Vitamin C inhibits crystallization of struvite from artificial urine in the presence of Pseudomonas aeruginosa

The Multidisciplinary Approach in the Management of Patients with Kidney Stone Disease-A State-of-the-Art Review

Kidney stone disease has a multifactorial etiology, and evolving dietary habits necessitate continuous updates on the impact of dietary components on lithogenesis. The relationship between diseases influenced by lifestyle, such as obesity and diabetes, and kidney stone risk underscores the need for comprehensive lifestyle analysis. Effective management of kidney stones requires a multidisciplinary approach, involving collaboration among nutritionists, urologists, nephrologists, and other healthcare professionals to address the complex interactions between diet, lifestyle, and individual susceptibility. Personalized dietary therapy, based on each patient's unique biochemical and dietary profile, is essential and necessitates comprehensive nutritional assessments. Accurate dietary intake evaluation is best achieved through seven-day, real-time dietary records. Key factors influencing urinary risk include fluid intake, dietary protein, carbohydrates, oxalate, calcium, and sodium chloride. Personalized interventions, such as customized dietary changes based on gut microbiota, may improve stone prevention and recurrence. Current research suggests individualized guidance on alcohol intake and indicates that tea and coffee consumption might protect against urolithiasis. There is potential evidence linking tobacco use and secondhand smoke to increased kidney stone risk. The effects of vitamins and physical activity on kidney stone risk remain unresolved due to mixed evidence. For diseases influenced by lifestyle, conclusive evidence on targeted interventions for nephrolithiasis prevention is lacking, though preliminary research suggests potential benefits. Management strategies emphasize lifestyle modifications to reduce recurrence risks, support rapid recovery, and identify predisposing conditions, highlighting the importance of these changes despite inconclusive data.

The key role of major and trace elements in the formation of five common urinary stones

BACKGROUND

Urolithiasis has emerged as a global affliction, recognized as one of the most excruciating medical issues. The elemental composition of stones provides crucial information, aiding in understanding the causes, mechanisms, and individual variations in stone formation. By understanding the interactions between elements in various types of stones and exploring the key role of elements in stone formation, insights are provided for the prevention and treatment of urinary stone disease.

METHODS

This study collected urinary stone samples from 80 patients in Beijing. The chemical compositions of urinary stones were identified using an infrared spectrometer. The concentrations of major and trace elements in the urinary stones were determined using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS), respectively. The data were processed using correlation analysis and Principal Component Analysis (PCA) methods.

RESULTS

Urinary stones are categorized into five types: the calcium oxalate (CO) stone, carbonate apatite (CA) stone, uric acid (UA) stone, mixed CO and CA stone, and mixed CO and UA stone. Ca is the predominant element, with an average content ranging from 2.64 to 27.68% across the five stone groups. Based on geochemical analysis, the high-content elements follow this order: Ca > Mg > Na > K > Zn > Sr. Correlation analysis and PCA suggested significant variations in the interactions between elements for different types of urinary stones. Trace elements with charges and ionic structures similar to Ca may substitute for Ca during the process of stone formation, such as Sr and Pb affecting the Ca in most stone types except mixed stone types. Moreover, the Mg, Zn and Ba can substitute for Ca in the mixed stone types, showing element behavior dependents on the stone types.

CONCLUSION

This study primarily reveals distinct elemental features associated with five types of urinary stones. Additionally, the analysis of these elements indicates that substitutions of trace elements with charges and ion structures similar to Ca (such as Sr and Pb) impact most stone types. This suggests a dependence of stone composition on elemental behavior. The findings of this study will enhance our ability to address the challenges posed by urinary stones to global health and improve the precision of interventions for individuals with different stone compositions.

Chemical characterization, anti-struvite crystal, anti-inflammatory, analgesic, and antidepressant activities of Papaver rhoeas L. root and leaf extracts

ETHNOPHARMACOLOGICAL RELEVANCE

Papaver rhoeas L. (P. rhoeas) is used to treat a wide range of pathologies. But there is no data on the anti-struvite, anti-inflammatory, analgesic, and anti-depressant effects of root and leaf extracts from this medicinal plant.

