Ramasamy Selvam

Calcium oxalate stone disease: role of lipid peroxidation and antioxidants

Abstract. Membrane injury facilitated the fixation of calcium oxalate crystals and subsequent growth into kidney stones. Oxalate-induced membrane injury was mediated by lipid peroxidation reaction through the generation of oxygen free radicals. In urolithic rat kidney or oxalate exposed cultured cells, both superoxide anion and hydroxyl radicals were generated in excess, causing cellular injury. In hyperoxaluric rat kidney, both superoxide and H2O2-generating enzymes such as glycolic acid oxidase (GAO) and xanthine oxidase (XO) were increased, and hydroxyl radical and transition metal ions, iron, and copper were accumulated. The lipid peroxidation products, thiobarbituric acid-reactive substances (TBARS), hydroperoxides, and diene conjugates were excessively released in tissues of urolithic rats and in plasma of rats as well as stone patients. The accumulation of these products was concomitant with the decrease in the antioxidant enzymes, superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), and glucose-6 phosphate dehydrogenase (G6PD) as well as radical scavengers, vitamin E, ascorbic acid, reduced glutathione (GSH), and protein thiol. All the above parameters were decreased in urolithic condition, irrespective of the agents used for the induction of urolithiasis. Oxalate binding activity and calcium oxalate crystal deposition were markedly pronounced, along with decreased adenosine triphosphatase (ATPase) activity. Lipid peroxidation positively correlated with cellular oxalate, oxalate binding, γ-glutamyl carboxylase, and calcium level and negatively correlated with GSH, vitamin E, ascorbic acid, and total protein thiol. Antioxidant therapy to urolithic rats with vitamin E, glutathione monoester, methionine, lipoic acid, or fish oil normalised the cellular antioxidant system, enzymes and scavengers, and interrupted membrane lipid and protein peroxidation reaction, ATPase inactivation, and its associated calcium accumulation. Antioxidant therapy prevented calcium oxalate precipitation in the rat kidney and reduced oxalate excretion in stone patients. Similarly, calcium oxalate crystal deposition in vitro to urothelium was prevented by free radical scavengers such as phytic acid and mannitol by protecting the membrane from free radical-mediated damage. All these observations were suggestive of the active involvement of free radical-mediated lipid peroxidation-induced membrane damage in the pathogenesis of calcium oxalate crystal deposition and retention.

Occurrence of histone-related oxalate binding in rat liver nucleus

The rat liver nuclear oxalate binding protein was isolated, purified by anion and cation exchange column chromatography using Diethyl Amino Ethyl Sephadex, Carboxy Methyl Cellulose and Carboxy Methyl Sephadex C-50 ion exchangers. The purified oxalate binding protein was found to be H1B of H1 fraction of histories. Kinetic analysis of oxalate binding showed the presence of two affinity sites, one with Kd of 133.5 nM and Bmax of 40 pmoles and another with Kd of 262.5 nM and Bmax of 210 pmoles. The optimal oxalate binding was at pH 4.2 and at 28°C. The oxalate binding was specific and reversible and not due to ionic charge interaction. The IC50 of other dicarboxylates was higher than that of oxalate. EGTA had no effect on oxalate binding but di- and tri-carboxylate carrier inhibitors and thiol modifying agents significantly lowered the binding activity. Oxalate binding to histones was significantly reduced in the presence of DNA or nucleotides, but RNA had no effect. ATP completely inhibited the oxalate binding activity at 1 mM concentration. Different tissues exhibited oxalate binding showing ubiquitous nature. Calf thymus H1 showed maximal binding similar to liver histones.

Supplementation of vitamin E and selenium prevents hyperoxaluria in experimental urolithic rats.

Renal injury is considered as one of the prerequisites for calcium oxalate retention. In order to determine the role of lipid peroxidation related effects for hyperoxaluria, we evaluated the alterations in lipid peroxidation, antioxidants and oxalate synthesizing enzymes in lithogenic rats with response to vitamin E + selenium treatment. In kidney of lithogenic rats, the level of lipid peroxidation and the activities of oxalate synthesizing enzymes were found to be increased whereas the levels/activities of non-enzymatic and enzymatic antioxidants were found to be decreased. The urinary excretion of both oxalate and calcium were significantly elevated. Supplementation of lithogenic rats with vitamin E + selenium decreased the levels of lipid peroxides and the activities of oxalate synthesizing enzymes like glycolic acid oxidase (GAO), lactate dehydrogenase (LDH), xanthine oxidase (XO) with a concomitant increase in the activities of enzymatic antioxidants like superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glucose-6-phosphate dehydrogenase (G6PDH) and increased levels of non-enzymatic antioxidants like ascorbic acid, alpha-tocopherol and reduced glutathione (GSH). The urinary excretion of oxalate and calcium were normalized. The antioxidants vitamin E + selenium thereby protected from hyperoxaluria.

