10 Related Studies

Jerico O. Julaton IV-Phoenix

EFFECTS OF AN AQUEOUS EXTRACT FROMPHYLLANTUS NIRURI ON CALCIUM

OXALATE CRYSTALLIZATION IN VITRO
Phyllanthus niruri is a plant used in Brazilian folk medicine for the treatment of urolithiasis. It was
previously observed that P. niruri shows no toxicity, potentially increases calculus voiding by stone forming
patients and inhibits the endocytosis of calcium oxalate (CaOx) crystals by MDCK cells. In addition, in a rat
model of urolithiasis it reduced calculus growth. In the present study, we evaluated the effect of an aqueous
extract of P. niruri on CaOx crystallization in vitro. CaOx precipitation was induced by the addition of 0.1 M
sodium oxalate to unfiltered urine samples from Wistar rats (n=14) and normal humans (n=18) in the presence
or absence of P. niruri extract (0.25 mg/ml of urine). The presence of CaOx crystals was evaluated immediately
and 24 h later. In vitro crystallization of human urine produced typical mono- and dihydrated CaOx crystals, but
only a few typical CaOx crystals were found in rat urine. The presence of P. niruri extract did not inhibit CaOx
precipitation and even more crystals were obtained, although they were significantly smaller than those in the
control urine. Crystal aggregation observed 24 h after crystallization was also inhibited by P. niruri extract. The
results showed an inhibitory effect of P. niruri extract on CaOx crystal growth and aggregation in human urine,
suggesting that it may interfere with the early stages of stone formation and may represent an alternative form
of treatment and/or prevention of urolithiasis.
STUDY ON IN VITRO ANTI-LITHIATIC ACTIVITY OF PHYLLANTHUS NIRURI LINN. LEAVES
BY HOMOGENOUS PRECIPITATION AND TURBIDITORY METHOD
Objective: Kidney stone is one of the most prevalent diseases worldwide and calcium oxalate has been shown
to be the main component of the
majority of stones formed in the urinary system of the patients. Traditional knowledge on use of medicinal
plants for curing chronic diseases is
proving its worth to modern society too. In this regards, study was conducted with an objective to find out the
role of Phyllanthus niruri Linn. leaves
extracts to inhibit stone formation and dissolution of already exiting stone in renal system using in vitro
methods in the laboratory
Methods: Leaves powder was serially extracted in petroleum ether, ethyl acetate, methanol and water. In vitro
study was conducted to assess antiurolithiatic
effect of plant for all the extracts with two standard drugs namely, Neeri and Cystone as control. Two methods,
turbidity method and
calcium oxalate dissolution methods were practiced to access the inhibition of stone formation and dissolution
of stone crystals respectively.
Microscopic study was done for the comparative evaluation of crystal density and size in each treatment in
turbidity method.
Results: Water extract of plant leaves proved its potential statistically equal to the standard drug, cystone in
dissolving the exiting calcium oxalate
crystals. Water extract could dissolve 56.8% crystals while cystone dissolved 58.4% crystals in in vitro study
and found statistically at par. Water
extract also could inhibit up to 53.09% aggregation of calcium oxalate crystals as compared to the cystone with
76.54%. Among other extracts,

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methanol extract got second position in anti-lithiatic activity.

Jerico O. Julaton IV-Phoenix

Conclusion: Common medical practice recommends use of cystone as effective medicine for preventing as well
as treating renal stone which found
at par with the water extract of plant leaves to inhibit the stone formation even in its crude form. Results guide
us for the further detailed
investigation and development of new drugs from this medicinal plant.

EVALUATION OF ANTIUROLITHIATIC ACTIVITY OF COMBINATION OF PHYLLANTHUS

NIRURI AND AERVA LANATA IN ETHYLENE GLYCOL INDUCED UROLITHIASIS IN RATS
Phyllanthus niruri and Aerva lanata are widely used for the treatment of urolithiasis in folklore system of
medicines. The present study was aimed to investigate the protective effect of combination of methanolic
extracts of both of the plants in renal cell injury. Urolithiasis was induced by administration of 0.75% v/v
ethylene glycol in drinking water and simultaneously the plant extracts were given to the urolithiatic rats both
alone and combination for 30 days. Urinary volume and the level of calcium, phosphate, oxalate in urine was
determined. Serum parameters (creatinine, uric acid, urea, blood urea nitrogen, malondialdehyde and
antioxidant enzyme (reduced glutathione, superoxide dismutase, catalase) level was also evaluated in
urolithiatic rats. Oxalate excretion significantly increased in hyperoxaluric animals as compared to control
urolitiatic animals. Combination of methanolic extracts of both of the plants significantly decreased the oxalate
and calcium excretion and increased the excretion of magnesium. The treatment also significantly reduced level
of malondialdehyde and improved the activity of antioxidant enzymes followed by reduction in blood urea
nitrogen, urea and serum creatinine. Histological analysis indicates that the treatment also inhibited deposition
of CaOx crystal and renal cell damage. The present study reveals that the combination of methanolic extract of
Phyllanthus niruri and Aerva lanata protects against hyperoxaluric oxidative stress and renal cell injury in
urolithiasis due to their antioxidant activity.

