of the pathophysiology of kidney stone formation is a research area to manage urolithiasis using new drugs. Therefore, this review has intended to provide a compiled up-to-date information on kidney stone etiology, pathogenesis, and prevention approaches.
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48
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The effects of HAP and macrophage cells to the expression of inflammatory factors and apoptosis in HK-2 cells of vitro co-cultured system. Urolithiasis 2017; 46:429-443. [PMID: 29236151 PMCID: PMC6153874 DOI: 10.1007/s00240-017-1032-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 11/11/2017] [Indexed: 01/26/2023]
Abstract
This study developed an in vitro system by co-culturing HK-2 cells with different concentration of hydroxyapatite (HAP) and/or macrophage cells to simulate the internal environment of urolithiasis as far as possible, investigating the regulatory effects of macrophage cells on HAP-induced expression of relative inflammatory factors of HK-2 cells. The control group (H group) was only comprised of HK-2 cells. Experimental groups included co-culturing HK-2 cells and macrophage cells (H + M group), co-culturing HK-2 cells and HAP (H + A group), co-culturing macrophage cells and HAP (M + A group), and co-culturing HK-2 cells and macrophage cells with HAP (H + M + A group). In the H + A, M + A, and H + M + A group, we set the concentration of HAP as 5 μg/cm2 (A1) and 10 μg/cm2 (A2). After co-culturing for 2, 4, and 6 h, we detected the expression of CCL-2 in the liquid by ELISA. We tested the expression of LDH and ROS to evaluate the damage of HK-2 cells. We assessed the apoptosis of HK-2 cells using DAPI staining assay, flow cytometry, and the rate of BAX/BCL-2. Western Blotting detected OPN, Fetuin-A, BAX, and BCL-2 of HK-2 cells. The expression of CCL-2 in the medium of H + A1 and H + A2 group increased significantly compared with the control (P < 0.05); CCL-2 of M + A1 and M + A2 group was higher than the H + A1 and H + A2 group (P < 0.05). The expression of CCL-2 in H + M + A1 and H + M + A2 group was also higher than M + A1 and M + A2 group (P < 0.05). Compared with control, the expression of OPN, LDH release, the ratio of BAX/BCL-2, and the generation of ROS in HK-2 cells increased in a dose- and time-dependent manner. Compared with the control, the expression of Fetuin-A decreased in various degrees at different incubation periods. Especially when co-culturing for 6 h, Fetuin-A decreased most seriously in the H + M + A1 group. (1) The HAP can induce the HK-2 cells oxidative stress and inflammatory damage and apoptosis, when adding the macrophages to co-culture, macrophage cells can aggravate the damage and apoptosis of the HK-2 cells. (2) After the stimulation of HAP, the expression of OPN in HK-2 cells increased in a time- and dose-dependent manner; macrophage cells can aggravate the increase of OPN in HK-2 cells. (3) In the HAP and HK-2 cells co-cultured system, the low-level Fetuin-A of HK-2 cells may be related to the excessive consumption of Fetuin-A in the process of HAP-induced renal tubular epithelial cell excessive oxidative stress, inflammatory injury, and cell apoptosis. When adding macrophage cells to co-culture, Fetuin-A decreased even more seriously, it reminds us that macrophage cells can slightly regulate the expression of Fetuin-A in the HK-2 cells.
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49
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Arzoz-Fabregas M, Roca-Antonio J, Ibarz-Servio L, Jappie-Mahomed D, Rodgers A. Stress-stones-stress-recurrent stones: a self-propagating cycle? Difficulties in solving this dichotomy. Urolithiasis 2017; 45:515-524. [PMID: 28324150 DOI: 10.1007/s00240-017-0970-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
Abstract
Numerous studies have reported an association between stress and urolithiasis. Although urinary risk factors have been measured in several of these, compelling evidence of a causal relationship has not been established. A shortcoming is that alterations in single urinary parameters rather than ratios and quotients, which provide a more synergistic risk evaluation, have been measured. Recently, we speculated about a possible association between chronic stress and stone recurrence. This presents an intriguing dichotomy of whether stress causes stones or vice versa, or whether they are linked in a self-propagating stress-stones-stress-recurrence cycle. We investigated the latter hypothesis in a retrospective case-control designed study in which we calculated urinary ratios and quotients which are regarded as diagnostic indicators of stone risk. These included Ca/Cr, Ox/Cr, Mg/Cr, Cit/Cr, urate/Cr and citrate-magnesium-calcium ratios, activity product quotient for calcium oxalate (CaOx) and relative supersaturation of CaOx, brushite and uric acid. Overnight urinary data from 128 participants comprising 31 first time (FS), 33 recurrent (RS) CaOx stone formers and 64 controls were used. All subjects had been previously assessed for chronic stress dimensions, as well as for stress caused by their stone episodes per se. Conditional and unconditional logistic regression (with a Bonferroni correction for multiple tests) and simple linear regression were used to analyse various components of the data. Although RS had more stressful life events, with greater intensity of perception than FS, there were no significant differences between the groups regarding any of the urinary risk factors. No significant association between stressful life events and any of the urinary ratios or quotients was observed. A direct causal link between stress and stone recurrence was not indicated. We believe that future studies should shift their focus from traditional urinary risk factors to other stone-forming mechanisms. However, we recognize that there is an inherent problem in attempting to solve the stress-stones dichotomy as it would be impossible to disentangle alterations in risk factors which arise from lifestyle stress and those arising from stone episodes themselves.
