Effect of A. lanata leaf extract and Vediuppu chunnam on the urinary risk factors of calcium oxalate urolithiasis during experimental hyperoxaluria

Toxicological evaluation of an antilithiatic polyherbal Siddha formulation-Sirupeellai Samoola Kudineer in experimental rats

Sirupeellai samoola kudineer (SK), a polyherbal decoction, has been used in Siddha system of medicine for the management of Urolithiasis. Since, there exists no documentation of preclinical toxicological evaluation of SK earlier, in the present study, acute and subacute toxicity of SK was assessed in Sprague Dawley rats as per OECD guideline 423 and 407, respectively. In the acute toxicity study, SK did not produce any toxic signs at a dose level of 50 ml/kg b.wt/p.o. Three doses of SK (4.5, 9.0, 18.0 ml/kg b.wt) were administered and observed for various behavioral, physiological, biochemical, and haematological changes for 28 days in the subacute toxicity study. Low and mid dose of SK (4.5 and 9.0 ml/kg b.wt) did not exhibit any significant physiological and haematological alterations. Whereas, high dose (18.0 ml/kg bw) treatment exhibited significant changes in creatinine, gamma glutamyl transferase (GGT) and acid phosphatase (ACP) levels in serum. Further, histopathological examinations of brain, heart, liver, kidney and sex organs revealed normal architecture signifying no morphological changes upto a dose of 9.0 ml/kg. However, 18.0 ml/kg of SK administration showed few histopathological changes as compared to the control. Based on these results, it can be concluded that Sirupeellai samoola kudineer is safe and non-toxic upto 9.0 ml/kg for 28 days in experimental rats.

Pharmacological and toxicological effects of Paronychia argentea in experimental calcium oxalate nephrolithiasis in rats

AIM OF THE STUDY

Renal protection and antiurolithiasic effects of two extracts of Paronychia argentea (PA), a traditional Algerian plant commonly known as Algerian tea, were evaluated. This study was carried out to determine whether the aqueous extract (APA) or the butanolic extract (BPA) of aerial parts could prevent or reduce calculi aggregation in experimental calcium oxalate (Ox) nephrolithiasis in Wistar rats.

MATERIALS AND METHODS

The two extracts (APA and BPA) were administrated orally and daily, during 28 days to nephrolithiasic treated rats at the dose of 250, 500 mg/kg b.w. and 10, 20mg/kg b.w. respectively. Body weight, renal index, liver index, serum level of creatinine, uric acid, urea, K(+), Ca(2+), Mg(2+), Na(+) and transaminase (alanine aminotransferase, ALT; aspartate aminotransferase, AST), phosphatase alkaline activity (PAL) were evaluated following the 28 days treatment in rats. In addition histopathological changes in kidney and liver were stained in hematoxylin eosin (HE).

RESULTS

The effect of the extracts could be advantageous in preventing urinary stone retention by reducing renal necrosis and thus inhibit crystal retention. In contradiction with APA, the two doses of BPA attenuated elevation in the serum creatinine (p<0.01) and blood urea levels (p<0.01) (nephroprotective effect). However, the increase in ALT (27%) and PAL (31-51%) serum levels and in the relative liver weights (p<0.01) in the groups treated with doses of APA may indicate that this extract has not a hepatoprotective effect against oxalate toxicity.

CONCLUSIONS

The presented data indicate that administration of the butanolic extract of aerial parts to rats with NaOx induced lithiasis, and reduced and prevented the growth of urinary stones in experimental calcium oxalate nephrolithiasis in Wistar rats.

Studies on diuretic and hypouricemic effects of Orthosiphon stamineus methanol extracts in rats

AIM OF THE STUDY

Orthosiphon stamineus (Labiatae) is a traditional folk medicine widely used in Southeast Asia for the treatment of several kidney disorders, gout and as a diuretic. This study was conducted to examine the diuretic and hypouricemic effects of Orthosiphon stamineus leaf extracts.

MATERIALS AND METHODS

The diuretic effect of different methanol extracts was examined by treating different groups of Sprague-Dawley rats with single (2g/kg) oral doses of methanol and methanol:water (1:1) extracts. Hydrochlorothiazide (10mg/kg) was used as positive control in acute study. Methanol and methanol water (1:1) extracts at 0.5 g/kg were administered for a period of 7 consecutive days. Cumulative urine volume and electrolytes (Na+ and K+) concentrations at different time intervals were measured. On the other hand, hypouricemic activity of methanol:water extract (1:1) was experimented using different oral single doses (0.25, 0.5, 1 and 2g/kg). Allopurinol was used as positive control. Uric acid concentration in serum was analyzed by using RP-HPLC at 280 nm.

RESULTS

Sodium and potassium excretion increased significantly (p<0.05 and <0.01) in the first 8h of treatment with a single dose (2g/kg) of the extracts in a pattern comparable to that of the known diuretic hydrochlorothiazide. Meanwhile, repeated administration of 0.5 g/kg methanol:water (1:1) extract showed a significant increase in urine volume (from day 3 to day 7) (p<0.01) and electrolytes excretion (Na+ and K+) from day 2 to day 7 (p<0.05 and <0.01). On the other hand, 0.5, 1 and 2g/kg of methanol:water (1:1) extract and the standard allopurinol reduced the serum urate level in hyperuricemic rats at hour 6.

