Asplin J R, Parks J H, Chen M S, Lieske J C, Toback F G, Pillay S N, Nakagawa Y, Coe F L
Renal Section, Department of Medicine, University of Chicago, Illinois 60637, USA.
Kidney Int. 1999 Oct;56(4):1505-16. doi: 10.1046/j.1523-1755.1999.00682.x.
Human urine is known to inhibit growth, aggregation, nucleation, and cell adhesion of calcium oxalate monohydrate (COM) crystals, the main solid phase of human kidney stones. This study tests the hypothesis that low levels of inhibition are present in men with calcium oxalate stones and could therefore promote stone production.
In 17 stone-forming men and 17 normal men that were matched in age to within five years, we studied the inhibition by dialyzed urine proteins of COM growth, aggregation, and binding to cultured BSC-1 renal cells, as well as whole urine upper limits of metastability (ULM) for COM and calcium phosphate (CaP) in relationship to the corresponding supersaturation (SS).
Compared with normals, patient urine showed reduced COM growth inhibition and reduced ULM in relationship to SS. When individual defects were considered, 15 of the 17 patients were abnormal in one or more inhibition measurements. ULM and growth inhibition defects frequently coexisted.
Reduced COM growth and CaP and CaOx ULM values in relationship to SS are a characteristic of male stone formers. Both defects could promote stones by facilitating crystal nucleation and growth. Abnormal inhibition may be a very important cause of human nephrolithiasis.
已知人类尿液可抑制一水草酸钙（COM）晶体的生长、聚集、成核及细胞黏附，COM晶体是人类肾结石的主要固相成分。本研究检验了以下假设：草酸钙结石男性患者体内存在低水平的抑制作用，因此可能促进结石形成。
选取17例草酸钙结石男性患者和17例年龄相差不超过5岁的正常男性，研究透析尿蛋白对COM晶体生长、聚集及与培养的BSC-1肾细胞结合的抑制作用，以及与相应过饱和度（SS）相关的COM和磷酸钙（CaP）的全尿亚稳极限（ULM）。
与正常人相比，患者尿液对COM晶体生长的抑制作用减弱，且与SS相关的ULM降低。若考虑个体缺陷，17例患者中有15例在一项或多项抑制测量中表现异常。ULM和生长抑制缺陷常同时存在。
与SS相关的COM晶体生长以及CaP和草酸钙ULM值降低是男性结石形成者的特征。这两种缺陷均可通过促进晶体成核和生长而促进结石形成。抑制作用异常可能是人类肾结石的一个非常重要的原因。
