Skip to main content
Erschienen in: Current Urology Reports 5/2019

01.05.2019 | Endourology (P Mucksavage and B Somani, Section Editors)

Understanding the Link Between Gut Microbiome and Urinary Stone Disease

verfasst von: Justin A. Lee, Joshua M. Stern

Erschienen in: Current Urology Reports | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

With recent advances in sequencing technologies and increasing research into the gut microbiome (GMB), studies have revealed associations between the GMB and urinary stone disease (USD). We sought to determine whether the evidence pointed towards a few specific gut bacteria or the broader GMB network is seemingly responsible for this relationship.

Recent Findings

Initially, Oxalobacter formigenes (OF) was pursued as the main link between GMB and USD given its ability to degrade oxalate in the gut. However, the latest studies consistently suggest that the entire GMB is much more likely to be involved in handling oxalate absorption and other risk factors for urinary stone formation, rather than just a few microbiota.

Summary

The GMB has complex networks that are likely involved in the pathophysiology of USD, although the causal mechanisms remain unclear. With increasing interest and research, potential modalities that act on the GMB may help to prevent incidence of USD.
Literatur
3.
Zurück zum Zitat Knoll RL, Forslund K, Kultima JR, Meyer CU, Kullmer U, Sunagawa S, et al. Gut microbiota differs between children with inflammatory bowel disease and healthy siblings in taxonomic and functional composition: a metagenomic analysis. Am J Physiol Gastrointest Liver Physiol. 2017;312(4):G327–G39. https://doi.org/10.1152/ajpgi.00293.2016.CrossRefPubMed Knoll RL, Forslund K, Kultima JR, Meyer CU, Kullmer U, Sunagawa S, et al. Gut microbiota differs between children with inflammatory bowel disease and healthy siblings in taxonomic and functional composition: a metagenomic analysis. Am J Physiol Gastrointest Liver Physiol. 2017;312(4):G327–G39. https://​doi.​org/​10.​1152/​ajpgi.​00293.​2016.CrossRefPubMed
15.
Zurück zum Zitat • Miller AW, Dale C, Dearing MD. Microbiota diversification and crash induced by dietary oxalate in the mammalian herbivore Neotoma albigula. mSphere. 2017;2(5). https://doi.org/10.1128/mSphere.00428-17 An experimental study of metabolism of dietary oxalate in an animal model. This study examined the stability of diverse microbiomes in relation to metabolism of dietary oxalate. Its findings suggested that more diverse networks of microbiota were resistant to destabilization. • Miller AW, Dale C, Dearing MD. Microbiota diversification and crash induced by dietary oxalate in the mammalian herbivore Neotoma albigula. mSphere. 2017;2(5). https://​doi.​org/​10.​1128/​mSphere.​00428-17 An experimental study of metabolism of dietary oxalate in an animal model. This study examined the stability of diverse microbiomes in relation to metabolism of dietary oxalate. Its findings suggested that more diverse networks of microbiota were resistant to destabilization.
19.
Zurück zum Zitat • Tang R, Jiang Y, Tan A, Ye J, Xian X, Xie Y, et al. 16S rRNA gene sequencing reveals altered composition of gut microbiota in individuals with kidney stones. Urolithiasis. 2018;46(6):503–14. https://doi.org/10.1007/s00240-018-1037-y This study looked at 13 stone formers with 13 healthy matched controls demonstrated decreased beta diversity amongst stone formers suggesting a unique profile for this cohort compared to controls. CrossRefPubMed • Tang R, Jiang Y, Tan A, Ye J, Xian X, Xie Y, et al. 16S rRNA gene sequencing reveals altered composition of gut microbiota in individuals with kidney stones. Urolithiasis. 2018;46(6):503–14. https://​doi.​org/​10.​1007/​s00240-018-1037-y This study looked at 13 stone formers with 13 healthy matched controls demonstrated decreased beta diversity amongst stone formers suggesting a unique profile for this cohort compared to controls. CrossRefPubMed
20.
Zurück zum Zitat • Ticinesi A, Milani C, Guerra A, Allegri F, Lauretani F, Nouvenne A, et al. Understanding the gut-kidney axis in nephrolithiasis: an analysis of the gut microbiota composition and functionality of stone formers. Gut. 2018;67:2097–106. https://doi.org/10.1136/gutjnl-2017-315734. This study of stool samples from 52 stone formers and 48 controls discovered that the abundance of five microbial taxa was associated with 24-h oxalate excretion, which further points towards a direct role for complex microbiota networks in the pathogenesis of stone formation.CrossRefPubMed • Ticinesi A, Milani C, Guerra A, Allegri F, Lauretani F, Nouvenne A, et al. Understanding the gut-kidney axis in nephrolithiasis: an analysis of the gut microbiota composition and functionality of stone formers. Gut. 2018;67:2097–106. https://​doi.​org/​10.​1136/​gutjnl-2017-315734. This study of stool samples from 52 stone formers and 48 controls discovered that the abundance of five microbial taxa was associated with 24-h oxalate excretion, which further points towards a direct role for complex microbiota networks in the pathogenesis of stone formation.CrossRefPubMed
