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

Nephroprotective effect of PHYMIN-22 on ethylene glycol induced urolithiasis rat model

The present study was designed to evaluate the antiurolithiatic effect of PHYMIN-22 against ethylene glycol-induced urolithiasis in rats. Healthy Albino male rats with 200-230 g body weight were randomly divided into five groups, each with 5 animals, control group, EG group (0.75%), PHYMIN-22 treatment group (0.75% EG 14 days and 100 mg/kg PHYMIN-22 next 14 days), PHYMIN-22 drug control group (100 mg/kg) and cystone treatment group (0.75% EG 14 days and 750 mg/kg cystone next 14 days). Biochemical testing was adopted for measuring the blood and urine parameters, as well as the level of antioxidants including superoxide dismutase (SOD), Catalase (Cat), Glutathione peroxidase (GPx) and glutathione (GSH) in kidney tissues. Hematoxylin and eosin (HE) staining was utilized to observe the histopathological changes in the kidney tissue. End of the experiment the PHYMIN-22 treatment reduced the urine and serum calcium (p < 0.01; p < 0.01), oxalate (p < 0.01; p < 0.01), phosphate (p < 0.01; p < 0.01), uric acid (p < 0.001; p < 0.001), protein (p < 0.001; p < 0.001), and creatinine (p < 0.001; p < 0.001) respectively, serum indicators ALT (p < 0.001) and AST (p < 0.001) level and non-enzymic antioxidant GSH (p < 0.001) compared to EG induced urolithiasis animals (Diseased control group). PHYMIN-22 treatment significantly increased urine volume, pH, and body weight, and antioxidants include CAT (p < 0.001; p < 0.001), SOD (p ˃ 0.05; p < 0.05), and GPX (p < 0.01; p < 0.001) compared to Diseased control group animals. The effect of PHYMIN-22 on EG-induced urolithiasis animals could be by improving kidney function, normalizing the urine and serum parameters, maintaining the kidney antioxidants, eliminating crystal deposition, and excretion of unwanted ions from the kidney and urinary tract.

In vivo investigation of the inhibitory effect of Peganum harmala L. and its major alkaloids on ethylene glycol-induced urolithiasis in rats

ETHNOPHARMACOLOGICAL RELEVANCE

Peganum harmala L. is a traditional medicinal plant used for centuries in folk medicine. It has a wide array of therapeutic attributes, which include hypoglycemic, sedative, anti-inflammatory, and antioxidant properties. The fruit decoction of this plant was claimed by Avicenna as traditional therapy for urolithiasis. Also, P. harmala seed showed a clinical reduction in kidney stone number and size in patients with urolithiasis.

AIM OF THE STUDY

In light of the above-mentioned data, the anti-urolithiatic activities of the seed extracts and the major β-carboline alkaloids of P. harmala were investigated.

MATERIALS AND METHODS

Extraction, isolation, and characterization of the major alkaloids were performed using different chromatographic and spectral techniques. The in vivo anti-urolithiatic action was evaluated using ethylene glycol (EG)-induced urolithiasis in rats by studying their mitigating effects on the antioxidant machinery, serum toxicity markers (i.e. nitrogenous waste, such as blood urea nitrogen, uric acid, urea, and creatinine), minerals (such as Ca, Mg, P, and oxalate), kidney injury marker 1 (KIM-1), and urinary markers (i.e. urine pH and urine output).

RESULTS

Two major alkaloids, harmine (P1) and harmalacidine HCl (P2), were isolated and in vivo evaluated alongside the different extracts. The results showed that P. harmala and its constituents/fractions significantly reduced oxidative stress at 50 mg/kg body weight, p.o., as demonstrated by increased levels of glutathione (GSH), glutathione reductase (GR), glutathione peroxidase (GPx), and catalase (CAT) in kidney homogenate as compared to the EG-treated group. Likewise, the total extract, pet. ether fraction, n-butanol fraction, and P1, P2 alleviated malondialdehyde (MDA) as compared to the EG-treated group. Serum toxicity markers like blood urea nitrogen (BUN), creatinine, uric acid, urea, kidney injury molecule-1 (Kim-1), calcium, magnesium, phosphate, and oxalate levels were decreased by total extract, pet. ether fraction, n-butanol fraction, P1, and P2 as compared to the EG-treated group. Inflammatory markers like NFκ-B and TNF-α were also downregulated in the kidney homogenate of treatment groups as compared to the EG-treated group. Moreover, urine output and urine pH were significantly increased in treatment groups as compared to the EG-treated group deciphering anti-urolithiatic property of P. harmala. Histopathological assessment by different staining patterns also supported the previous findings and indicated that treatment with P. harmala caused a gradual recovery in damaged glomeruli, medulla, interstitial spaces and tubules, and brown calculi materials as compared to the EG-treated group.

CONCLUSION

The current research represents scientific evidence on the use of P. harmala and its major alkaloids as an effective therapy in the prevention and management of urolithiasis.

Combined effect of polyacrylic acid and vitamin E in preventing calcium oxalate crystal deposition in the kidneys of experimental hyperoxaluric rats

Our study explores the combined effect of polyacrylic acid and vitamin E as prophylactic and curative agent against ethylene glycol (EG) induced calcium oxalate stone formation in Wistar rats. Male Wistar rats (54) were divided into nine groups, including control. The experimental groups were equally segregated into two for preventive study (4) and curative study (4). Urolithiasis was induced with 0.75% (v/v) EG in drinking water. Polyacrylic acid (10 mg/kg) and vitamin E (300 IU/day) were supplemented from day 1 for preventive and day 30 for curative studies. Restoration of urinary lithogenic factors (calcium, oxalate, phosphate, citrate and magnesium) and renal function (urea and creatinine in serum) by intervening agents were accomplished compared to urolithic rats (P < .001). Abnormal localization and increased expression of Tamm-Horsfall Protein, osteopontin and transferrin were observed in the kidneys of urolithic rats (P < .001) from immunohistochemistry and immunoblotting analysis. Polyacrylic acid and vitamin E supplementation have regulated the expression of the urinary macromolecules. Pro-inflammatory cytokines in kidney were significantly reduced (P < .001) by the intervening agents compared to urolithic rats. Therefore, polyacrylic acid and vitamin E in combination could be a potential formulation for better management of urolithiasis.

Pharmacological Evaluation of Mentha piperita Against Urolithiasis: An In Vitro and In Vivo Study

Background: Mentha piperita L. (peppermint) is one of the most widely consumed medicinal herbs that has gained attention from food and pharmaceutical industries due to its distinct aroma and taste. Purpose: Present study was aimed to rationalize the traditional use of peppermint in urolithiasis and to explore its possible underlying mechanism. Research Design: The aqueous methanolic crude extract of Mentha piperita (Mp.Cr) was assessed for phytochemical constituents and antioxidant activity. In vitro crystallization assays were performed to determine the inhibitory effects of Mp.Cr against crystal nucleation, aggregation and growth. In vivo urolithiasis model was developed in rats by the administration of ammonium chloride and ethylene glycol in drinking water. The antiurolithic effects of Mp.Cr were evaluated by analyzing kidney homogenate, biochemical and histological parameters. Results: HPLC analysis showed the presence of epicatechin, quercetin, gallic acid, syringic acid, kaempferol, caffeic acid and coumaric acid. The maximum quantity of quercetin equivalent flavonoid and gallic acid equivalent phenolic content was found to be 63.73 ± .24 mg QE/g and 43.76 ± .6 mg GAE/g of Mp.Cr, respectively. Mp.Cr significantly normalized urinary and serum biochemistry, similar to the standard cystone treatment. Conclusions: The current study validated the preventive and curative potential of Mp.Cr against urolithiasis and justified its traditional use in kidney stone disease.

Anti-urolithiatic activity of Bryophyllum pinnatum Lam. hydroalcoholic extract in sodium oxalate-induced urolithiasis in rats

Background and Aim

Despite advances in modern medicine, the development and growth of calculi continues to be a source of concern for mankind, as there is no effective treatment for kidney stones. In the present study we investigated antiurolithiatic activity of Bryophyllum pinnatum Lam against sodium oxalate (NaOx) induced urolithiasis in rats.

Experimental procedure

In rats with renal calculi caused by sodium oxalate (NaOx, 70 mg/kg, i.p.); the antiurolithiatic action of Bryophyllum pinnatum hydroalcoholic extract (BPHE) was studied. BPHE was given every day orally at doses of 50, 200 mg/kg for 14 days to rats to examine activity against sodium oxalate (NaOx) mediated urolithiasis, with Cystone (500 mg/kg, p.o.) as a reference standard. The effect of the extract on urine oxalate, creatinine and phosphate retention and excretion in the kidney, as well as serum and biochemical analysis of kidney homogenate and histopathological examinations were studied.

