Document Detail


Reduction of oxaluria after an oral course of lactic acid bacteria at high concentration.
MedLine Citation:
PMID:  11532105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hyperoxaluria is a major risk factor for renal stones, and in most cases, it appears to be sustained by increased dietary load or increased intestinal absorption. Previous studies have shown that components of the endogenous digestive microflora, in particular Oxalobacter formigenes, utilize oxalate in the gut, thus limiting its absorption. We tested the hypothesis of whether oxaluria can be reduced by means of reducing intestinal absorption through feeding a mixture of freeze-dried lactic acid bacteria. METHODS: Six patients with idiopathic calcium-oxalate urolithiasis and mild hyperoxaluria (>40 mg/24 h) received daily a mixture containing 8 x 10(11) freeze-dried lactic acid bacteria (L. acidophilus, L. plantarum, L. brevis, S. thermophilus, B. infantis) for four weeks. The 24-hour urinary excretion of oxalate was determined at the end of the study period and then one month after ending the treatment. The ability of bacteria to degrade oxalate and grow in oxalate-containing media, and the gene expression of Ox1T, an enzyme that catalyzes the transmembrane exchange of oxalate, also were investigated. RESULTS: The treatment resulted in a great reduction of the 24-hour excretion of oxalate in all six patients enrolled. Mean levels +/- SD were 33.5 +/- 15.9 mg/24 h at the end of the study period and 28.3 +/- 14.6 mg/24 h one month after treatment was interrupted compared with baseline values of 55.5 +/- 19.6 mg/24 h (P < 0.05). The treatment was associated with a strong reduction of the fecal excretion of oxalate in the two patients tested. Two bacterial strains among those used for the treatment (L. acidophilus and S. thermophilus) proved in vitro to degrade oxalate effectively, but their growth was somewhat inhibited by oxalate. One strain (B. infantis) showed a quite good degrading activity and grew rapidly in the oxalate-containing medium. L. plantarum and L. brevis showed a modest ability to degrade oxalate even though they grew significantly in oxalate-containing medium. No strain expressed the Ox1T gene. CONCLUSIONS: The urinary excretion of oxalate, a major risk factor for renal stone formation and growth in patients with idiopathic calcium-oxalate urolithiasis, can be greatly reduced with treatment using a high concentration of freeze-dried lactic acid bacteria. We postulate that the biological manipulation of the endogenous digestive microflora can be a novel approach for the prevention of urinary stone formation.
Authors:
C Campieri; M Campieri; V Bertuzzi; E Swennen; D Matteuzzi; S Stefoni; F Pirovano; C Centi; S Ulisse; G Famularo; C De Simone
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Kidney international     Volume:  60     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-04     Completed Date:  2001-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1097-105     Citation Subset:  IM    
Affiliation:
Department of Nephrology, S. Orsola University Hospital, Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bacteria* / genetics,  growth & development
Bifidobacterium
DNA, Bacterial / isolation & purification
Feces / chemistry
Freeze Drying
Humans
Hyperoxaluria / metabolism,  therapy*,  urine
Intestinal Absorption
Kidney Calculi / metabolism,  therapy*,  urine
Lactic Acid / metabolism*
Lactobacillus
Middle Aged
Oxalates / analysis*,  urine
Oxalic Acid / analysis
Pilot Projects
Polymerase Chain Reaction
Streptococcus
Chemical
Reg. No./Substance:
0/DNA, Bacterial; 0/Oxalates; 144-62-7/Oxalic Acid; 50-21-5/Lactic Acid

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