Expression of Osteopontin in Rat Kidneys: Induction During Ethylene Glycol Induced Calcium Oxalate Nephrolithiasis:

Naturally produced crystals obtained from kidney stones are less injurious to renal tubular epithelial cells than synthetic crystals

OBJECTIVE

To determine the differences in cell responses to synthetic and biological crystals of calcium oxalate (CaOx) and brushite

MATERIALS AND METHODS

Nephrolithiasis depends on crystal retention within the kidneys, often promoted by crystal attachment to the injured renal epithelium; studies often use various crystals that might be injurious to cells and cause the exposure of crystal binding molecules on cell surfaces, thus promoting crystal attachment and retention. The synthetic crystals used in these studies might be more injurious than the biological crystals naturally produced in the kidneys and that form kidney stones. We exposed the renal epithelial cell line NRK 52E in vitro to CaOx or brushite crystals at 67 or 133 microg/cm(2) for 3 or 6 h. Synthetic crystals were purchased and the biocrystals were obtained by pulverizing CaOx and brushite stones. We determined the release of lactate dehydrogenase (LDH), hydrogen peroxide (H(2)O(2)) and 8-isoprostane (8-IP), and monocyte chemoattractant protein-1 (MCP-1), as markers of injury, oxidative stress and inflammation, respectively. Cells were also examined after trypan blue staining to determine their membrane integrity. We also examined crystals of CaOx by scanning electron microscopy both in the native state as well as after decalcification.

RESULTS

Exposure to both the synthetic and biological crystals resulted in a significant increase in LDH release and trypan blue staining, as a sign of crystal-induced injury. There was increased production of H(2)O(2) and 8-IP, suggesting the development of oxidative stress. In addition MCP-1 production was also significantly increased. However, the synthetic crystals caused significantly higher increases in all the indicators than the biological crystals.

CONCLUSIONS

These results indicate that even though both synthetic and naturally produced biocrystals invoke a response from the renal epithelial cells, the latter are significantly less injurious and inflammatory. Exposure to low concentrations of these crystals alone might not invoke an inflammatory response, cause the uncovering of crystal binding molecules on epithelial cell surfaces, and promote crystal attachment and retention.

Oxalate ions and calcium oxalate crystal-induced up-regulation of osteopontin and monocyte chemoattractant protein-1 in renal fibroblasts

OBJECTIVE

To examine the responses of renal fibroblasts to high oxalate (Ox) and calcium Ox (CaOx) crystals, as the latter are found in the renal interstitium of patients with primary or enteric hyperoxaluria, and in animals with experimental CaOx nephrolithiasis, and are associated with tubulointerstitial inflammation (TI). TI might begin with the production of chemoattractants by the renal epithelial cells exposed to high Ox and/or CaOx crystals; as Ox levels are also high in the renal interstitium and crystal deposition in nephrolithiasis might start in the interstitium, we hypothesized that renal fibroblasts might also be involved in the development of TI.

MATERIALS AND METHODS

We exposed renal fibroblast cells of line NRK 49F in vitro to Ox ions (500 micromol/L) or CaOx monohydrate crystals (67 microg/cm(2)). We assessed the production of osteopontin and monocyte chemoattractant protein-1 (MCP-1), and expression of their mRNA, in the cells. We also determined the cellular malondialdehyde content as a marker of reactive oxygen species (ROS)-induced lipid peroxidation, and Trypan blue staining and the release of lactate dehydrogenase as markers of injury.

RESULTS

Similar to renal epithelial cells, renal fibroblasts were stimulated by exposure to Ox and CaOx crystals. They showed signs of injury and ROS-induced lipid peroxidation. The mRNA expression and production of osteopontin and MCP-1 increased significantly.

CONCLUSIONS

These results indicate that fibroblasts respond to high Ox and CaOx crystals by up-regulating specific pathways producing pro-inflammatory conditions. Migration of monocytes/macrophages to sites of interstitial crystal deposits can lead to localized interstitial inflammation and fibrosis.

Plasma osteopontin levels are predictive of disease stage in patients with transitional cell carcinoma of the bladder

OBJECTIVE

To measure plasma levels of osteopontin in patients with transitional cell carcinoma (TCC) of the bladder, and to determine if osteopontin levels relate to disease stage.

PATIENTS AND METHODS

Blood samples were collected from 72 consecutive patients with TCC. Clinical data were obtained from medical record reviews. Patients were divided into subgroups based on disease status (active vs inactive) and clinical and pathological stage of TCC (tumour, nodes and metastases staging system). Osteopontin levels were measured using an enzyme-linked immunosorbent assay.

RESULTS

Plasma osteopontin levels were higher in patients with active TCC than in controls (P = 0.035). Plasma osteopontin levels were not significantly different between patients with active and inactive TCC, but were higher in patients with metastases than in patients with active, clinically organ-confined TCC (P = 0.021).

CONCLUSIONS

Plasma osteopontin levels increase with tumour stage in TCC of the bladder. These findings suggest that larger, more extended studies on plasma osteopontin levels in patients with TCC are warranted.

Study of a rat model for calcium oxalate crystal formation without severe renal damage in selected conditions

BACKGROUND

Although nephrotoxic in high doses, ethylene glycol (EG) has been used with ammonium chloride (NH(4)Cl) or vitamin D(3) to study calcium oxalate stone formation in rat models. In the present study we used EG alone or with NH(4)Cl to study hyperoxaluria, crystaluria, and crystal attachment to renal epithelial cells in rats with minimal renal damage.

METHODS

Six-week-old male Sprague-Dawley (SD) rats were given food and special drinking water. In experiment 1 the drinking water contained 1.0% NH(4)Cl plus four different concentrations of EG (0.8%, 0.4%, 0.2%, 0.1%). In experiment 2 the drinking water contained EG alone (0.8%, 0.4%, 0.2%, 0.1%). Urine was collected for 24 h before the rats were sacrificed. In experiment 1 the rats were sacrificed 5-13 days after starting the special water. In experiment 2 the rats were sacrificed 7-21 days after starting the special water. Bladder urine was also obtained. Blood and urine were tested for calcium, phosphorus, and creatinine. In addition, urine was tested for pH, oxalate and N-acetyl-beta-D glucosaminidase (NAG). Kidney sections were stained with hematoxylin-eosin, von Kossa and Pizzolato stain. Crystal morphology was determined using polarizing microscopy, and composition was determined using high-resolution X-ray powder diffraction.

RESULTS

Experiment 1: Aggravation of renal function, an increase in urinary oxalate and NAG excretion, and crystals observed in the kidneys all correlated with EG concentration and length of drinking time. In bladder urine, calcium oxalate monohydrate (COM) crystals exceeded calcium oxalate dihydrate (COD) crystals. Experiment 2: Renal function remained unchanged. Oxalate excretion increased and NAG increased slightly. Crystals occurred only in the papillary tip region. Crystals in bladder urine were mostly COD.

CONCLUSION

In the current rat model, calcium oxalate crystaluria could be induced without severe renal damage in selected cases. Either and/or both COM and COD might form and interact with kidney epithelium. We propose different experimental conditions to study the various phases of calcium oxalate stone formation in young male SD rats.