chondroitin-sulfates and Urinary-Calculi

Topics: Calcium Oxalate; Chondroitin Sulfates; Crystallization; Glycosaminoglycans; Heparin; Humans; Kidney Calculi; Urinary Calculi

To investigate the effectiveness and safety of instilling highly concentrated hyaluronic acid (HA)/chondroitin sulphate (CS) on ureteric stent-related pain, urinary symptoms, and quality of life (QoL) of patients who underwent ureteroscopic lithotripsy for ureteric stones followed by ureteric stent placement.. Eligible patients were randomly allocated to receive intravesical instillation with HA/CS or normal saline just after ureteric stent placement. Just before stent removal on postoperative day 7, the patients completed the Ureteric Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS) QoL question, and a pain visual analogue scale (VAS).. In total, 92 patients (46 each in the treatment and control arms) completed the study. The groups did not differ in terms of age or stent indwelling time. Compared with the control group, the treatment group had significantly lower USSQ urinary symptom domain scores (24.6 vs 32.5; P < 0.001), better IPSS QoL scores (3.5 vs 4.4, P = 0.018), and lower VAS pain scores (2.0 vs 3.2; P < 0.001). They also had lower total body pain subscores (16.7 vs 22.0; P = 0.01) and lower additional pain subscores due to urinary tract infections (2.1 vs. 3.2; P = 0.01) in the USSQ.. Highly concentrated HA/CS effectively improved urinary symptoms and pain, and reduced the need for additional medication or procedures after ureteric stent placement.

Topics: Administration, Intravesical; Adult; Chondroitin Sulfates; Female; Humans; Hyaluronic Acid; Lithotripsy; Lower Urinary Tract Symptoms; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Pilot Projects; Stents; Ureter; Ureteroscopy; Urinary Calculi; Urological Agents

Proteus mirabilis cause urinary tract infections which are recurrent and can lead to formation of urinary calculi. Both bacterial and the host factors are involved in the development of urolithiasis. To determine the impact of glycosaminoglycans (GAGs) in the formation of P. mirabilis-induced urinary stones, we investigated the in vitro crystallization, aggregation and adhesion of crystals in the presence of GAGs naturally appearing in urine. Crystallization experiments were performed in synthetic urine infected with P. mirabilis in the presence of: hyaluronic acid (HA), heparan sulfate (HS), chondroitin sulfate A, B and C (ChSA, ChSB, ChSC). The intensity of crystallization and aggregation were established by counting particles and phase-contrast microscopy. To analyze the adhesion of crystals, we used normal urothelium and (45)Ca isotope-labeled crystals. In the presence of ChSC, both the size of the crystals formed and their number were higher compared with the control. GAGs increased crystals adhesion to the cells, but only for ChSA this effect was significant. Chondroitin sulfates, which accelerate the first stages of infection-induced stones formation, may play an important role in the pathogenesis of infectious urolithiasis.

Topics: Adhesiveness; Apatites; Cell Line; Chondroitin Sulfates; Crystallization; Dermatan Sulfate; Glycosaminoglycans; Heparitin Sulfate; Host-Pathogen Interactions; Humans; Hyaluronic Acid; Magnesium Compounds; Microscopy, Phase-Contrast; Models, Biological; Phosphates; Proteus Infections; Proteus mirabilis; Struvite; Urinary Calculi; Urinary Tract Infections; Urothelium; Virulence

Urinary polyanions recovered from the urine samples of kidney stone-formers and normal controls were subjected to preparative agarose gel electrophoresis, which yielded fractions 1-5 in a decreasing order of mobility. In both groups, chondroitin sulfates were identified in the fast-moving fractions and heparan sulfates in the slow-moving fractions. Furthermore, two types of heparan sulfates were identified based on their electrophoretic mobility: slow-moving and fast-moving. The fractionated urinary polyanions were then tested in an in vitro calcium oxalate crystallization assay and compared at the same uronic acid concentration, whereby, the chondroitin sulfates of stone-formers and heparan sulfates of normals enhanced crystal nucleation. Fraction 5 of the normals, containing glycoproteins (14-97 kDa) and associated glycosaminoglycans, were found to effectively inhibit crystallization. Papainization of this fraction in stone-formers revealed crystal-suppressive effects of glycoproteins, which was not seen in similar fractions of normals. It was concluded that glycoproteins could modulate the crystal-enhancing glycosaminoglycans such as chondroitin sulfates of stone-formers but not in normals. The differing crystallization activities of electrophoretic fraction 1 of normals and stone-formers revealed the presence of another class of glycosaminoglycan-hyaluronan. Hence, in the natural milieu, different macromolecules combine to have an overall outcome in the crystallization of calcium oxalate.

