MP07-12 REVISITING THE ROLE OF OXALOBACTER FORMIGENES IN STONE FORMATION: A DEEP DIVE INTO THE MICROBIOME AT MULTIPLE BODY SITES

Abstract

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology (MP07)1 Sep 2021MP07-12 REVISITING THE ROLE OF OXALOBACTER FORMIGENES IN STONE FORMATION: A DEEP DIVE INTO THE MICROBIOME AT MULTIPLE BODY SITES Kait Al, Benjamin Joris, John Denstedt, John Chmiel, Jennifer Bjazevic, Gregory Gloor, Hassan Razvi, and Jeremy Burton Kait AlKait Al More articles by this author , Benjamin JorisBenjamin Joris More articles by this author , John DenstedtJohn Denstedt More articles by this author , John ChmielJohn Chmiel More articles by this author , Jennifer BjazevicJennifer Bjazevic More articles by this author , Gregory GloorGregory Gloor More articles by this author , Hassan RazviHassan Razvi More articles by this author , and Jeremy BurtonJeremy Burton More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001980.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a longstanding belief that intestinal colonization by Oxalobacter formigenes can reduce the risk of oxalate-based stone disease through its capacity to degrade calcium oxalate. However, literature on the topic remains controversial, and mounting evidence instead suggests a polymicrobial effect from both the urinary and gut microbiome may play a greater role in the disease. The aim of the present study was to address this knowledge gap by comprehensively characterizing the microbial communities of interest in kidney stone formers and healthy controls. METHODS: In the largest study of its kind, the microbiota of fecal and urine samples from 83 stone formers (SF) and 30 healthy controls (HC) was evaluated with whole shotgun metagenomic sequencing and 16S rRNA amplicon sequencing, respectively. Stone fragments and intraoperative urine from SF were also analyzed, and urinary oxalate concentrations were determined with HPLC. RESULTS: The findings demonstrate that despite similar dietary micronutrient consumption between the groups, urinary oxalate concentrations were higher in the SF cohort. Alongside these differences, the SF gut microbiota was significantly enriched in Enterobacteriaceae and several presumptive uropathogens, while depleted in microbes known to be beneficial such as Faecalibacterium prausnitzii. The gut microbiota of SFs was also aberrant compared to HC in several metabolic capacities. Importantly, there was no difference between groups in the relative abundance of O. formigenes, nor genes involved in oxalate catabolism including formyl-CoA transferase and oxalyl-CoA decarboxylase. The urinary microbiota was altered between HC and SF, and significantly differed in the SF over time (pre-operative vs. intraoperative urine samples), exhibiting enrichment in pathogenic bacteria following perioperative antibiotic treatment that were similar to those elevated in the SF gut. Interestingly, kidney stones harboured a microbiota distinct from urine, and this was not dictated by the stone's crystalline composition. CONCLUSIONS: Together these findings suggest that the microbiome of SF is dysfunctionally altered in a multimodal manner, aggravating stone formation. The microbiome at multiple body sites, as an interconnected system, likely plays a far more significant role in nephrolithiasis beyond the dogmatic perspective that O. formigenes colonization is the key to stone prevention. Source of Funding: W. Garfield Weston Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e144-e144 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kait Al More articles by this author Benjamin Joris More articles by this author John Denstedt More articles by this author John Chmiel More articles by this author Jennifer Bjazevic More articles by this author Gregory Gloor More articles by this author Hassan Razvi More articles by this author Jeremy Burton More articles by this author Expand All Advertisement Loading ...