Differential oral and gut microbial structure related to systemic metabolism in kidney stone patients.

OBJECTIVES: To investigate the role of the oral and gut microbiome related to systemic metabolism and clinical parameters in various types of kidney stone disease. PATIENTS AND METHODS: We conducted a case-control study by analyzing 16S rRNA and untargeted metabolomics profiling of 76 fecal, 68 saliva, 73 urine, and 43 serum samples from 76 participants aged 18-75 years old. The participants included 15 patients with uric acid stones, 41 patients with calcium oxalate stones, and 20 healthy controls. Correlations among microbiome, metabolism, and clinical parameters were identified through Spearman's correlation analysis. (Clinical trial No. ChiCTR2200055316). RESULTS: Patients with uric acid stones exhibited reduced richness and diversity in their microbiome, as well as altered composition in both oral and gut microbiome. Furthermore, their fecal samples showed lower relative abundances of Bacteroides and Lachnospiraceae, while their saliva samples showed higher relative abundances of Porphyromonas and Neisseria. Predicted KEGG metabolism pathways, including amino acid and fatty acid metabolisms, were significantly altered in subjects with uric acid stones. Oral, gut microbiota, and metabolism were also associated with low water intake and urine pH. The area under the curve (AUC) of the specific microbiota and metabolite prediction models was over 0.85. CONCLUSION: The structure and composition of the oral and gut microbiome in different types of kidney stone disease, the correlations between oral and gut microbiome, and the associations among oral and gut microbiota, systemic metabolism and clinical parameters imply an important role that the oral and gut microbiome may play in kidney stone disease.

Ureteroscopic and flexible ureteroscopic lithotripsy: continuation or discontinuation of anticoagulant or antiplatelet drugs? A Chinese survey among urologists.

PURPOSE: To evaluate the management of antithrombotic drugs made by different urologists before ureteroscopic lithotripsy and flexible ureteroscopy in stone patients undergoing active anticoagulant or antiplatelet therapy. METHODS: A survey was distributed to 613 urologists in China, which included personal work information and views on the management of anticoagulants (AC) or antiplatelet (AP) drugs during the perioperative period of ureteroscopic lithotripsy (URL) and flexible ureteroscopy (fURS). RESULTS: 20.5% of urologists believed that AP drugs could be continued and 14.7% believed that AC drugs could be continued. 26.1% of the urologists who participated in more than 100 ureteroscopic lithotripsy or flexible ureteroscopy surgeries each year believed that AP drugs could be continued and 19.1% believed that AC drugs could be continued, compared with 13.6% (P < 0.01) and 9.2% (P < 0.01) of the urologists who performed less than 100 surgeries. Among the urologists with more than 20 cases undergoing active AC or AP therapy per year, 25.9% thought that AP drugs could be continued and 19.7% thought that AC drugs could be continued, compared with 17.1% (P = 0.008) and 11.5% (P = 0.005) of the urologists with less than 20 cases. CONCLUSION: The decision on the continuation of AC or AP drugs before ureteroscopic and flexible ureteroscopic lithotripsy should be individualized. The experience in URL and fURS surgeries and in dealing with patients under AC or AP therapy is the influencing factor.

Upregulation of KLF14 expression attenuates kidney fibrosis by inducing PPARα-mediated fatty acid oxidation.

Tubulointerstitial fibrosis (TIF) is essential during the development of end-stage kidney disease (ESKD) and is associated with the impairment of fatty acid oxidation (FAO). Kruppel-like factor 14 (KLF14) is an important gene in lipid metabolism, but its role in TIF remains unknown. TGF-ß-stimulated HK-2 cells and mouse unilateral ureteral obstruction (UUO) were used as renal fibrosis models. The role of KLF14 in the process of renal fibrosis was verified by gene knockout mice, genetic or pharmacological interference in animal model and cell model respectively. In the current study, we found that KLF14 expression increased after activation of the TGF-ß signaling pathway during TIF. In KLF14-/- mice, more severe fibrosis was observed after unilateral ureteral obstruction (UUO) was induced. In human HK2 cells, knockdown of KLF14 led to more severe fibrosis induced by TGF-ß1, while overexpression of KLF14 partially attenuated this process. Specifically, KLF14 deficiency decreased mitochondrial FAO activity, resulting in lipid accumulation. Thus, the energy supply to the cells was insufficient, finally resulting in TIF. We further proved that KLF14 could target peroxisome proliferator activated receptor alpha (PPARα) as a transcriptional activator. This study identified the upregulation of KLF14 expression in response to kidney stress during the process of fibrosis. Upon TIF, the activated TGF-ß signaling pathway can enhance KLF14 expression, while the upregulation of KLF14 expression can decrease the degree of TIF by improving FAO activity in tubular epithelial cells and recovering the energy supply mediated by PPARα.