Results and conclusion

Oral administration of BPHE at doses of 50,100, and 200 mg/kg to rats with sodium oxalate-mediated renal calculi showed dose-dependent substantial (P<0.05) antiurolithiatic potential, with notable reversal of NaOx-induced ion excretion and urinary CaOx concentration. These findings justify the traditional use of Bryophyllum pinnatum hydroalcoholic extract (BPHE) in the treatment of renal calculi.

•

Supporting its traditional use in renal calculi.

•

Demonstrated dose-dependent antiurolithiatic capacity.

•

A notable reversal of NaOx-induced ion excretion.

6-Shogaol attenuated ethylene glycol and aluminium chloride induced urolithiasis and renal injuries in rodents

The 6-shogaol, is a flavanone type flavonoid that is abundant in citrus fruit and has a wide range of pharmacological effects. The present study attempted to evaluate the antiurolithic effect of 6-shogaol on ethylene glycol (EG) and ammonium chloride (AC)-induced experimental urolithiasis in rats. The efficacy of 6-shogaol 50 mg/kg and 100 mg/kg was studied in EG 0.75% (V/V) and AC 1% (W/V) experimentally induced urolithiasis in rats for 21 days. The weight difference, urine volume, the levels of calcium, phosphate, magnesium, oxalate and uric acid in urine was observed. The blood urea nitrogen, creatinine, uric acid in serum and levels of malondialdehyde (MDA) and glutathione (GSH) were also measured. Histopathological analyses in kidneys were also performed. The rats weights were higher in the 6-shogaol groups than the urolithiasis group. EG caused a significant increase in serum creatinine (p < 0.05), BUN (P < 0.001), and uric acid (p < 0.01) while treatment with Cystone (750 mg/kg), and 6-shogaol (50 and 100 mg/kg) showed the significant reduction in increased serum levels of creatinine (p < 0.001), uric acid (p < 0.01) and BUN (p < 0.001). Administration of EG and AC showed statistically significant (p < 0.001) elevated levels of MDA and reduction in GSH levels. Treatment of Cystone (750 mg/kg), and 6-shogaol (50 and 100 mg/kg) significantly (p < 0.001) reduced MDA levels and an increase GSH levels as compared to EG and AC-treated group. The histological findings further attested antiurolithiatic properties of 6-shogaol. The present study attributed clinical shreds of evidence first time that claiming the significant antiurolithic effect of 6-shogaol and could be a cost-effective candidate for the prevention and treatment of urolithiasis.

Antiurolithic efficacy of a phenolic rich ethyl acetate fraction of the aerial parts of Aerva lanata (Linn) Juss. ex Schult. in ethylene glycol induced urolithic rats

OBJECTIVES

The study was carried out to evaluate the in vivo antiurolithic efficaciousness of an ethyl acetate fraction of Aerva lanata (EAFAL) derived from the hydromethanolic extract of its aerial parts (HMEAL).

METHODS

In vivo pharmacological potency of EAFAL was assessed by ethylene glycol (EG) induced urolithiasis model in male Wistar albino rats. Urine samples of the animals were analysed for physical parameters, stone promoters, inhibitors along with an evaluation of the biochemical parameters of serum and kidneys. Histopathological investigation of the kidneys was done. The fraction was further subjected to LC-MS and HPLC for its phytochemical evaluation.

KEY FINDINGS

EAFAL demonstrated a significant antiurolithic effect by a restoration of the balance between urinary promoters and inhibitors along with an amelioration of the urinary pH. The abnormally elevated levels of serum nitrogenous substances, calcium, albumin, globulin, total protein along with altered renal calcium, oxalate and uric acid were also alleviated significantly followed by an improvement of the histopathological aberrancies. Phytochemical analysis showed evidence of phenolic components and flavonoids.

CONCLUSIONS

The current findings prove the beneficial role of phenolic and flavonoid rich EAFAL in ameliorating urolithiasis induced abnormalities of urine, serum and kidneys.

Nephroprotective Effect of Pleurotus ostreatus and Agaricus bisporus Extracts and Carvedilol on Ethylene Glycol-Induced Urolithiasis: Roles of NF-κB, p53, Bcl-2, Bax and Bak

This study was designed to assess the nephroprotective effects of Pleurotus ostreatus and Agaricus bisporus aqueous extracts and carvedilol on hyperoxaluria-induced urolithiasis and to scrutinize the possible roles of NF-κB, p53, Bcl-2, Bax and Bak. Phytochemical screening and GC-MS analysis of mushrooms’ aqueous extracts were also performed and revealed the presence of multiple antioxidant and anti-inflammatory components. Hyperoxaluria was induced in Wistar rats through the addition of 0.75% (v/v) ethylene glycol in drinking water for nine weeks. The ethylene glycol-administered rats were orally treated with Pleurotus ostreatus and Agaricus bisporus aqueous extracts (100 mg/kg) and carvedilol (30 mg/kg) daily during the last seven weeks. The study showed that Pleurotus ostreatus, Agaricus bisporus and carvedilol all successfully inhibited ethylene glycol-induced histological perturbations and the elevation of serum creatinine, serum urea, serum and urinary uric acid, serum, urinary and kidney oxalate, urine specific gravity, kidney calcium, kidney NF-κB, NF-κB p65, NF-κB p50, p53, Bax and Bak expressions as well as serum TNF-α and IL-1β levels. Moreover, the treatment decreased the reduction in urinary creatinine, urinary urea, ratios of urinary creatinine to serum creatinine and urinary urea to serum urea, Fex Urea and Bcl-2 expression in kidney. In conclusion, although Pleurotus ostreatus and Agaricus bisporus extracts and carvedilol all significantly inhibited the progression of nephrolithiasis and showed nephroprotective effects against ethylene glycol-induced kidney dysfunction, Pleurotus ostreatus and Agaricus bisporus seemed to be more effective than carvedilol. Moreover, the nephroprotective effects may be mediated via affecting NF-κB activation, extrinsic apoptosis and intrinsic apoptosis pathways.

Effect of Macrotyloma uniflorum in ethylene glycol induced urolithiasis in rats

Macrotyloma uniflorum Linn. (Fabaceae) seeds are widely used for their diuretic and urolithiatic effects in India. The present study investigated the effect of aqueous extract of Macrotyloma uniflorum seeds (AEMU) on ethylene glycol induced urolithiasis in rats. To induce urolithiasis, 0.75% v/v ethylene glycol was administered orally for 14 days. The curative doses of 400 and 800 mg/kg were administered from 15^th to 28^th day. On the 28th day, 24 h urine, serum was collected and various biochemical parameters were estimated in urine, serum and kidney homogenate along with histology of kidney. Co-administration of AEMU with ethylene glycol has significantly (p < 0.001) increased the urine volume and the level of calculus inhibitors like magnesium, citrate and decreased the level of calculus promoters like calcium, oxalate, uric acid and urea also decreased in crystalluria in urine. AEMU supplement also prevented the pathological changes in the kidney and increased the glomerulus activity of the kidney. These results indicate that AEMU showed significant activity in urolithiasis which might be due to its diuretic, calcium oxalate crystal formation inhibitory effects and its ability to increase the levels of inhibitors and decrease the level of promoters of urolithiasis.

Antiurolithiatic activity of Boldoa purpurascens aqueous extract: An in vitro and in vivo study

ETHNOPHARMACOLOGICAL RELEVANCE

Boldoa purpurascens Cav. (Nyctaginaceae) is a plant species used in traditional medicine in Cuba as antiurolithiatic.

AIM OF THE STUDY

The aim of the present investigation was to evaluate the in vitro and in vivo antiurolothiatic activity of an aqueous extract from the leaves of Boldoa purpurascens.

MATERIALS AND METHODS

The aqueous extract from leaves of Boldoa purpurascens was evaluated for antiurolithiatic activity in vitro and in vivo. In vitro crystallization of calcium oxalate (CaOx) was assessed using a nucleation, aggregation and growth assay. The effects of the extract and of Cystone®, used as a positive control, on the slope of nucleation and aggregation, as well as on the growth of CaOx crystals, were evaluated spectrophotometrically. The densities of the formed crystals were compared microscopically. In vivo activity was evaluated in an urolithiasis model in rats, in which kidney stones are induced by ethylene glycol (0.75%) and ammonium chloride (2%) in drinking water for 10 days. Three different experimental doses (100, 200 and 400 mg/kg, p.o.) of the extract and Cystone® were administered for 10 days. After 10 days, various biochemical parameters were measured in urine and serum, and histopathological analysis of the kidneys was carried out.