Topics: Adult; Calcium Oxalate; Chondroitin Sulfates; Crystallization; Electrophoresis, Agar Gel; Electrophoresis, Cellulose Acetate; Glycoproteins; Heparitin Sulfate; Humans; Kidney Calculi; Middle Aged; Urinary Calculi; Urolithiasis

Calcium oxalate crystal growth and aggregation leads to the formation of renal calculi. It is known to be inhibited by several compounds both in vitro and in vivo conditions. The present study highlights the inhibitory potential of sodium pentosan polysulphate (SPP), a semi-synthetic glycosaminoglycan (GAG) on calcium oxalate crystal growth in vitro. Its efficacy was compared with those of known inhibitors like pyrophosphate, heparin and chondroitin-4-sulphate. Of the above compounds pyrophosphate was found to be the most potent inhibitor. Among the GAGs, SPP exhibited 80% inhibitory activity as compared to heparin. A lesser degree of inhibition was observed with chondroitin-4-sulphate.

Topics: Calcium Oxalate; Chondroitin Sulfates; Crystallization; Depression, Chemical; Diphosphates; Heparin; Pentosan Sulfuric Polyester; Urinary Calculi

1. Urinary glycosaminoglycans were recovered from the papain digest of polyanions precipitated sequentially by cetylpyridinium chloride and sodium acetate-saturated ethanol. Those from the early morning urine of 48 stone formers and 43 normal control subjects measured 11 and 16 micrograms of uronic acid/ml of urine, respectively. 2. Preparative agarose gel electrophoresis of the recovered glycosaminoglycans in barium acetate buffer (pH 5.8) yielded fractions containing purely chondroitin sulphate, co-polymeric chondroitin/dermatan sulphates and heparan sulphate. Identification was based on the susceptibility of the fractions to chondroitinase or nitrous acid treatment. Similar compositions of glycosaminoglycan classes were observed in samples from stone formers and normal control subjects. 3. The fractionated glycosaminoglycans were dissolved in urine ultrafiltrate to assay for nucleation-promoting and growth-inhibiting activities towards crystallization of urinary calcium oxalate. When compared at the same uronic acid concentration, both the urinary chondroitin sulphate isomers and heparan sulphates of stone formers demonstrated the capacity to enhance crystal nucleation from calcium oxalate endogenous in urine ultrafiltrates, whereas only urinary heparan sulphates of normal control subjects demonstrated this capacity. 4. Tissue-derived reference chondroitin sulphate, dermatan sulphate and heparin, when similarly tested, showed negligible crystal nucleation-promoting activity. The tissue-derived heparan sulphate was similar to the urinary heparan sulphates in showing marked crystal nucleation-promoting activity. 5. Crystal-growth inhibitory activity was evident in all urinary glycosaminoglycan fractions studied. In particular, urinary heparan sulphate of normal control subjects showed higher activity than that of stone formers or the chondroitin sulphate isomers of both stone formers and normal control subjects (P < 0.005).

Topics: Adult; Calcium Oxalate; Chondroitin Sulfates; Crystallization; Electrophoresis, Agar Gel; Electrophoresis, Cellulose Acetate; Heparitin Sulfate; Humans; Middle Aged; Urinary Calculi

Chondroitin polysulfate (CPS) have inhibitory activity on stone formation of calcium oxalate. This study compared the inhibitory effect of three CPS (CPS S-I, CPS S-II, CPS S-III) with sodium pentosan polysulfate (SPP) and chondroitin sulfate (CS). Crystal growth inhibition was measured in a seeded crystal growth system with 14C-oxalate, and CPS S-I and CPS S-II were the most active substances inhibiting crystal growth. Since CPS S-II and CPS S-III had remarkable hemorrhagic adverse effect, these two substances were excluded from the following study. The study of administration of the rest of the substances (CPS S-I, SPP, CS) to rats revealed that CPS S-I highly inhibited formation of stone in kidney. About 65 percent of CPS S-I administered subcutaneously was excreted in 24 hours urine. Therefore it may be of value to study clinical usefulness of CPS S-I for treatment of patient with urolithiasis.

