Internet claims on dietary and herbal supplements in advanced nephropathy: truth or myth

Cymbopogon proximus and Petroselinum crispum seed ethanolic extract/Gum Arabic nanogel emulsion: Preventing ethylene glycol and ammonium chloride-induced urolithiasis in rats

Urolithiasis is a prevalent urological disorder that contributes significantly to global morbidity. This study aimed to assess the anti-urolithic effects of Cymbopogon proximus (Halfa Bar) and Petroselinum crispum (parsley) seed ethanolic extract /Gum Arabic (GA) emulsion, and its nanogel form against ethylene glycol (EG) and ammonium chloride (AC)-induced experimental urolithiasis in rats. Rats were divided into four groups: group 1 served as the normal control, group 2 received EG with AC in drinking water for 14 days to induce urolithiasis, groups 3 and 4 were orally administered emulsion (600 mg/kg/day) and nanogel emulsion (600 mg/kg/day) for 7 days, followed by co-administration with EG and AC in drinking water for 14 days. Urolithiatic rats exhibited a significant decrease in urinary excreted magnesium, and non-enzymic antioxidant glutathione and catalase activity. Moreover, they showed an increase in oxalate crystal numbers and various urolithiasis promoters, including excreted calcium, oxalate, phosphate, and uric acid. Renal function parameters and lipid peroxidation were intensified. Treatment with either emulsion or nanogel emulsion significantly elevated urolithiasis inhibitors, excreted magnesium, glutathione levels, and catalase activities. Reduced oxalate crystal numbers, urolithiasis promoters' excretion, renal function parameters, and lipid peroxidation while improving histopathological changes. Moreover, it decreased renal crystal deposition score and the expression of Tumer necrosis factor-α (TNF-α) and cleaved caspase-3. Notably, nanogel emulsion showed superior effects compared to the emulsion. Cymbopogon proximus (C. proximus) and Petroselinum crispum (P. crispum) seed ethanolic extracts/GA nanogel emulsion demonstrated protective effects against ethylene glycol induced renal stones by mitigating kidney dysfunction, oxalate crystal formation, and histological alterations.

Buchu (Agathosma betulina and A. crenulata): Rightfully Forgotten or Underutilized?

Today, the term buchu refers to the two species in commerce, Agathosma betulina (P.J.Bergius) Pillans and Agathosma crenulata (L.) Pillans (Rutaceae). Its traditional use in urinary tract infections and related ailments made it a popular remedy, specifically in the US, in 19th century, but with the advent of antibiotics it became largely obsolete. Recent focus is on technological use and on the essential oil for use in the perfume and food-flavouring industry. A review of the scarce pharmacological research revealed moderate antimicrobial activity for a leaf extract but not the essential oil of both species in the MIC assay. In the 5-lipoxygenase (5-LO) assay the essential oil of both species revealed IC50 values of 50.37 ± 1.87 μg/ml and 59.15 ± 7.44 μg/ml, respectively. In another study 98% inhibitory activity was determined for 250 μg/ml of an ethanolic extract of A. betulina on cyclooxygenase (COX)-1 and a 25% inhibitory activity on COX-2. Analgesic activity of an ethanolic extract of A. betulina was shown in mice. Moderate antioxidant activity was determined for methanol:dichlormethane extracts of A. betulina and A. crenulata and an aqueous extract of A. betulina showed a Trolox equivalent antioxidant capacity (TEAC) of 11.8 µM Trolox. Recent in vitro studies with a commercial aqueous extract of buchu revealed increased uptake of glucose added to 3T3-L1 cell line, significant inhibition of the respiratory burst of neutrophils and monocytes, reduction in the expression of adhesion molecules and inhibition of the release of IL-6 and TNF-α. In diabetic rats the ingestion of aqueous buchu extract completely normalized the glucose level and in rats receiving a high fat diet the consumption of aqueous buchu extract resulted in less weight gain and less intraperitoneal fat gain as well as reduction of elevated blood pressure to normal associated with cardioprotective effects. Limitations in the hitherto conducted research lie in the undisclosed composition of the buchu extracts used and the difficulty in extrapolating data from animal studies to humans. Health claims for buchu products need to be substantiated by randomized, double-blind and placebo-controlled studies. Only then can they be promoted for their true therapeutic potential.

Attitude and awareness of medicinal plants in treatment of kidney lithiasis in eastern Morocco: a retrospective study

Introduction: Kidney stone is a major public health problem. Over 5% of the population is affected by kidney stones, with causes a lifetime risk of transmitting renal lithiasis of about 8 to 10%.

Objective: The goal of our study is the attitude and awareness of lithiasis patients regarding the use of medicinal plants in eastern Morocco.

Methods: We carried out a study on lithiasis patients to retrospectively identify medicinal plants used in this disease, using a pre-established questionnaire. The study was carried out from 10 December 2017 to 28 February 2018.

Results: Our survey describes several medicinal plants used to treat renal lithiasis in eastern Morocco. Most patients used Herniaria hirsuta L., Zea mays L., Urtica dioica L., and Petroselinum crispum (Mill.) Fuss. This preliminary study showed that the first reason to use medicinal plants in half of lithiasis patients is to calm the pain and expel the stones. The primary source of plant use information is oral tradition. However 67% of lithiasis patients are unaware of the harmful and toxic effects that can appear.

