Efficacy Study of Dolichos biflorus in the Management of Nephrotoxicity

Himalayan Citrus jambhiri juice reduced renal crystallization in nephrolithiasis by possible inhibition of glycolate oxidase and matrix metalloproteinases

ETHNOPHARMACOLOGICAL RELEVANCE

Citrus fruits are a very rich source of electrolytes and citric acid. They have been used traditionally for treating urinary ailments and renal stones. Citrus jambhiri is indigenously used as a diuretic.

AIM OF THE STUDY

Present study aimed at establishing the antiurolithiatic potential of the juice of Citrus jambhiri fruits along with the elucidation of the mechanism involved in the urolithiasis disease defying activity.

METHODS

The antiurolithiatic activity was established by means of nucleation, growth and aggregation assay in the in vitro settings and by means of ethylene glycol mediated calcium oxalate urolithiasis in the male Wistar rats. Docking studies were performed in an attempt to determine the mechanism of the antiurolithiatic action.

RESULTS

Present study revealed the role of C. jambhiri fruit juice in reducing nucleation, growth and aggregation of calcium oxalate crystals by possible reduction in the urinary supersaturation relative to calcium oxalate and raising the zeta potential of the calcium oxalate crystals. C. jambhiri fruit juice treatment in experimental rats produced significant amelioration of hypercalciuria, hyperoxaluria, hyperphosphaturia, hyperproteinuria, hyperuricosuria, hypocitraturia and hypomagnesiuria and ion activity product of calcium oxalate. It exhibited nephroprotection against calcium oxalate crystals induced renal tubular dilation and renal tissue deterioration. Docking studies further revealed high binding potential of the phytoconstituents of C. jambhiri viz. narirutin, neohesperidin, hesperidin, rutin and citric acid with glycolate oxidase and matrix metalloproteinase-9.

CONCLUSION

C. jambhiri fruit juice possesses excellent antiurolithiatic activity. The study reveals antiurolithiatic mechanism that involves restoration of equilibrium between the promoters and inhibitors of stone formation; and inhibition of matrix metalloproteinases and glycolate oxidase.

Nephrotonic and Nephroprotective medicinal herbs in traditional Persian Medicine: Review and assessment of scientific evidence

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The tendency to use herbal and complementary therapies has been increased dramatically in last decades. The aim of this study is reviewing nephrotonic and nephroprotective medicinal herbs in traditional Persian Medicine (TPM) historical books, and assessment of relevant scientific evidence and possible mechanisms of action. In this study, seven major references among pharmaceutical books of PM from the 11th to 19th centuries were selected and were searched with key words equivalent to “nephroprotection”. To find new studies, the scientific name of medicinal herbs which were repeated twice or more were searched using data bases including PubMed, and Google scholar with keywords of nephroprotective, renal disorder, renal failure and kidney. Also, probable effective mechanisms were explored with key words including oxidative stress, antioxidant, inflammation, anti-inflammatory and angiotensin-converting-enzyme inhibitor. 210 herbal remedies were found with kidney strengthening, nephroprotective, and atrophy prevention effects in reviewed books. The most repeated herbs were 41 Results of scientific evidence showed that the possible functional mechanisms of these plants include anti-inflammatory, anti-oxidative, blood pressure/glucose-lowering effect as well as improvement of glomerular filtration, prevention of tissue damage, and enhancing the reconstructive power of cells. The list of medicinal herbs in this study can be used as a base of future studies on production of new medicines for prevention or treatment of renal failure and for the enhancement of renal performance.

Lithotriptic effect of Safūf Hajar-al Yahūd in patients of Hasat-ul Kilya (Nephrolithiasis) - an open prospective clinical validation trial

BACKGROUND

Hasat-ul Kilya (Nephrolithiasis) is one of the most common chronic conditions and has been known to the mankind since antiquity. The incidence is increasing globally with geographic, racial and gender variation in its occurrence. Medical management of Nephrolithiasis still poses a considerable challenge for modern medical practice. Unani drugs possessing lithotriptic activity are not only cost effective but also have least side effects. Safūf Hajar-al Yahūd has been used since long for the treatment of Hasat-ul Kilya (Nephrolithiasis) but no documentary evidence based on scientific parameters as to its safety and efficacy are available.

OBJECTIVE

To validate the safety and efficacy of Safūf Hajar-al Yahūd in the treatment of Hasat-ul Kilya.

