Crystallization of L-cystine is a critical process in the pathogenesis of kidney stone formation in cystinuria, a disorder affecting more than 20 000 individuals in the United States alone. In an effort to elucidate the crystallization of L-cystine and the mode of action of tailored growth inhibitors that may constitute effective therapies, real-time in situ atomic force microscopy has been used to investigate the surface micromorphology and growth kinetics of the {0001} faces of L-cystine at various supersaturations and concentrations of the growth inhibitor Lcystine dimethylester (CDME). Crystal growth is actuated by screw dislocations on the {0001} L-cystine surface, producing hexagonal spiral hillocks that are a consequence of six interlacing spirals of anisotropic molecular layers. The high level of elastic stress in the immediate vicinity around the dislocation line results in a decrease in the step velocities and a corresponding increase in the spacing of steps. The kinetic curves acquired in the presence of CDME conform to the classical Cabrera−Vermilyea model. Anomalous birefringence in the {101̅ 0} growth sectors, combined with computational modeling, supports a high fidelity of stereospecific binding of CDME, in a unique orientation, exclusively at one of the six crystallographically unique projections on the {101̅ 0} plane.
■ INTRODUCTIONCystinuria, a genetic disorder that afflicts more than 20 000 individuals in the United States alone, is associated with abnormal levels of L-cystine in the kidney and is often accompanied by recurring formation of L-cystine stones. Current treatments for L-cystine stone prevention include dilution through high fluid intake, 1 increasing urine pH through ingestion of alkalinizing potassium or sodium salts, 1,2 or the administration of L-cystine binding thiol drugs (CBTDs). 3 These treatments suppress, but typically do not completely prevent, stone formation. Moreover, CBTDs do not reduce Lcystine concentrations sufficiently at dosages regarded as below the threshold for hypersensitivity and toxicity. Our laboratory recently demonstrated that low concentrations of certain additivesmethyl esters of L-cystine that mimic the structure of L-cystineinhibited the formation of L-cystine crystals, suggesting a new approach to a therapy for this disease. 4 Realtime in situ atomic force microscopy (AFM) of L-cystine crystals in supersaturated L-cystine solutions revealed growth hillocks emanating from screw dislocations on the (0001) face. The micromorphology of these hillocks was attributed to interlaced spirals of anisotropic molecular layers of L-cystine bunching in a manner that deceptively appeared as stacks of hexagonal islands. The addition of the L-cystine methyl esters to the growth solution resulted in roughening of the hillock steps as well as a decrease in step velocity. These observations suggested that step pinning by "molecular imposters," sometimes referred to as tailor-made additives that are known to affect crystal morphology, 5−7 was responsible for growth i...