Inducing Oxalobacter formigenes Colonization Reduces Urinary Oxalate in Healthy Adults

Area of Science:

• Microbiology
• Gastroenterology
• Nephrology

Background:

• Oxalate-degrading intestinal bacteria, like Oxalobacter formigenes, may reduce urinary oxalate.
• High urinary oxalate is a risk factor for calcium oxalate kidney stone formation.

Purpose of the Study:

• To assess the safety and efficacy of live Oxalobacter formigenes ingestion in healthy adults.
• To determine if O. formigenes can establish sustainable gut colonization.
• To evaluate the impact of O. formigenes on urinary oxalate excretion.

Main Methods:

• 22 healthy adults, not colonized with O. formigenes, consumed controlled oxalate and calcium diets.
• 24-hour urine and stool oxalate levels were measured before and after O. formigenes ingestion.
• Ion chromatography coupled with mass spectrometry was used for oxalate quantification.

Main Results:

• Successful colonization occurred in all participants after a single dose.
• Stool oxalate concentration decreased by 54% and urine oxalate excretion by 14%.
• 10 participants maintained colonization for at least 1 year; antibiotic use impacted colonization.

Conclusions:

• Live O. formigenes is safe and can colonize the gut, reducing urinary oxalate excretion.
• Further research is warranted to investigate O. formigenes efficacy in patients with kidney stones and enteric hyperoxaluria.