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Negri AL, Spivacow FR. Kidney stone matrix proteins: Role in stone formation. World J Nephrol 2023; 12:21-28. [PMID: 37035509 PMCID: PMC10075018 DOI: 10.5527/wjn.v12.i2.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/18/2023] [Accepted: 03/17/2023] [Indexed: 03/21/2023] Open
Abstract
Stone formation is induced by an increased level of urine crystallization promoters and reduced levels of its inhibitors. Crystallization inhibitors include citrate, magnesium, zinc, and organic compounds such as glycosaminoglycans. In the urine, there are various proteins, such as uromodulin (Tamm-Horsfall protein), calgranulin, osteopontin, bikunin, and nephrocalcin, that are present in the stone matrix. The presence of several carboxyl groups in these macromolecules reduces calcium oxalate monohydrate crystal adhesion to the urinary epithelium and could potentially protect against lithiasis. Proteins are the most abundant component of kidney stone matrix, and their presence may reflect the process of stone formation. Many recent studies have explored the proteomics of urinary stones. Among the stone matrix proteins, the most frequently identified were uromodulin, S100 proteins (calgranulins A and B), osteopontin, and several other proteins typically engaged in inflammation and immune response. The normal level and structure of these macromolecules may constitute protection against calcium salt formation. Paradoxically, most of them may act as both promoters and inhibitors depending on circumstances. Many of these proteins have other functions in modulating oxidative stress, immune function, and inflammation that could also influence stone formation. Yet, the role of these kidney stone matrix proteins needs to be established through more studies comparing urinary stone proteomics between stone formers and non-stone formers.
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Affiliation(s)
- Armando Luis Negri
- Department of Physiology and Biophysics, Universidad del Salvador, Instituto de Investigaciones Metabólicas, Buenos Aires 1012, Argentina
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Ciongradi CI, Filip F, Sârbu I, Iliescu Halițchi CO, Munteanu V, Candussi IL. The Impact of Water and Other Fluids on Pediatric Nephrolithiasis. Nutrients 2022; 14:nu14194161. [PMID: 36235817 PMCID: PMC9573375 DOI: 10.3390/nu14194161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022] Open
Abstract
Pediatric nephrolithiasis cases have been on the rise in the past several years, resulting in increased healthcare costs and other burdens on the juveniles with this ailment. Recent research has shown that present trends in pediatric nephrolithiasis have changed as a result of fluid intake, including water consumption, nutrition, obesity prevalence, lifestyle, and imaging procedures. A specific cause, meanwhile, is still elusive. Trends in pediatric nephrolithiasis need to be thoroughly researched. Furthermore, variables specific to pediatric nephrolithiasis that could cause greater difficulties in an affected child elevate the level of worry with cumulative prevalence. Doctors should rigorously assess patients who present with kidney stones when they have dynamics such as varied clinical presentation, high recurrence of kidney stones linked to metabolic and urinary tract problems, and the potential existence of rare genetic kidney stone illnesses. This review aims to identify adaptive risk factors and anomalies that call for specialized treatment and prescription. More specifically, the major goals of medical and surgical treatments are to eliminate kidney stone risk and stop relapse while concurrently lowering interventional barriers. A dedicated nephrolithiasis clinic run by a pediatric nephrologist, nutritionist, urologist, and clinical nurse may sometimes be beneficial for patients in serious danger. Such a clinic offers significant chances to learn more about pediatric nephrolithiasis, which has been linked to water consumption and hence fosters urgently required study in this area.
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Affiliation(s)
- Carmen Iulia Ciongradi
- 2nd Department of Surgery—Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Florin Filip
- Pediatric Surgery and Orthopedics Department, County Hospital, “Ștefan cel Mare” University, 720229 Suceava, Romania
| | - Ioan Sârbu
- 2nd Department of Surgery—Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Correspondence: (I.S.); (V.M.)
| | | | - Valentin Munteanu
- Department of Biomedical Sciences, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Correspondence: (I.S.); (V.M.)
| | - Iuliana-Laura Candussi
- Clinical Surgery Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800008 Galați, Romania
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Correlation between Ion Composition of Oligomineral Water and Calcium Oxalate Crystal Formation. CRYSTALS 2021. [DOI: 10.3390/cryst11121507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The ion content of drinking water might be associated with urinary stone formation, representing a keystone of conservative nephrolithiasis management. However, the effects of specific ions on calcium oxalate crystal formation and their mechanism of action are still highly controversial. We report an investigation of the effects of oligomineral waters with similar total salt amount but different ion composition on calcium oxalate (CaOx) precipitation in vitro, combining gravimetric and microscopic assays. The results suggest that the “collective” physicochemical properties of the aqueous medium, deriving from the ion combination rather than from a single ionic species, are of importance. Particularly, the ability of ions to strengthen/weaken the aqueous medium structure determines an increase/decrease in the interfacial energy, modulating the formation and growth of CaOx crystals.