RESULTS

The aqueous extract of Boldoa purpurascens inhibited the slope of nucleation and aggregation of CaOx crystallization, and decreased the crystal density. It also inhibited the growth and caused the dissolution of CaOx crystals. Cystone® exhibited similar effects. At a dose of 400 mg/kg the extract reduced the concentration of uric acid in urine, as well as the serum concentration of uric acid and creatinine. Histopathologic analysis of the kidneys of the same treatment group revealed reduced tissue damage; the results were almost similar to the untreated healthy control group.

CONCLUSION

This study indicates that an aqueous leaf extract of Boldoa purpurascens may be effective in the prevention of urinary stone formation, and substantiates the traditional claim.

Effect of Prunus Mahaleb L. Seed Extract on Ethylene glycol- and Ammonium Chloride-Induced Urolithiasis in BALB/c Mice

BACKGROUND

Kidney stone disease can be quite painful, recurrent, and affects many people. Despite advances in drug therapy, there is still a need to find effective drugs with fewer complications for long-term treatment of kidney stones and to prevent its recurrence. The present study aimed to evaluate the effect of Prunus Mahaleb L. seed extract on ethylene glycol- and ammonium chloride-induced urolithiasis in BALB/c mice.

METHODS

The Prunus Mahaleb L. seeds were collected in Mashhad (Iran) in June 2017. Urolithiasis was induced in male BALB/c mice by adding ethylene glycol (EG) 0.75% (v/v) and ammonium chloride (AC) 2% (w/v) to their drinking water for 21 consecutive days. A total of 72 animals were randomly divided into six groups of twelve animals each. Group 1 received purified water as control; group 2 received EG+AC in drinking water; groups 3-5 received the extracts by gavage in dosages of 100, 300, 500 mg/kg body weight, respectively; and group 6 received 888 mg/kg Sankol by gavage. Note that urolithiasis was induced in groups 3-6 in the same manner as in group 2. The data were analyzed using GraphPad Prism Software (version 5.01).

RESULTS

The group receiving Prunus Mahaleb L. extract in a 500 mg/kg dose responded better to the treatment and less damage to the kidney tissue was observed. The serum parameters remarkably decreased in the calculi-induced animals. Besides, the acute toxicity test showed that the use of the extract was safe in animals.

CONCLUSION

The results showed that the use of Prunus Mahaleb L. extract effectively prevented the formation of kidney stones.

Inhibitive Effects of Huashi Pill on Formation of Renal Stones by Modulating Urine Biochemical Indexes and Osteopontin in Renal Stone Rat Models

Background

Renal stones are the accumulated or deposited crystals that form and appear in supersaturated urine. This study aimed to the investigate the therapeutic effects of Huashi Pill on clearance of renal stones.

Material/Methods

Sprague Dawley rats were divided into normal control, positive control, low-dosage Huashi Pill, medium-dosage Huashi Pill, and high-dosage Huashi Pill groups. A renal rat model was established by using ethylene glycol, ammonium chloride, and calcium gluconate. The urinary pH, urine protein, and uric acid levels, as well as the calcium, magnesium, and phosphorus levels were examined. The blood urea nitrogen (BUN) and creatinine (Cr) levels were also evaluated. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBIL) levels were evaluated. Crystal formation and calcium deposits were examined using hematoxylin and eosin (H and E) staining and von Kossa staining, respectively. Osteopontin (OPN) expression was evaluated with quantitative real-time polymerase chain reaction assay and immunohistochemical assay.

Results

A renal stone rat model was successfully established. Huashi Pill significantly improved water and food intake and enhanced pH value of urine (P<0.05). Huashi Pill significantly improved the liver functions by decreasing ALT and TBIL levels (P<0.05). Huashi Pill regulated the amounts of microelements. Huashi Pill significantly decreased the urine protein, uric acid, and Cr levels (P<0.05). Huashi Pill inhibited formation of stone crystals and reduced the insoluble calcium deposition. Huashi Pill significantly downregulated expression of OPN in the kidney tissues of renal rat models (P<0.05).

Conclusions

Huashi Pill inhibited stone formation by regulating urine biochemical indexes and reducing OPN expression in kidney tissue in a renal stone rat model.

Delving into the Antiurolithiatic Potential of Tribulus terrestris Extract Through -In Vivo Efficacy and Preclinical Safety Investigations in Wistar Rats

Modern treatment interventions for kidney stones are wrought with side-effects, hence the need for alternative therapies such as plant-based medicines. We have previously documented through in vitro studies that statistically optimized aqueous extract of Tribulus terrestris (Zygophyllaceae family) possesses antiurolithic and antioxidant potential. This provides strong scientific foundation to conduct in vivo efficacy and preclinical safety studies to corroborate and lend further proof to its ability to prevent and cure kidney stones. The preventive and curative urolithiatic efficacy in experimentally induced nephrolithiatic Wistar rats, along with preclinical toxicity was evaluated following oral administration of statistically optimized aqueous extract of T. terrestris. Treatment showed augmented renal function, restoration of normal renal architecture and increase in body weight. Microscopic analysis of urine revealed excretion of small sized urinary crystals, demonstrating that treatment potentially modulated the morphology of renal stones. Tissue enzymatic estimation affirmed the antioxidant efficacy of treatment with reduced free radical generation. Significant upregulation of p38MAPK at both the gene and protein level was noted in hyperoxaluric group and interestingly treatment reversed it. Acute oral toxicity study established the Median Lethal Dose (LD₅₀) to be greater than 2000 mg/kg body weight (b.wt.) No observed adverse effect level (NOAEL) by repeated oral toxicity for 28 days at 750 mg/kg b.wt. was noted. This study lends scientific evidence to the safe, preventive and curative potential of statistically optimized aqueous extract of T. terrestris at a dose of 750 mg/kg b.wt. and suggests that the extract shows promise as a therapeutic antiurolithic agent.

Protective effect of pentoxifylline on oxidative renal cell injury associated with renal crystal formation in a hyperoxaluric rat model

The aim of the study is to investigate the effects of pentoxifylline (PTX) on the renal tubular cell injury and stone formation in a hyperoxaluric rat model induced by ethylene glycol and its possible underlying mechanisms. The study was performed with 30 male Wistar rats and randomized into three groups of teen. The sham-control (group 1) received only drinking water orally. The EG/untreated (group 2) received drinking water containing 0.75% EG for 4 weeks orally. The EG/PTX treated (group 3) received drinking water containing 0.75% EG for 4 weeks orally and PTX. Urine and blood were collected to determine some parameters. The kidneys were also removed for histological examination. Serum and urinary parameters were significantly improved in the EG/PTX treated. In the EG/PTX-treated group, the MDA, TOS and MPO activity reduced and the TAS, SOD, CAT and GSH-Px activities were increased markedly compared with the group 2. In urine of the group 2 rats, a large number of CaOx crystals were displayed and most tubules that contained crystals were dilated and showed degeneration, necrosis, and desquamation of the lining epithelium. Only few CaOx crystals were r in EG/PTX-treated animal's urine. Mild tissue damage was observed in PTX-treated rats. iNOS expression was significantly elevated in the group 2. In contrast, in the EG/PTX-treated group, eNOS expression in renal tubular epithelial cells was increased. Current study indicates that PTX may partially reduce renal tubular injury resulting from hyperoxaluria-induced oxidative and nitrosative stress.

Pharmaceutical, Ethnopharmacological, Phytochemical and Synthetic Importance of Genus Aerva: A Review

Aerva plants are known widely for their exceptional medicinal uses. They have been employed conventionally for their medicinal properties by the common folk in several regions of the world. This indicates the efficacy of these remarkable herbs. They are also known for their multiple biological activities such as antioxidant, antibacterial, antilithiatic, hepatoprotective, antidiabetic, anticancer, antihyperlipidemic and nephroprotective potential. These pharmacological actions are associated with the presence of valuable nutrients and biochemical compounds such as sterols/terpenes, flavonoids, alkaloids, phenolics and sugars. The proper utilization of the substances obtained from these plants can enhance the finesse of the capabilities of these plants. These plants are not only medicinally important but are significantly serving several other scientific purposes. In the prospect of medicinal, scientific uses and the bioavailability of precious chemicals of Aerva species, a comprehensive review is compiled, which focuses on the detailed profile of biochemical compounds, pharmacological functions and biological activities of Aerva plants. The review also discusses the synthetic importance and the toxicity of these plants. The study aims to compile comprehensively what is already done and what more is needed to be done in the future investigations related to Aerva species.