Topics: Animals; Calcium Oxalate; Chondroitin Sulfates; Crystallization; Male; Rats; Rats, Sprague-Dawley; Urinary Calculi

Struvite crystals were produced by Proteus mirabilis growth in artificial urine, in the presence of a number of naturally occurring crystallization inhibitors. The use of phase contrast light microscopy enabled the effects of added chondroitin sulfate A, chondroitin sulfate C, heparin sulfate, or sodium citrate, on struvite crystal growth rates to be rapidly monitored as changes in crystal habit. Struvite crystals formed as a consequence of the urease activity of P. mirabilis under all chemical conditions. In the absence of inhibitor, early crystal development was marked by large quantities of amorphous precipitate, followed immediately by the appearance of rapidly growing X-shaped or planar crystals. Addition of the glycosaminoglycans, chondroitin sulfate A, chondroitin sulfate C, or heparin sulfate to the artificial urine mixture had no effect on the rate of crystal growth or appearance. When sodium citrate was present in elevated concentrations, crystal appearance was generally slowed, and the crystals assumed an octahedral, slow growing appearance. None of the added compounds had any influence on bacterial viability, pH, or urease activity. It is therefore likely that the inhibitory activity displayed by sodium citrate might be related to its ability to complex magnesium or to interfere with the crystal structure during struvite formation. From these experiments it would appear that citrate may be a factor in the natural resistance of whole urine to struvite crystallization.

Topics: Chondroitin Sulfates; Citrates; Citric Acid; Crystallization; Heparin; Humans; In Vitro Techniques; Magnesium; Magnesium Compounds; Microscopy, Phase-Contrast; Phosphates; Proteus mirabilis; Struvite; Urinary Calculi

Uric acid is implicated in calcium oxalate kidney stone formation. Conspicuously so far, two hypotheses have been proposed: direct induction of calcium oxalate precipitation by uric acid, and uric acid as anti-inhibitor by binding urinary glycosaminoglycans (GAGS). The aim of this work is to evaluate uric acid and the relationship with GAGS in a group of patients with calcium oxalate lithiasis, and in a control group for detecting possible differences between the two groups. It was found that the lower concentration of GAGS in stone formers could impede their inhibitory activity on the heterogeneous nucleation of uric acid in calcium stone formation.

Topics: Biomarkers; Calcium; Calcium Oxalate; Chondroitin Sulfates; Female; Glycosaminoglycans; Humans; Male; Oxalates; Reference Values; Uric Acid; Urinary Calculi

We have examined by the coulter counter method whether some substances promote or inhibit calcium oxalate monohydrate crystal aggregation. The substances tested were hyaluronic acid, chondroitin sulfate and urinary lyophilized material of less than 10 k dalton fractions having aggregate activity. As a result, hyaluronic acid promoted aggregation at low concentrations but inhibited it at higher concentrations, and chondroitin sulfate only inhibited it. They seem, therefore, to have quite different effects, depending on their urinary concentrations, on calcium oxalate crystal aggregation process. However, urinary fractions only promoted aggregation in a dose-response manner. This promoting effect might be caused by not only hyaluronic acid that was contained in the fractions but also by some other promoters.

Topics: Calcium Oxalate; Chondroitin Sulfates; Crystallization; Glycosaminoglycans; Humans; Hyaluronic Acid; Urinary Calculi

The possible inhibitors of heterogeneous nucleation were investigated. The effects of magnesium, pyrophosphate, citrate and Chondroitin Sulphate on calcium phosphate or uric acid heterogeneous nucleation of calcium oxalate were studied. It was found that whereas magnesium, pyrophosphate and citrate acted as effective inhibitors in the presence of calcium phosphate as heterogeneous nucleant, only chondroitin sulphate manifested important inhibitory effects when uric acid was the heterogeneous nucleant.

