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Everything You Need To Know About Oxalobacter Formigenes

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Welcome to my blog post ‘Everything You Need To Know About Oxalobacter Formigenes’.

You may also be interested in these other blog posts:

  • The Ultimate Guide To Irritable Bowel Syndrome: click here.
  • Can gut health and our microbiome effect mental health?: click here.
  • Irritable Bowel Syndrome & Chronic Fatigue Syndrome: click here.

What Is Oxalobacter Formigenes?

Oxalobacter formigenes is a bacteria that metabolises oxalate in the intestines and is present in a large proportion of the normal adult population. Little is known about when and how individuals become colonised or the persistence of the bacterium over time, but it seems to be present in a large proportion of the normal adult population, with reported prevalence ranging from 46 to 77%.

It is hypothesised that the absence of oxalobacter formigenes could lead to increased colonic absorption of oxalate, and the subsequent increase in urinary oxalate could favour the development of stones (2).

In conclusion, these results suggest that colonisation with O. formigenes is associated with a 70% reduction in the risk for being a recurrent calcium oxalate stone former (2).

What Is Oxalate?

Oxalate is derived from both endogenous and exogenous sources.

  • Endogenously: Oxalate is formed in the liver by amino acid catabolism and from fungus such as Aspergillus, Penicillium, and possibly Candida.
  • Exogenously: It is also present in a wide range of food and drinks, including tea, coffee, chocolate, and fruit and vegetables.

What Foods Are High In Oxalates?

  • Tea
  • Coffee
  • Chocolate
  • Fruit
  • Vegetables

What Is Hyperoxaluria?

Hyperoxaluria is an excessive urinary excretion of oxalate. Individuals with hyperoxaluria often have calcium oxalate kidney stones.

Why Do I have Hyperoxaluria?

The absence of O. formigenes could permit more absorption of dietary oxalate in the colon and decreased secretion from endogenous sources, resulting in higher oxalate excretion in the urine and thus predisposition to Calcium Oxalate calculus formation.

Data from a number of relatively small studies show that patients with renal calculi and some conditions related to hyperoxaluria have a lower prevalence of O. formigenes in the stool than control subjects (2)

Oxalates and Autism

The Great Plains Laboratory have found correlations between oxalic acid, tested for in their organic acid test, with autism.

36% of the children on the autistic spectrum had values higher than 90 mmol/mol creatinine, the value consistent with a diagnosis of genetic hyperoxalurias while none of the normal children had values this high. 84% of the children on the autistic spectrum had oxalate values outside the normal range

How Do You Treat Hyperoxaluria?

One approach to preventing recurrent calculi is to decrease consumption of foods high in oxalate, but the effectiveness of this treatment is uncertain.

The concept of reducing oxalate absorption by a microbiological approach (supplementing oxalobacter formigenes) has received increasing attention in recent years.

If you suspect fungus may be contributing to elevated oxalic acid levels then anti fungal agents may be helpful (such as oregano oil, caprylic acid or colostrum), alongside broad spectrum high dose probiotics.

Is Oxalobacter Formigenes The Only Bacteria To Degrade Oxolate?

It remains questionable whether oxalobacter formigenes is the only, or most-important, species involved in oxalate degradation in the human gut. Other oxalate-degrading bacteria that have been isolated from human stool samples include Eubacterium lentum WYH-1 and Enterococcus faecalis (1).

However in contrast to Oxalobacter formigenes, these species are able to use substrates other than oxalate for growth, and whether they will degrade oxalate in the gut where alternative substrates are provided has not been determined.

It is possible that as-yet-uncultivated species may contribute to oxalate degradation in the gut

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Can Probiotics Help With Kidney Stones?

Kidney stones represent an important health problem in many countries. In the United States, the lifetime risk for developing a stone is approximately 5 to 15%, and the 5-yr risk for a recurrence is approximately 30 to 50% (2).

In addition to the effects on individuals, the impact of renal stone disease on the medical care system is substantial; stones account for approximately 0.1% of hospital admissions and have an economic impact of $2 billion dollars per year!

Studies have shown that select species of Lactobacillus, the most commonly included genus in modern probiotic supplements, can degrade oxalate in vitro and even decrease urinary oxalate in animal models of Primary Hyperoxaluria. Although the purported health benefits of Lactobacillus probiotics vary significantly between species, there is supporting evidence for their potential use as probiotics for oxalate diseases (10).

