Epitaxial relationships between uric acid crystals and mineral surfaces: a factor in urinary stone formation

Kidney stone growth through the lens of Raman mapping

Bulk composition of kidney stones, often analyzed with infrared spectroscopy, plays an essential role in determining the course of treatment for kidney stone disease. Though bulk analysis of kidney stones can hint at the general causes of stone formation, it is necessary to understand kidney stone microstructure to further advance potential treatments that rely on in vivo dissolution of stones rather than surgery. The utility of Raman microscopy is demonstrated for the purpose of studying kidney stone microstructure with chemical maps at ≤ 1 µm scales collected for calcium oxalate, calcium phosphate, uric acid, and struvite stones. Observed microstructures are discussed with respect to kidney stone growth and dissolution with emphasis placed on < 5 µm features that would be difficult to identify using alternative techniques including micro computed tomography. These features include thin concentric rings of calcium oxalate monohydrate within uric acid stones and increased frequency of calcium oxalate crystals within regions of elongated crystal growth in a brushite stone. We relate these observations to potential concerns of clinical significance including dissolution of uric acid by raising urine pH and the higher rates of brushite stone recurrence compared to other non-infectious kidney stones.

Comparison of the different monosodium urate crystals in the preparation process and pro-inflammation

OBJECTIVES

The deposition of monosodium urate (MSU) crystals within synovial joints and tissues is the initiating factor for gout arthritis. Thus, MSU crystals are a vital tool for studying gout's molecular mechanism in animal and cellular models. This study mainly compared the excellence and worseness of MSU crystals prepared by different processes and the degree of inflammation induced by MSU crystals.

METHODS

MSU crystals were prepared using neutralization, alkali titration, and acid titration methods. The crystals' shape, length, quality, and uniformity were observed by polarized light microscopy and calculated by the software Image J. The foot pad and air pouch models were used to assess the different degrees of inflammation induced by the MSU crystals prepared by the three different methods at different time points. Paw swelling was evaluated by caliper. In air pouch lavage fluid, inflammatory cell recruitment was measured by hemocytometer, and the level of IL-1β, TNF-α, and IL-18 by ELISA. Inflammatory cell infiltration was assayed by immunohistochemistry of air pouch synovial slices.

RESULTS

For the preparation of MSU crystals with the same uric acid, the quantity acquired by the alkalization method was highest, followed by neutralization, with the acid titration method being the lowest. The crystals prepared by neutralization were the longest. The swelling index of the foot pad induced by MSU crystals prepared by acid titration was significantly lower than that of the other methods at 24 h. The inflammatory cell recruitment and level of IL-1β, TNF-α, and IL-18 in air pouch lavage fluid were lowest in animals with crystals prepared by acid titration. IL-1β secretion induced by MSU crystals prepared by acid titration was significantly lower than that of the other two groups, but there was no significant difference in IL-18 secretion between the three groups in THP-1 macrophages and BMDMs.

CONCLUSIONS

All three methods can successfully prepare MSU crystals, but the levels of inflammation induced by the crystals prepared by the three methods were not identical. The degree of inflammation induced by MSU crystals prepared by neutralization and alkalization is greater than by acid titration, but the quantity of MSU crystals obtained by the alkalization method is higher and less time-consuming. Apparently, the window of inflammation triggered by acid titration preparation is shorter compared to other forms of crystal preparation. Overall, MSU crystals prepared by the alkaline method should be recommended for studying the molecular mechanisms of gout in animal and cellular models.

Size, Shape, and Phase of Nanoscale Uric Acid Particles

Uric acid particles are formed due to hyperuricemia, and previous works have focused on understanding the surface forces, crystallization, and growth of micron- and supermicron-sized particles. However, little to no work has furthered our understanding about uric acid nanonuclei that precipitate during the initial stages of kidney stone formation. In this work, we generate nanosized uric acid particles by evaporating saturated solution droplets of uric acid. Furthermore, we quantify the effects of drying rate on the morphology of uric acid nanonuclei. An aerosol droplet drying method generates uric acid nanoparticles in the size range of 20-200 nm from aqueous droplets (1-6 μm). Results show that uric acid nanonuclei are non-spherical with a shape factor value in the range of 1.1-1.4. The shape factor values change with drying rate and indicate that the nanoparticle morphology is greatly affected by drying kinetics. The nanonuclei are amorphous but can grow to form crystalline micron-sized particles. Indeed, a pre-crystallization phase was observed for heterogeneous nucleation of uric acid particles in the size range of a few hundred nanometers. Our findings show that the morphology of uric acid nanonuclei is significantly different from that of crystalline supermicron-sized particles. These new findings imply that the dissolution characteristics, surface properties, elimination, and medical treatment of uric acid nanonuclei formed during the initial stages of nucleation must be reconsidered.

