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Chapter 26 : Urease, Urolithiasis, and Colonization of the Urinary Tract

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Abstract:

In urinary tracts with functional or anatomical abnormalities in which the normal flow of urine is disrupted or in which residual urine cannot be expressed from the bladder, a distinct group of bacterial species may cause infection. These infections are most frequently polymicrobial. The placement of a long-term indwelling catheter ensures that a urinary tract infection (UTI) will develop. , a dimorphic gram-negative bacterium, commonly causes UTI in individuals with structural abnormalities or long term catheterization, i.e., complicated UTI. Flagella and the mannose-resistant, -like (MR/P) fimbriae and fimbriae (PMF) have been identified as virulence factors of that contribute to its colonization of the urinary tract in a murine model. Urease inhibitors have been used to treat patients with urolithiasis. The level of bladder colonization by the urease-negative mutant was >200-fold higher in the catheterized mice than in the uncatheterized mice. Despite the successful colonization of the bladders of the catheterized mice by the urease-negative mutant, urolithiasis or death was never observed. The low-level urease activity detected in the uninduced culture of the wild type is consistent with a previous finding that the expression of UreD is not as tightly regulated in as it is in expressing cloned urease genes.

Citation: Mobley H. 2005. Urease, Urolithiasis, and Colonization of the Urinary Tract, p 395-407. In Nataro J, Cohen P, Mobley H, Weiser J (ed), Colonization of Mucosal Surfaces. ASM Press, Washington, DC. doi: 10.1128/9781555817619.ch26

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Urinary Tract Infections
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Figures

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Figure 1

Scanning electron micrographs of a urease-induced bladder stone. (A) One-quarter of the bladder viewed at low magnification (bar, 500 μm). The orientation of the bladder is indicated by an arrowhead pointing to the bottom of the bladder (the end leading to the urethra). (B) Higher magnification (bar, 100 μm) of the boxed area in panel A. (C) Higher magnification (bar, 5 μm) of the boxed area in panel B. (D and E) Representative views of bladder stone (bars, 2 μm). Reprinted from reference 43.

Citation: Mobley H. 2005. Urease, Urolithiasis, and Colonization of the Urinary Tract, p 395-407. In Nataro J, Cohen P, Mobley H, Weiser J (ed), Colonization of Mucosal Surfaces. ASM Press, Washington, DC. doi: 10.1128/9781555817619.ch26
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Figure 2

Hypothetical models of urease structural and accessory protein interactions. (Top) The 6,500-bp urease gene cluster encodes eight proteins that comprise, regulate, and assemble the urease holoenzyme. Previously described UreA and UreE homomultimeric interactions were confirmed in vivo ( ). Likewise, UreA and UreC structural interactions were also confirmed in vivo ( ). UreD associates with UreC in the context of the apo-urease independently of the UreA structural protein; UreD was arbitrarily drawn contacting the apo-enzyme face opposite to UreA; there is no direct evidence for this structure. UreD may interact with coaccessory protein UreF prior to associating with the apo-urease. Although UreD and UreF interact in the absence of structural proteins, UreD is still capable of associating with the apo-urease without coaccessory proteins such as UreF. (Bottom) Data reported in reference 26 suggest that UreD is capable of homomultimeric interactions in vivo. Based on the homotrimeric nature of the apo-urease, one explanation for our observation is that a single molecule of UreD associated with UreABC may interact with additional UreD molecules bound to adjacent UreABC heterotrimers. These interactions could stabilize overall the accessory protein interactions with the apo-urease and hypothetically coordinate nickel uptake among the three active sites of urease. A similar hypothesis could be applied to UreF; homomultimeric UreF interactions in vivo could occur between individual UreF molecules bound through UreD to adjacent UreABC heterotrimers. The three-dimensional structure of urease is inferred from that of the closely related urease of ( ). Reprinted from reference 26.

Citation: Mobley H. 2005. Urease, Urolithiasis, and Colonization of the Urinary Tract, p 395-407. In Nataro J, Cohen P, Mobley H, Weiser J (ed), Colonization of Mucosal Surfaces. ASM Press, Washington, DC. doi: 10.1128/9781555817619.ch26
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Figure 3

Confocal images of GFP-expressing in a bladder stone. GFP-expressing organisms in a mouse bladder stone were revealed using confocal laser-scanning microscopy. Two representative pictures are shown (scale bar, 25 μm). Reprinted from reference 43.

Citation: Mobley H. 2005. Urease, Urolithiasis, and Colonization of the Urinary Tract, p 395-407. In Nataro J, Cohen P, Mobley H, Weiser J (ed), Colonization of Mucosal Surfaces. ASM Press, Washington, DC. doi: 10.1128/9781555817619.ch26
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