Urology and Andrology

Diagnostic significance of quorum sensing activators in the pathogenesis of urolithiasis

The objective. Diagnostic evaluation of «quorum sensing» activators in the pathogenesis of development of urolithiasis (UL) with the help of modern biochemical methods of analysis. Patients and methods. 109 patients with UL treated in the urological department of Moscow City Clinical Hospital No in the period of 2007 to 2010 and 20 patients of the control group without UL were examined for «quorum sensing» activators in urine. 69.7% of patients were 31 to 50 years of age, males prevailed. All patients underwent complex clinical examination that included laboratory (testing of hematological and biochemical blood values, clinical and bacteriological examination of urine) and modern chromatographic methods of urine and blood analysis both during the stay at hospital and in the period of outpatient-polyclinic follow-up. Results.  The  levels  of  «quorum  sensing»  activators  in  patients  with  nephrolithiasis  totaled:  for  lactones  –  0.026  ±  0.0013 mmol/l-  for  quinolones  –  0.015  ±  0.0012  mmol/l-  for  furan  esters  –  0.018  ±  0.0010  mmol/l.  The  diagnostic  significance  of chromatographic methods of searching signalling compounds of microbial «quorum-sensing» factors in patients with calcium phosphate and «mixed» forms of UL was for lactones: diagnostic sensitivity– 66.6%, diagnostic specificity– 42.8%, positive predictability  –  66.6%,  negative  predictability  –  42.8%-  for  quinolones:  diagnostic  sensitivity–  70.0%,  diagnostic  specificity– 25.0%, positive predictability – 40.0%, negative predictability – 62.5%- for furan esters: diagnostic sensitivity– 64.2%, diagnostic specificity– 66.6%, positive predictability – 85.7%, negative predictability – 16.6%. Conclusion.  The  obtained  evidence  permitted  to  make  a  conclusion  about  the  possibility  of  using  the  levels  of  hydrolytic enzymes and microbial «quorum-sensing» activators as diagnostic and prognostic criteria in patients with various forms of UL, which in its turn is significant for development of scientifically grounded methods of managing and preventing relapses of stone formation.