AIM OF THE STUDY

This study aimed to chemically characterize and determine the antidepressant, analgesic, anti-inflammatory, and anti-struvite activities of the root extract (RE) and leaf extract (LE) of P. rhoeas, a wild plant.

MATERIALS AND METHODS

The extraction of secondary metabolites and phytochemical screening were carried out using standard methods. The anti-struvite effect of our samples was assessed by Fourier transform infrared spectroscopy (FT-IR) and microscopic observation. For the anti-inflammatory impact, we used the carrageenan-induced paw edema technique in rats. To assess the analgesic effect of the extracts, we recorded the resulting abdominal contraction after intraperitoneal (IP) acetic acid injection. Finally, we assessed the antidepressant effect by conducting the Forced Swimming Test (FST).

RESULTS

Phytochemical screening results revealed the presence of phenols, flavonoids, saponins, tannins, coumarins, terpenoids, and alkaloids. Extraction results confirmed that our extracts were rich in secondary metabolites. Both P. rhoeas extracts limited struvite crystal development by reducing the size and number of crystals, as indicated by FT-IR analysis and microscopic observation. Additionally, the anti-struvite effects of the LE sample were greater than those of the RE sample. The results of the anti-inflammatory capacity of our extracts demonstrate the maximum inhibition of carrageenan-induced edema following 6 h (T6) of injection, ranging from 72.73 ± 7.7% for LE (400 mg/kg) to 95.45 ± 6.42% for the RE sample (400 mg/kg). On the other hand, the results for analgesic activity showed that the number of abdominal contractions in rats treated with RE and LE ranged from 11 ± 1.73 for RE (400 mg/kg) to 18 ± 1.50 for LE (200 mg/kg), while that of aspirin was 10.33 ± 0.57. Furthermore, the FST results show that the immobility time in rats treated with RE and LE varied from 91.98 ± 4.24 s for LE-treated rats (300 mg/kg) to 123.54 ± 7.83 s for RE-treated rats (150 mg/kg).

CONCLUSION

Based on these results, the roots and leaves of the studied plant can be considered a significant source of biologically active molecules for use in the pharmaceutical industry.

Small organic molecules containing amorphous calcium phosphate: synthesis, characterization and transformation

As the primary solid phase, amorphous calcium phosphate (ACP) is a pivotal precursor in cellular biomineralization. The intrinsic interplay between ACP and Howard factor underscores the significance of understanding their association for advancing biomimetic ACP development. While organic compounds play established roles in biomineralization, this study presents the synthesis of ACP with naturally occurring organic compounds (ascorbate, glutamate, and itaconate) ubiquitously found in mitochondria and vital for bone remodeling and healing. The developed ACP with organic compounds was meticulously characterized using XRD, FTIR, and solid-state 13C and 31P NMR. The morphological analysis revealed the characteristic spherical morphology with particle size close to 20 nm of all synthesized ACP variants. Notably, the type of organic compound strongly influences true density, specific surface area, particle size, and transformation. The in vitro analysis was performed with MC3T3-E1 cells, indicating the highest cell viability with ACP_ASC (ascorbate), followed by ACP_ITA (itaconate). The lowest cell viability was observed with 10 %w/v of ACP_GLU (glutamate); however, 1 %w/v of ACP_GLU was cytocompatible. Further, the effect of small organic molecules on the transformation of ACP to low crystalline apatite (Ap) was examined in Milli-Q® water, PBS, and α-MEM.

