IMR Press / FBL / Volume 9 / Issue 2 / DOI: 10.2741/1347

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Modulators of urinary stone formation
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1 Department of Pathology, University of Florida, Gainesville, Florida
2 Paediatric Urology, ErasmusMC, Rotterdam, The Netherlands
Academic Editor:Saeed Khan
Front. Biosci. (Landmark Ed) 2004, 9(2), 1450–1482; https://doi.org/10.2741/1347
Published: 1 May 2004
(This article belongs to the Special Issue Kidney stones; their formation, removal and prevention)
Abstract

Urine contains compounds that modulate the nucleation, growth and aggregation of crystals as well as their attachment to renal epithelial cells. These compounds may function to protect the kidneys against: 1, the possibility of crystallization in tubular fluid and urine, which are generally metastable with respect to calcium salts, 2, crystal retention within the kidneys thereby preventing stone formation and 3, possibly against plaque formation at the nephron basement membrane. Since oxalate is the most common stone type, the effect of various modulators on calcium oxalate (CaOx) crystallization has been examined in greater details. Most of the inhibitory activity resides in macromolecules such as glycoproteins and glycosaminoglycans while nucleation promotion activity is most likely sustained by membrane lipids. Nephrocalcin, Tamm-Horsfall protein, osteopontin, urinary prothrombin fragment 1, and bikunin are the most studied inhibitory proteins while chondroitin sulfate (CS), heparan sulfate (HS) and hyaluronic acid (HA) are the best studied glycosaminoglycans. Crystallization modulating macromolecules discussed here are also prominent in cell injury, inflammation and recovery. Renal epithelial cells on exposure to oxalate and CaOx crystals produce some of the inflammatory molecules such as monocyte chemoattractant protein-1 (MCP-1) with no apparent role in crystal formation. In addition, macrophages surround the CaOx crystals present in the renal interstitium. These observations indicate a close relationship between inflammation and nephrolithiasis.

Keywords
Crystallization inhibitors
Osteopontin
Bikunin
Apoptosis
Oxidative stress
Inflammation
Phospholipids
Oxalate
Hyaluronic Acid
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