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Renal stone formation is a complex multifactorial disease, and it is believed that the initial step in the pathogenesis of urolithiasis must be the precipitation of an organic matrix of mucoproteins followed by precipitation of minerals onto this matrix. An important factor in this process may be the activity and/or concentration of the urinary enzyme, urokinase, which would affect the level of urinary mucoproteins such as uromucoid. In support of this hypothesis, ELISA studies were conducted to investigate the urokinase concentrations in urine obtained from males (22-60 years) with and without renal stones. These results showed a significant decrease in urinary urokinase concentration of renal stone patients which, once again, underlines the possible involvement of urokinase in renal stone formation. Therefore, it seems logical to conclude that urokinase may play an integral role in this multifactorial disease.

Urokinase-type plasminogen activator (uPA) is an important protease enzyme in carcinogenesis, and is involved in both invasion and metastasis of cancer. Increased uPA activity and decreased essential fatty acid (EFA) levels have been reported in cancer. This phenomenon may be explained by the fact that certain EFAs, such as gamma-linolenic acid (GLA) and eicosapentaenoic acid (EPA), inhibit uPA activity. The effect of EFA on human prostate DU-145 cell growth and uPA production is still unknown and was investigated in this study. Data obtained from the different unsaturated fatty acids showed that oleic acid (OA) and EPA enhanced DU-145 cell proliferation at 0.004 and 0.04 mM for up to 4 days. However, alpha-linolenic acid (ALA), linoleic acid (LA), GLA and arachidonic acid (AA) suppressed cell proliferation under the same conditions, possibly as a result of inhibition of DNA and protein synthesis as measured using labelled thymidine and glycine incorporation. In contrast to the cell proliferation, uPA production was inhibited by all the unsaturated fatty acids under investigation. Therefore, the absence of EFAs, as reported, may affect invasion and metastasis of cancer.

Many hypotheses have been proposed for renal stone formation. It has been argued that with infection-induced renal stones the hydrolysis of urea by bacterial urease increases urinary pH, with consequent stone formation. Unfortunately, this theory is not applicable to the micro-organisms that do not produce urease (e.g. Escherichia coli). It has been recently reported that E. coli reduces the urinary urokinase activity of male rats, but does not influence the urinary sialidase activity. This study has now been expanded to the urease-producing bacteria Proteus mirabilis, Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa and Micrococcus luteus. Subcutaneous injections with these bacteria were found to significantly (P < 0.003) reduce the UK activity of extrarenally obstructed kidneys. The urease-producing mammalian skin bacterium, M. luteus, was, however, the exception (P = 0.1079). In contrast to S. epidermidis, P. aeruginosa and M. luteus (P < 0.0213), P. mirabilis and S. aureus had no effect on renal sialidase activity (P < 0.4047). These results may explain why Proteus species are predominant in infection-induced renal stones. According to the urokinase-sialidase hypothesis, a decrease in urinary urokinase activity should increase the uromucoid levels, whilst no effect on the urinary sialidase activity should favour conversion of urinary uromucoid to mineralizable matrix. These conditions may lead to renal stone formation. An increase in urinary pH resulting from urease-producing micro-organisms will increase salt precipitation on the uromucoid. It is thus concluded that urease-producing bacteria may play a double role in renal stone formation.

Malignant cells show increased urokinase (UK) activity and decreased peroxidation of essential fatty acids (EFA). In order to explore this phenomenon the effect of UK on the lipoxidase activity was spectrophotometrically investigated. Decreased lipoxidase activity was obtained with increased UK concentrations (r = -1.000, p < 0.0001). This proteolytic effect of UK on lipoxidase was eliminated with the addition of the UK inhibitor leupeptin. These results suggest that the increase in UK activity in malignant cells may decrease the lipoxidase activity and thus peroxidation of EFA. The effectiveness of a given EFA in killing cancer cells would therefore depend on the modulation of the lipoxidase activity by the UK-type plasminogen activator.