Papaver rhoeas L. stem and flower extracts: Anti-struvite, anti-inflammatory, analgesic, and antidepressant activities

The Papaver rhoeas L. (P. rhoeas) plant, which belongs to the Papaveraceae family, is also used as food and is exploited to treat several health problems. The purpose of this research is to determine the anti-struvite, anti-inflammatory, analgesic, and antidepressant effects of the stem extract (SE) and flower extract (FE) of the plant P. rhoeas. We used polarizing microscopy and Fourier transform infrared spectrometry (FT-IR) to evaluate the anti-struvite effect of our plant. The edema approach induced by the carrageenan molecule was used to study the anti-inflammatory impact of our extracts. The analgesic test was determined by calculating the number of abdominal contractions induced by the intraperitoneal (IP) administration of acetic acid. To evaluate the antidepressant effect of our extracts, we used the forced swimming test (FST). According to the results of the secondary metabolite extraction, both extracts contained high contents of secondary metabolites, while the results of the screening test showed that flavonoids, alkaloids, phenols, tannins, coumarins, saponins, and terpenoids were present. The result of struvite crystallization inhibition observed by polarizing microscopy and FT-IR shows the inhibition of struvite crystal aggregation by SE by decreasing the amount and size of crystals in a manner similar to cystone. The results of anti-inflammatory activity show maximum inhibition of edema after six hours of carrageenan injection in rats (T₆) for all extracts, with a maximum value of 86.36% for SE at the dose of 200 mg/kg. Regarding the analgesic effect of our plant, the lowest number of abdominal contractions was observed in rats treated with SE at a dose of 400 mg/kg. The FST results show that the lowest immobilization time was observed in rats treated with FE at a dose of 400 mg/kg. The results obtained show that the flowers and stems of P. rhoeas can constitute a rich source of bioactive molecules with potential pharmaceutical applications.

Kidney Stone Prevention

Kidney stone disease (KSD) (alternatively nephrolithiasis or urolithiasis) is a global health care problem that affects almost people in developed and developing countries. Its prevalence has been continuously increasing with a high recurrence rate after stone removal. Although effective therapeutic modalities are available, preventive strategies for both new and recurrent stones are required to reduce physical and financial burdens of KSD. To prevent kidney stone formation, its etiology and risk factors should be first considered. Low urine output and dehydration are the common risks of all stone types, whereas hypercalciuria, hyperoxaluria, and hypocitraturia are the major risks of calcium stones. In this article, up-to-date knowledge on strategies (nutrition-based mainly) to prevent KSD is provided. Important roles of fluid intake (2.5-3.0 L/d), diuresis (>2.0-2.5 L/d), lifestyle and habit modifications (for example, maintain normal body mass index, fluid compensation for working in high-temperature environment, and avoid cigarette smoking), and dietary management [for example, sufficient calcium at 1000-1200 mg/d, limit sodium at 2 or 3-5 g/d of sodium chloride (NaCl), limit oxalate-rich foods, avoid vitamin C and vitamin D supplements, limit animal proteins to 0.8-1.0 g/kg body weight/d but increase plant proteins in patients with calcium and uric acid stone and those with hyperuricosuria, increase proportion of citrus fruits, and consider lime powder supplementation] are summarized. Moreover, uses of natural bioactive products (for example, caffeine, epigallocatechin gallate, and diosmin), medications (for example, thiazides, alkaline citrate, other alkalinizing agents, and allopurinol), bacterial eradication, and probiotics are also discussed. Adv Nutr 2023;x:xx-xx.

Malonate utilization by Pseudomonas aeruginosa affects quorum-sensing and virulence and leads to formation of mineralized biofilm-like structures