POTENT HERBAL WEALTH WITH LITHOLYTIC ACTIVITY: A REVIEW

The most painful urologic disorder is calculi or stone formation in the kidneys and urinary bladder due
to imbalance between promoters and inhibitors of crystallization in urine. Stone formation is documented from
traditional periods and is considered as a medical challenge due to its multifactorial etiology. Stone formation
commonly occur due to inadequate urinary drainage, foreign bodies in urinary tract, microbial infections, diet
with excess oxalates and calcium, vitamin abnormalities like vitamin A deficiencies, excess vitamin D, and
metabolic diseases like hyperthyroidism, cystinuria, gout, intestinal dysfunction etc., Herbal remedies are
gaining their importance due to inefficiency of standard pharmaceutical drugs, and reoccurance is possible by
treating with ultrasonic energy and surgery. As investigations proved that phytotherapy is potent in preventing
and curing renal calculi with less side effects and produced satisfactory results in preventing reoccurance of
renal stones, the present study is mainly focused on providing information on potent herbal wealth with
litholytic property.

10 Related Studies
Jerico O. Julaton IV-Phoenix
ANTIUROLITHIATIC AND ANTIOXIDANT ACTIVITY OF MIMUSOPS ELENGI ON ETHYLENE
GLYCOL-INDUCED UROLITHIASIS IN RATS
Objective:
To evaluate the potential of Mimusops elengi in the treatment of renal calculi.
Materials and Methods:
Petroleum ether, chloroform, and alcohol extracts of Mimusops elengi bark were evaluated for antiurolithiatic
and antioxidant activity in male albino Wistar rats. Ethylene glycol (0.75%) in drinking water was fed to all the
groups (Groups IIIX) except normal control (Group I) for 28 days to induce urolithiasis for curative (CR) and
preventive (PR) regimen. Groups IV, V, and VI served as CR, and groups VII, VIII, and IX as PR were treated
with different extracts of M. elengi bark. Groups I, II, and III served as normal control, positive control
(hyperurolithiatic), and standard (cystone 750 mg/kg), respectively. Oxalate, calcium, and phosphate were
monitored in the urine and kidney. Serum BUN, creatinine, and uric acid were also recorded. In vivo antioxidant
parameters such as lipid peroxidation (MDA), glutathione (GSH), superoxide dismutase (SOD), and catalase
(CAT) were also monitored.
Results:
All the extracts of M. elengi were safe orally and exhibited no gross behavioral changes in the rats. In
hypercalculi animals, the oxalate, calcium, and phosphate excretion grossly increased. However, the increased
deposition of stone forming constituents in the kidneys of calculogenic rats were significantly (P < 0.001)
lowered by curative and preventive treatment with alcohol extract (AlE) of M. elengi. It was also observed that
alcoholic extract of M. elengi produced significant (P < 0.001) decrease in MDA, and increased GSH, SOD, and
CAT. These results confirm that AlE of M. elengi possess potent antiurolithiatic activity.
Conclusion:
The results obtained suggest potential usefulness of the AlE of M. elengi bark as an antiurolithiatic agent.
Keywords: Antiurolithiatic activity, BUN, creatinine, Mimusops elengi
DIMINUTION OF OXALATE INDUCED RENAL TUBULAR EPITHELIAL CELL INJURY AND
INHIBITION OF CALCIUM OXALATE CRYSTALLIZATION IN VITRO BY AQUEOUS EXTRACT
OF TRIBULUS TERRESTRIS
Purpose: Recurrence and persistent side effects of present day treatment for urolithiasis restrict their use,
so an alternate solution, using phytotherapy is being sought. The present study attempted to evaluate the
antilithiatic properties of Tribulus terrestris commonly called as gokhru which is often used in ayurveda to
treat
various
urinary
diseases
including
urolithiasis.
Materials and Methods: The activity of Tribulus terrestris was investigated on nucleation and the growth of the
calcium oxalate (CaOx) crystals as well as on oxalate induced cell injury of NRK 52E renal epithelial cells.
Results: Tribulus terrestris extract exhibited a concentration dependent inhibition of nucleation and the growth
of CaOx crystals. When NRK-52E cells were injured by exposure to oxalate for 72 h, Tribulus terrestris extract
prevented the injury in a dose-dependent manner. On treatment with the different concentrations of the plant,
the cell viability increased and lactate dehydrogenase release decreased in a concentration dependent manner.
Conclusion: The current data suggests that Tribulus terrestris extract not only has a potential to inhibit