Urokinase (UK) is an important protease enzyme in carcinogenesis, and is involved in the invasion and metastasis of cancer. Thus, regulation of UK activity is likely to be important in healthy cell metabolism. As it has been reported that a decrease in delta 6-desaturated essential fatty acid (EFA) metabolites occurs in malignant cells and that gamma-linolenic acid (GLA) and eicosapentaenoic acid (EPA) exert antimutagenic effects, the effects of GLA and EPA on UK activity have been investigated in this study. Both GLA (n-6) and EPA (n-3) acted as competitive inhibitors of UK with Ki values of 120 and 96 microM respectively. No modification of plasmin activity occurred with either 1.4 x 10(-4) M GLA or EPA. These results could explain why malignant cells with decreased EFA concentrations show increased UK activity. The addition of EFAs to available therapeutic regimens may be worth considering in the treatment of cancer.

Renal stone formation can be caused by many different and varied disturbances, some of which are poorly understood. The relationship between urinary infection and renal stone formation has not been completely clarified. It is argued that renal stones form primarily as a consequence of the hydrolysis of urea by the bacterial enzyme urease. However, no explanation is given for microorganisms that produce urease only occasionally or not at all. The question arises as to whether the infection-induced microorganisms might not be playing a double role in renal stone formation by not only producing urease, but also by affecting in vivo urokinase (UK) and sialidase (SA) activity. With this in mind, the effect of Escherichia coli on renal UK and SA activity has been studied in male rats with a normal diet. The renal UK (P = 0.208) and SA (P = 0.2135) activities did not differ significantly between the two kidneys of the same rat. In contrast, when drainage from one kidney of a rat was externally obstructed, the UK and SA activities differed significantly between kidneys (P < 0.015). An increase in UK (r = 0.6456, P < 0.0001) and SA (r = 0.7507, P < 0.0001) activity was observed over time in the obstructed kidney. Subcutaneous injections with E coli reduced the UK activity of the obstructed kidney significantly (p = 0.017). However, the SA activity remained the same (P = 0.3929).(ABSTRACT TRUNCATED AT 250 WORDS)

This study was undertaken to assess whether additions of different oils to the diets of male rats would affect the renal urokinase (UK) activity of healthy and pyelonephritic kidneys. Four groups of fatty acid diets were studied: fat-free, coconut oil, fish oil and evening primrose oil (EPO). Pyelonephritis was obtained by unilateral extrarenal urinary obstruction and subcutaneous injection of Escherichia coli. The UK activity of the non-obstructed kidneys did not differ statistically between rats infected and not infected with bacteria (P > 0.056), except within the coconut oil group. A statistically decreased UK activity was obtained with bacteria injected animals on a coconut oil diet (P < 0.0001). This phenomenon, namely a decrease in UK activity, was also seen with pyelonephritic kidneys of rats on fat-free, coconut and fish oil diets (P < 0.0065). However, the UK activity of the obstructed kidneys with and without infection in the EPO group remained similar (P = 0.8477). These results suggest that the UK activity in infection-induced renal stones may be restored by EPO containing diets and may be of high relevance in the prevention and treatment of infection-induced renal stones. This revelation now needs to be more fully investigated.

The effect of a promoter (calcium) and an inhibitor (magnesium) of urolithiasis was spectrophotometrically studied on urokinase (0.45 IU) and sialidase (5 mM). Although these mineral did not affect the sialidase activity, total inhibition of urokinase activity was observed with either 0.05 M calcium chloride or 0.1 M magnesium chloride. This observation might explain why calcium and magnesium respectively function as a promoter and an inhibitor of stone formation.

It has been hypothesized that urinary urokinase and sialidase may play a role in urolithiasis. If these theories have substance it is to be expected that microorganisms may also affect these enzymes, since the association between urinary tract infection and renal stone formation is well known. It is generally assumed that Proteus mirabilis and Staphylococcus albus, which produce the urea-splitting enzyme urease, are responsible for stone formation. However, the importance of non-urease-producing microorganisms (Escherichia coli and Enterococcus) in urolithiasis is unclear. Spectrophotometric studies were therefore devised to clarify this problem. Microorganisms associated with infection-induced stones (Proteus mirabilis and Escherichia coli) respectively inhibited the urokinase and stimulated the sialidase activity. In contrast, microorganisms which were not associated with infection stones (Bacillus subtilis) had significantly less effect on urokinase and sialidase activity. This study may explain infection-induced stone formation and could open a completely new line of research.