TOTAL NONDIALYZABLE SOLIDS (TNDS) IN HUMAN URINE. XIII. IMMUNOLOGICAL DETECTION OF A COMPONENT PECULIAR TO RENAL CALCULOUS MATRIX AND TO URINE OF CALCULOUS PATIENTS.

An organic matrix is universally present in mammalian bone, teeth, salivary, biliary, and uri-nary calculi. Such matrices invariably contain both protein and carbohydrate and appear by gross analyses to be mucosubstances. The interrelations of organic matrix and crystals of urinary calculi suggest that stone building is a process of crystal growth upon the molecular surfaces and within the interstices of a "pre-formed" mucoid matrix (1, 2). "Preformed" here is used in terms of addition of as little as a single molecule or as much as the total matrix mass. Analyses of total urinary stone matrix suggested that it was not derived from bone matrix but could represent an altered form of the urinary uromucoid which is contained in the R-1 fraction of normal urine (3, 4). The matrix contained less glucide than normal uromucoid and no sialic acid. Dulce (5), Thiele (6), and Gasser, Brauner and Preisinger (7) have independently concluded from their analyses that mucoproteins of the matrix of calcium stones differ from total colloids in normal urine; hence some process of selectivity is involved. Whether these differences existed prior to stone formation has not been determined. The relative insolubility of stone matrix has hampered study of this material. Anderson, Lepper and Winzler (8) produced antibodies in rabbits against some components of the insoluble organic matrix of calcigerous renal calculi. These antibodies gave immunological reactions with components of both a-and 8-globulin fractions of normal and poliomyelitis urinary colloids. A specific increase of the immunological reactivity to these antibodies was noted in the urine of poliomyelitis patients, and a positive correlation was established with daily urine volume and calcium-binding ability of the urinary colloids. Is stone matrix some essential, actively mineral-sequestering molecule occurring only in the urine of patients who form calculi, or is it only a non-essential adsorbate formed of the various proteins and mucosubstances which occur in normal urine? Stated conversely, if ambient conditions for crystal-lization are met, can calculi form and grow in otherwise normal urine or do there exist individuals who have no "matrix molecule" and hence may have crystalluria but are incapable of concrement formation? The present studies were undertaken to test the hypothesis that, although normal mu-cosubstances of urine may be incorporated by adsorption into the matrix, there must be peculiar or aberrant molecules to account for the genesis of renal calculi. METHODS Preparations of antigens. Individual renal calculi removed at surgery were immediately …