Antiurolithiatic effect of the taraxasterol on ethylene glycol induced kidney calculi in male rats

Taraxasterol is one of the important constituents of Taraxacum officinale L. (Compositae) with antioxidant potential. The present study was designed to evaluate and compare the antiurolithiatic effects of taraxasterol and potassium citrate in the ethylene glycol induced urolithiatic rat. Urolithiasis was induced by ammonium chloride and ethylene glycol in adult male rats. Taraxasterol (2, 4 and 8 mg/kg) and potassium citrate (2.5 g/kg) were treated for 33 days by gavage. Then, the animals were anesthetized and weighted and blood, urine, liver and kidney sampling were done. The kidney sections were prepared by hematoxylin & eosin staining. The liver and kidney coefficients, urine pH, calcium, magnesium, oxalate and citrate levels, serum albumin, calcium and magnesium levels, serum alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase activities, superoxide dismutase and glutathione peroxidase activities in serum, kidney and liver, number of calcium oxalate crystal deposits, score of crystal deposits, score of histopathological damages and score of inflammation in kidney sections were evaluated. The results showed that taraxasterol decreased liver and kidney coefficients (p < 0.001), serum calcium (p < 0.01) level, serum alanine aminotransferase (p < 0.001), aspartate aminotransferase (p < 0.001), lactate dehydrogenase (p < 0.05) activities, urine magnesium (p < 0.05) and oxalate (p < 0.001) levels, number of crystal deposits (p < 0.001), score of crystal deposits (p < 0.01), score of histopathological damages (p < 0.001) and score of inflammation (p < 0.01) in kidney sections, while increased urine pH (p < 0.01), calcium (p < 0.001) and citrate (p < 0.05), serum magnesium (p < 0.001) and albumin (p < 0.01) levels, superoxide dismutase and glutathione peroxidase in serum (p < 0.01), kidney (p < 0.05 and p < 0.001, respectively) and liver (p < 0.01 and p < 0.001, respectively) tissue homogenates in treated urolithiatic rats in comparison to the control urolithiatic rats. The effect of potassium citrate is the same as taraxasterol in treated urolithiatic rats. In conclusion, the effect of taraxasterol could be by improving liver function, changing serum and urine parameters, maintaining the antioxidant environment, reducing crystal deposition, excretion of small deposits from kidney and reducing the chance of them being retained in the urinary tract.

Antiurolithiatic Effect of Sirupeelai Samoola Kudineer: A Polyherbal Siddha Decoction on Ethylene Glycol-induced Renal Calculus in Experimental Rats

Background:

Sirupeelai Samoola Kudineer (SK), a polyherbal decoction containing four medicinal plants has been used in Siddha system of medicine, practiced in Southern parts of India for the management of urolithiasis.

Objective:

The present study is carried out to scientifically validate the traditional claim and to study the mechanism of action of the drug.

Materials and Methods:

In the present study, anti-urolithiatic effect of SK was evaluated in Sprague-Dawley rats using ethylene glycol through drinking water and intraperitoneal injection of sodium oxalate. Renal damage was confirmed by the increased production of thiobarbituric acid reactive substance (TBARS).

Results:

Co-treatment with SK to urolithiatic rats for 21 days significantly prevented the elevation of renal and urinary stone biomarkers in plasma and renal tissue thereby preventing renal damage and the formation of renal calculi. Administration of SK at all doses and cystone restored the antioxidant (glutathione) levels by preventing the elevation of TBARS in the kidney tissue, which was further confirmed by histological sections.

Conclusions:

SK treatment promotes diuresis which leads to flushing of the renal stones and maintains the alkaline environment in the urinary system which probably mediates the antilithiatic activity. SK provides structural and functional protection to the kidneys by enhancing its physiological function against stone formation and validates its clinical use.

SUMMARY

SK exhibited antilithiatic and diuretic potential in ethylene glycol and sodium oxalate induced urolithiasis in rats

Elevated urinary stone markers (Calcium, oxalate, uric acid, magnesium and phosphates) in plasma and renal tubular enzymes (LDH, GGT, ALP, AST ALT) in urolithiatic rats were reversed by SK treatment

SK administration significantly reduced the level of renal stress markers like Urea, Creatinine, LPO and elevated SOD, GPx, GSH levels aiding in nephroprotection

SK also provides structural and functional protection against ethylene glycol- induced renal calculus in rats as evidenced by histopathological studies.

Abbreviations used: SK: Sirupeelai Samoola Kudineer; TBARS: ThioBarbituric Acid Reactive Substances; SOD: SuperOxide Dismutase; GPx: Gluthathione peroxidase; GSH- Glutathione; LPO: Lipid peroxidation as measured as TBARS; AST: Aspartate AminoTransferase; ALT: Alanine Amino transferase; GGT: Gamma Glutamyl Transferase; LDH: Lactate Dehydrogenase.

Effect of hydro-alcoholic extract of Vernonia cinerea Less. against ethylene glycol-induced urolithiasis in rats

Objective:

Aim of this study is to evaluate antiurolithiatic potential of whole plant hydro-alcoholic (30:70) extract of Vernonia cinerea Less. in accordance to its claims made in ancient literature and also being one of the ingredients of cystone, a marketed formulation widely used in the management of urolithiasis.

Materials and Methods:

To induce urolithiasis, 0.75% v/v ethylene glycol was administered orally for 14 days. The curative dose of 400 mg/kg b.w. and preventive doses of 100, 200, and 400 mg/kg b.w. were administered from 15^th to 28^th and 1^st to 28 days, respectively. Cystone 750 mg/kg b.w. was selected as the reference standard for both curative and preventive doses. On 28^th day, urinate of 24 h was collected and subjected for estimation of calcium, oxalate, and phosphates. Serum biochemical and kidney homogenate analysis was done for determination of renal oxalate contents.

Results:

The diseased Group II showed marked increase (P < 0.001 vs. normal Group I) in levels of urine calcium, oxalate, and phosphate. Serum creatinine, urea, and uric acid levels were also increased. Histopathological studies of kidney sections revealed significant changes. Treatment with hydro-alcoholic extract of V. cinerea showed significant (P < 0.01 vs. calculi-induced Group II) dose-dependent activity. A progressive increase in urine output, body weight, and decline in concentrations of stone-forming components such as calcium, oxalates, and phosphates was observed.

Conclusion:

It can be inferred that V. cinerea Less. is effective in ethylene glycol-induced urolithiasis and may have a potential in preventing and curing urolithiasis.

Herbal remedies for urinary stones used in India and China: A review

ETHANOPHARMACOLOGICAL RELEVANCE

The process of formation or appearance of a urinary stone anywhere in the renal tract is known as urolithiasis. It is a longstanding health problem, known to exist since early age of civilization. Records about symptoms, signs and treatment strategies of urinary stones diseases are found in the several ancient texts of traditional medicines such as Ayurveda, Traditional Chinese Medicine (TCM), Siddha and Unani. In Ayurveda, urolithiasis has been considered as one of the eight most troublesome diseases. Ayurvedic management and cure of urinary stone involves herbal formulas, alkaline liquids and surgical procedures. Whereas, TCM recommends polyherbal drugs, acupuncture and mexibustion for treatment of the urinary stones. Among these therapies, herbal remedies are in practice till today for the treatment and cure urinary stone diseases.

MATERIALS AND METHODS

A comprehensive review of the scientific literature about pathophysiology of urinary stones and antiurolithiatic plants was undertaken using the following bibliographic databases: MEDLINE/PubMed, Scopus, Web of Knowledge and Google Scholar. The search was conducted from publications from all years until Dec., 2015 by combination of the search terms and Boolean operators; 'urinary stone' OR 'kidney stone' AND 'plant' OR 'medicine' OR 'antiurolithiatic plants'. Outputs were restricted to those completed studies only published in English. In this review, literatures about plants which are used as diuretic and/or in treatment urinary tract infections have not also been considered. The Plant List and Royal Botanical Garden, Kew databases were used to authenticate botanical names of plants. Books and monographs published in English were used to collect information about historical records of antiurolithiatic plants.

RESULTS

Recent pharmacological interventions accredited ancient antiurolithiatic claims to several plants and their formulations. The majority of antiurolithiatic plants were found to either dissolve the stones or inhibit the process of urinary stone formation. Plants such as Phyllanthus niruri L. and Elymus repens (L.) Gould, as well as herbal products including 'Wu-Ling-San' formula, 'Cystone' and 'Herbmed' have been proved their utility as promising antiurolithiatic medicines in the different phases of clinical trials. In addition, some of the isolated phytochemicals such as berberine, lupeol, khelin, visnagin, 7-hydroxy-2',4',5'-trimethoxyisoflavone and 7-hydroxy-4'-methoxyisoflavone were reported to have potent antiurolithiatic activity.