CONCLUSION

These results provided an evidence of the high tendency of methanol:water (1:1) extract of Orthosiphon stamineus towards diuretic and hypouricemic effects in rats.

Uricosuric effect of Roselle (Hibiscus sabdariffa) in normal and renal-stone former subjects

AIM OF THE STUDY

The Roselle (Hibiscus sabdariffa) was investigated for its uricosuric effect.

MATERIALS AND METHODS

A human model with nine subjects with no history of renal stones (non-renal stone, NS) and nine with a history of renal stones (RS) was used in this study. A cup of tea made from 1.5 g of dry Roselle calyces was provided to subjects twice daily (morning and evening) for 15 days. A clotted blood and two consecutive 24-h urine samples were collected from each subject three times: (1) at baseline (control); (2) on days 14 and 15 during the tea drinking period; and (3) 15 days after the tea drinking was stopped (washout). Serum and 24-h urinary samples were analyzed for uric acid and other chemical compositions related to urinary stone risk factors.

RESULTS

All analyzed serum parameters were within normal ranges and similar; between the two groups of subjects and among the three periods. Vis-à-vis the urinary parameters, most of the baseline values for both groups were similar. After taking the tea, the trend was an increase in oxalate and citrate in both groups and uric acid excretion and clearance in the NS group. In the RS group, both uric acid excretion and clearance were significantly increased (p<0.01). When the fractional excretion of uric acid (FEUa) was calculated, the values were clearly increased in both the NS and SF groups after the intake of tea and returned to baseline values in the washout period. These changes were more clearly observed when the data for each subject was presented individually.

CONCLUSIONS

Our data demonstrate a uricosuric effect of Roselle calyces. Since the various chemical constituents in Roselle calyces have been identified, the one(s) exerting this uricosuric effect need to be identified.

Prophylaxis effect of Trigonella foenum graecum L. seeds on renal stone formation in rats

Despite considerable progress in medical therapy, there is no satisfactory drug to treat kidney stones. Therefore, the current study aimed to look for an alternative by using Trigonella foenum graecum (Tfg) on nephrolithiasic rats as a preventive agent against the development of kidney stones, which is commonly used in Morocco as a phytotherapeutic agent. The inhibitory effect of the aqueous extract of Tfg seeds was examined on the formation of calcium oxalate renal stones induced by ethylene glycol (EG) with ammonium chloride. At the end of the experiment all kidneys were removed and examined microscopically for possible crystal/stone locations and the total calcium amount in the renal tissue was evaluated. The blood was recovered to determine the levels of calcium, phosphorus, creatinine and urea. The results showed that the amount of calcification in the kidneys and the total calcium amount of the renal tissue in rats treated with Tfg were significantly reduced compared with the untreated group. Consequently, Tfg may be a useful agent in the treatment of patients with calcic urolithiasis.

A traditional Chinese herbal antilithic formula, Wulingsan, effectively prevents the renal deposition of calcium oxalate crystal in ethylene glycol-fed rats

We investigated the effects of a traditional Chinese herbal formula, Wulingsan (WLS), on renal stone prevention using an ethylene glycol-induced nephrocalcinosis rat model. Forty-one male Sprague-Dawley (SD) rats were divided into four groups. Group 1 (n=8) was the normal control; group 2 (n=11) served as the placebo group, and received a gastric gavage of starch and 0.75% ethylene glycol (EG) as a stone inducer; group 3 received EG and a low dose of WLS (375 mg/kg); and group 4 received EG and a high dose of WLS (1,125 mg/kg). Baseline and final 24 h urine samples were collected individually; biochemical data of urine and serum were also obtained at the beginning and at the end of the experiment. After 4 weeks, animals were killed and kidneys were harvested. The kidney specimens were examined by polarized light microscopy and the crystal deposits were evaluated by a semi-quantitative scoring method using computer software (ImageScoring). The results revealed that the rats of placebo group gained the least significant body weight; in contrast, the rats of WLS-fed groups could effectively reverse it. The placebo group exhibited lower levels of free calcium (p=0.059) and significantly lower serum phosphorus (p=0.015) in urine than WLS-fed rats. Histological findings of kidneys revealed tubular destruction, damage and inflammatory reactions in the EG-water rats. The crystal deposit scores dropped significantly in the WLS groups, from 1.40 to 0.46 in the low-dose group and from 1.40 to 0.45 in the high-dose group. Overall, WLS effectively inhibited the deposition of calcium oxalate (CaOx) crystal and lowered the incidence of stones in rats (p=0.035). In conclusion, WLS significantly reduced the severity of calcium oxalate crystal deposits in rat kidneys, indicating that Wulingsan may be an effective antilithic herbal formula.

