Establishing the Principle of Herbal Therapy for Antiurolithiatic Activity: A Review

Antilithiatic activity of a non-pharmacopoeial Unani formulation in chemically induced urolithiasis in rats

OBJECTIVES

Parshioshan (Adiantum capillus-veneris L.), Duqu (Peucedanum grande C.B. Clarke), Kaknaj (Physalis alkekengi L.) and Kharekhasak (Tribulus terresteris L.) have been selected for this study as they have been associated with medicinal actions for litholytic activity.

METHODS

The experiment was carried out in Sprague Dawley rats divided into seven groups, serving as plain control, disease control, standard control, curative A and B and preventive A and B groups. Animals of plain control received distilled water. Remaining six groups received Ethylene glycol 0.75% and Ammonium chloride 1% by adding in the drinking water for the first three days followed by 0.75% Ethylene glycol for 18 days. From 8th day till 21st day, standard control received Cystone in the dose of 750 mg/kg. Preventive and curative test groups were treated with hydroalcoholic extract of the test drug in the dose of 132 mg/kg and 264 mg/kg from 1st to 21st day and 8th to 21st day of calculi induction.

RESULTS

Test drug reduced the number of calcium oxalate crystals in the urine; the level of urinary calcium, creatinine, magnesium, phosphorus, sodium and chloride decreased significantly in standard and test groups. The urine volume increased significantly in all the test groups. The level of serum calcium, urea, phosphorus and creatinine were significantly reduced in all the test groups.

CONCLUSIONS

These results indicated that the test drug reduced and prevented the growth of urinary stones. Moreover, the test drug also possessed significant antiurolithiatic activity. However, the protective effect was found more than its curative effect.

Antiurolithiatic effects of pentacyclic triterpenes: The distance traveled from therapeutic aspects

Globally, approximately 12% of the population is inflicted by various types of urolithiasis. Standard treatments are available both to avert and treat urolithiasis, but with significant adverse side effects. Pentacyclic triterpenes represent a group of naturally occurring compounds which holds immense potential as therapeutic for treating kidney stone. This review aims to provide an integrative description on how pentacyclic triterpenes can effectively treat calcium oxalate urolithiasis through various mechanisms such as antioxidant, anti-inflammatory, diuretic, and angiotensin-converting enzyme inhibition. Some of the pentacylic triterpenes which shows promising activities include lupeol, oleanolic acid, betulin, and taraxasterol. Moreover, future perspectives in the development of pentacyclic triterpenes in formulations/drugs for urinary stone prevention are highlighted. It is anticipated that compiled information would serve as a scientific baseline to advocate further investigations on the potential of pentacyclic triterpenes in urolithiasis remediation.

In vitro antilithiatic activity of the hydro-alcoholic extract of Cinnamomum zeylanicum Blume bark on calcium oxalate crystallization

OBJECTIVE

The study examines the effect of the hydro-alcoholic extract of Cinnamomum zeylanicum Blume bark on crystallization of calcium oxalate.

METHODS

The antilithiatic effect of various concentrations of the hydro-alcoholic extract of C. zeylanicum was investigated at various stages of stone formation, using Cystone as a standard reference drug. The effect on calcium oxalate crystallization was evaluated by measuring the change in turbidity over time, during crystal nucleation, growth and aggregation, in the metastable solution of calcium chloride and sodium oxalate. The slope from the change in turbidity over time was measured using a spectrophotometer at 620 and 214 nm in respective tests. The inhibition rate was estimated by comparing turbidity in the presence and absence of extract. Crystals formed under experimental conditions were observed under a light microscope, and number and shape of the crystals were assessed in a randomly selected field. Phytochemical analysis and high-performance thin-layer chromatography of the extract was also carried out.

RESULTS

C. zeylanicum significantly reduced crystal nucleation at concentrations of 4, 8 and 10 mg/mL (P < 0.001). The inhibition percentage of crystal growth was between 28.30% and 92.46% in the presence of C. zeylanicum extract and from 20.76% to 64.15% with various concentrations of Cystone. The maximum inhibition of crystal growth was obtained from C. zeylanicum at 2 mg/mL (92.46%). Microscopic examination revealed a reduction in the number and size of crystals. In the aggregation assay, the inhibition percentage of C. zeylanicum was between 16.27% and 100%, while Cystone was from -214.68% to 100% at different concentrations. The highest (100%) inhibition of aggregation was found at 4 mg/mL of both the test and standard drugs.