Pseudomonas aeruginosa is an opportunistic pathogen that uses malonate among its many carbon sources. We recently reported that, when grown in blood from trauma patients, P. aeruginosa expression of malonate utilization genes was upregulated. In this study, we explored the role of malonate utilization and its contribution to P. aeruginosa virulence. We grew P. aeruginosa strain PA14 in M9 minimal medium containing malonate (MM9) or glycerol (GM9) as a sole carbon source and assessed the effect of the growth on quorum sensing, virulence factors, and antibiotic resistance. Growth of PA14 in MM9, compared to GM9, reduced the production of elastases, rhamnolipids, and pyoverdine; enhanced the production of pyocyanin and catalase; and increased its sensitivity to norfloxacin. Growth in MM9 decreased extracellular levels of N-acylhomoserine lactone autoinducers, an effect likely associated with increased pH of the culture medium; but had little effect on extracellular levels of PQS. At 18 hr of growth in MM9, PA14 formed biofilm-like structures or aggregates that were associated with biomineralization, which was related to increased pH of the culture medium. These results suggest that malonate significantly impacts P. aeruginosa pathogenesis by influencing the quorum sensing systems, the production of virulence factors, biofilm formation, and antibiotic resistance.

Lscβ and lscγ, two novel levansucrases of Pseudomonas syringae pv. actinidiae biovar 3, the causal agent of bacterial canker of kiwifruit, show different enzymatic properties

Bacterial canker disease caused by Pseudomonas syringae pv. actinidiae (Psa) biovar 3 involved all global interest since 2008. We have found that in Psa3 genome, similarly to other P. syringae, there are three putative genes, lscα, lscβ and lscγ, coding for levansucrases. These enzymes, breaking the sucrose moiety and releasing glucose can synthetize the fructose polymer levan, a hexopolysaccharide that is well known to be part of the survival strategies of many different bacteria. Considering lscα non-coding because of a premature stop codon, in the present work we cloned and expressed the two putatively functional levansucrases of Psa3, lscβ and lscγ, in E. coli and characterized their biochemical properties such as optimum of pH, temperature and ionic strength. Interestingly, we found completely different behaviour for both sucrose splitting activity and levan synthesis between the two proteins; lscγ polymerizes levan quickly at pH 5.0 while lscβ has great sucrose hydrolysis activity at pH 7.0. Moreover, we demonstrated that at least in vitro conditions, they are differentially expressed suggesting two distinct roles in the physiology of the bacterium.

Deep insights into urinary tract infections and effective natural remedies

Background

Urinary tract infection (UTI) is a common occurrence in females, during pregnancy, and in peri- and postmenopausal women. UTIs are associated with significant morbidity and mortality, and they affect the quality of life of the affected patients. Antibiotic therapy is an effective approach and reduces the duration of symptoms. Development of resistance, adverse effects of antibiotics, and other associated problems lead to establishing the research framework to find out the alternative approaches in controlling UTIs. Natural approaches have been extensively used for the management of various diseases to improve symptoms and also improve general health.

Main body

Different databases were employed to identify studies reporting on natural options including herbal medicines, vitamins, trace elementals, sugars, and probiotics without time limitations.

Conclusion

Herbal medicines can be effective at the first sign of the infection and also for short-term prophylaxis. Using vitamins, trace elementals, and/or sugars is an effective approach in preventing UTIs, and a combination of them with other antibacterial agents shows positive results. Probiotics have great potential for the threat of antibiotic over-usage and the prevalence of antibiotic-resistant microorganisms. This study may be of use in developing the efficient formulation of treatment of UTI.

Microstructural diversity of gallstones revealed by spectral microanalyses and their association with hepatic parameters

BACKGROUND

Gallstones (GS) are formed as a result of impaired metabolic regulation and can be reflected in serum parameters. This study was focused on classifying GS based on spectral microanalysis and identifying the possible role of serum hepatic parameters on GS of different compositions.

METHODS

The study included a total of 126 GS from 80 consecutive patients who underwent cholecystectomy for GS diseases in a single center. The composition and microstructure of GS were analyzed using Fourier-transform infrared (FTIR) spectroscopy, field emission scanning electron microscopy (FESEM), and energy dispersive X-ray spectroscopy (EDS). The serum hepatic parameters were studied in order to establish a possible etiologic relationship with GS composition.