Topics: Calcium Oxalate; Calcium Phosphates; Chondroitin Sulfates; Citrates; Citric Acid; Crystallization; Diphosphates; Humans; Magnesium; Uric Acid; Urinary Calculi

The inhibitory capacity of pyrophosphate, citrate, magnesium and chondroitin sulphate was investigated, using the urine of 21 calcium oxalate stone-forming patients without metabolic alterations. The inhibitory effect of these substances was assessed by a combination of nephelometry (light scattering) and optical microscopy. The results showed that citrate and magnesium had an inhibitory effect in a significant number of cases. Pyrophosphate and chondroitin sulphate had a less marked effect. The main urinary lithogenic biochemical parameters of the patients were also studied to see if there was a relationship between them and the inhibitory capacity of the compounds.

Topics: Calcium Oxalate; Chondroitin; Chondroitin Sulfates; Citrates; Citric Acid; Crystallization; Diphosphates; Humans; Magnesium; Urinary Calculi

Opinions vary on the effects produced by urinary inhibitors of crystallisation. We describe a simple method for studying inhibitory effects in urine based on nephelometry and optical microscopy. It was concluded that the inhibitory effect of a given substance on calcium oxalate crystallisation depends on the particular sample of urine being examined and that the most effective inhibitor can be determined only by studying the urine of each patient individually.

Topics: Calcium Oxalate; Chondroitin; Chondroitin Sulfates; Citrates; Crystallization; Diphosphates; Humans; Magnesium; Nephelometry and Turbidimetry; Urinary Calculi

The effect of stone growth inhibitors (citrate, pyrophosphate, ethane diphosphonate, methane diphosphonate, chondroitin sulfate A, chondroitin sulfate C, heparin and ribonucleic acid) on crystal-membrane interactions of whewellite, weddellite, apatite, brushite, struvite, uric acid, monosodium urate and quartz (control) stones was quantitated. As a model for the initial retention of microcrystals by kidney epithelial membranes, crystal-induced membranolysis of red blood cells served as a measure of crystal-membrane interactions. The inhibitors induced changes in hemolytic potential from approximately 320 per cent enhancement to 80 per cent inhibition. No inhibitor behaved the same way for all crystals studied. However, some crystals showed consistent trends in altered hemolytic potential in the presence of inhibitors. These crystals included weddellite and sodium urate, which were inhibited consistently, and apatite and quartz, which were enhanced consistently. Whewellite, uric acid, brushite and struvite exhibited mixed patterns in the altered hemolytic potentials owing to the inhibitors.

Topics: Calcium Oxalate; Chondroitin Sulfates; Citrates; Citric Acid; Crystallization; Diphosphates; Diphosphonates; Erythrocyte Membrane; Etidronic Acid; Hemolysis; Heparin; Humans; RNA; Urinary Calculi

This study presents a method for the isolation and identification of urinary glycosaminoglycans. Aliquots of 24-hour urine specimens are ultrafiltered through a Biogel filtration column to obtain the macromolecular fractions. These fractions are then subjected to electrophoretic, enzymatic and chemical analyses to obtain qualitative and quantitative information about the glycosaminoglycans contained. The methodology presented is intended to be used in subsequent studies where data can be analyzed and determinations can be made concerning the character of glycosaminoglycans in the urine of stone formers and non-stone formers.

Topics: Chondroitin Sulfates; Densitometry; Electrophoresis; Glycosaminoglycans; Heparitin Sulfate; Humans; Hyaluronic Acid; Macromolecular Substances; Methods; Urinary Calculi; Uronic Acids

Topics: Adult; Chondroitin Sulfates; Female; Glycosaminoglycans; Heparitin Sulfate; Humans; Male; Urinary Calculi

Urinary inhibition of calcium oxalate crystal growth was measured in metastable solutions of sodium oxalate and calcium chloride at different pH. Inhibition of calcium oxalate crystal growth in urine from patients with calcium oxalate stone disease increased with increasing pH. The increase was most pronounced between pH 5.5 and 7.0. Sodium pyrophosphate in a similar way inhibited calcium oxalate crystal growth in this pH interval, and between pH 6.0 and 7.5 there was also a slight increase in the inhibiting activity by chondroitin sulphate and citrate. Approximative correction factors were calculated in order to obtain a more appropriate value of the inhibition index when urine pH was different from 6.0, and a reasonably good correlation was obtained between inhibition indices calculated by means of the correction factor and inhibition indices derived from direct measurements of the crystal growth rate in solutions with different pH.