Role of glutathione on renal mitochondrial status in hyperoxaluria

Role of glutathione on kidney mitochondrial integrity and function during stone forming process in hyperoxaluric state was investigated in male albino rats of Wistar strain. Hyperoxaluria was induced by feeding ethylene glycol (EG) in drinking water. Glutathione was depleted by administering buthionine sulfoximine (BSO), a specific inhibitor of glutathione biosynthesis. Glutathione monoester (GME) was administered for supplementing glutathione. BSO treatment alone or along with EG, depleted mitochondrial GSH by 40% and 51% respectively. Concomitantly, there was remarkable elevation in lipid peroxidation and oxidation of protein thiols. Mitochondrial oxalate binding was enhanced by 74% and 129% in BSO and BSO + EG treatment. Comparatively, EG treatment produced only a 33% increase in mitochondrial oxalate binding. Significant alteration in calcium homeostasis was seen following BSO and BSO + EG treatment. This may be due to altered mitochondrial integrity and function as evidenced from decreased activities of mitochondrial inner membrane marker enzymes, succinate dehydrogenase and cytochrome-c-oxidase and respiratory control ratio and enhanced NADH oxidation by mitochondria in these two groups. NADH oxidation (r = -0.74) and oxalate deposition in the kidney (r = -0.70) correlated negatively with mitochondrial glutathione depletion. GME supplementation restored normal level of GSH and maintained mitochondrial integrity and function, as a result of which oxalate deposition was prevented despite hyperoxaluria. These results suggest that mitochondrial dysfunction resulting from GSH depletion could be a contributing factor in the development of calcium oxalate stones.

Vitamin E Pretreatment Prevents Cyclosporin A-lnduced Crystal Deposition in Hyperoxaluric Rats

The in vivo effect of cyclosporin A (CsA) on renal calcium oxalate (CaOx) crystal retention in experimental hyperoxaluric rats was investigated. Further, the effect of pretreatment of vitamin E on the above conditions was also studied. Male Wistar rats were divided into two major groups each containing 40 rats. One of the groups was pretreated with vitamin E. Both major groups were then subgrouped into four groups: group 1 received the vehicle (olive oil); group 2 received CsA in olive oil (50 mg/kg); group 3 received 3% ammonium oxalate (AmOx), and group 4 received CsA + AmOx. Nephrotoxicity was assessed by the activities of urinary marker enzymes and also by histopathology. Urinary oxalate excretion as well as the activities of lactate dehydrogenase, gamma-glutamyltranspeptidase, alkaline phosphatase and inorganic pyrophosphatase enzymes were elevated either in CsA-alone or AmOx-alone treated groups. On combined administration of both CsA and AmOx, further elevations of these enzymes were observed. Urinary excretion of oxalate concentration positively correlated with urinary excretion of these enzymes. Deposition of CaOx crystals was seen only in the kidneys of rats that received combined treatment. On pretreatment with vitamin E the observed increased urinary activities of the enzymes and oxalate, histopathological changes and the deposition of CaOx crystals by administration of CsA in hyperoxaluria were prevented suggesting that vitamin E could be supplemented to prevent CsA-induced membrane damage.

Methionine feeding prevents kidney stone deposition by restoration of free radical mediated changes in experimental rat urolithiasis

Abstract Feeding calculi producing diet (CPD) to rats for 4 weeks produced calcium oxalate stones deposition. Supplementation of methionine to CPD (m-CPD) prevented the stone deposition. However the urine pH and excretion of oxalate and calcium in m-CPD-fed rats was still as high as in CPD-fed groups compared to that of the control group. The CPD-fed rats exhibited an increase in liver oxalate synthesizing enzymes and glycolic acid oxidase (GAO) and lactate dehydrogenase (LDH), and these activities were not restored in m-CPD-fed rats. Similarly, the elevated LDH activity and oxalate concentration observed in the kidney of CPD-fed rats were not restored by methionine supplementation. Kidney sub-cellular fractions of CPD-fed rats showed increased susceptibility for lipid peroxidation in presence of iron, ascorbate, and t-butyl hydroperoxide. Antioxidant enzyme activities of superoxide dismutase (SOD), catalase, and glutathione peroxidase and antioxidant concentrations of reduced glutathione, total thiols, ascorbic acid, and vitamin E were significantly decreased, while the xanthine oxidase activity and concentrations of hydroxyl radical, diene conjugates, and hydroperoxides were significantly increased in CPD-fed rats. The susceptibility to lipid peroxidation, activities of antioxidant enzymes, and the concentration of antioxidants were normalized in m-CPD—fed rats, thus suggesting that methionine feeding prevents the stone formation by neutralizing the free radical induced changes.

