Macrophage Function in Calcium Oxalate Kidney Stone Formation: A Systematic Review of Literature

Abstract

BackgroundThe global prevalence and recurrence rate of kidney stones is very high. Recent studies of Randall plaques and urinary components in vivo, and in vitro including gene manipulation, have attempted to reveal the pathogenesis of kidney stones. However, the evidence remains insufficient to facilitate the development of novel curative therapies. The involvement of renal and peripheral macrophages in inflammatory processes offers promise that might lead to the development of therapeutic targets. The present systematic literature review aimed to determine current consensus about the functions of macrophages in renal crystal development and suppression, and to synthesize evidence to provide a basis for future immunotherapy.MethodsWe systematically reviewed the literature during February 2021 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles investigating the relationship between macrophages and urolithiasis, particularly calcium oxalate (CaOx) stones, were extracted from PubMed, MEDLINE, Embase, and Scopus. Study subjects, languages, and publication dates were unrestricted. Two authors searched and screened the publications.ResultsAlthough several studies have applied mixed modalities, we selected 10, 12, and seven (total, n = 29) of 380 articles that respectively described cultured cells, animal models, and human samples.The investigative trend has shifted to macrophage phenotypes and signaling pathways, including micro (m)-RNAs since the discovery of macrophage involvement in kidney stones in 1999. Earlier studies of mice-associated macrophages with the acceleration and suppression of renal crystal formation. Later studies found that pro-inflammatory M1- and anti-inflammatory M2-macrophages are involved. Studies of human-derived and other macrophages in vitro and ex vivo showed that M2-macrophages (stimulated by CSF-1, IL-4, and IL-13) can phagocytose CaOx crystals, which suppresses stone development. The signaling mechanisms that promote M2-like macrophage polarization toward CaOx nephrocalcinosis, include the NLRP3, PPARγ-miR-23-Irf1/Pknox1, miR-93-TLR4/IRF1, and miR-185-5p/CSF1 pathways.Proteomic findings have indicated that patients who form kidney stones mainly express M1-like macrophage-related proteins, which might be due to CaOx stimulation of the macrophage exosomal pathway.ConclusionsThis systematic review provides an update regarding the current status of macrophage involvement in CaOx nephrolithiasis. Targeting M2-like macrophage function might offer a therapeutic strategy with which to prevent stones via crystal phagocytosis.

Construction and Analysis of Immune Infiltration-Related ceRNA Network for Kidney Stones

“…The polarization of macrophages has been recognized to be involved in the pathogenesis of kidney stones ( Taguchi et al, 2021 ). Taguchi et al (2016) found that M1-macrophage transfusion promoted kidney stone formation in hyperoxaluric mice and that M2-macrophage transfusion suppressed stone formation.…”

“…Conventionally, the immune system plays a crucial role in the formation and pathogenesis of kidney stones. Throughout kidney stone development, CaOx crystals promote the secretion of inflammatory cytokines and chemokines, possibly recruiting various immune cells to renal interstitium, including neutrophils, macrophages, and T cells ( Zhu et al, 2019 ; Taguchi et al, 2021 ). The dysfunction of the immune microenvironment in the kidney could not only initiate adverse factors, but also further exacerbate kidney stone formation ( Khan et al, 2021 ).…”

“…The dysfunction of the immune microenvironment in the kidney could not only initiate adverse factors, but also further exacerbate kidney stone formation ( Khan et al, 2021 ). Previous studies have revealed that M2 macrophages can phagocytize and degrade crystals to suppress stone formation and prevent CaOx inflammatory damage ( Taguchi et al, 2021 ). However, the polarization of M1 macrophages induces cell damage and increases stone burden ( Taguchi et al, 2021 ).…”

“…Previous studies have revealed that M2 macrophages can phagocytize and degrade crystals to suppress stone formation and prevent CaOx inflammatory damage ( Taguchi et al, 2021 ). However, the polarization of M1 macrophages induces cell damage and increases stone burden ( Taguchi et al, 2021 ). In this context, another study has shown that aberrant γδT cells were activated and accumulated in CaOx kidney stones in a mouse model ( Zhu et al, 2019 ).…”

Identification of the pivotal role of SPP1 in kidney stone disease based on multiple bioinformatics analysis

“…In addition, SPP1 is a chemical attractant for macrophages, which could regulate immune response through macrophages infiltration [ 8 ]. Recently, macrophage polarization is confirmed to play an important role in the development of KSD [ 11 ]. However, no study has investigated the relationship between SPP1 and macrophages in KSD, which needs to be fully explored.…”