CONCLUSION

In ancient medicinal texts, antiurolithiatic potential has been ascribed to several plants and their formulations. Present scientific studies provide scientific evidences for few of these claims however, they are insufficient to establish many of these plants and herbal formulations as therapeutic remedies for the treatment and management of urinary stones. Conversely, findings of pre-clinical and clinical studies about some plants and herbal formulations are promising, which underlines the utility of herbal remedies as alternative medicines for the treatment and management of urinary stones in the future.

Protective effect of ethyl acetate fraction of Biophytum sensitivum extract against sodium oxalate-induced urolithiasis in rats

The methanolic whole plant extract of Biophytum sensitivum (感应草gǎnyìng cǎo) has been found to possess antiurolithiatic effect. The present study was undertaken to evaluate the antiurolithiatic effect of some fractions of methanolic whole plant extract of B. sensitivum (MBS) in rats as a step toward activity-directed isolation of antiurolithiatic component. The MBS was successively extracted with dichloromethane, ethyl acetate, ethanol and water to obtain fractions. Sodium oxalate (70 mg/kg, i.p.) was administered to rats for seven days to develop calcium oxalate urolithiasis. These rats were treated with two doses (20 and 40 mg/kg, p.o.) of the fractions, 1 h before sodium oxalate injections. Antiurolithiatic activity was assessed by estimating biochemical changes in urine, serum and kidney homogenate along with histological changes in kidney tissue. Sodium oxalate administration caused biochemical alterations in urine which was found to be prevented significantly by the ethyl acetate fraction. Supplementation with ethyl acetate fraction prevented the elevation of serum creatinine, uric acid and blood urea nitrogen levels. The elevated calcium, oxalate and phosphate levels in the kidney tissue homogenate of lithiatic rats were significantly reduced by the treatment with ethyl acetate fraction. The ethyl acetate fraction also caused significant decrease in lipid peroxidation activity, accumulation of calcium oxalate deposits and histological changes in the kidney tissue. The results showed that the antiurolithiatic component of the methanolic whole plant extract of the plant is contained in the ethyl acetate fraction. The effect is attributed to its diuretic, antioxidant, nephroprotective properties and effect on lowering the concentration of urinary stone-forming constituents.

Antiurolithiatic effect of lithocare against ethylene glycol-induced urolithiasis in Wistar rats

Aim:

This study is aimed to investigate the protective effect of Lithocare (LC) (a polyherbal formulation) against ethylene glycol (EG) induced urolithiasis in Wistar rats.

Materials and Methods:

The protective effect of LC (400 and 800 mg/kg) was evaluated using EG-induced urolithiasis in rats.

Results:

Administration of EG in drinking water resulted in hyperoxaluria, hypocalcemia as well as an increased renal excretion of phosphate. Supplementation with LC significantly reduced the urinary calcium, oxalate, and phosphate excretion dose-dependently. There was a significant reduction in the levels of calcium, oxalate as well as a number of calcium oxalate crystals deposits in the kidney tissue of rats administered with LC in EG-treated rats. There was a significant reduction in creatinine, urea, uric acid, and blood urea nitrogen when LC was administered in EG-treated rats.

Conclusions:

From this study, it was concluded that the supplementation of LC protected EG-induced urolithiasis as it reduced the growth of urinary stones. The mechanism underlying this effect might be due to its antioxidant, diuretic, and reduction in stone-forming constituents.

NEPHROPROTECTIVE AND DIURETIC EFFECT OF NIGELLA SATIVA L SEEDS OIL ON LITHIASIC WISTAR RATS

Background and objective:

The purpose of the current investigation was to study the influences, preventive and diuretic, of Nigella sativa L. seeds oil (NSSO) on calcium oxalate (CaOx) urolithiasis induced in Wistar male rats.

Methodology:

Seeds of Nigella sativa L. (N.S) were analysed for the evaluation of the concentration of oxalate and calcium. Nigella sativa L. seeds oil is obtained by hydrodistillation and HPTLC densitometric method was adopted to determine the amount of thymoquinone (TQ) present.

Thirty male Wistar rats were divided into 5 groups (N=6). Group I, negative control, drank tap water. The other groups were II Positive control, III, IV and V received a treatment model inducing calcium oxalate urolithiasis for 28 days, using an aqueous solution involve 0.75% (EG) ethylene glycol and 1.0 % (AC) chloride ammonium. Rats in group III received in addition, 750 mg/kg Cystone from the beginning to the end of calculi induction experimentation.

However, rats in Groups IV and V received (NSSO) at 5 ml/kg b.w by gavage on days 1^st to 28^th and 15^th to 28^th days, respectively. On days 0, 7, 14, 21 and 28, body weights were measured and the 24-hour urine samples were accumulated and analysed for biochemical elements. On the 28^th day, blood samples were collected for the estimation of serum parameters including creatinine, BUN and uric acid.

All animals were sacrificed at the end of the experiment and the kidneys were detached for histopathological examination.

Results:

Administration of (NSSO) at 5 ml/kg body weight/dose/day for 28 days exerts a protective effect by reducing significantly (p <0.01) urinary and serum rates of calcium, phosphate and oxalate. This preventive diet could increase the volume of urine excreted.

Conclusion:

The nephroprotectrice and diuretic activity demonstrated by Nigella sativa L. gives a scientific basis that approves their traditional use like a remedy against urolithiasis.

List of Abbreviations:NSSO: Nigella sativa L. Seeds oil ; CaOx: Calcium Oxalate; N.S: Nigella sativa L.; HPTLC: High performance thin layer chromatography; TQ: Thymoquinone; N: Number; EG: Ethylene Glycol; AC: Chloride Ammonium BUN: Blood Urea Nitrogen; LD₅₀: Lethal Dose 50; b.w: body weight; H & E: Haematoxyline and Eosin; HPLC-UV:;Caph: calcium phosphate; FR: glomerular filtration rate

Polyacrylic acid attenuates ethylene glycol induced hyperoxaluric damage and prevents crystal aggregation in vitro and in vivo

The study explores calcium oxalate crystal inhibiting characteristic of polyacrylic acid (pAA), an anionic polymer in in vitro and in vivo. Animals were divided into 5 groups where group 1 served as control, group 2 were made hyperoxaluric by supplementing with Ethylene glycol (EG) 0.75% (v/v) for 30 days. Group 3, 4 & 5 were also given with EG and treated simultaneously with 2.5, 5 & 10 mg of pAA/kg of body weight, respectively. Urine, serum and tissue analyses along with histological studies were performed at the end of the 30 days study. In vitro crystallization was significantly inhibited by pAA and further it was supported by particle size analyses, XRD and FT-IR studies. Toxicological analyses showed that pAA was safe to use in animals at concentrations below 100 mg/kg BW. In vivo anti-urolithic study showed significant improvement in urinary lithogenic factors (calcium, oxalate, phosphate, citrate & magnesium) and renal function parameters (creatinine, urea and protein). Tissue analyses on anti-oxidant enzyme activity and lipid peroxides showed maintenance of tissue antioxidant status in the pAA supplemented rats and histological studies demonstrated the nephroprotection offered by pAA and were concurrent to the biochemical analyses. Supplementation of pAA not only reduces the crystal aggregation but also regulates the expression and localization of crystal inhibiting proteins and gene expression of inflammatory cytokines in experimental animals. In summary, pAA is a potent anti-urolithic agent in rats and we can propose that 10 mg/kg body weight is the effective dosage of pAA and this concentration can be used for further studies.

Antiurolithiatic activity of Abelmoschus moschatus seed extracts against zinc disc implantation-induced urolithiasis in rats

Background:

The commonly used techniques for removing renal calculi are associated with the risk of acute renal injury and increase in stone recurrence which indicates an urgent need for alternate therapy.

Objectives:

The aim was to evaluate the antiurolithiatic activity of Abelmoschus moschatus seed extracts in rats.

Materials and Methods:

Urolithiasis was induced by surgical implantations of zinc disc in the urinary bladders of rats. Upon postsurgical recovery, different doses of chloroform (CAM) and methanolic (MAM) extracts of A. moschatus seeds (viz., 100, 200 and 400 mg/kg body weight) were administered to disc implanted rats for the period of 7 days by the oral route. Antiurolithiatic activity was evaluated by measuring various dimensions of stones and estimating levels of various biomarkers in serum and urine samples.

