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Am J Physiol Renal Physiol (September 26, 2007). doi:10.1152/ajprenal.00383.2007
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Submitted on August 12, 2007
Accepted on September 24, 2007

Renal Calcinosis and Stone Formation in Mice Lacking Osteopontin, Tamm-Horsfall Protein or Both

Lan Mo1, Lucy Liaw2, Andrew P. Evan3, Andre J. Sommer4, John C. Lieske5, and Xue-Ru R. Wu1*

1 Urology, New York University School of Medicine, New York, New York, United States
2 Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, Maine, United States
3 Department of Anatomy, MS-259, Indiana University School of Medicine, Indianapolis,, Indiana, United States
4 Department of Chemistry and Biochemistry, Miami University, Miami, Florida, United States
5 Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States

* To whom correspondence should be addressed. E-mail: xue-ru.wu{at}med.nyu.edu.

Although often supersaturated with mineral salts such as calcium phosphate and calcium oxalate, normal urine possesses an innate ability to keep them from forming harmful crystals. This inhibitory activity has been attributed to the presence of urinary macromolecules, although controversies abound regarding their role, or lack thereof, in preventing renal mineralization. Here we show that 10% of the mice lacking osteopontin (OPN) and 14.3% of the mice lacking Tamm-Horsfall protein (THP) spontaneously form interstitial deposits of calcium phosphate within the renal papillae, events never seen in wild-type mice. Lack of both proteins causes renal crystallization in 39.3% of the double null mice. Urinalysis revealed elevated concentrations of urine phosphorus and brushite (calcium phosphate) supersaturation in THP-null and OPN/THP-double null mice, suggesting that impaired phosphorus handling may be linked to interstitial papillary calcinosis in THP-, but not in OPN-null mice. In contrast, experimentally induced hyperoxaluria provokes widespread intratubular calcium oxalate crystallization and stone formation in OPN/THP double null mice, while completely sparing the wild-type controls. Whole urine from OPN-, THP-, or double-null mice all possessed a dramatically reduced ability to inhibit the adhesion of calcium oxalate monohydrate crystals to renal epithelial cells. These data establish OPN and THP as powerful and functionally synergistic inhibitors of calcium phosphate and calcium oxalate crystallization in vivo, and suggest that defects in either molecule may contribute to renal calcinosis and stone formation, an exceedingly common condition that afflicts up to 12% males and 5% females.




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