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A critical analysis of the role of gut Oxalobacter formigenes in oxalate stone disease
Author(s) -
Siva Siddharth,
Barrack Evelyn R.,
Reddy G. Prem Veer,
Thamilselvan Vijayalakshmi,
Thamilselvan Sivagnanam,
Me Mani,
Bhandari Mahendra
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08122.x
Subject(s) - oxalate , calcium oxalate , colonization , obligate anaerobe , probiotic , microbiology and biotechnology , disease , kidney stones , urinary system , bacteria , medicine , biology , chemistry , genetics , organic chemistry
Hyperoxaluria is a major risk factor for the formation of calcium oxalate stones, but dietary restriction of oxalate intake might not be a reliable approach to prevent recurrence of stones. Hence, other approaches to reduce urinary oxalate to manage stone disease have been explored. The gut‐dwelling obligate anaerobe Oxalobacter formigenes (OF) has attracted attention for its oxalate‐degrading property. In this review we critically evaluate published studies and identify major gaps in knowledge. Recurrent stone‐formers are significantly less likely to be colonized with OF than controls, but this appears to be due to antibiotic use. Studies in animals and human subjects show that colonization of the gut with OF can decrease urinary oxalate levels. However, it remains to be determined whether colonization with OF can affect stone disease. Reliable methods are needed to detect and quantify colonization status and to achieve durable colonization. New information about oxalate transport mechanisms raises hope for pharmacological manipulation to decrease urinary oxalate levels. In addition, probiotic use of lactic acid bacteria that metabolize oxalate might provide a valid alternative to OF.