Appraising the potency of small molecule inhibitors and their graphene surface-mediated organizational attributes on uric acid-melamine clusters

Uric acid (UA) and melamine (MM) crystallization in humans is associated with adverse medical conditions, including the germination of kidney stones, because of their low solubility. The growth of kidney stones, usually formed on renal papillary facades, is accomplished on the matrix-coated surface by the aggregation of preformed crystals or secondary crystal nucleation. Therefore, the effects of inhibitors such as theobromine (TB) and allopurinol (AP) on MM-UA aggregation are investigated by employing classical molecular dynamics simulations on a graphene surface. This impersonates the exact essence of the precipitation of kidney stones. The interaction between MM-UA is very intense and, thus, large clusters are formed on the surface. The presence of TB and AP will, however, substantially inhibit their aggregation. TB and AP significantly impede UA aggregation in particular. Therefore, lower order UA clusters are formed. These smaller UA clusters then pull a lower number of MM towards themselves, resulting in a smaller order UA-MM cluster. MM and UA aggregation on a 2D graphene surface is found to be spontaneous. There is no difference in these molecules' adsorption with a change in the force field parameters (i.e., GAFF and OPLS-AA) for graphene. Moreover, the greater the surface area of graphene, the more molecules are absorbed. The solute-surface van der Waals interaction energy plays a driving force in the adsorption of solute molecules on the surface. In addition, interactions like hydrogen bonding and π-stacking over the graphene surface involve binding all like molecules. These aggregated solute molecules strongly attract more like molecules until all solute molecules are adsorbed on the graphene surface, as estimated by enhanced sampling. The molecular origin of graphene exfoliation by MM is also described here. The present work helps to design novel kidney stone inhibitors.

What roles do alkali metal ions play in the pathological crystallization of uric acid?

Na+ and K+ regulate the crystal growth of uric acid dihydrate by kink blocking and rough growth mechanisms.

Electron probe micro-analysis reveals the complexity of mineral deposition mechanisms in urinary stones

Urinary stones are complex mineralogical formations in the urinary system often impairing the kidney function. Several studies have attempted to understand the mechanisms of stone formation and growth; however, it remains to be fully explored. Here, we present a detailed investigation on the morphological and mineralogical characterizations of urinary stones. Structural properties of different types of urinary stones were done by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and field-emission scanning electron microscope (FE-SEM) analyses. X-ray maps of major and the trace elements were obtained using electron microprobe (EPMA) technique. Basic metabolic panel and urinary parameters of the patients were used for comparing mineral compositions among stone types. The study included five major types of stones identified based on the FTIR spectra. FTIR and XRD helped in identifying the major components of these stones. FE-SEM images revealed distinct microstructure and morphology of the stones among the stone types. EPMA analysis showed the presence of many metals other than calcium and certain non-metals within the urinary stone matrix at measurable levels, sometimes with distinct distribution patterns. The study demonstrates the characteristic micro-structure, morphology, distribution, and composition of elements in different stone types. Findings of the study provide scope for understanding the complex mechanisms involved in the urolithogenesis and association of trace elements in it.

The crystallization of monosodium urate

Gout is a common crystal-induced arthritis, in which monosodium urate (MSU) crystals precipitate within joints and soft tissues and elicit an inflammatory response. The causes of elevated serum urate and the inflammatory pathways activated by MSU crystals have been well studied, but less is known about the processes leading to crystal formation and growth. Uric acid, the final product of purine metabolism, is a weak acid that circulates as the deprotonated urate anion under physiologic conditions, and combines with sodium ions to form MSU. MSU crystals are known to have a triclinic structure, in which stacked sheets of purine rings form the needle-shaped crystals that are observed microscopically. Exposed, charged crystal surfaces are thought to allow for interaction with phospholipid membranes and serum factors, playing a role in the crystal-mediated inflammatory response. While hyperuricemia is a clear risk factor for gout, local factors have been hypothesized to play a role in crystal formation, such as temperature, pH, mechanical stress, cartilage components, and other synovial and serum factors. Interestingly, several studies suggest that MSU crystals may drive the generation of crystal-specific antibodies that facilitate future MSU crystallization. Here, we review MSU crystal biology, including a discussion of crystal structure, effector function, and factors thought to play a role in crystal formation. We also briefly compare MSU biology to that of uric acid stones causing nephrolithasis, and consider the potential treatment implications of MSU crystal biology.

An in Situ Atomic Force Microscopy Study of Uric Acid Crystal Growth

Kidney stones are heterogeneous polycrystalline aggregates that can consist of several different building blocks. A significant number of human stones contain uric acid crystals as a crystalline component, though the molecular-level growth of this important biomaterial has not been previously well-characterized. In the present study, in situ atomic force microscopy (AFM) is used to investigate the real-time growth on the (100) surface of uric acid (UA) single crystals as a function of fundamental solution parameters. Layer-by-layer growth on UA (100) was found to be initiated at screw dislocation sites and to proceed via highly anisotropic rates which depend on the crystallographic direction. The smallest b-steps exhibited minimum heights corresponding to two molecular layers, while fast-moving c-steps more commonly showed monolayer heights. Growth kinetics measured under a range of flow rates, supersaturation levels, and pH values reveal linear trends in the growth kinetics, with faster growth attained in solutions with higher supersaturation and/or pH. The calculated kinetic parameters for UA growth derived from these experiments are in good agreement with the values reported for other crystal systems.