RESULTS

In the study group, the incidence of GS was higher in females 62 (77.5%) compared with males 18 (22.5%). The mean age was 42.81 ± 13.01 and 43.78 ± 14.4 years for female and male patients, respectively. Based on composition, the GS were assigned to four major groups: cholesterol, pigment, phosphate, and mixed stones. Mixed composition stones totally represented the majority 53 (66.3%), followed by pure cholesterol 23 (28.8%), pigment stones 2 (2.5%), and phosphate stones 2 (2.5%), respectively. Elemental composition revealed the presence of carbon (C), oxygen (O), calcium (Ca), and phosphorus (P) to be major elements along with traces of sodium (Na), magnesium (Mg), aluminum (Al), iron (Fe), copper (Cu), bromine (Br), manganese (Mn), and zinc (Zn). Among serum parameters, total bilirubin, direct bilirubin, indirect bilirubin, serum glutamic-oxaloacetic transaminase, and total protein were higher in patients with pigment GS than cholesterol GS.

CONCLUSIONS

Characterization of GS indicates that different types of stones have different characteristics in terms of microstructure, elemental composition, and distribution. Serum hepatic function test profiles showed an association with the compositions of GS.

Morphological characteristics and microstructure of kidney stones using synchrotron radiation μCT reveal the mechanism of crystal growth and aggregation in mixed stones

Understanding the mechanisms of kidney stone formation, development patterns and associated pathological features are gaining importance due to an increase in the prevalence of the disease and diversity in the presentation of the stone composition. Based on the microstructural characteristics of kidney stones, it may be possible to explain the differences in the pathogenesis of pure and mixed types of stones. In this study, the microstructure and distribution of mineral components of kidney stones of different mineralogy (pure and mixed types) were analyzed. The intact stones removed from patients were investigated using synchrotron radiation X-ray computed microtomography (SR-μCT) and the tomography slice images were reconstructed representing the density and structure distribution at various elevation planes. Infrared (IR) spectroscopes, X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used to confirm the bulk mineral composition in the thin section stones. Observations revealed differences in the micro-morphology of the kidney stones with similar composition in the internal 3-D structure. Calcium oxalate monohydrate stones showed well-organised layering patterns, while uric acid stones showed lower absorption signals with homogenous inner structure. Distinct mineral phases in the mixed types were identified based on the differential absorption rates. The 3-D quantitative analysis of internal porosity and spatial variation between nine different types of stones were compared. The diversity among the microstructure of similar and different types of stones shows that the stone formation is complex and may be governed by both physiological and micro-environmental factors. These factors may predispose a few towards crystal aggregation and stone growth, while, in others the crystals may not establish stable attachment and/or growth.

Morphological and micro-tomographic study on evolution of struvite in synthetic urine infected with bacteria and investigation of its pathological biomineralization

Pathological biomineralization in the urinary system leads to urolithiasis. Formation of kidney stones involves a series of events during which they undergo morphological and mineralogical changes. We investigated the mineralization of biogenic struvite (in vitro) and examined the transformation of distinct interior and exterior structure of struvite. In vitro crystallization of struvite was performed in the presence of two bacteria that were originally isolated from the kidney stone patients. Morphological evaluation was carried out using SR-μCT as well as FESEM, XRD and FT-IR. Characteristic internal 3-D morphology and porosity of the stones were studied. For comparison, patient derived struvite stones were used. From the results obtained, we report that the presence of bacteria enhances the crystallization process of struvite in vitro. A series of time-resolved experiments revealed that struvite crystals experienced a significant morphologic evolution from pin pointed structure to X-shaped and tabular morphologies. These X-shaped and unusual tabular habits of struvite resembled biogenic morphologies of struvite. SR-μCT showed similarities between the patient derived and the in vitro derived struvite crystals. In conclusion, these experiments revealed that the bacteria play a major role in the specific morphogenesis of struvite and can able to control the nucleation, modulate crystalline phases, and shape of the growing crystal.