Estimation of the fraction of soil-borne particulates in indoor air by PMF and its impact on health risk assessment of soil contamination in Guangzhou, China.

The fraction of soil-borne particulates in indoor air (fspi), a principal exposure factor in health risk assessment of soil, is used to calculate the inhaled dose of contaminants in air particulates (PM10) from soil. To investigate the fspi, consecutive 24-h PM10 samples (n = 180) of indoor ambient were collected from September 2019 to January 2020 in Guangzhou main urban areas, China. The concentrations of twenty-six metal elements, five anions, organic carbon (OC) and elemental carbon (EC) in samples were measured. The sources of indoor ambient PM10 and the value of fspi were identified by the method of Positive Matrix Factor analysis (PMF). Results showed that the main sources contributing to indoor PM10 content were combustion sources (50.53%) and vehicular sources (28.17%). The soil sources (the local fspi) were 19.96%. The soil contents of indoor PM10 in Guangzhou main urban areas were in accordance with those in similar monsoon climate regions, such as Malaysia. The health risks of the inhalation route were dropped by about 62% for some common brownfield contaminants (Cr (VI), Ni, Be and Cd) with the investigated local fspi in Guangzhou main urban areas, compared with using the fspi (0.8) recommended by the C-RAG model in China. The results supplied a new effective methodology for estimation of the local fspi value in health risk assessment of soil contamination in urban areas.

Improving cadmium accumulation by Solanum nigrum L. via regulating rhizobacterial community and metabolic function with phosphate-solubilizing bacteria colonization.

Soil cadmium (Cd) mobilized with phosphate-solubilizing bacteria (PSB), especially for strains effectively colonized in rhizosphere, is an important pathway for promoting its accumulation by Cd-hyperaccumulators. In this study, screened PSB strains, Acinetobacter pittii (AP) and Escherichia coli (EC), were used to evaluate their effects on Cd mobilization in rhizosphere, Cd accumulation by Solanum nigrum L., and rhizobacterial community and metabolic function under different colonization condition. Results indicated that AP or EC inoculated in soils significantly promoted plant growth, and simultaneously motivated Cd accumulation in S. nigrum L. by 119% and 88%, respectively, when compared with that of uninoculated treatment. Higher efficiency colonization of AP contributed to more organic acids (malic, l-proline, l-alanine, and γ-aminobutanoic) production in the rhizosphere soil and Cd accumulation by S. nigrum L., when compared with that of EC treatment. Taxonomic distribution and co-occurrence network analyses demonstrated that inoculation of AP or EC enriched dominant microbial taxa with plant growth promotion function and keystone taxa related to Cd mobilization in the rhizosphere soil, respectively. Inoculated strains up-regulated the expression of genes related to bacterial mobility, amino acid metabolism, and carbon metabolism among rhizobacterial community. Overall, this study provided a feasible method for soil Cd phytoremediation by promoting Cd mobilization with the enhancement of keystone taxa and organic acid secretion based on the high-efficiency colonization of PSB.

Regulation of heavy metals accumulated by Acorus calamus L. in constructed wetland through different nitrogen forms.

Improving accumulation of heavy metals (HMs) by plants is an important pathway for constructed wetland (CW) to alleviate the environmental risks caused by their release. This study aims to regulate HMs (Cr, Ni, Cu, Zn, and Cd) accumulated by Acorus calamus L. in the sandy substrate CW with different nitrogen forms, including ammonia (NH4+), nitrate (NO3‾), and NH4+/NO3‾ (1:1) in synthetic tailwaters. In general, the removal efficiency of HMs by CW could reach 92.4% under the initial concentrations below 500 µg/L. Accumulation percentages of HMs in the shoots and roots of plants in CW with NH4+ and NH4+/NO3‾ influents increased by 52-395% and 15-101%, respectively, when compared with that of NO3‾ treatment. Influents with NH4+ promoted plant growth of Acorus calamus L. and metabolic functions, such as carbohydrate metabolism/amino acid metabolism, related to HMs mobilization of rhizosphere bacterial communities, which might induce more organic acids and amino acids secreted by plants and microbes during their metabolic processes. These are the main reasons for the enhancive mobilization of HMs from their precipitation fractions and their uptake by plants in CW with NH4+ treatments. Moreover, the enhancement of organics secreted from plants and microbes also led to the high denitrification efficiency and nitrogen removal in CW. Overall, this study could provide a feasible method for the enhancive accumulation of HMs by wetland plants via the regulation water treatment process to appropriately increase NH4+ for CW.