Publications by authors named "Ross Holmes"

Oxalobacter formigenes, a unique anaerobic bacterium that relies solely on oxalate for growth, is a key oxalate-degrading bacterium in the mammalian intestinal tract. Degradation of oxalate in the gut by plays a critical role in preventing renal toxicity in animals that feed on oxalate-rich plants. The role of in reducing the risk of calcium oxalate kidney stone disease and oxalate nephropathy in humans is less clear, in part due to difficulties in culturing this organism and the lack of studies which have utilized diets in which the oxalate content is controlled.

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  • Patients with kidney stones are advised to limit animal protein, sodium, and oxalate while eating a diet rich in fruits and vegetables and having moderate calcium intake, usually from dairy.
  • This study compared the nutritional contents of popular milk alternatives regarding their effects on kidney stones and chronic kidney disease.
  • Oat, macadamia, rice, and soy milk have similar nutritional profiles to dairy milk and may pose lower risks for kidney stones, while almond and cashew milk are higher in risk factors, and coconut milk may be beneficial for chronic kidney disease due to its low potassium, sodium, and oxalate content.
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  • Kidney stone disease is becoming more common, with calcium oxalate being the most prevalent type of stone, influenced by both diet and the body's production of oxalate.
  • Research shows that dietary oxalate impacts urinary oxalate levels and the risk of developing kidney stones, with gut bacteria potentially helping to lower this risk by reducing oxalate absorption.
  • Ascorbic acid (vitamin C) is the key dietary source leading to internal oxalate production, and understanding how these factors interact is crucial in addressing kidney stone disease.
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Introduction: Crystalluria is thought to be associated with kidney stone formation and can occur when urine becomes supersaturated with calcium, oxalate, and phosphate. The principal method used to identify urinary crystals is microscopy, with or without a polarized light source. This method can detect crystals above 1 μm in diameter (microcrystals).

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Purpose Of Review: The review of potential therapies in the treatment of hyperoxaluria is timely, given the current excitement with clinical trials and the mounting evidence of the importance of oxalate in both kidney stone and chronic kidney disease.

Recent Findings: Given the significant contribution of both endogenous and dietary oxalate to urinary oxalate excretions, it is not surprising therapeutic targets are being studied in both pathways. This article covers the existing data on endogenous and dietary oxalate and the current targets in these pathways.

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The major clinical manifestation of the Primary Hyperoxalurias (PH) is increased production of oxalate, as a consequence of genetic mutations that lead to aberrant glyoxylate and hydroxyproline metabolism. Hyperoxaluria can lead to the formation of calcium-oxalate kidney stones, nephrocalcinosis and renal failure. Current therapeutic approaches rely on organ transplants and more recently modifying the pathway of oxalate synthesis using siRNA therapy.

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The rate of disease progression in autosomal-dominant (AD) polycystic kidney disease (PKD) exhibits high intra-familial variability suggesting that environmental factors may play a role. We hypothesized that a prevalent form of renal insult may accelerate cystic progression and investigated tubular crystal deposition. We report that calcium oxalate (CaOx) crystal deposition led to rapid tubule dilation, activation of PKD-associated signaling pathways, and hypertrophy in tubule segments along the affected nephrons.

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  • Primary Hyperoxaluria (PH) is a rare genetic disorder that leads to high oxalate levels in the body, causing kidney stones and potential kidney failure.
  • Recent research indicates that using RNA interference (RNAi) can effectively reduce oxalate production by targeting the LDHA enzyme in the liver, leading to significant reductions in urinary oxalate levels in mouse models of PH.
  • The findings suggest the potential for RNAi treatments in managing PH, but further studies are needed to understand the full metabolic impact and alternative pathways for oxalate production in different tissues.
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Introduction: Compliance with 24-hour urine collections for assessing kidney stone risk is important in assigning preventive therapy. We determined factors associated with compliance and the impact of an intervention.

Methods: In 2015 those patients requiring 24-hour urine testing were instructed to contact the vendor (Litholink®) and were given instructions by the same nurse to arrange for collections.

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Dietary oxalate is plant-derived and may be a component of vegetables, nuts, fruits, and grains. In normal individuals, approximately half of urinary oxalate is derived from the diet and half from endogenous synthesis. The amount of oxalate excreted in urine plays an important role in calcium oxalate stone formation.

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There is a paucity of studies addressing the accuracy of 24-hour urine collection for assessing stone risk parameters. Collection accuracy is thought to be essential for assigning optimal therapy for stone prevention. The objective of this study was to determine factors associated with accurate and inaccurate collections.

