Urolithiasis (2014) 42:309–315 DOI 10.1007/s00240-014-0674-z
Original Paper
The inhibitory effect of an ethanol extract of the spores of Lygodium japonicum on ethylene glycol‑induced kidney calculi in rats Hyuk Jin Cho · Woong Jin Bae · Su Jin Kim · Sung Hoo Hong · Ji Youl Lee · Tae‑Kon Hwang · Yeong Jin Choi · Sung Yeoun Hwang · Sae Woong Kim
Received: 23 December 2013 / Accepted: 9 June 2014 / Published online: 29 June 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract We investigated the effect of an ethanol extract of Lygodii spora (LS) as a preventive and therapeutic agent for experimentally induced calcium oxalate nephrolithiasis with ethylene glycol (EG) in rats. Male Wistar rats were randomly divided into preventive (n = 18, for 28 days) and therapeutic (n = 24, for 42 days) groups. The preventive group was further subdivided into three groups of six rats each: preventive control, preventive lithiatic control (EG) and preventive lithiatic LS (EG + 400 mg/kg LS). Similarly, the therapeutic group was subdivided into four groups of six rats each: therapeutic control, therapeutic lithiatic control, therapeutic lithiatic untreated, and therapeutic lithiatic LS. Lithiasis was induced by adding 0.75 % EG to the drinking water of all groups except the preventive and therapeutic control groups. Preventive and therapeutic subjects also received the LS ethanol extract in drinking water at a dose of 400 mg/kg, since day 0 or day 28, respectively. At the end of the each experimental period, various biochemical parameters were measured in urine and kidney
homogenates. The kidneys were subjected to histopathological analysis. The results revealed that treatment with the LS preventive protocol significantly decreased the levels of urinary calcium, oxalate and uric acid, and increased the levels of urinary citrate as compared to those in the EG control. No significant changes in the urinary parameters except oxalate and citrate levels were observed in the rats in the therapeutic protocol. In both preventive and therapeutic protocols, the extract significantly decreased kidney peroxides, renal calcium, oxalate content, and the number of kidney oxalate deposits as compared to those in the EG group. We conclude that LS is useful as a preventive and therapeutic agent against the formation of oxalate kidney stones. Keywords Nephrolithiasis · Calcium oxalate · Lygodii spora · Ethylene glycol
Introduction H. J. Cho · S. J. Kim · S. H. Hong · J. Y. Lee · T.-K. Hwang · S. W. Kim (*) Department of Urology, Seoul St. Mary’s Hospital, The Catholic University of Korea, 505 Banpo‑dong, Seocho‑gu, Seoul 137‑040, Korea e-mail: [email protected] W. J. Bae Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea Y. J. Choi Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea S. Y. Hwang Korea Bio Medical Science Institute, Seoul, Korea
The lifetime incidence of urolithiasis is 5–12 %, affecting 13 % of men and 7 % of women [1]. After a symptomatic stone event, the 5 years recurrence rate is 35–50 % without specific treatment; therefore, urolithiasis is of great importance for public health, and the economic burden of urolithiasis is immense [2]. About 80 % of these calculi are composed of calcium oxalate and calcium phosphate. Stones cause renal colic, urinary tract obstructions, infections, and loss of renal function [3]. Advances have been made in the management of urolithiasis following the introduction of several techniques including extracorporeal shock wave lithotripsy and endourological stone removal. Shock waves may cause complications such as decreased renal function,
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subcapsular hematomas, inflammation, ischemia, and renal fibrosis [4]. Furthermore, these invasive procedures are costly and do not prevent the likelihood of recurrence. Medical therapy for preventing recurrence, such as, thiazide diuretics and citrate preparations, is not consistently effective and may have adverse side effects that compromise their long-term use [5]. Therefore, alternative treatments using natural resources showing antiurolithiatic activity are important. Medicinal plants are used worldwide, and there is increasing interest in treating kidney stones using medicinal plants. A growing number of studies suggest that plants can act as antiurolithic agents. Numerous herbs such as Bombax ceiba, Alcea rosea, berberine, Cynodon dactylon, Leea macrophylla, Hibiscus sabdariffa, and Punica granatum show antilithic effects [6–13]. Lygodii Spora is the dried spore of Lygodium japonicum (family Schizaeaceae) and is widely distributed in Eastern Asia and southern to northern Australia. The whole plant or the mature spore or the roots of Lygodium japonicum are used in Chinese traditional medicine to treat skin eczema, dysuria, male urodynia, nephritis, urinary calculus, and urinary tract infection [14, 15]. The chemical constituents on the genus are mainly flavones, phenolic acid and sterosides [16–18]. However, no scientific data are available to establish the beneficial effect of this plant on urolithiasis. The present study investigated the antiurolithiatic effect of an ethanol extract of Lygodii Spora in an ethylene glycol (EG)-induced urolithiasis model of rats.
