Oxalate degrading bacteria: new treatment option for patients with primary and secondary hyperoxaluria?
- Bernd HoppeAffiliated withUniversity Children’s Hospital Cologne, Division of Pediatric Nephrology Email author
- , Gerd von UnruhAffiliated withDepartment of Internal Medicine I, University of Bonn
- , Norbert LaubeAffiliated withDivision of Experimental Urology, Department of Urology
- , Albrecht HesseAffiliated withDivision of Experimental Urology, Department of Urology
- , Harmeet SidhuAffiliated withIxion Biotechnology Inc, Gainesville
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Current treatment options in patients with primary and secondary hyperoxaluria are limited and do not always lead to sufficient reduction in urinary oxalate excretion. Intestinal oxalate degrading bacteria are capable of degrading oxalate to CO2 and formate, the latter being further metabolized and excreted via the feces. It is speculated, that both endogenously produced, as well as dietary oxalate can be significantly removed via the intestinal tract. Oxalobacter formigenes, an obligate anaerobic microbe normally found in the intestinal tract has one oxalate degrading enzyme, oxalyl-CoA decarboxylase, which is also found in Bifidobacterium lactis. Other bacteria with possible oxalate degrading potency are lactic acid bacteria, as well as Enterococcus faecalis and Eubacterium lentum. However, specific therapeutic studies on humans are scarce and, except for Oxalobacter, data are not congruent. We found the oral application of Oxalobacter successful in patients with primary hyperoxaluria. However, long-term post-treatment follow-up of 1–2 years showed that constant intestinal colonization is not achieved in most patients. In one patient with constant colonization, urinary oxalate excretion normalized over time. Short-term studies with other bacteria such as lactic acid bacteria did not show a specific reduction in urinary oxalate excretion. O. formigenes might be a promising new therapeutic tool in patients with primary and secondary hyperoxaluria.
KeywordsPrimary Secondary Hyperoxaluria Oxalate degrading bacteria Treatment
- Oxalate degrading bacteria: new treatment option for patients with primary and secondary hyperoxaluria?
Volume 33, Issue 5 , pp 372-375
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- 1. University Children’s Hospital Cologne, Division of Pediatric Nephrology, University of Cologne, Kerpenerstrasse 62, 50931 Cologne, Germany
- 2. Department of Internal Medicine I, University of Bonn, Germany
- 3. Division of Experimental Urology, Department of Urology, University of Bonn, Germany
- 4. Ixion Biotechnology Inc, Gainesville, FL, USA