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Turudic D, Golubic AT, Lovric M, Bilic M, Milosevic D. Age-Specific Excretion of Calcium, Oxalate, Citrate, and Glycosaminoglycans and Their Ratios in Healthy Children and Children with Urolithiasis. Biomolecules 2021; 11:biom11050758. [PMID: 34069381 PMCID: PMC8158688 DOI: 10.3390/biom11050758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/15/2021] [Accepted: 05/16/2021] [Indexed: 11/23/2022] Open
Abstract
We analyzed children with urolithiasis with age- and gender-matched healthy children. Calcium (mmol/mmol creatinine) and the calcium/citrate ratio (mol/mmol) are the only variables that differentiate children before puberty from healthy children (ROC analysis confirmed only calcium/citrate as a significant variable with cut-off value > 0.84). Peri-pubertal children are distinguished from age- and gender-matched healthy children by the following variables: citrate (mmol/mol creatinine), calcium/citrate (mol/mmol), oxalate/glycosaminoglycans (mmol/g), oxalate/citrate ratios (mmol/mmol) and oxalate/(citrate × glycosaminoglycans) (mol oxalate × mol creatinine)/(mol citrate × g glycosaminoglycans). All variables were confirmed by ROC analysis with cut-off values ≤ 327.87, >1.02, >11.24, >0.12 and >0.03, respectively. These results indicate a different risk of urinary stones development before puberty vs. pubertal/postpubertal children and increasing importance (deficiency) of citrate and glycosaminoglycans in such children. J48 classifier confirmed the importance of the oxalate/(citrate × glycosaminoglycans) and the calcium/citrate ratios (Ox/Cit × GAG 0.22 and Cit/GAG 0.612) with the practically applicable classification tree for distinguishing between pubertal/postpubertal children with urolithiasis with age- and gender-matched healthy children.
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Affiliation(s)
- Daniel Turudic
- Department of Pediatrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- Correspondence:
| | - Anja Tea Golubic
- Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Mila Lovric
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Marko Bilic
- Department of Urology, University Hospital “Sveti Duh”, 10000 Zagreb, Croatia;
| | - Danko Milosevic
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- General Hospital Zabok and Croatian Veterans Hospital, 49210 Zabok, Croatia
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Ustundağ Y, Huysal K, Guzelsoy M, Genim CE, Yavuz A. Urine and serum glycosaminoglycan levels in the diagnosis of urological diseases and conditions: A narrative review of the literature. Urologia 2020; 88:103-109. [PMID: 33043817 DOI: 10.1177/0391560320960003] [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] [Indexed: 11/15/2022]
Abstract
Glycosaminoglycans (GAGs) are sulfated, negatively charged polysaccharides produced in almost every cell of the human body. As GAGs are extracellularly localized, the changes in body fluids such as blood and urine may reflect pathological changes in the urinary system as observed in other pathologies. In this review, we determined the potential of urinary and/or serum GAG levels as a marker for kidney and urothelial system diseases. We performed a search in the PubMed, MEDLINE, and ScienceDirect databases until September 30, 2019. A number of studies reported changes in the urinary and/or plasma GAG levels or composition in urological diseases and conditions, such as renal cell carcinoma, kidney stone, bladder carcinoma, and overactive bladder. GAGs were found to have a predictive biomarker potential that could be limited by generalizability concerns.
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Affiliation(s)
- Yasemin Ustundağ
- Department of Clinical Biochemistry, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Kağan Huysal
- Department of Clinical Biochemistry, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Muhammet Guzelsoy
- Department of Urology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Canan Erdem Genim
- Department of Obstetrics and Gynecology,Department of Obstetrics and Gynecology, Acıbadem Maslak Hospital, Istanbul, Turkey
| | - Ayca Yavuz
- Department of Physiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Urinary sulfated glycosaminoglycan insufficiency and chondroitin sulfate supplement in urolithiasis. PLoS One 2019. [PMID: 30845174 DOI: 10.1371/journal.pone.0213180.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Familial members of urolithiasis have high risk for stone development. We observed the low sulfated glycosaminoglycan (GAG) excretion in urolithiasis patients and their descendants. In this study, we investigated urinary excretion of sulfated GAG, chondroitin sulfate (CS), heparan sulfate (HS) and hyaluronic acid (HA) in urolithiasis and their children, and explored the effect of CS and HA supplement in urolithic hyperoxaluric rats. The 24-hour urines were collected from urolithiasis patients (28) and their children (40), as well as healthy controls (45) and their children (33) to measure urinary sulfated GAG, CS, HS and HA excretion rate. Our result showed that urinary sulfated GAG and CS were diminished in both urolithiasis patients and their children, while decreased HS and increased HA were observed only in urolithiasis patients. Percentage of HS per sulfated GAG increased in both urolithiasis patients and their children. In hyperoxaluric rats induced by ethylene glycol and vitamin D, we found that CS supplement could prevent stone formation, while HA supplement had no effect on stone formation. Our study revealed that decreased urinary GAG and CS excretion are common in familial members of urolithiasis patients, and CS supplement might be beneficial in calcium oxalate urolithiasis prophylaxis for hyperoxaluric patients.