10 Related Studies
Jerico O. Julaton IV-Phoenix
nucleation and the growth of the CaOx crystals but also has a cytoprotective role. Our results indicate that it
could be a potential candidate for phytotherapy against urolithiasis.
ANTIUROLITHIATIC ACTIVITY OF ETHANOLIC ROOT EXTRACT OF SACCHARUM
SPONTANEUM ON GLYCOLIC ACID INDUCED UROLITHIASIS IN RATS
The effect of the alcoholic extract of Saccharum spontaneum (Poaceae) against glycolic acid
induced urolithiasis urolithiasis in albino rats is summarized in this study. Lithiasis was induced in rats by fed
with a calculi-producing diet (CPD: commercial diet mixed with 3% glycolic acid) for 28 days and was
manifested by high urinary calcium, phosphate, oxalate, protein, and low urinary magnesium content.
Therapeutic treatment with plant extract (200 and 300mg/kg b.wt.dose-1 day-1oral-1) has significantly
ameliorated to near normalcy in the curative group. It also increased the urine volume, thereby reducing the
tendency for crystallization. These results of the present study concluded that S.spontaneum can play an
important role in the prevention of disorders associated with kidney stone formation.
AN OVERVIEW ON POTENT INDIGENOUS HERBS FOR URINARY TRACT INFIRMITY:
UROLITHIASIS
Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich
source of therapeutic agents for the prevention of various ailments. Urolithiasis is the condition where urinary
calculi are formed in the urinary tract. It is a common disorder estimated to occur in approximately 12% of the
population, with a recurrence rate of 70-81% in males, and 47-60% in females. It causes serious health
problems such as severe pain, urinary-tract obstruction and infection that adversely affect well-being of
individuals. Treatment option includes shock wave lithotripsy (SWL), ureteroscopy, percutaneous
nephrostolithotomy (PCNL), and open or laproscopic stone removal which are costly and painful. Many
synthetic drugs like diuretics and narcotic analgesics are being used in treatment of kidney stone but overuse of
synthetic drugs, which results in higher incidence of adverse drug reactions have motivated humans to return to
nature for safe remedies. As herbs and herbal drugs have clinically proven effects like immunomodulation,
adaptogenic and antimutagenic, they play a vital role in treatment of kidney stone disease. Number of medicinal
plants shows antiurolithiatic activity such as Kanghi (Abuliton indicum), Chaya (Aerva lanta), Bishkapa or
purnava (Boerhaavia diffusa), Ajuba (Bryophyllum pinnatum), Gokhuru (Tribulus terrestis), Makka (Zea mays)
etc.In the present article, an attempt has been made to emphasize on potent indigenous herbs used in treatment
of urolithiasis.
INFLUENCE OF CUCUMIS TRIGONUS R. FRUIT EXTRACT ON BIOCHEMICAL PARAMETERS
INUROLITHIASIS INDUCED WISTAR ALBINO RATS
Plants are utilized as therapeutic agents since time immemorial in both organized (Ayurveda, Unani) and
unorganized (folk, tribal, native) form. The ethanolic fruit extract of Cucumis trigonus Roxb of family
Cucurbitaceae was used to treat the urolithiasis induced by ethylene glycol. On this course, the extract also
repairs the changes that happened in the biochemical parameters urea, uric acid and creatinine in serum and
urine of the urolithiatic rats. The ethanol extract (150 mg / kg b.w.) reduced the levels of elevated biochemical
parameters in serum and urine significantly (p<0.05) when compared with the toxic groups. The results shown
by the ethanol extract (150 mg / kg b.w.) was compared to standard thiazide drug treated group showing no
significant difference (p<0.05) and thus exhibited potent antiurolithiatic activity.

10 Related Studies
Jerico O. Julaton IV-Phoenix
TWO SYNERGETIC EFFECTS OF SONCHUS ARVENSIS L. LEAVES DECOCTION IN CALCIUM
OXALATE BLADDER STONE THERAPY ON MALE WISTAR RAT
The anticalculi effect of Sonchus arvensis L. decoction on rat bladder stone has been done. The
objective of the research is to determine its effect in bladder stone therapy. Bladder stone was done by matrixglycolic acid induction method, used silk string matrix which inserted by surgical in bladder and two day
afterwards given per orally glycolic acid at the dosage 500 mg/kg BW/day during 7 days. Preventive group was
treated with 1.30 mg/kg BW/day decoction. The curative group 8 days later received the same treatment during
8 days. The result was measured with the weight of bladder stone which was deposited on string matrix and
were statistically analyzed by Students t-test. In prevention occurred 47.48% (p0.05) the inhibition effect. In
curative occurred the inhibition and dissolving effects of existed bladder stone 46.50% (p0.02) and 4.02%
respectively. In conclusion two effects can be shown namely (1) preventive measure: by the inhibition effect, it
inhibits the formation of bladder stone and (2) curative measure: by the inhibition of bladder stone enlargement
and dissolving of existed bladder stone.