Effect of depletion of reduced glutathione and its supplementation by glutathione monoester on renal oxalate retention in hyperoxaluria

Abstract The effect of glutathione (GSH) depletion followed by administration of glutathione monoester (GME) on the metabolism of oxalate in hyperoxaluric condition was investigated. Renal GSH was depleted by intraperitoneal administration of buthionine sulfoximine (BSO, 4 mmol/kg b.w) twice a day for 20 days to rats with or without hyperoxaluria induced by adding 0.75% ethylene glycol (EG) in drinking water. GME was administered intraperitoneally (5 m mol in water/kg body weight) simultaneously. Tissue GSH was depleted by 47% and 58% by treatment with BSO and BSO + EG, respectively. Oxalate content was enhanced maximally (125% of control) only in BSO + EG treated group. A polarized light microscopic examination showed prominent deposition of calcium oxalate crystals only in the kidney of BSO + EG-treated rats. GME treatment brought down kidney oxalate and calcium content dramatically and reduced calcium oxalate retention. However, GME did not have any effect on urinary oxalate level. The observed decreased creatinine clearance, elevated urinary excretion of lactate dehydrogenase (LDH) and γ-glutamyl transpeptidase (γ-GT), and decreased tissue nonenzymatic and enzymatic antioxidants, and thiol status in BSO + EG treated rats were all restored to normal values on GME supplementation. GSH depletion increases the retention of calcium oxalate in renal cells and normalization of GSH by administration of glutathione monoester prevents it.

A novel basic protein from human kidney which inhibits calcium oxalate crystal growth

Objectives To isolate calcium oxalate‐binding proteins from human kidney and characterize the functional properties.

Increased calcium oxalate crystal nucleation and aggregation by peroxidized protein of human kidney stone matrix and renal cells.

Abstract Kidney stone matrix protein fractions eluted from DEAE cellulose column showed increased oxalate binding activity and had negative correlation with reduced thiol content. Fraction 1 (eluted in Tris-HCl, pH 7.4) and fraction 3 (0.3 M NaCl in buffer) showed nucleation and aggregation-promoting properties while fraction 2 (0.05 M NaCl in buffer) showed an inhibitory effect in an in vitro crystallization system. On peroxidation, fractions 1 and 3 showed a further increase in the promoting effect whereas fraction 2 showed a reduction in the inhibitory effect of nucleation and aggregation of calcium oxalate crystals. Protein peroxidation was negatively correlated with the inhibitory activity of the protein on calcium oxalate nucleation and aggregation. A similar promoting effect of nucleation and aggregation was seen with mitochondria and nucleus after peroxidation. These studies suggested that peroxidation of protein or tissue had greater influence on the nucleation and aggregation property of calcium oxalate crystal growth.

Renal Injury Mediated Calcium Oxalate Nephrolithiasis: Role of Lipid Peroxidation

The role of lipid peroxidation (LPO) in renal tubular damage mediated calcium oxalate retention was investigated in a rat model. Hyperoxaluria, without deposition of oxalate in kidney, was induced by administration of ethylene glycol (EG), a precursor of oxalate. Oxidative stress condition was produced by administration of buthionine sulfoximine (BSO), an inhibitor of glutathione biosynthesis. BSO-treated rats showed a significant (p < 0.001) increase in LPO over EG-treated rats and it was almost doubled in BSO + EG treated rats. LPO was accompanied by significant urinary excretion of renal damage marker enzymes such as gamma-glutamyl transpeptidase (gamma-GT), alkaline phosphatase (ALP) and cathepsin D, mucoproteins, and glycosaminoglycans (GAGs) in the BSO and BSO + EG groups but not in the EG group. Urinary excretion of gamma-GT (r = +0.90) (p < 0.001) and deposition of oxalate (r = +0.78) (p < 0.001) in kidney positively correlated with LPO. These results suggest that LPO initiates renal damage, thereby leading to calcium oxalate retention and stone formation.