METHODOLOGY

An open prospective clinical trial was carried out on 107 subjects of renal calculi of 3-7 mm diameter diagnosed by Ultrasonogram-KUB (USG-KUB). Subjects were evaluated by clinical history & examination, laboratory investigations followed by USG-KUB for confirmation. The safety was assessed by reporting of adverse events and by pathological and biochemical investigations. Assessment of efficacy was based on improvement observed in VAS score and expulsion/reduction of stone size as detected by USG-KUB.

RESULTS

Substantial reduction (53%) in the size of calculi confirmed by USG-KUB and considerable lowering of VAS score (75%) were observed with the active intervention in majority of the cases.

CONCLUSION

The trial has revealed that the Unani pharmacopoeal formulation Safūf Hajar-al Yahūd was well tolerated and has the therapeutic potential in the reduction and expulsion of renal calculi.

Nephroprotective activity of Combretum micranthum G. Don in cisplatin induced nephrotoxicity in rats: In-vitro, in-vivo and in-silico experiments

Nephrotoxicity is known to be a major complication during cisplatin chemotherapy in cancer patients. In the present study, the protective effect of a hydroalcoholic extract of Combretum micranthum (CM) against cisplatin (CP)-induced renal damage was evaluated using in-vitro human embryonic kidney (HEK)-293 cells and in-vivo experiments. Further, in-silico molecular docking and dynamic experiments were carried out with bioactive compounds of the title plant against nuclear factor kappa B (NF-κB) and soluble epoxide hydrolase (sEH). Incubation of HEK-293 cells with cisplatin resulted in a significant increase in cell death with changes in normal cellular morphology. Co-treatment of HEK-293 cells with CP and CM extract at varying concentrations resulted in significant enhancement of cell growth compared to CP treatment indicating the cytoprotective activity of CM with an EC₅₀ 8.136 μg/mL. In vivo nephroprotective activity was evaluated by administering CM (200 and 400 mg/kg, p.o) to rats for 10 days followed by single intraperitonial injection of CP (7.5 mg/kg) on the 5th day of the experiment. Nephrotoxicity induced by CP was apparent by elevated levels of serum and urine kidney function markers, transaminases, oxidative stress markers and histopathological alterations in kidney. Pre-treatment with CM normalized the renal function at both the doses by ameliorating the CP-induced renal damage markers, oxidative stress and histopathological variations. In-silico studies showed that, out of the thirty bioactive compounds, isovitexin and gallic acid exhibited a higher docking score of -22.467, -21.167 kcal/mol against NF-κB. Cianidanol and epicatechin exhibited a higher docking score of -14.234, -14.209 kcal/mol against sEH. The protective effect of CM extract in CP-induced nephrotoxicity might be attributed to its antioxidant, anti-inflammatory activity by inhibiting NF-κB and sEH upregulation.

Antioxidant and nephroprotection activities of Combretum micranthum: A phytochemical, in-vitro and ex-vivo studies

Management of chronic renal failure is exceedingly expensive. Despite of encouraging experimental outcomes, there is a lack of potent nephroprotective drugable molecules in a clinics or market. To develop a nephroprotective phytomedicine, the present study was designed to do a literature survey on reported phytochemical and biological analysis of Combretum micranthum and to carry out chemoprofiling, in-vitro antioxidant and ex-vivo nephroprotective capacity of the title plant. The phytochemical and biological activity survey of C. micranthum has reveals the presence of many bioactive compounds such as flavonoids, terpenoids, steroids and alkaloids with many biological activities. Phytochemical investigation re-confirmed the presence of these compounds. Hydroalcoholic extract of C. micranthum (CM extract) showed a strong antioxidant activity by scavenging AAPH, DPPH, nitric oxide, hydrogen peroxide and chelating metal ions. CM extract exhibited significant (P < 0.001) dose dependent inhibition of ferric chloride-ascorbic acid induced lipid peroxidation. Diabetic nephropathy is a serious and common complication leading to end stage renal disease. Therefore, in the present study, glucose-induced toxicity was also studied in human embryonic kidney cells (HEK-293) as an in vitro model for diabetic nephropathy. The results showed that exposure of cells to high glucose (100 mM) for 72 h significantly reduced the cell viability resulting in morphological changes such as cell shrinkage, rounded cell shape and cytoplasmic vacuolation. Treatment with CM extract at 10 and 25 μg/mL resulted in significant improvement in cell viability from 10 to 23% compared to the high glucose control. This study demonstrated the potential antioxidant and nephroprotective properties of C. micranthum, justifying its traditional use in the treatment of various diseases.