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Dissayabutra T, Kalpongnukul N, Chindaphan K, Srisa-art M, Ungjaroenwathana W, Kaewwongse M, Iampenkhae K, Tosukhowong P. Urinary sulfated glycosaminoglycan insufficiency and chondroitin sulfate supplement in urolithiasis. PLoS One 2019; 14:e0213180. [PMID: 30845174 PMCID: PMC6405089 DOI: 10.1371/journal.pone.0213180] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/16/2019] [Indexed: 11/18/2022] Open
Abstract
Familial members of urolithiasis have high risk for stone development. We observed the low sulfated glycosaminoglycan (GAG) excretion in urolithiasis patients and their descendants. In this study, we investigated urinary excretion of sulfated GAG, chondroitin sulfate (CS), heparan sulfate (HS) and hyaluronic acid (HA) in urolithiasis and their children, and explored the effect of CS and HA supplement in urolithic hyperoxaluric rats. The 24-hour urines were collected from urolithiasis patients (28) and their children (40), as well as healthy controls (45) and their children (33) to measure urinary sulfated GAG, CS, HS and HA excretion rate. Our result showed that urinary sulfated GAG and CS were diminished in both urolithiasis patients and their children, while decreased HS and increased HA were observed only in urolithiasis patients. Percentage of HS per sulfated GAG increased in both urolithiasis patients and their children. In hyperoxaluric rats induced by ethylene glycol and vitamin D, we found that CS supplement could prevent stone formation, while HA supplement had no effect on stone formation. Our study revealed that decreased urinary GAG and CS excretion are common in familial members of urolithiasis patients, and CS supplement might be beneficial in calcium oxalate urolithiasis prophylaxis for hyperoxaluric patients.
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Affiliation(s)
- Thasinas Dissayabutra
- STAR Unit of Renal Biochemistry and Stone Disease, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- * E-mail:
| | - Nuttiya Kalpongnukul
- STAR Unit of Renal Biochemistry and Stone Disease, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kanokporn Chindaphan
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Monpicha Srisa-art
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | | | - Maroot Kaewwongse
- Division of Physiology, School of Medical Science, University of Phayao, Phayao, Thailand
| | - Kroonpong Iampenkhae
- Renal Immunology and Transplant Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Piyaratana Tosukhowong
- STAR Unit of Renal Biochemistry and Stone Disease, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Genotype-phenotype Correlation of β-Thalassemia in Croatian Patients: A Specific HBB Gene Mutations. J Pediatr Hematol Oncol 2018; 40:e77-e82. [PMID: 29240028 DOI: 10.1097/mph.0000000000001039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An analysis of genotype-phenotype correlation was performed for 14 patients with beta-thalassemia who had been registered in Referral Centre for hematology and oncology of the University Hospital Centre, Zagreb, Croatia. HBB gene mutations were determined using a gene-specific Q5 High-Fidelity PCR analysis with direct DNA sequencing of amplified transcripts. Mahidol score index used for classification of thalassemia severity was found to be low for all the patients enrolled in the study, indicating a mild β-thalassemia phenotype with no signs of disease progression. Most of the patients have already described gene mutations: IVS-II-666 C>T (HBB:c.316-185C>T) and IVS-II-16 G>C (HBB:c.315+16G>C). Each of the aforementioned mutations was found in (11/14; 78,57%) and (10/14; 71,43%) of our patients, respectively. Recently published HBB:c.9T>C mutation was found in 8 of 14 (57,14%) in our study group. IVSII-74 T>G (HBB:c.315+74T>G) is a worldwide mutation found in 6 of 14 (42.86%) of our patients. All these mutations occur among Croatian children with no obvious Indian/Near Eastern/Iranian ancestry. We also identified 7 de novo mutations (c.316-135het_dupT, c.316-133A>G, c.93-54G>A, c.316-68_316-67het_insCGG, c.316-342delA, c.316-312delT, c.316-209delT) of mild severity phenotype according to Mahidol classification score index. We did not find children or adults with thalassemia major severity phenotype.
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