Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA.
J Urol. 2010 Sep;184(3):1189-96. doi: 10.1016/j.juro.2010.04.065. Epub 2010 Jul 21.
The availability of various transgenic and knockout mice provides an excellent opportunity to better understand the pathophysiology of calcium oxalate stone disease. However, attempts to produce calcium oxalate nephrolithiasis in mice have not been successful. We hypothesized that calcium oxalate nephrolithiasis in mice requires increasing urine calcium and oxalate excretion, and experimentally induced hyperoxaluria alone is not sufficient. To provide evidence we induced hyperoxaluria by administering hyperoxaluria inducing agents in normocalciuric and hypercalciuric mice, and investigating various aspects of nephrolithiasis.
We administered ethylene glycol, glyoxylate or hydroxyl proline via diet in male and female normocalciuric B6 mice, and in hypercalciuric sodium phosphate co-transporter type 2 a -/- mice for 4 weeks. We collected 24-hour urine samples on days 0, 3, 7, 14, 21 and 28, and analyzed them for pH, creatinine, lactate dehydrogenase calcium and oxalate. Kidneys were examined using light microscopy. Urine was examined for crystals using light and scanning electron microscopy.
Hypercalciuric mice on hydroxyl proline did not tolerate treatment and were sacrificed before 28 days. All mice on ethylene glycol, glyoxylate or hydroxyl proline became hyperoxaluric and showed calcium oxalate crystalluria. No female, normocalciuric or hypercalciuric mice showed renal calcium oxalate crystal deposits. Calcium oxalate nephrolithiasis developed in all mice on glyoxylate and in some on ethylene glycol. In all mice the kidneys showed epithelial injury. Male mice particularly on glyoxylate had more renal injury and inflammatory cell migration into the interstitium around the crystal deposits.
Results confirm that hyperoxaluria induction alone is not sufficient to create calcium oxalate nephrolithiasis in mice. Hypercalciuria is also required. Kidneys in male mice are more prone to injury than those in female mice and are susceptible to calcium oxalate crystal deposition. Perhaps epithelial injury promotes crystal retention. Thus, calcium oxalate nephrolithiasis in mice is gender dependent, and requires hypercalciuria and hyperoxaluria.
各种转基因和基因敲除小鼠的出现为更好地理解草酸钙结石病的病理生理学提供了极好的机会。然而,在小鼠中产生草酸钙肾结石的尝试并未成功。我们假设,在小鼠中产生草酸钙肾结石需要增加尿钙和草酸排泄,而单独诱导高草酸尿是不够的。为了提供证据,我们在正常钙尿和高钙尿的 B6 小鼠以及高草酸尿磷酸钠共转运蛋白 2a-/- 小鼠中通过饮食给予高草酸尿诱导剂,来诱导高草酸尿,并研究肾结石的各个方面。
我们在雄性和雌性正常钙尿的 B6 小鼠以及高草酸尿磷酸钠共转运蛋白 2a-/- 小鼠中通过饮食给予乙二醇、乙醛酸或羟脯氨酸,持续 4 周。我们在第 0、3、7、14、21 和 28 天收集 24 小时尿液样本,并分析其 pH 值、肌酐、乳酸脱氢酶钙和草酸。用光学显微镜检查肾脏。用光学和扫描电子显微镜检查尿液中的晶体。
接受羟脯氨酸治疗的高钙尿小鼠不能耐受治疗,并在 28 天前死亡。所有接受乙二醇、乙醛酸或羟脯氨酸治疗的小鼠均出现高草酸尿,并出现草酸钙结晶尿。没有雌性、正常钙尿或高钙尿的小鼠出现肾草酸钙晶体沉积。所有接受乙醛酸和部分接受乙二醇治疗的小鼠均发生了草酸钙肾结石。所有小鼠的肾脏均出现上皮损伤。雄性小鼠,特别是接受乙醛酸治疗的雄性小鼠,肾脏损伤更严重,炎症细胞向晶体沉积物周围的间质迁移。
结果证实,单独诱导高草酸尿不足以在小鼠中产生草酸钙肾结石。还需要高钙尿。雄性小鼠的肾脏比雌性小鼠更容易受到损伤,并且更容易受到草酸钙晶体沉积的影响。也许上皮损伤促进了晶体的保留。因此,小鼠草酸钙肾结石的发生具有性别依赖性,需要高钙尿和高草酸尿。