Results:

A significant decrease in urinary output was observed in disc implanted animals, which was prevented by the treatment with extracts. Supplementation with extracts caused significant improvement in glomerular filtration rate and urinary total protein excretion. The elevated levels of serum creatinine, uric acid, and blood urea nitrogen were also prevented by the extracts. The extracts significantly reduced deposition of calculi deposition around the implanted disc. This antiurolithiatic potential is observed at all doses (100, 200, and 400 mg/kg) of MAM, whereas only higher dose (400 mg/kg) of CAM showed significant antiurolithiatic potential.

Conclusion:

The extracts of A. moschatus seeds possessed significant antiurolithiatic activity. The possible mechanism underlying this effect is mediated collectively through diuretic, antioxidant, and free-radical scavenging effects of the plant.

Diuretic and antiurolithiatic activities of an ethanolic extract of Acorus calamus L. rhizome in experimental animal models

Acorus calamus is a plant commonly used as a traditional herbal medicine and possesses the wide range of pharmacological applications. The present study investigated the diuretic and antiurolithiatic activities of an ethanolic extract of Acorus calamus L. (Family: Araceae) rhizome (EEAC). For diuretic activity, three doses of EEAC (250, 500 and 750 mg/kg) were studied, and measurement of the urinary volume and electrolytes (Na⁺ and K⁺) concentration were taken as evaluation parameters. On the other hand, ethylene glycol induced urolithiasis (0.75% v/v in drinking water for 28 days) was used to study the antiurolithiatic effect of EEAC at the oral dose of 750 mg/kg in male Wistar albino rats. CYSTONE (750 mg/kg, p.o.) was used as a standard reference drug in the present study. After completion of the 28-days respective treatments, the level of various urolithiatic promoters in the biological samples (urine, serum and kidney homogenate) and renal function were used as criteria for assessing the antiurolithiatic effect of EEAC. Results indicate that, the EEAC (750 mg/kg, p.o.) produced significant increase in urine volume (p < 0.001) and urinary excretion of Na⁺ and K⁺ electrolytes (p < 0.05) in a pattern comparable to that of furosemide. In ethylene glycol induced urolithiatic model, EEAC significantly (p < 0.05) decreased excretion and deposition of various urolithiatic promoters as compared to urolithiatic control in a pattern comparable to that of CYSTONE. The EEAC supplementation also prevents the impairment of renal functions. The antiurolithiatic mechanism is mediated possibly through diuretic and nephroprotective actions of the active compounds of rhizomes.

Beneficial effect of Citrus limon peel aqueous methanol extract on experimentally induced urolithic rats

CONTEXT

Citrus limon (L.) Burm.f. (Rutaceace) is a commonly available fruit variety with high medicinal and industrial values.

OBJECTIVE

Lemon peel (LP) extract was studied as a potent preventive and curative agent for experimentally induced hyperoxaluric rats.

MATERIALS AND METHODS

Gas chromatography-mass spectrometry (GC-MS) analyses and toxicity study were performed for aqueous methanol LP extract. Twenty-four Wistar rats were segregated into four groups. Group 1: Control; Group 2: Urolithic (ethylene glycol (EG) - 0.75%); Group 3: Preventive study (EG + LP extract administration from 0th to 7th week); Group 4: Curative study (EG + LP extract administration from 4th to 7th week). Animals received LP extract daily by oral administration (100 mg/kg body weight) for 7 weeks.

RESULTS AND DISCUSSION

GC-MS analyses revealed that compound 6 was abundant in the LP extract (32%) followed by compound 1 (∼21%). The LD50 value of LP extract was found to be >5000 mg/kg of body weight. Urolithic rats showed significantly higher urinary calcium and oxalate (4.47 ± 0.44 and 18.86 ± 0.55 mg/24 h, respectively) excretion compared with control and experimental rats. Renal function parameters like urea (84 ± 8.5 and 96.1 ± 3.6 mg/dL), creatinine (1.92 ± 0.27 and 1.52 ± 0.22 mg/dL), and urinary protein (2.03 ± 0.02 and 2.13 ± 0.16 mg/24 h) were also reduced by LP extract (p < 0.001) and corroborated with tissue analyses (SOD, catalase, and MDA levels) and histological studies in normal and experimental animals. Immunohistochemical staining of THP and NF-κB in urolithic animals showed elevated expression than the control, while LP extract suppressed the expression of these proteins.

CONCLUSION

In conclusion, lemon peel is effective in curing kidney stone disease and also can be used to prevent the disease and its recurrence.

Anti-urolithiatic activity of standardized extract of Biophytum sensitivum against zinc disc implantation induced urolithiasis in rats

Biophytum sensitivum (L.) DC (family: Oxalidaceae) has been used in the Indian indigenous system of medicine, Ayurveda, for the treatment of various health aliments including renal calculi. The present study was undertaken to investigate the anti-urolithiatic activity of standardized methanolic extract of whole plant of B. sensitivum (MBS) in rats. Urolithiasis was induced by surgical implantations of zinc disc in the urinary bladders of rats. Upon postsurgical recovery, different doses of MBS (viz., 100, 200, and 400 mg/kg body weight) were administered to zinc disc-implanted rats for the period of 7 days by the oral route. Anti-urolithiatic activity was evaluated by measuring various dimensions of stones and estimating levels of various biomarkers in serum and urine samples. A significant decrease in urinary output was observed in the disc-implanted animals, which was prevented by the MBS treatment. Supplementation with MBS caused significant improvement in glomerular filtration rate and protein excretion. The elevated levels of serum creatinine, uric acid, and blood urea nitrogen were also prevented by the MBS treatment. The MBS treatment showed reduced formation of deposition around the implanted zinc disc. The higher dose of MBS (400 mg/kg) found more effective. These results indicate that the administration of MBS significantly prevents the growth of urinary stones. The possible mechanism underlying this effect is mediated collectively through diuretic, antioxidant and anti-inflammatory effects of the plant. The results concluded that the methanolic extract of whole plant of B. sensitivum possessed significant anti-urolithiatic activity.

Antinephrolithiatic and antioxidative efficacy of Dolichos biflorus seeds in a lithiasic rat model

CONTEXT

Dolichos biflorus sensu auct non L. (Fabaceae) is widely used for the treatment of kidney stones, leucorrhoea, urinary disorders, and menstrual troubles, and is known for its antioxidant activity.

OBJECTIVES

To evaluate the preventive effect of hydro-alcoholic extract of Dolichos biflorus seeds (DBE) in ethylene glycol induced nephrolithiasis.

MATERIALS AND METHODS

In vitro antioxidative capacity of DBE was estimated in terms of reducing power, superoxide radical, 2,2- diphenyl-1-picrylhydrazyl radical, and nitric oxide scavenging activity. A validated HPLC method was used for standardization using quercetin as a marker. Adult female Wistar rats were administered with DBE (150 and 300 mg/kg body weight/day) along with ethylene glycol (0.75%, v/v) for 28 d. The various biochemical parameters were measured in urine, serum, and kidney followed by histochemistry.

RESULTS

Ethylene glycol caused a significant increase in calcium, oxalate, phosphate, and total protein in urine as well as in kidney whereas decrease in calcium, sodium, and magnesium in serum was observed (p < 0.001). Ethylene glycol also caused a significant increase in lipid peroxidation and concurrent decrease in activities of antioxidant enzymes in kidney (p < 0.001). However, the seed extract of D. biflorus caused significant restoration of all these parameters (p < 0.001). Histopathological and histochemical studies also showed the reduced calcifications in kidney of seed extract treated rats.

DISCUSSION AND CONCLUSION

These results indicated that seeds of D. biflorus have significant prophylactic effect in preventing the nephrolithiasis, which might be due to the antioxidant activity of the active compounds of the plant.

Antioxidative mechanism involved in the preventive efficacy of Bergenia ciliata rhizomes against experimental nephrolithiasis in rats

CONTEXT

Bergenia ciliata Haw. (Saxifragaceae) is widely used in traditional medicines for renal disorders including kidney stones, inflammation and also well known for its antioxidant activity. Use of traditional herbs proved to be an important strategy for the management of kidney stones by modulating the oxidative stress imposed by calcium oxalate nephrolithiasis.

OBJECTIVES

To evaluate the antinephrolithiatic and antioxidative activity of B. ciliata rhizomes as a preventive agent on ethylene glycol (EG)-induced nephrolithiasis.