CONCLUSION

We found that C. zeylanicum hydro-alcoholic extract has notable inhibitory effects on various stages of crystallization, in terms of turbidity of solution, as well as the crystal size, number and morphology.

Phytochemical, Free Radical Scavenging and Antifungal Profile of Cuscuta campestris Yunck. Seeds

This work was conceptualized with the goal to investigate the phytochemical, free radical scavenging and antifungal profile of Cuscuta campestrisYunck. seeds. Total phenolics, amino acid and carbohydrate contents were evaluated in ethanolic, acetone and chloroform extract. Effective antioxidant activity was evaluated throughout seven antioxidant methods. The antifungal activity was assessed against eight fungal strains and Candida albicans. The results showed total phenol, flavonoid, flavonols and phenolic acids contents in amount of 1.51 - 6.35 mg GAE/mL, 78 - 425 μg RU/mL, 1.04 - 2.98 mg QU/g and 12.01 - 30.58 μg CAE/mL, respectively. The total amino acids and carbohydrates content ranged from 8.29 to 185.45 μg Gly/mL and from 0.05 to 0.12 μg Glu/mL. The ethanolic extract showed the best antioxidant activity in phosphomolybdenum, DPPH free radical scavenging, ferric reducing power and lipid peroxidation assays. The best activity in ferrous ion chelating and H₂ O₂ assays had the acetone extract, whereas the best hydroxyl radical scavenging activity was observed with the chloroform extract. The ethanolic extract at a concentration of 6 mg/mL proved to be the most effective antimycotic, since it inhibited the growth of all tested fungi except Penicillium verrucosum. The obtained results indicate that C. campestris seeds could be attributed to a potential source of natural antioxidants in food and pharmaceutical products.

A polyherbal formulation attenuates hyperoxaluria-induced oxidative stress and prevents subsequent deposition of calcium oxalate crystals and renal cell injury in rat kidneys

INTRODUCTION

Cystone is an approved Ayurvedic polyherbal proprietary medicine used in India for various urinary disorders, including urolithiasis.

AIM

To evaluate the protective effect of Cystone against hyperoxaluria-induced oxidative stress and calcium oxalate crystal deposition in urolithiasis.

METHODS

Ethylene glycol (EG) (0.75%, V/V) in drinking water was given to rats for 28 days to induce urolithiasis with simultaneous treatment of Cystone (500 and 750 mg/kg body weight), and various urinary risk factors of urolithiasis and antioxidant markers were assessed.

RESULTS

EG treatment lead to increased urine volume and lowered urinary pH, along with increased urinary excretion of oxalate, calcium and phosphate in untreated animals. These changes caused extensive calcium oxalate crystal deposition, increased lipid peroxidation and decreased activity of antioxidant enzymes (SOD, catalase and GPx) in the kidney of untreated rats. Cystone prevented these hyperoxaluric manifestations and inhibited calcium oxalate crystal deposition in treated rats at both doses.

CONCLUSIONS

Cystone therapy provides protection against hyperoxaluria-induced oxidative stress and calcium oxalate crystal deposition by improving renal tissue antioxidant status and diuresis.

HPLC and HPTLC methods by design for quantitative characterization and in vitro anti-oxidant activity of polyherbal formulation containing Rheum emodi

Safoof-e-Pathar phori (SPP) is a traditional polyherbal formulation and has been used since long time for its anti-urolithiatic activity. It contains three plant constituents Didymocarpous pedicellata, Dolichous biflorus and Rheum emodi. Emodin and chrysophanic acid were selected as chemical markers for SPP and quantified using simultaneous HPTLC and RP-HPLC methods in R. emodi and in SPP. The simultaneous methods were found linear r(2) = 0.991 in a wide range (10-800 ng spot(-1) with HPTLC, 5-500 µg mL(-1) with HPLC) precise, accurate and robust for both the drugs. Anti-oxidant activity of SPP, R. emodi as well as standard emodin and chrysophanic acid were determined by using DPPH (2,2-diphenyl-1-picryl hydrazyl radical), which showed better activity of R. emodi (IC50 = 12.27) extract when compared with SPP (IC50 = 32.99) and standard drugs (IC50 = 66.81). The robustness of methods were proved by applying the Box-Behnken response surface design software and other validation parameters evaluated were satisfactorily met; hence, the developed method found suitable for application in the quality control of several formulations containing emodin and chrysophanic acid.