Stone research on the bench: where we are and where we are going.
Stone research on the bench: where we are and where we are going.
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板凳上的石头研究：我们现在在哪里，我们要去哪里。
DOI：
10.1089/089277902760261473
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发表时间：
2002
影响因子：
2.7
通讯作者：
Khan,SaeedR
中科院分区：
文献类型：
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作者：
Khan,SaeedR
肾结石形成涉及细胞和细胞外事件。细胞外事件发生在肾小管腔和肾盂中，而细胞事件发生在肾细胞中，包括肾上皮细胞和肾小管细胞。在20世纪世纪中期，大多数基础研究关注细胞外事件，主要是尿液的特殊特征，这些特征将结石形成者尿液与非结石形成者尿液区分开来。有人认为，来自非结石形成个体的尿液含有抑制结晶的物质。含有这些抑制物质的尿液被认为是“好的”，而没有这些物质的尿液被认为是“邪恶的”。1焦磷酸盐、柠檬酸盐、镁和一种未鉴定的低分子量成分被认为是良好尿液的主要成分。也有人认为，尿液中可能含有通过诱导晶体的异质成核来促进结晶的物质。在这方面，对结石的有机基质和称为“基质物质A”的尿粘液进行了详细研究。[2]众所周知，人的尿液处于亚稳定的过饱和状态。因此，非常重视理解溶解度概念和负责维持过饱和和影响晶体成核、生长和聚集的各种因素之间的相互作用。3-5早期的研究人员认为草酸盐（Ox）是一种无害排泄的代谢废物。6Ox只有在与钙结合并形成草酸钙（CaOx）晶体后才变得有害，即使这样，只有当CaOx晶体不能作为结晶颗粒无害地通过时才有害。据计算，通过肾单位是快速的，从肾单位的一端到另一端不到3分钟，并且晶体的生长不够快，仅基于它们的大小就不能保留它们。结论是晶体通过固定滞留在肾单位内是结石形成的必要条件。7
KIDNEY STONE FORMATION involves cellular and extracellular events. Extracellular events occur in renal tubular lumens and renal pelvises, while cellular events take place in the renal cells including cells of the renal epithelium and interstitium. In the middle part of the 20th century most of the basic research was concerned with extracellular events, primarily those special characteristics of the urine, which distinguished stone formers urine from non-stone-formers urine. It was suggested that urine from non-stone-forming individuals contained substances that inhibit crystallization. Urine with these inhibitory substances was considered “good” and urine without them,“evil.” 1 Pyrophosphate, citrate, magnesium, and an unidentified low molecular weight component were considered the main ingredients of good urine. It was also suggested that urine may contain substances that promote crystallization by inducing heterogeneous nucleation of crystals. In this regard, organic matrix of stones and a uromucoid called “Matrix Substance A” were studied in great detail. 2 It was well understood that human urine exists in a metastable supersaturated state. As a result, great emphasis was placed on understanding the solubility concepts and interactions between various factors responsible for maintaining supersaturation and influencing crystal nucleation, growth and aggregation. 3–5 Early researchers considered oxalate (Ox) to be a metabolic waste product that was excreted harmlessly. 6 Ox became harmful only after associating with calcium and forming calcium oxalate (CaOx) crystals and, even then, only when CaOx crystals could not be innocuously passed as crystalluria particles. It was calculated that passage through the nephron is fast, less than 3 min from one end of the nephron to the other, and that the growth of crystals was not fast enough for their retention based only on their size. It was concluded that crystal retention within the nephron through fixation was essential for stone formation. 7