oxalates and Colonic-Neoplasms

This is the first prospective study to investigate the association between kidney stones, bone mineral density, serum testosterone, colon cancer and O. formigenes colonization. 40 kidney stone patients and 85 controls were enrolled. O. formigenes colonization was established. BMD was examined from T- and Z-scores using dual energy absorptiometry. O. formigenes was found in 28 of 40 cases and 80 of 85 controls. BMD was significantly reduced in patients (p < 0.05). The evaluation revealed a significant association between lowered O. formigenes colonization and low testosterone. Urinary calcium and oxalates levels were greater in patient. Serum testosterone and urinary citrate concentrations was reduced in patients with a significant difference. Also an association between O. formigenes and colon cancer was noted. Absence of O. formigenes might stand for a pathogenic factor in calcium oxalate stone, low bone mineral density, low testosterone levels and also colon cancer, when antibiotics are prescribed generously.

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Bone Density; Calcium; Case-Control Studies; Colonic Neoplasms; Feces; Female; Humans; Kidney Calculi; Male; Middle Aged; Oxalates; Oxalobacter formigenes; Prospective Studies; Risk Assessment; Testosterone; Young Adult

A gene has been described, Down Regulated in Adenoma (dra), which is expressed in normal colon but is absent in the majority of colon adenomas and adenocarcinomas. However, the function of this protein is unknown. Because of sequence similarity to a recently cloned membrane sulfate transporter in rat liver, the transport function of Dra was examined. We established that dra encodes for a Na(+)-independent transporter for both sulfate and oxalate using microinjected Xenopus oocytes as an assay system. Sulfate transport was sensitive to the anion exchange inhibitor DIDS (4,4'-diisothiocyano-2,2' disulfonic acid stilbene). Using an RNase protection assay, we found that dra mRNA expression is limited to the small intestine and colon in mouse, therefore identifying Dra as an intestine-specific sulfate transporter. dra also had a unique pattern of expression during intestinal development. Northern blot analysis revealed a low level of expression in colon at birth with a marked increase in the first 2 postnatal weeks. In contrast, there was a lower, constant level of expression in small intestine in the postnatal period. Caco-2 cells, a colon carcinoma cell line that differentiates over time in culture, demonstrated a marked induction of dra mRNA as cells progressed from the preconfluent (undifferentiated) to the postconfluent (differentiated) state. These results show that Dra is an intestine-specific Na(+)-independent sulfate transporter that has differential expression during colonic development. This functional characterization provides the foundation for investigation of the role of Dra in intestinal sulfate transport and in the malignant phenotype.

Topics: 4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid; Animals; Antiporters; Base Sequence; Carrier Proteins; Cell Differentiation; Chloride-Bicarbonate Antiporters; Colon; Colonic Neoplasms; DNA, Complementary; Gene Expression Regulation, Developmental; Genes; Humans; Intestine, Small; Membrane Proteins; Mice; Molecular Sequence Data; Neoplasm Proteins; Oocytes; Organ Specificity; Oxalates; Recombinant Fusion Proteins; RNA, Messenger; Sulfate Transporters; Sulfates; Tumor Cells, Cultured; Xenopus

Because of their amphiphilic properties, bile acids have important physiological functions. However, they can also be pathogenetically active. Some recent findings on the biochemistry and enterohepatic circulation of bile acids are presented. In contrast to the adult liver where the only primary bile acids formed are cholic- and chenodeoxycholic acid, the foetal liver is able to synthesise a variety of "atypical" bile acids. Under certain circumstances, a retrograde differentiation is possible in the adult. The very effective transport systems in gut and in the sinusoidal and canalicular membrane of the liver cell limit the bile acids almost exclusively to the enterohepatic circulation. During transport in blood, through biomembranes and in the liver cytosol, bile acids are bound to carrier proteins. The carrier has been detected using photoaffinity labelling. Following biotransformation (sulphation and glucuronidation) pathogenetically active bile acids can be converted into derivatives which can be rapidly eliminated. Disturbances of these mechanisms result in functional defects and diseases. The pathological significance of bile acids in hepato-biliary diseases is represented with regard to the cholestatic and proliferative effect of individual bile acids. The significance of bile acids in chologenic diarrhea, steatorrhea and enteral hyperoxaluria are presented as examples of the pathogenetic effects of bile acids on the gut. In these diseases it is possible to recognise the specific effects of certain bile acids on the colon mucosa. Recent studies have demonstrated that bile acids are possibly of pathogenetic significance in the case of epidemiologically proven relationship between colon carcinoma and high fat, high cholesterol and low fibre diets.

Topics: Bile Acids and Salts; Biliary Tract Diseases; Biological Transport, Active; Carrier Proteins; Celiac Disease; Cholestasis; Colonic Neoplasms; Cytosol; Diarrhea; Humans; Intestinal Absorption; Kidney Calculi; Lipoproteins, HDL; Liver; Liver Diseases; Molecular Weight; Oxalates

During the last years bile acids have gained more and more clinical importance. They play a decisive part in intestinal fat resorption. Increased bile acid content in the colon will result in diarrhea. By determination of serum bile acids the liver function can be judged exactly. It seems probable that bile acids take part in the pathogenesis of gastritis gastric ulcer and colonic cancer. By administration of chenodeoxycholic acid and ursodeoxycholic acid dissolution of cholesterol stones within the gall bladder is possible.

Topics: Bile Acids and Salts; Chenodeoxycholic Acid; Cholelithiasis; Colonic Neoplasms; Deoxycholic Acid; Gastritis; Humans; Intestinal Absorption; Liver Diseases; Oxalates; Stomach Ulcer

Topics: Adolescent; Adult; Aged; Biopsy; Calcium; Child; Child, Preschool; Colonic Neoplasms; Cystine; Epithelial Cells; Female; Humans; Hyperparathyroidism; Kidney Calculi; Kidney Tubules, Distal; Male; Middle Aged; Nephrocalcinosis; Nephrons; Oxalates; Peptic Ulcer; Phosphates; Uric Acid; Urinary Tract Infections