Topics: Calcium Oxalate; Chondroitin Sulfates; Citrates; Citric Acid; Crystallization; Humans; Hydrogen-Ion Concentration; Urinary Calculi

Neither the macromolecular mass fractions of urine from stone-formers nor those from the matrix of calcium-containing urinary calculi contain factors which promote the crystal growth rate of calcium oxalate crystals in vitro.

Topics: Calcium Oxalate; Chondroitin Sulfates; Chromatography, Gel; Crystallization; Glycosaminoglycans; Humans; Male; Spectrophotometry, Ultraviolet; Ultrafiltration; Urinary Calculi

A simple radiochemical method is proposed for the in vitro assay of the inhibitory activity of urine with respect to calcium oxalate crystal growth using [14C]oxalate as a tracer. The method shows an improved sensitivity over existing methods and indicates that citrate, pyrophosphate and chondroitin sulphate are active inhibitors of calcium oxalate crystal growth down to concentrations of 10(-5), 10(-7) and 10(-10) mol/l respectively. The inhibitory activity in the urines of 12 recurrent calcium stone-formers was significantly lower than in the urines of matched control subjects (P less than 0.01), confirming the clinical usefulness of the test.

Topics: Calcium Oxalate; Chondroitin Sulfates; Citrates; Crystallization; Diphosphates; Dose-Response Relationship, Drug; Humans; Urinary Calculi

An extract of glycosaminoglycans was prepared from normal urine and components fractionated by electrophoresis on Vinylite support medium. Several fractions displayed an ability to inhibit formation of calcium oxalate crystals in vitro. Inasmuch as well recognized urinary glycosaminoglycans such as chondroitin sulfates and hyaluronic acid must contribute to the urine inhibitory power, an unknown material was isolated with potent inhibitory properties. The material contained little detectable uronic acid of hexosamine and had a molecular weight greater than 10,000.

Topics: Calcium Oxalate; Chondroitin Sulfates; Crystallization; Electrophoresis, Cellulose Acetate; Glycosaminoglycans; Humans; Hyaluronic Acid; Male; Methods; Urinary Calculi

The adsorption of proteins and mucopolysaccharides on calcium oxalate crystals was measured by solution depletion. Anionic protein adsorption was found to be sensitive to calcium ion concentration. Adsorption of fibrinogen was anomalously large in the presence of 0.01 M Ca2+. Adsorption of cationic protein (histone) was sensitive to oxalate ion concentration. A small alteration in adsorption of protein as a result of pH or temperature change was also observed. Plots of adsorption versus concentration were interpreted in terms of a Langmuir adsorption isotherm. The derived Langmuir adsorption parameters were then used to investigate the contribution of protein, by physical adsorpti, to the quantity of matrix in urinary stones. It was concluded that physical adsorption can account for the deposition of part but not all of the matrix in calcium oxalate stones. It was also concluded that physical adsorption of mucopolysaccharides by calcium oxalate crystals could explain the inhibition of growth and aggregation of calcium oxalate crystals seen with in vitro precipitation systems. Recalculation of published data indicates that adsorption of protein on dental enamel (calcium hydroxyapatite) results in approximately the same extent of surface coverage as adsorption on calcium oxalate crystals, but protein has a much lower affinity for dental enamel than for calcium oxalate crystals.

Topics: Adsorption; Alpha-Globulins; Calcium; Chondroitin Sulfates; Crystallization; Fibrinogen; Glycosaminoglycans; Heparin; Histones; Humans; Hydrogen-Ion Concentration; Mathematics; Proteins; Serum Albumin, Bovine; Urinary Calculi

Mucopolysaccharides were extracted from both normal and stone-forming urines, and those from the stone-forming samples showed a higher degree of sulfation than those from normal urines, as determined by sulfate analysis and electrophoretic measurement. The sulfated mucopolysaccharides from stone-forming urines formed insoluble calcium salts, whereas those from normal urines generally remained soluble in the presence of calcium ion. Rachitic rat cartilage was found to have more highly sulfated mucopolysaccharides than normal rat cartilage. Highly sulfated mucopolysaccharides appear to be a significant factor in calcium stone formations.

Topics: Animals; Cattle; Chondroitin Sulfates; Electrophoresis; Glycosaminoglycans; Heparitin Sulfate; Rats; Sulfates; Urinary Calculi