Conclusion: Medicinal plants must, like medicines, comply with strict requirements and standard rules of use to which only the specialist in herbal medicine can respond and sensitize people to the dangers of irrational consumption of medicinal plants.

Determination of the Popularity of Dietary Supplements Using Google Search Rankings

The internet provides access to information about dietary supplements and allows their easy purchase. We aimed to rank the interest of Google users in dietary supplements and to determine the changes that occurred in their popularity from 2004 to 2019. We used Google Trends to generate data over time on regional interest in dietary supplements (n = 200). We categorized each included supplement and calculated the interest in all topics in proportion to the relative search volume (RSV) of "lutein". We analyzed the trends over time of all topics and categories. Globally, the topics with the highest popularity were "magnesium", which was 23.72 times more popular than "lutein", "protein" (15.22 times more popular), and "iron" (15.12). The categories of supplements receiving most interest were protein (9.64), mineral (5.24), and vitamin (3.47). The RSV of seven categories of topics (amino acid, bacterial, botanical, fiber, mineral, protein, and vitamin) increased over time while two categories (enzyme and fat or fatty acid) saw a drop in their RSV. Overall, 119 topics saw an increase in interest over time, 19 remained stable, and 62 saw interest in them decrease. Google Trends provides insights into e-discourse and enables analysis of the differences in popularity of certain topics across countries and over time.

Lipid Accumulation and Chronic Kidney Disease

Obesity and hyperlipidemia are the most prevalent independent risk factors of chronic kidney disease (CKD), suggesting that lipid accumulation in the renal parenchyma is detrimental to renal function. Non-esterified fatty acids (also known as free fatty acids, FFA) are especially harmful to the kidneys. A concerted, increased FFA uptake due to high fat diets, overexpression of fatty acid uptake systems such as the CD36 scavenger receptor and the fatty acid transport proteins, and a reduced β-oxidation rate underlie the intracellular lipid accumulation in non-adipose tissues. FFAs in excess can damage podocytes, proximal tubular epithelial cells and the tubulointerstitial tissue through various mechanisms, in particular by boosting the production of reactive oxygen species (ROS) and lipid peroxidation, promoting mitochondrial damage and tissue inflammation, which result in glomerular and tubular lesions. Not all lipids are bad for the kidneys: polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) seem to help lag the progression of chronic kidney disease (CKD). Lifestyle interventions, especially dietary adjustments, and lipid-lowering drugs can contribute to improve the clinical outcome of patients with CKD.

Dietary Plants for the Prevention and Management of Kidney Stones: Preclinical and Clinical Evidence and Molecular Mechanisms

Kidney stones are one of the oldest known and common diseases in the urinary tract system. Various human studies have suggested that diets with a higher intake of vegetables and fruits play a role in the prevention of kidney stones. In this review, we have provided an overview of these dietary plants, their main chemical constituents, and their possible mechanisms of action. Camellia sinensis (green tea), Rubus idaeus (raspberry), Rubia cordifolia (common madder), Petroselinum crispum (parsley), Punica granatum (pomegranate), Pistacia lentiscus (mastic), Solanum xanthocarpum (yellow-fruit nightshade), Urtica dioica (stinging nettle), Dolichos biflorus (horse gram), Ammi visnaga (khella), Nigella sativa (black-cumin), Hibiscus sabdariffa (roselle), and Origanum vulgare (oregano) have received considerable interest based on scientific evidence. Beside these dietary plants, phytochemicals—such as catechin, epicatechin, epigallocatechin-3-gallate, diosmin, rutin, quercetin, hyperoside, and curcumin—as antioxidant dietary phyto-phenols were found to be effective for the prevention of urolithiasis (the process of stone formation in the urinary tract). The main underlying mechanisms of these dietary plants and their isolated phytonutrients in the management of urolithiasis include diuretic, antispasmodic, and antioxidant activity, as well as an inhibitory effect on crystallization, nucleation, and aggregation of crystals. The results as presented in this review demonstrate the promising role of dietary plants and phytophenols in the prevention and management of kidney stones. Further investigations are required to confirm the safety and efficacy of these compounds.

The quality of information on the internet relating to top-selling dietary supplements in the Czech Republic

Background The purchase of dietary supplements (DS) via the Internet is increasing worldwide as well as in the Czech Republic. Objective The aim of the study is to evaluate the quality of information on DS available on the Internet. Setting Czech websites related to dietary supplements. Methods A cross-sectional study was carried out involving the analysis of information placed on the websites related to the 100 top-selling DS in the Czech Republic in 2014, according to IMS Health data. Main outcome measure The following criteria were evaluated: contact for the manufacturer, recommended dosage, information on active substances as well as overall composition, permitted health claims, % of the daily reference intake value (DRIV) for vitamins and minerals, link for online counseling, pregnancy/breastfeeding, allergy information, contraindications, adverse reactions, and supplement-drug interactions (some criteria were evaluated from both points of view). Results A total of 199 web domains and 850 websites were evaluated. From the regulatory point of view, all the criteria were fulfilled by 11.3% of websites. Almost 9% of the websites reported information referring to the treatment, cure, or prevention of a disease. From the clinical point of view, all the criteria were only met by one website. Conclusions The quality of information related to DS available on the Internet in the Czech Republic is quite low. The consumers should consult a specialist when using DS purchased online.