Be aware that commercial probiotics that have been on marketed to help degrade oxalate, were tested and did not contain identifiable O. formigenes or viable oxalate-degrading organisms (11).

What Causes Low Oxalobacter Formigenes?

Oxalate-degrading activity cannot be detected in the gut flora of some individuals, possibly because Oxalobacter is susceptible to commonly used antimicrobials.

Clarithromycin, doxycycline, and some other antibiotics inhibited oxalate degradation by two human strains of O. formigenes (1).

Aside from antibiotics, little is known about factors that may affect O. formigenes.

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A study in Ukrainian children provides some evidence of early acquisition and colonisation over time. O. formigenes was not detected in children who were younger than one year old; the prevalence rose to 100% (by PCR; approximately 80% by culture) between ages 6 and 8 and declined to approximately 75% at age 12.

Patients with cystic fibrosis or inflammatory bowel disease, who receive multiple antibiotic courses also have lower O. formigenes prevalence than controls (3)

A fascinating study compared the prevalence of these organisms among subjects in two remote areas in which modern medical practices have hardly been present, with a USA group of mothers and their infants for the first three years of life. Among the Amerindians of the Yanomami-Sanema and Yekwana ethnic groups in Venezuela and the Hadza in Tanzania, O. formigenes was detected in 60–80% of the adult subjects, higher than found in adults from USA in this and prior studies. In young children, the prevalence was much lower in USA than in either tribal village. These data extend our understanding of the epidemiology of O. formigenes carriage, and are consistent with the hypothesis that the rising incidence of kidney stones is associated with the progressive loss of O. formigenes colonization in populations that have been highly impacted by modern medical practices (3)

Finally, other research has O. formigenes abundance associated with particular host demographic and clinical features including:

  • Age
  • Sex
  • Race
  • Geographical location
  • BMI
  • Antibiotic history

Furthermore, the authors found that O. formigenes presence was an indicator of altered host gut microbiota structure, including higher community diversity, global network connectivity, and stronger resilience to simulated disturbances (5)

These data extend our understanding of the epidemiology of O. formigenes carriage, and are consistent with the hypothesis that the rising incidence of kidney stones is associated with the progressive loss of O. formigenes colonization in populations that have been highly impacted by modern medical practices (6)

How Do I Repopulate Oxalobacter Formigenes?

Interestingly some researches have observed an increase in the prevalence of O. formigenes with increasing oxalate consumption, expected because dietary oxalate is a major energy source for this bacterium, along with oxalate from endogenous production.

This relation was not observed in the case patients, however, and there is no clear explanation for the latter finding.

In the not too distant future there will be commercially available probiotics with this bacteria also.

Oxalobacter Formigenes Probiotic

The possibility of using the bacterium as a probiotic is in the early stages of investigation. The results of a recent trial of patients with primary hyperoxaluria show some promise in this regard: Among 16 patients treated with O. formigenes as a frozen paste or enteric-coated capsules, 11 showed a reduction in urinary or plasma oxalate.

Challenges exist in the preparation of O. formigenes as a successful probiotic due to it being an anaerobe with fastidious growth requirements (4)

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Summary:

  • Oxalobacter Formigenes is a bacteria that metabolises oxalates.
  • Oxalates are associated with kidney stone formation when elevated.
  • There are other bacteria that can degrade oxalates.
  • Oxalobacter Formigenes has been associated with antibiotic usage among other factors.
  • There is no Oxalobacter Formigenes probiotic available, yet.
  • Other probiotics may be helpful however.

References

  1. Oxalobacter formigenes and Its Potential Role in Human Health: click here.
  2. Oxalobacter formigenes May Reduce the Risk of Calcium Oxalate Kidney Stones: click here.
  3. Comparative prevalence of Oxalobacter formigenes in three human populations: click here.
  4. Probiotic properties of Oxalobacter formigenes: an in vitro examination: click here.
  5. Oxalobacter formigenes-associated host features and microbial community structures examined using the American Gut Project: click here.
  6. Comparative prevalence of Oxalobacter formigenes in three human populations: click here
  7. The role of the microbiome in kidney stone formation: click here.
  8. The Presence of Oxalobacter formigenes in the Microbiome of Healthy Young Adults: click here.
  9. The role of the microbiome in kidney stone formation: click here.
  10. Metabolomic profiling of oxalate-degrading probiotic Lactobacillus acidophilus and Lactobacillus gasseri: click here.
  11. Analysis of commercial kidney stone probiotic supplements: click here.
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