Direct correlation between hyperoxaluria/oxalate stone disease and the absence of the gastrointestinal tract-dwelling bacterium Oxalobacter formigenes: Possible prevention by gut recolonization or enzyme replacement therapy

Harmeet Sidhu, Matthias E. Schmidt, Janet G. Cornelius, Sivagnanam Van Thamilsel, Saeed R. Khan, Albrecht Hesse, Ammon B. Peck

Research output: Contribution to journalArticle

Abstract

Oxalobacter formigenes is a specific oxalate-degrading, anaerobic bacterium inhabiting the gastrointestinal tracts of vertebrates, including humans. This bacterium maintains an important symbiotic relationship with its host by regulating oxalate homeostasis, primarily by preventing enteric absorption. Increased absorption of oxalate can lead to multiple complications associated with hyperoxaluria, especially recurrent calcium oxalate urolithiasis. Detection of O. formigenes in the gastrointestinal tract has attracted attention because the absence of this bacterium appears to be a risk factor for development of hyperoxaluria and/or recurrent calcium oxalate kidney stone disease. In the present study, epidemiologic studies with patients at high risk for calcium oxalate urolithiasis showed a direct correlation between the number of recurrent kidney stone episodes and the lack of O. formigenes colonization. As expected, the lack of O. formigenes revealed a clear association with prophylactic antibiotic therapy. To confirm the importance of O. formigenes in regulating hyperoxaluria, laboratory rats known to be noncolonized were colonized with live bacteria or treated with a preparation of oxalate-degrading enzymes derived from O. formigenes to determine any subsequent increased resistance to high oxalate challenge. Rats receiving either bacteria or enzyme replacement therapy excreted far lower levels of oxalate, did not develop the crystalluria observed with control rats, and resisted the formation of calcium oxalate crystals in their nephrons. These observations, taken together, support the concept that O. formigenes is important in maintaining oxalate homeostasis, that its absence from the gut increases the risk for hyperoxaluria and recurrent kidney stone disease, and that replacement therapy is an efficient procedure to prevent hyperoxaluria and its complications.

Original languageEnglish (US)
JournalJournal of the American Society of Nephrology
Volume10
Issue numberSUPPL. 14
StatePublished - Nov 1999
Externally publishedYes

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Oxalobacter formigenes
Hyperoxaluria
Enzyme Replacement Therapy
Oxalates
Gastrointestinal Tract
Bacteria
Kidney Calculi
Calcium Oxalate
Kidney Diseases
Homeostasis
Anaerobic Bacteria
Nephrons
Vertebrates
Epidemiologic Studies
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Nephrology

Cite this

Direct correlation between hyperoxaluria/oxalate stone disease and the absence of the gastrointestinal tract-dwelling bacterium Oxalobacter formigenes : Possible prevention by gut recolonization or enzyme replacement therapy. / Sidhu, Harmeet; Schmidt, Matthias E.; Cornelius, Janet G.; Van Thamilsel, Sivagnanam; Khan, Saeed R.; Hesse, Albrecht; Peck, Ammon B.

In: Journal of the American Society of Nephrology, Vol. 10, No. SUPPL. 14, 11.1999.

Research output: Contribution to journalArticle

Sidhu, Harmeet ; Schmidt, Matthias E. ; Cornelius, Janet G. ; Van Thamilsel, Sivagnanam ; Khan, Saeed R. ; Hesse, Albrecht ; Peck, Ammon B. / Direct correlation between hyperoxaluria/oxalate stone disease and the absence of the gastrointestinal tract-dwelling bacterium Oxalobacter formigenes : Possible prevention by gut recolonization or enzyme replacement therapy. In: Journal of the American Society of Nephrology. 1999 ; Vol. 10, No. SUPPL. 14.
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