Application of metabolomics in urolithiasis: the discovery and usage of succinate

• Published in: Signal transduction and targeted therapy Vol. 8; no. 1; pp. 41 - 13
• Main Authors: Zhang, Xiu-zhen, Lei, Xiong-xin, Jiang, Yan-lin, Zhao, Long-mei, Zou, Chen-yu, Bai, Yun-jin, Li, Ya-xing, Wang, Rui, Li, Qian-jin, Chen, Qiu-zhu, Fan, Ming-hui, Song, Yu-ting, Zhang, Wen-qian, Zhang, Yi, Li-Ling, Jesse, Xie, Hui-qi
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 21.01.2023; Nature Publishing Group
• Subjects: 692/308/153; 692/699/317; Abdomen; Acids; Animals; Biomarkers; Bladder; Calcium oxalate; Cancer Research; Cell adhesion; Cell Biology; Cell differentiation; Crystallization; Gentisic acid; Hospitals; Internal Medicine; Kidney Calculi - chemistry; Kidney Calculi - drug therapy; Kidney Calculi - genetics; Kidney stones; Kidneys; Lithiasis; Medicine; Medicine & Public Health; Metabolic disorders; Metabolites; Metabolomics; Nephrolithiasis; Oncology; Osteogenesis; Pathology; Rats; Signal transduction; Succinates - therapeutic use; Succinic Acid - therapeutic use; Transcriptomics; Tricarboxylic acid cycle; Ultrasonic imaging; Urinary tract diseases; Urine; Urolithiasis - metabolism; Urology
• ISSN: 2059-3635; 2095-9907; 2059-3635
• DOI: 10.1038/s41392-023-01311-z

Urinary stone is conceptualized as a chronic metabolic disorder punctuated by symptomatic stone events. It has been shown that the occurrence of calcium oxalate monohydrate (COM) during stone formation is regulated by crystal growth modifiers. Although crystallization inhibitors have been recognized as a therapeutic modality for decades, limited progress has been made in the discovery of effective modifiers to intervene with stone disease. In this study, we have used metabolomics technologies, a powerful approach to identify biomarkers by screening the urine components of the dynamic progression in a bladder stone model. By in-depth mining and analysis of metabolomics data, we have screened five differential metabolites. Through density functional theory studies and bulk crystallization, we found that three of them (salicyluric, gentisic acid and succinate) could effectively inhibit nucleation in vitro. We thereby assessed the impact of the inhibitors with an EG-induced rat model for kidney stones. Notably, succinate, a key player in the tricarboxylic acid cycle, could decrease kidney calcium deposition and injury in the model. Transcriptomic analysis further showed that the protective effect of succinate was mainly through anti-inflammation, inhibition of cell adhesion and osteogenic differentiation. These findings indicated that succinate may provide a new therapeutic option for urinary stones.