Crystal-cell interaction in the pathogenesis of kidney stone disease.
OBJECTIVE
Renal stone formation depends not so much on the formation of crystals, but on their retention in the kidney. Evidence has emerged that crystal retention is caused predominantly by the adherence of crystals to the epithelial cells lining the renal tubules. Understanding the mechanisms involved in crystal retention could lead to new therapeutic approaches for interfering with the renal stone-forming process in patients. Cell-culture studies have been performed to obtain insights into the susceptibility of the cell surface to crystal attachment, and to uncover cell-surface crystal-binding molecules. This review aims to put the relevant publications of the last decade in perspective.


RESULTS
Crystal-cell interaction has been investigated by using various renal tubular cell types in culture. Such studies have yielded several candidate crystal-binding molecules, including phosphatidylserine, sialic acid, collagen IV, osteopontin and, recently, hyaluronan.


CONCLUSIONS
Here, the results obtained in crystal-binding studies are recapitulated, compared and evaluated. Arguments are provided in support of the view that many of the proposed crystal-binding molecules could be linked in the series of events resulting in crystal retention. Under pathological conditions, pericellular matrices rich in the polysaccharide hyaluronan are proposed as the key binding substance for crystals at the surface of renal tubular cells.
Asselman
Marino
M
Department of Urology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Verkoelen
Carl Friedrich
CF
D000818:Animals; D002478:Cells, Cultured; D003460:Crystallization; D005109:Extracellular Matrix / Q000378:metabolism; D006801:Humans; D006820:Hyaluronic Acid / Q000737:chemistry / Q000378:metabolism; D007669:Kidney Calculi / Q000209:etiology*; D019158:N-Acetylneuraminic Acid / Q000378:metabolism; D010718:Phosphatidylserines / Q000378:metabolism
D010718:Phosphatidylserines; D006820:Hyaluronic Acid; D019158:N-Acetylneuraminic Acid