Herbal medicines as diuretics: a review of the scientific evidence

There is increasing interest in the health and wellness benefits of herbs and botanicals. This is with good reason as they might offer a natural safeguard against the development of certain conditions and be a putative treatment for some diseases. One such area may be the lowering of blood pressure in those where it is elevated (i.e., hypertension). One class of clinical medicines used to lower blood pressure are known as diuretics and work by increasing the excretion of urine from the body as well as the amount of sodium in urine. There are a growing number of studies purporting diuretic effects with traditional medicines. The aim of this article was to review these studies and identify which extracts promote diuresis (which we assessed on terms of urine excreted and urinary sodium excretion) and also to identify the research needs in this area. We identified a number of species and genuses reporting diuretic effects. Of these, the most promising, at the present time, are the species Foeniculum vulgare, Fraxinus excelsior, Hibiscus sabdariffa, Petroselinum sativum and Spergularia purpurea, and species from the genuses Cucumis (Cucumis melo and Cucumis trigonus), Equisetum (Equisetum bogotense, Equisetum fluviatile, Equisetum giganteum, Equisetum hiemale var. affine and Equisetum myriochaetum), Lepidium (Lepidium latifolium and Lepidium sativum), Phyllanthus (Phyllanthus amarus, Phyllanthus corcovadensis and Phyllanthus sellowianus) and Sambucus (Sambucus mexicana and Sambucus nigra). However, there the number of studies is limited and we recommend that further studies be conducted to confirm reported effects. Such evidence is needed to provide scientific credence to the folklore use of traditional medicines and even be helpful in the development of future medicines, treatments and treatment guidelines.

Consumption of Historical and Current Phytotherapeutic Agents for Urolithiasis: A Critical Review

PURPOSE

Recent years have shown a dramatic expansion in the knowledge of molecular mechanism of phytotherapeutic agents used to treat urolithiasis. The discovery and elucidation of the mechanism of action, in particular the clinical role of these herbal remedies, has made an important contribution to treatment for urinary stone disease as an alternative or adjunct therapy. Thus, the potential clinical application of these folk medicines to urolithiasis is discussed.

MATERIALS AND METHODS

The literature on phytotherapeutic agents with scientifically determined efficiency and historically consumed agents was reviewed using MEDLINE after 1940 to the present.

RESULTS

Although information on the complete mechanism of action of each remedy is lacking, commonly known extracts exert antilithogenic properties by altering the ionic composition of urine or by expressing diuretic activity. Also, some of them contain saponins that can disaggregate suspensions of mucoproteins, which are actually promoters of crystallization and some herbal remedies have antimicrobial properties that protect the anti-adherent layer of the mucosa, which acts as a protective barrier against urinary stone disease.

CONCLUSIONS

Although phytotherapeutic extracts are popular in folk culture, because of the absence of scientific data on the exact clinical role, efficacy and side effects of these herbs the potential consumption of this alternative medical therapy as an alternative or adjunct to classic therapy remains to be determined. In this respect scientific research designed to determine the exact mechanism of action of these drugs would be fruitful for willing investigators.

Effect of Moringa oleifera Lam. root-wood on ethylene glycol induced urolithiasis in rats

In India, drumstick (Moringa oleifera Lam. (Moringaceae)) is commonly used as a phytotherapeutic agent. The effect of oral administration of aqueous and alcoholic extract of Moringa oleifera root-wood on calcium oxalate urolithiasis has been studied in male Wistar albino rats. Ethylene glycol feeding resulted in hyperoxaluria as well as increased renal excretion of calcium and phosphate. Supplementation with aqueous and alcoholic extract of Moringa oleifera root-wood significantly reduced the elevated urinary oxalate, showing a regulatory action on endogenous oxalate synthesis. The increased deposition of stone forming constituents in the kidneys of calculogenic rats was also significantly lowered by curative and preventive treatment using aqueous and alcoholic extracts. The results indicate that the root-wood of Moringa oleifera is endowed with antiurolithiatic activity.

Effect of Aerva lanata against hepatotoxicity of carbon tetrachloride in rats

The partially purified petroleum ether extractable fraction of the whole plant Aerva lanata (PF) was evaluated for the protective effect against liver damage induced by carbon tetra chloride (CCl(4)) in Sprague Dawley rats. Rats were orally administered with PF (50 and 100mg/kg body weight) for 14 days before CCl(4) challenge and 100mg of PF alone for toxicity analysis without CCl(4) administration. The results showed that CCl(4) administration significantly damaged the liver as evident from histopathology and very high activity of serum and liver marker enzymes. It also reduced the antioxidant enzyme status of the animals. PF administration significantly reversed the histopathological changes and restored the elevated activities of liver marker enzymes and also enhanced the antioxidant enzyme activities. The extract also reduced hepatic lipid peroxidation and increased the serum total protein and albumin/globulin (A/G) ratio. Preliminary phytochemical analysis of PF showed the presence of alkaloids. These observations clearly indicate that PF contains antioxidant alkaloids capable of ameliorating the CCl(4)-induced hepatic injury by virtue of its antioxidant activity.