MATERIALS AND METHODS

The hydro-methanol extract (30:70, v/v) of B. ciliata rhizomes was orally administrated simultaneously at a dose of 150 and 300 mg/kg body weight/day, to adult female Wistar rats for 28 d along with EG (0.75%, v/v) in drinking water. The results were compared to a parallel study conducted with marketed polyherbal drug cystone under identical dosage conditions. The biochemical parameters were measured in urine, serum and kidney followed by histochemistry. A validated HPLC method was used for standardization using gallic acid as a marker.

RESULTS

EG caused a significant increase in calcium, oxalate and phosphate levels in urine and kidney and concurrent decrease in calcium, sodium and magnesium in serum (p<0.001). EG also caused an increase in lipid peroxidation and a decrease in activities of antioxidative enzymes in kidney. Co-treatment with B. ciliata rhizomes extract caused restoration of all these parameters (p<0.001). Histochemical studies showed reduced calcifications with extract treatment.

CONCLUSION

B. ciliata has a significant prophylactic effect in preventing the nephrolithiasis, which might be mediated through antioxidant activity of these active compounds.

Evaluation for the anti-urolithiatic activity of Launaea procumbens against ethylene glycol-induced renal calculi in rats

Launaea procumbens Linn. is a plant commonly found in the west India and has been reported to decrease the renal calculi. This study investigated the anti-urolithiatic activity of L. procumbens against ethylene glycol-induced urolithiasis and its possible underlying mechanisms. The crude methanolic extract of L. procumbens leaves was studied using ethylene glycol-induced renal calculi in rat model. Results indicate that ethylene glycol feeding to rats resulted in to hyper oxaluria, hypercalciuria, as well as increased renal excretion of phosphate. Supplementation with methanolic extract of L. procumbens leaves (MELP) significantly prevented changes in urinary calcium, oxalate and phosphate excretion dose-dependently. The increased calcium and oxalate level and number of calcium oxalate crystal in the kidney tissue of calculogenic rats were significantly reverted by supplementation with MELP. The MELP supplementation also prevents the impairment of renal functions. The mechanism underlying this effect is mediated possibly through antioxidant nephroprotection and its effect on urinary concentration of stone forming constituents and risk factor.

Conclusion

These results indicate that methanolic extracts of L. procumbens leaves are effective against the urolithiasis.

Effect of Hygrophila spinosa in ethylene glycol induced nephrolithiasis in rats

OBJECTIVE

Hygrophila spinosa (Acanthaceae) is traditionally used to treat urinary calculi. The present study aimed to evaluate the antiurolithiatic activity of methanolic extract of Hygrophila spinosa (Acanthaceae) in ethylene glycol induced nephrolithiasic rats.

MATERIALS AND METHODS

Methanolic extract of Hygrophila spinosa (HSME) (250 and 500 mg/ kg body weight) was administered orally to male Wistar albino rats. Ethylene glycol (EG) was used to induce nephrolithiasis. The parameters studied included water intake, urinary volume, urinary pH, urinary and kidney oxalate and calcium, urinary magnesium and serum uric acid.

RESULTS

Ethylene glycol feeding resulted in hyperoxaluria as well as increased renal excretion of calcium and serum uric acid along with decreased excretion of urinary magnesium. Treatment with HSME significantly reduced the elevated urinary oxalate, urinary calcium and serum uric acid with increase in reduced urinary magnesium. Ethylene glycol feeding also resulted in increased levels of calcium and oxalate in kidney which was decreased after the treatment with HSME. The increased deposition of stone forming constituents in the kidneys of ethylene glycol treated rats was significantly lowered by treatment with HSME.

CONCLUSION

The results indicate that the aerial parts of Hygrophila spinosa are endowed with antiurolithiatic activity, thereby justifying its traditional claim.

Efficacy of Adiantum capillus veneris Linn in chemically induced urolithiasis in rats

ETHNOPHARMACOLOGICAL RELEVANCE

Adiantum capillus veneris Linn has been recommended in ancient literature of Unani system of medicine as an important ingredient of many formulations for the treatment of urolithiasis. Its decoction has long been used for the same purpose by several Unani physicians.

AIM OF STUDY

To investigate the antiurolithiasic effect of the hydro alcoholic extract of Adiantum capillus veneris Linn in male Sprague Dawley rats.

MATERIAL AND METHODS

The effects of oral administration of hydro alcoholic extract of test drug were studied on calcium oxalate urolithiasis. A total of 48 rats were used for the study. The animals were divided into six groups of eight animals each. Plain control rats were treated with distilled water only, throughout the study period, whereas in other groups nephrolithiasis was induced by providing drinking water containing 0.75% ethylene glycol and 1% ammonium chloride for 7 days. Thereafter, urine was examined for the presence of crystals. Negative control group A rats were sacrificed after 7 days, whereas negative control group B was left untreated up to the end of study. Test groups were treated with 127.6 mg/kg and 255.2 mg/kg of test drug and standard control with Cystone (750 mg/kg) for 21 days. At the end of experiment, number of crystals in urine and levels of calcium, phosphorus, urea and creatinine in serum were observed. Histopathological study of the kidney was done by light microscopy.

RESULTS

Urine microscopy showed significant reduction (p<0.001 and p<0.01) in the number of crystals in test groups A and B respectively. Serum levels of calcium, phosphorous, and blood urea were found to be decreased significantly in all the groups. In both the test groups, serum creatinine level was found to be similar as in plain control. The animals treated with test drug showed much improvement in body weight. Histopathology of kidney showed almost normal kidney architecture in treated groups.

CONCLUSION

The above findings indicate the antiurolithic activity of Adiantum capillus veneris Linn, and thus, validate the claims of Unani physicians for its medicinal use in urolithiasis.

Antiurolithiatic Effects of Solanum xanthocarpum Fruit Extract on Ethylene-Glycol-Induced Nephrolithiasis in Rats

This study was designed to evaluate the effects of Solanum xanthocarpum fruit extract in ethylene-glycol-induced urolithiasis in the male Wistar rats. Nephrolithiasis was induced in male Wistar rats by adding ethylene glycol (0.75%) in drinking water for 28 days. Animals were divided into six groups, each containing six viz. Vehicle control, model control, S. xanthocarpum methanol extract in different doses of 100, 200, and 400 mg/kg p.o., Cystone (750 mg/kg, p.o.) served as a standard. Hyperoxaluria as well as an increase in the excretion of calcium, phosphate, uric acid and decrease in citrate and magnesium in urine, impairment of renal function and oxidative imbalance in kidney were observed in the calculi-induced group. Treatment with S. xanthocarpum decreases hyperoxaluria, calcium, and uric acid, improves renal function, and also produces antioxidant effects. Crystalluria was characterized by excretion calcium oxalate (CaOX) crystals, which were enormous in the lithogenic group but smaller in the drug-treated group. The histology showed that the calculi-induced group had a large deposition of CaOX crystals in kidney while the treated group had trivial and fewer deposits. The result indicates the antiurolithiatic activity of S. xanthocarpum mediated possibly by CaOX crystal inhibition, diuretic, antioxidant and maintaining balance between stone promoter and inhibitor constituents, and this study rationalized its medicinal use in urolithiasis.

Antiurolithiatic activity of saponin rich fraction from the fruits of Solanum xanthocarpum Schrad. & Wendl. (Solanaceae) against ethylene glycol induced urolithiasis in rats

ETHNOPHARMACOLOGICAL RELEVANCE

A well-known traditional herb Solanum xanthocarpum is widely used in India for the management of different ailments including urolithiasis. This study was designed to rationalize the use of Solanum xanthocarpum in kidney stone and to investigate its mechanism of action.

MATERIALS AND METHODS

The saponin rich fraction prepared from fruits of Solanum xanthocarpum (SXS) was evaluated for antiurolithiatic activity by in vitro and in vivo studies. In ethylene glycol (EG, 0.75% in drinking water for 28 days) induced urolithiasis model, two different experimental doses (20 mg/kg and 40 mg/kg, p.o., for 28 days) of saponin rich fraction were selected by dose fixation study. After 28 days, various biochemical parameters were measured in urine, serum and kidney homogenate. Kidneys were also subjected to histopathological analysis.

RESULTS

In vitro calcium oxalate crystal (CaOx) nucleation as well as aggregation was inhibited in artificial urine solution by SXS. The lithogenic treatment caused polyuria, damage renal function and oxidative stress, manifested as increased malondialdehyde, depleted reduced glutathione and decreased antioxidant enzyme catalase activities of the kidneys, which were prevented by simultaneous administration with SXS. Lithogenic treatment also caused crystalluria, hyperoxaluria, hypercalciuria, hypocitrauria, and hypomagnesaemia. Deposition of CaOx in renal tissue and cellular injury were seen in histopathology. Co-administration of SXS had potential to prevent these pathological changes due to lithogenic treatment. Moreover, SXS raised level of glycosaminoglycan, a stone inhibitor macromolecule found in urine which decreased.

