Could the urolithiasis be treated by anti-nanobacterial therapy?

Could the urolithiasis be treated by anti-nanobacterial therapy?

Correspondence / Medical Hypotheses 74 (2010) 754–760 Mark R. Goldstein Fountain Medical Court, Bonita Springs, FL, USA E-mail address: markrgoldstei...

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Correspondence / Medical Hypotheses 74 (2010) 754–760

Mark R. Goldstein Fountain Medical Court, Bonita Springs, FL, USA E-mail address: [email protected]

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Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, PR China Tel.: +86 571 8723 6735; fax: +86 571 8707 2577. E-mail address: [email protected] (L.-P. Xie)

doi:10.1016/j.mehy.2009.11.009 doi:10.1016/j.mehy.2009.11.025

Could the urolithiasis be treated by anti-nanobacterial therapy? Max Delbrück, Lafcadio Hearn and The Tale of the Heike In a recent paper, Eby [1] proposed that the urolithiasis could be treated by anti-nanobacterial therapy–gallium. The hypothesis is very interesting, but we feel that existing evidence is insufficient to draw a definite conclusion. Patients with urolithiasis constitute an important part of everyday urological practice. Calcium calculus is the commonest kind [1,2]. Nanobacteria, a kind of microorganisms in urine have been described able to form calcium phosphate (CaPh) crystals [3]. These CaPh crystals seem to be the origin for the development of future calcium oxalate (CaOx) stones, which were formed by the attachment of CaOx and matrix molecules [4]. It seems that antinanobacterial therapy could treat the urolithiasis. However, the woman mentioned in the paper did not shown kidney stones upon X-ray examination, suggesting that the stones were negative calculus containing no calcium. Moreover, about 60–80% of the calcium stone is CaOx calculus [2]. CaPh crystals may constitute the cores of the CaOx calculus, but the external part of the stones is still the CaOx. The anti-nanobacterial therapy may prevent the initial formation of CaPh crystals [1,5], but could not dissolve the CaOx calculus themselves once already formed! Another important factor had been ignored-Oxalobacter formigenes (Ox.Fs). Dwelling in the gut of humans, Ox.Fs are a kind of microorganisms with strong oxalate-degrading function. Lack of Ox.Fs might be an important risk factor for CaOx stone formation. Ox.Fs are probably antibiotic sensitive, and repeated antibiotic therapies could eradicate them [5]. Would gallium also kill Ox.Fs? No evidence had been presented. Given above considerations, we presume that anti-nanobacterial therapy may contribute to the prevention of urolithiasis, but has little therapeutic values. In addition, the safety of anti-nanobacterial therapy using gallium still needs further investigation. Conflicts of interest statement None declared. References [1] Eby GA. A hypothesis for anti-nanobacteria effects of gallium with observations from treating kidney disease. Med Hypotheses 2008;71:584–90. [2] Tiselius HG. Epidemiology and medical management of stone disease. BJU Int 2003;91:758–67. [3] Silay Mesrur Selcuk, Cengiz Miroglu. The risk of urolithiasis recurrence may be reduced with anti-nanobacterial therapy. Med Hypotheses 2008;68:1348–50. [4] Wendt-Nordahl G, Evan AP, Spahn M, Knoll T. Calcium oxalate stone formation. New pathogenetic aspects of an old disease. Urologe A 2008;47(538):540–4. [5] Mittal RD, Kumar R, Bid HK, Mittal B. Effect of antibiotics on Oxalobacter formigenes colonization of human gastrointestinal tract. J Endourol 2005;19:102–6.

Guan-Lin Liu Xiang-Yi Zheng Li-Ping Xie

It was about 15 years ago that I read the biography of molecular geneticist Max Delbrück (Fischer EP, Lipson C. Thinking About Science—Max Delbrück and the Origin of Molecular Biology. New York: W.W. Norton; 1988). And on page 277, it was stated that Delbrück quoted a Japanese poem to express his feeling on his Nobel Prize in Physiology or Medicine at the end of press conference in October 1969. The temple bell echoes the impermanence of all things The colors of the flowers testify to the truth That those who flourish must decay Pride lasts but a little while like a dream in a spring night Before long the mighty are cast down And are as dust before the wind. After reading this poem of implying an essence of Buddhism thoughts, I found it is a very famous piece of work from the opening lines of The Tale of the Heike (Heike Monogatari). Two versions of the English translation of Delbrück0 s quotation are cited in the following: The bell of the Gion Temple tolls into every man’s heart to warn him that all is vanity and evanescence. The faded flowers of the sala trees by the Buddha’s deathbed bear witness to the truth that all who flourish are destined to decay. Yes, pride must have its fall, for it is as unsubstantial as a dream on a spring night. The brave and violent man—he too must die away in the end, like a whirl of dust in the wind. (Book 1, Chapter1, ‘‘Gion Temple” The Tale of the Heike translated by Hiroshi Kitagawa and Bruce T. Tsuchida. University of Tokyo Press; 1975). The sound of the Gion Shôja bells echoes the impermanence of all things; the color of the sâla flowers reveals the truth that the prosperous must decline. The proud do not endure, they are like a dream on a spring night; the mighty fall at last, they are as dust before the wind. (The Tale of the Heike translated by Helen Craig McCullough. Stanford University Press; 1988). Based on the German cultural atmosphere surrounding Delbrück as well as his educational background, I would say that the citation of this famous paragraph from a classical Japanese literature by Delbrück was really unusual. The Tale of the Heike is about the long time conflict and fight between the Heike clan and the Genji clan. The final and decisive sea battle between the Heike clan and the Genji clan took place at Dan-no-Ura of the narrow Kanmon Straits (today, between Shimonoseki City and Moji City) in 1185, and the Heike clan was defeated. The Kwaidan (means ‘‘ghost story”) written by Lafcadio Hearn who immersed himself in Japanese culture and Buddism. (after becoming a Japanese citizen, he was known as Yakumo Koizumi) includes a story of the battle between the Heike and Genji clans at Dan-no-Ura. Later, the classic movie version of Kwaidan was di-