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Role of Oxalobacter formigenes Colonization in Calcium Oxalate Kidney Stone Disease

  • Chapter
The Role of Bacteria in Urology

Abstract

Oxalobacter formigenes is part of the bacterial flora in the large intestine of humans and many other mammalian species. It is unique in that it requires oxalate both as an energy and carbon source. A lack of colonization with O. formigenes is a risk factor for idiopathic recurrent calcium oxalate stone disease. Protection against calcium oxalate stone disease appears to be due to the oxalate degradation that occurs in the gut as measurements of 24 h urinary oxalate indicate that O. formigenes colonized calcium oxalate stone formers excrete less oxalate compared to non-colonized individuals when ingesting standardized diets. There is also some evidence that suggests a possible mechanism involving intestinal oxalate secretion triggered by the bacterium itself, as O. formigenes colonization appears to lower plasma oxalate. Whether high oral doses of this organism can promote sufficient intestinal oxalate secretion to diminish the oxalate burden on the kidney in individuals with Primary Hyperoxaluria is currently being tested by OxThera, Inc. in a phase 2 clinical trial. Much still remains to be learned about how O. formigenes establishes and maintains gut colonization and the precise mechanisms by which it modifies stone risk.

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Acknowledgements

The work from our laboratory was supported by NIH grants DK62284 and DK87967.

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Authors and Affiliations

  1. Department of Urology, University of Alabama at Birmingham, 1720 Second Ave S, Birmingham, AL, 35294, USA

    John Knight PhD & Ross P. Holmes PhD

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  1. John Knight PhD
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  2. Ross P. Holmes PhD
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Correspondence to Ross P. Holmes PhD .

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Editors and Affiliations

  1. Basic Science Research, The Stone Centre at Vancouver General Hospital, Vancouver, British Columbia, Canada

    Dirk Lange

  2. Clinical Research, The Stone Center at Vancouver General Hospital, Vancouver, British Columbia, Canada

    Ben Chew

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Knight, J., Holmes, R.P. (2016). Role of Oxalobacter formigenes Colonization in Calcium Oxalate Kidney Stone Disease. In: Lange, D., Chew, B. (eds) The Role of Bacteria in Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-17732-8_8

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  • DOI: https://doi.org/10.1007/978-3-319-17732-8_8

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17731-1

  • Online ISBN: 978-3-319-17732-8

  • eBook Packages: MedicineMedicine (R0)

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