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Affiliation(s)
| | - Josep Roca-Antonio
- Department of Epidemiology, Hospital Germans Trias I Pujol, Badalona, Spain
| | - Luis Ibarz-Servio
- Department of Urology, Hospital Germans Trias I Pujol, Badalona, Spain
| | | | - Allen Rodgers
- Department of Chemistry, University of Cape Town, Rondebosch, Cape Town, 7701, South Africa.
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Hu H, Zhang J, Lu Y, Zhang Z, Qin B, Gao H, Wang Y, Zhu J, Wang Q, Zhu Y, Xun Y, Wang S. Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis. Nutrients 2017; 9:nu9030301. [PMID: 28335477 PMCID: PMC5372964 DOI: 10.3390/nu9030301] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 02/27/2017] [Accepted: 03/16/2017] [Indexed: 12/20/2022] Open
Abstract
Many studies compared the serum/plasma 1,25 dihydroxyvitamin D₃ (1,25(OH)₂D) and 25 hydroxyvitamin D₃ (25(OH)D) between people with and without nephrolithiasis, and their results were conflicting. After systematically searching PubMed, Web of Science, The Cochrane Library, CNKI, and the Wanfang Database, we conducted a meta-analysis. Thirty-two observational studies involving 23,228 participants were included. Meta-analysis of these studies showed that of stone formers (SFs), calcium SFs had significantly higher concentrations of 1,25(OH)₂D (weighted mean difference (WMD), 10.19 pg/mL; 95% confidence interval (CI), 4.31-16.07; p = 0.0007 and WMD, 11.28 pg/mL; 95% CI, 4.07-18.50; p = 0.002, respectively) than non-stone formers, while the levels of 25(OH)D (WMD, 0.88 ng/mL; 95% CI, -1.04-2.80; p = 0.37 and WMD, -0.63 ng/mL; 95% CI, -2.72-1.47; p = 0.56, respectively) are similar. Compared with controls and normocalciuria SFs, hypercalciuria SFs had increased circulating 1,25(OH)₂D (WMD, 9.41 pg/mL; 95% CI, 0.15-18.67; p = 0.05 and WMD, 2.75 pg/mL; 95% CI, -0.20-5.69; p = 0.07, respectively) and markedly higher 25(OH)D (WMD, 5.02 ng/mL; 95% CI, 0.99-9.06; p = 0.01 and WMD, 5.02 ng/mL; 95% CI, 2.14-7.90; p = 0.0006, respectively). Normocalciuria SFs had elevated 1,25(OH)₂D level (WMD, 6.85 pg/mL; 95% CI, -5.00-18.71; p = 0.26) and comparable 25(OH)D (WMD, 0.94 ng/mL; 95% CI, -3.55-5.43; p = 0.68). Sensitivity analysis generated similar results. Current evidence suggests that increased circulating 1,25(OH)₂D is associated with urinary stones and a higher level of circulating 25(OH)D is significantly associated with hypercalciuria urolithiasis. Further studies are still needed to reconfirm and clarify the role of vitamin D in the pathogenesis of stones.
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Affiliation(s)
- Henglong Hu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Jiaqiao Zhang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yuchao Lu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Zongbiao Zhang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Baolong Qin
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Hongbin Gao
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yufeng Wang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Jianning Zhu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Qing Wang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yunpeng Zhu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yang Xun
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Shaogang Wang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
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