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  • TRPV5 is a calcium channel in the kidney essential for calcium reabsorption, and a specific genetic variant (A563T) enhances its transport function.
  • The study used computational modeling to analyze how this genetic change affects TRPV5’s structure and dynamics, revealing increased stability and interactions that improve calcium transport.
  • Findings show that the A563T variation not only stabilizes TRPV5 but also enlarges the pore radius at the calcium-selective filter, leading to increased calcium influx.
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  • Endogenous oxalate synthesis is a key factor in calcium oxalate stone disease, particularly in inherited conditions like primary hyperoxaluria (PH), but its mechanisms are not fully understood.
  • A study involving 28 participants measured how hydroxyproline (Hyp) metabolism contributes to the formation of oxalate and glycolate through intravenous infusions, revealing significant differences between healthy individuals and those with various types of PH.
  • Results showed that Hyp metabolism is a significant source of urinary oxalate in individuals with PH, especially PH2 and PH3; however, the main sources of oxalate in PH1 patients remain unidentified.
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Monocytes/macrophages are thought to be recruited to the renal interstitium during calcium oxalate (CaOx) kidney stone disease for crystal clearance. Mitochondria play an important role in monocyte function during the immune response. We recently determined that monocytes in patients with CaOx kidney stones have decreased mitochondrial function compared to healthy subjects.

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TRPV5 is a Ca-selective channel that plays a key role in the reabsorption of Ca ions in the kidney. Recently, a rare L530R variation (rs757494578) of TRPV5 was found to be associated with recurrent kidney stones in a founder population. However, it was unclear to what extent this variation alters the structure and function of TRPV5.

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Potato virus Y (PVY) is the most important viral pathogen affecting potato crops worldwide. PVY can be transmitted non-persistently by aphids that do not colonize the host plant, resulting in a rapid acquisition and transmission of the virus between plants. PVY exists as a complex of strains that can be distinguished according to their pathogenicity, serology and genomic analysis.

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  • Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) was studied to see if it correlates with fat malabsorption in severely obese patients.
  • Before RYGB, patients had mild to moderate steatorrhea but no correlation between fecal fat and urine oxalate excretion was found, while after RYGB, steatorrhea and urine oxalate increased significantly with a positive correlation.
  • The study suggests that while hyperoxaluria was common pre-bypass, it was likely not due to excess unabsorbed fats, but possibly driven by other factors like obesity or metabolic syndrome, with a more direct correlation observed post-surgery.
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Recent advances in RNA interference (RNAi) delivery and chemistry have resulted in the development of more than 20 RNAi-based therapeutics, several of which are now in Phase III trials. The most advanced clinical trials have utilized modifications such as lipid nanoparticles and conjugation to N-acetyl galactosamine to treat liver specific diseases. Recent reports have suggested that reducing endogenous oxalate synthesis by RNAi may be a safe and effective therapy for patients with the rare disease, Primary Hyperoxaluria (PH).

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Primary hyperoxaluria type 1 (PH1), an inherited rare disease of glyoxylate metabolism, arises from mutations in the enzyme alanine-glyoxylate aminotransferase. The resulting deficiency in this enzyme leads to abnormally high oxalate production resulting in calcium oxalate crystal formation and deposition in the kidney and many other tissues, with systemic oxalosis and ESRD being a common outcome. Although a small subset of patients manages the disease with vitamin B6 treatments, the only effective treatment for most is a combined liver-kidney transplant, which requires life-long immune suppression and carries significant mortality risk.

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In humans, approximately 60 mg of ascorbic acid (AA) breaks down in the body each day and has to be replaced by a dietary intake of 70 mg in women and 90 mg in men to maintain optimal health and AA homeostasis. The breakdown of AA is non-enzymatic and results in oxalate formation. The exact amount of oxalate formed has been difficult to ascertain primarily due to the limited availability of healthy human tissue for such research and the difficulty in measuring AA and its breakdown products.

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Objective: To investigate whether mitochondrial function is altered in circulating immune cells from calcium oxalate (CaOx) stone formers compared to healthy subjects.

Materials And Methods: Adult healthy subjects (n = 18) and CaOx stone formers (n = 12) were included in a pilot study. Data collection included demographic and clinical values from electronic medical records.

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Background And Purpose: Urinary oxalate excretion is a risk factor for nephrolithiasis and is a result of endogenous metabolism and gastrointestinal processes. Gastrointestinal absorption of oxalate has been well demonstrated but to our knowledge evidence for secretion of oxalate is absent in humans. The objective of this study was to measure the amount and conformation of oxalate in the stomach and small intestine of adult subjects undergoing gastrointestinal endoscopy.

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is a unique intestinal organism that relies on oxalate degradation to meet most of its energy and carbon needs. A lack of colonization is a risk factor for calcium oxalate kidney stone disease. The release of the genome sequence of has provided an opportunity to increase our understanding of the biology of .

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The hereditary kidney stone disease primary hyperoxaluria type 1 (PH1) is caused by a functional deficiency of the liver-specific, peroxisomal, pyridoxal-phosphate-dependent enzyme, alanine:glyoxylate aminotransferase (AGT). One third of PH1 patients, particularly those expressing the p.[(Pro11Leu; Gly170Arg; Ile340Met)] mutant allele, respond clinically to pharmacological doses of pyridoxine.

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Transient receptor potential cation channels, vanilloid subfamily, member 5 (TRPV5) plays a key role in active Ca(2+) reabsorption in the kidney. Variations in TRPV5 occur at high frequency in African populations and may contribute to their higher efficiency of Ca(2+) reabsorption. One of the African specific variations, A563T, exhibits increased Ca(2+) transport ability.

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