21.
Zurück zum Zitat Prien EL, Prien EL Jr. Composition and structure of urinary stone. Am J Med. 1968;45(5):654–72.CrossRefPubMed Prien EL, Prien EL Jr. Composition and structure of urinary stone. Am J Med. 1968;45(5):654–72.CrossRefPubMed
32.
Zurück zum Zitat •• Milliner D, Hoppe B, Groothoff J. A randomised Phase II/III study to evaluate the efficacy and safety of orally administered Oxalobacter formigenes to treat primary hyperoxaluria. Urolithiasis. 2017. https://doi.org/10.1007/s00240-017-0998-6 A phase 3 clinical trial of 36 patients that demonstrated the use of oral Oxalobacter formigenes was not associated with changes in urinary oxalate excretion. This was the first large study to show that OF alone was not capable of inducing changes in urinary oxalate excretion in a meaningful way. CrossRefPubMedPubMedCentral •• Milliner D, Hoppe B, Groothoff J. A randomised Phase II/III study to evaluate the efficacy and safety of orally administered Oxalobacter formigenes to treat primary hyperoxaluria. Urolithiasis. 2017. https://​doi.​org/​10.​1007/​s00240-017-0998-6 A phase 3 clinical trial of 36 patients that demonstrated the use of oral Oxalobacter formigenes was not associated with changes in urinary oxalate excretion. This was the first large study to show that OF alone was not capable of inducing changes in urinary oxalate excretion in a meaningful way. CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat • Caudarella R, Vescini F. Urinary citrate and renal stone disease: the preventive role of alkali citrate treatment. Arch Ital Urol Androl. 2009;81(3):182–7 This study focused on the lack of efficacy of probiotics containing oxalate-degrading bacteria, rather suggesting a robust network of bacteria that work together in regulating oxalate degradation.PubMed • Caudarella R, Vescini F. Urinary citrate and renal stone disease: the preventive role of alkali citrate treatment. Arch Ital Urol Androl. 2009;81(3):182–7 This study focused on the lack of efficacy of probiotics containing oxalate-degrading bacteria, rather suggesting a robust network of bacteria that work together in regulating oxalate degradation.PubMed
36.
Zurück zum Zitat Soucie JM, Thun MJ, Coates RJ, McClellan W, Austin H. Demographic and geographic variability of kidney stones in the United States. Kidney Int. 1994;46(3):893–9.CrossRefPubMed Soucie JM, Thun MJ, Coates RJ, McClellan W, Austin H. Demographic and geographic variability of kidney stones in the United States. Kidney Int. 1994;46(3):893–9.CrossRefPubMed
38.
Zurück zum Zitat Marotz CA, Zarrinpar A. Treating obesity and metabolic syndrome with fecal microbiota transplantation. Yale J Biol Med. 2016;89(3):383–8.PubMedPubMedCentral Marotz CA, Zarrinpar A. Treating obesity and metabolic syndrome with fecal microbiota transplantation. Yale J Biol Med. 2016;89(3):383–8.PubMedPubMedCentral
39.
Zurück zum Zitat Lopez J, Grinspan A. Fecal microbiota transplantation for inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2016;12(6):374–9. Lopez J, Grinspan A. Fecal microbiota transplantation for inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2016;12(6):374–9.
40.
Zurück zum Zitat •• Stern J, Burk R, Schoenfeld D, Davies K, Asplin J, Suadicani S. Fecal transplant modifies urine chemistry risk factors for urinary stone disease. Phys Rep. 2019; This study demonstrated that the ability of fecal transplants of the whole gut microbiome could modulate urinary parameters related to stone formation in an animal model. •• Stern J, Burk R, Schoenfeld D, Davies K, Asplin J, Suadicani S. Fecal transplant modifies urine chemistry risk factors for urinary stone disease. Phys Rep. 2019; This study demonstrated that the ability of fecal transplants of the whole gut microbiome could modulate urinary parameters related to stone formation in an animal model.
58.
Zurück zum Zitat De Ferrari ME, Macaluso M, Brunati C, Pozzoli R, Colussi G. Hypocitraturia and Ureaplasma urealyticum urinary tract infection in patients with idiopathic calcium nephrolithiasis. Nephrol Dial Transplant. 1996;11(6):1185.CrossRefPubMed De Ferrari ME, Macaluso M, Brunati C, Pozzoli R, Colussi G. Hypocitraturia and Ureaplasma urealyticum urinary tract infection in patients with idiopathic calcium nephrolithiasis. Nephrol Dial Transplant. 1996;11(6):1185.CrossRefPubMed
Metadaten
Titel
Understanding the Link Between Gut Microbiome and Urinary Stone Disease
verfasst von
Justin A. Lee
Joshua M. Stern
Publikationsdatum
01.05.2019
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 5/2019
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-019-0882-8

Weitere Artikel der Ausgabe 5/2019

Current Urology Reports 5/2019 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.