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Interaction of Stone Components with Cells and Tissues

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Urinary Tract Stone Disease

Abstract

This chapter is a review of the interaction of stone-forming materials with cells and tissues. The evidence for intratubular and interstitial locations of calcium oxalate and calcium phosphate is examined; the latter mineral with particular reference to its appearance in Randall’s plaques. The mechanisms of surface adherence and nucleation of crystals are discussed, as well as the evidence for internalization of crystals by renal tubular epithelium and their further processing. The cellular consequences of crystal–cell interaction, specifically stimulation of cell division and initiation of several varieties of cell damage or death, are reviewed. The specificity of crystal–cell interaction is also covered. This includes a discussion of the features of cultured cells responsible for the reported specificity and the molecules expressed on the cell surface responsible for crystal adherence, with particular emphasis on the case of calcium oxalate monohydrate (COM). The smaller amount of evidence regarding the above phenomena for other stone forming crystals – uric acid, brushite, and apatite is also reviewed. The issue of whether cell or tissue damage predisposes to stone formation is also covered; particularly the large amount of data on the toxic effects of oxalate, as well as the lesser amount of information available regarding hypercalciuria, hyperphosphaturia, and hyperuricosuria. The chapter concludes with a synthesis of the material into a comprehensive hypothesis for the initiation of stone disease through interaction of stone-forming constituents with cells and tissues.

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Notes

  1. 1.

    Plus unpublished observations

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Authors and Affiliations

  1. Department of Nephrology, Veterans Affairs Medical Center and the Medical College of Wisconsin, Milwaukee, WI, USA

    Jack G. Kleinman

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  1. Jack G. Kleinman
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Correspondence to Jack G. Kleinman .

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  1. Dept. Urology, Spire Manchester Hospital, Russell Road, Manchester, M16 8AJ, United Kingdom

    Nagaraja P. Rao

  2. Division of Urologic Surgery, Duke University Medical Center, Durham, 27710, North Carolina, USA

    Glenn M. Preminger

  3. Department of Urology, South Manchester University Hospitals, Manchester, M20 2LR, United Kingdom

    John P. Kavanagh

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Kleinman, J.G. (2010). Interaction of Stone Components with Cells and Tissues. In: Rao, N., Preminger, G., Kavanagh, J. (eds) Urinary Tract Stone Disease. Springer, London. https://doi.org/10.1007/978-1-84800-362-0_6

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