CONCLUSION

The antiurolithiatic activity in Solanum xanthocarpum is mediated possibly through the inhibition of CaOx crystal formation and its effect on the urinary concentration of stone-forming constituents and nephrolithiasis inducing factors and this study rationalizes its medicinal use in urolithiasis.

Effect of Lagenaria siceraria fruit powder on sodium oxalate induced urolithiasis in Wistar rats

Background:

In spite of advances in the present practice of medicine, the formation and growth of calculi continues to trouble mankind, as there is no satisfactory drug to treat kidney stones. In India, many indigenous drugs are in use for the treatment of urinary calculus disease.

Objective:

The present study was intended to determine anti-urolithiatic effect of Lagenaria siceraria fruit powder (LSFP) against sodium oxalate (NaOx) induced urolithiasis in rats.

Materials and Methods:

Animals were grouped as Vehicle Group (received vehicle gum acacia 2% w/v 1 mL/kg/p.o.), NaOx Group(Sodium oxalate 70 mg/kg,i.p.), LSFP Group (500 mg/kg, p.o. LSFP suspended in gum acacia 2% + Sodium oxalate 70 mg/kg), Cystone Group (500 mg/kg, p.o. Cystone suspended in gum acacia 2% + Sodium oxalate 70 mg/kg).

Result:

The increased severity of microscopic calcium oxalate (CaOx) crystals deposition along with increased concentration in the kidney was seen after 7 days of NaOx (70 mg/kg, i.p.) pre-treatment. LSFP (500 mg/kg, p.o.) and standard marketed formulation Cystone (500 mg/kg, p.o.) caused a significant reversal of NaOx-induced changes in ion excretion and urinary CaOx concentration in 7 days treatment.

Conclusion:

From the results, it was concluded that LSFP showed beneficial effect against urolithiasis by decreasing CaOx excretion and preventing crystal deposition in the kidney tubules.

Alcea rosea root extract as a preventive and curative agent in ethylene glycol-induced urolithiasis in rats

Introduction:

Alcea rosea L. is used in Asian folk medicine as a remedy for a wide range of ailments. The aim of the present study was to investigate the effect of hydroalcoholic extract of Alcea rosea roots on ethylene glycol-induced kidney calculi in rats.

Materials and Methods:

Male Wistar rats were randomly divided into control, ethylene glycol (EG), curative and preventive groups. Control group received tap drinking water for 28 days. Ethylene glycol (EG), curative and preventive groups received 1% ethylene glycol for induction of calcium oxalate (CaOx) calculus formation; preventive and curative subjects also received the hydroalcoholic extract of Alcea rosea roots in drinking water at dose of 170 mg/kg, since day 0 or day 14, respectively. Urinary oxalate concentration was measured by spectrophotometer on days 0, 14 and 28. On day 28, the kidneys were removed and examined histopathologically under light microscopy for counting the calcium oxalate deposits in 50 microscopic fields.

Results:

In both preventive and curative protocols, treatment of rats with hydroalcoholic extract of Alcea rosea roots significantly reduced the number of kidney calcium oxalate deposits compared to ethylene glycol group. Administration of Alcea rosea extract also reduced the elevated urinary oxalate due to ethylene glycol.

Conclusion:

Alcea rosea showed a beneficial effect in preventing and eliminating calcium oxalate deposition in the rat kidney. This effect is possibly due to diuretic and anti-inflammatory effects or presence of mucilaginous polysaccharides in the plant. It may also be related to lowering of urinary concentration of stone-forming constituents.

Curative treatment with extracts of Bombax ceiba fruit reduces risk of calcium oxalate urolithiasis in rats

CONTEXT

Drawbacks of presently available treatments for urolithiasis necessitate finding the treatment of hyperoxaluria specifically aimed at reduction in oxalate excretion. Interestingly, many Indian tribes use Bombax ceiba L. (Bombacaceae) fruits as a traditional medicine for the treatment of urinary stones.

OBJECTIVE

The present study investigated the efficacy of B. ceiba fruit extracts as curative agents in experimentally induced calcium oxalate urolithiatic rats.

MATERIALS AND METHODS

Calcium oxalate lithiasis was induced in rats by oral administration of 0.75% ethylene glycol for 14 consecutive days. Treatments with aqueous and ethanol extract of B. ceiba fruit (400 mg/kg body weight) was performed in the same manner for further 14 consecutive days. Cystone (750 mg/kg body weight) was used as reference antiurolithiatic drug. The urinary excretion and kidney deposition of offending salt components, and serum biochemical parameters were investigated.

RESULTS

Oral administration of ethylene glycol resulted in hyperoxaluria and increased renal excretion of calcium and phosphate. However, supplementation with aqueous and ethanol extracts of B. ceiba fruit significantly (p < 0.05) reduced the elevated urinary oxalate, showing a regulatory action on endogenous oxalate synthesis. The increased deposition of stone forming constituents in kidneys of calculogenic rats was also significantly lowered with curative treatment of aqueous and ethanol extract.

DISCUSSION AND CONCLUSION

The results indicate that the fruit of B. ceiba is endowed with lithontriptic activity warranting further development for curative treatment of urolithiasis.

Helichrysum plicatum DC. subsp. plicatum extract as a preventive agent in experimentally induced urolithiasis model

ETHNOPHARMACOLOGICAL RELEVANCE

Since ancient times, various herbal preparations have been used in treatment of urolithiasis, which is basically formation of calcium oxalate stones in kidney. The aim of our study is to assess the effects of Helichrysum plicatum DC. subsp. plicatum (HP) as a preventive agent in experimentally induced urolithiasis model in rats.

MATERIALS AND METHODS

The efficacy of 125, 250, and 500 mg/kg HP extract was studied in 1% ethylene glycol and 1% ammonium chloride-induced urolithiasis for 21 days in rats. The weight difference and the levels of calcium, magnesium, phosphorus, urea nitrogen, creatinine and uric acid in both serum and 24h-urine were measured. The calcium oxalate (CaOx) and pH were defined in urine. Histo-pathological analyses in kidneys were also performed.

RESULTS

The rats' weights were higher in HP groups than urolithiasis group. Urolithiasis caused a significant increase in both serum and urine biochemical parameters compared to healthy rats. HP extract decreased levels of these parameters. Urine CaOx level was high in urolithiasis rats, whereas it was decreased by HP extract. Histopathological examinations revealed extensive intratubular crystal depositions and degenerative tubular structures in urolithiasis group, but not in HP treatment groups.

CONCLUSION

More studies will be necessary to elucidate the antiurolithiatic activity of HP. Nonetheless, having a beneficial effect in preventing and eliminating CaOx deposition into kidneys, HP extract may be a potential drug for urolithiasis treatment.

In Vitro Effect of Wheat Bran (Triticum aestivum) Extract on Calcium Oxalate Urolithiasis Crystallization

Urolithiasis can lead to the loss of renal function in some cases. In this study, we tested the inhibiting effect of wheat bran ( Triticum aestivum L) extract on calcium oxalate crystallization in a turbidimetric model, by FTIR spectroscopy, and polarized microscopy. The results show that this plant extract has a major inhibitory effect on calcium oxalate crystallization.

Antiurolithiatic Activity of Whole-Plant Hydroalcoholic Extract of Pergularia daemia in Rats

The whole-plant, Pergularia daemia (Family: Asclepediaceae), extract (50% alcohol) was investigated for its antiurolithiatic and diuretic activity. Ethylene glycol (0.75% in water) feeding resulted in hyperoxaluria as well as increased renal excretion of calcium and phosphate. Alcoholic extract (400 mg/kg) of P. daemia was given orally in curative and preventive regimens over a period of 28 days. Supplementation with extract significantly (P < 0.001) lowered the urinary excretion and kidney retention levels of oxalate, calcium and phosphate. Furthermore, high serum levels of urea nitrogen, creatinine and uric acid were significantly (P < 0.001) reduced by the extract. The results were comparable with the standard drug, cystone (750 mg/kg). The reduction of stone-forming constituents in urine and their decreased kidney retention reduces the solubility product of crystallizing salts such as calcium oxalate and calcium phosphate, which could contribute to the antiurolithiatic property of the extract. The extract exhibited significant diuretic activity at dose of 400 mg/kg body weight as evidenced by increased total urine volume and the urine concentration of Na(+), and K(+). These findings affirm assertions made regarding the effectiveness of the extract of this plant against urinary pathologies in the Indian folk medicine.