Materials and methods Plant materials Lygodii Spora was purchased from Kwangmyungdang Pharmacy Co. Ltd. (Ulsan, Korea) and graciously identified by the College of Korean Medicine, Woosuk University. The spores were powdered and dried. Then, 100 g of the prepared powder was mixed with a sufficient volume of 95 % ethanol and extracted with a Soxhlet apparatus for 24 h at room temperature. The filtered ethanol was concentrated under reduced pressure using a rotator vacuum evaporator (NE-2001) at a temperature
Original Paper
The inhibitory effect of an ethanol extract of the spores of Lygodium japonicum on ethylene glycol‑induced kidney calculi in rats Hyuk Jin Cho · Woong Jin Bae · Su Jin Kim · Sung Hoo Hong · Ji Youl Lee · Tae‑Kon Hwang · Yeong Jin Choi · Sung Yeoun Hwang · Sae Woong Kim
Received: 23 December 2013 / Accepted: 9 June 2014 / Published online: 29 June 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract We investigated the effect of an ethanol extract of Lygodii spora (LS) as a preventive and therapeutic agent for experimentally induced calcium oxalate nephrolithiasis with ethylene glycol (EG) in rats. Male Wistar rats were randomly divided into preventive (n = 18, for 28 days) and therapeutic (n = 24, for 42 days) groups. The preventive group was further subdivided into three groups of six rats each: preventive control, preventive lithiatic control (EG) and preventive lithiatic LS (EG + 400 mg/kg LS). Similarly, the therapeutic group was subdivided into four groups of six rats each: therapeutic control, therapeutic lithiatic control, therapeutic lithiatic untreated, and therapeutic lithiatic LS. Lithiasis was induced by adding 0.75 % EG to the drinking water of all groups except the preventive and therapeutic control groups. Preventive and therapeutic subjects also received the LS ethanol extract in drinking water at a dose of 400 mg/kg, since day 0 or day 28, respectively. At the end of the each experimental period, various biochemical parameters were measured in urine and kidney
homogenates. The kidneys were subjected to histopathological analysis. The results revealed that treatment with the LS preventive protocol significantly decreased the levels of urinary calcium, oxalate and uric acid, and increased the levels of urinary citrate as compared to those in the EG control. No significant changes in the urinary parameters except oxalate and citrate levels were observed in the rats in the therapeutic protocol. In both preventive and therapeutic protocols, the extract significantly decreased kidney peroxides, renal calcium, oxalate content, and the number of kidney oxalate deposits as compared to those in the EG group. We conclude that LS is useful as a preventive and therapeutic agent against the formation of oxalate kidney stones. Keywords Nephrolithiasis · Calcium oxalate · Lygodii spora · Ethylene glycol
Introduction H. J. Cho · S. J. Kim · S. H. Hong · J. Y. Lee · T.-K. Hwang · S. W. Kim (*) Department of Urology, Seoul St. Mary’s Hospital, The Catholic University of Korea, 505 Banpo‑dong, Seocho‑gu, Seoul 137‑040, Korea e-mail: [email protected] W. J. Bae Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea Y. J. Choi Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea S. Y. Hwang Korea Bio Medical Science Institute, Seoul, Korea
The lifetime incidence of urolithiasis is 5–12 %, affecting 13 % of men and 7 % of women [1]. After a symptomatic stone event, the 5 years recurrence rate is 35–50 % without specific treatment; therefore, urolithiasis is of great importance for public health, and the economic burden of urolithiasis is immense [2]. About 80 % of these calculi are composed of calcium oxalate and calcium phosphate. Stones cause renal colic, urinary tract obstructions, infections, and loss of renal function [3]. Advances have been made in the management of urolithiasis following the introduction of several techniques including extracorporeal shock wave lithotripsy and endourological stone removal. Shock waves may cause complications such as decreased renal function,
13
310
subcapsular hematomas, inflammation, ischemia, and renal fibrosis [4]. Furthermore, these invasive procedures are costly and do not prevent the likelihood of recurrence. Medical therapy for preventing recurrence, such as, thiazide diuretics and citrate preparations, is not consistently effective and may have adverse side effects that compromise their long-term use [5]. Therefore, alternative treatments using natural resources showing antiurolithiatic activity are important. Medicinal plants are used worldwide, and there is increasing interest in treating kidney stones using medicinal plants. A growing number of studies suggest that plants can act as antiurolithic agents. Numerous herbs such as Bombax ceiba, Alcea rosea, berberine, Cynodon dactylon, Leea macrophylla, Hibiscus sabdariffa, and Punica granatum show antilithic effects [6–13]. Lygodii Spora is the dried spore of Lygodium japonicum (family Schizaeaceae) and is widely distributed in Eastern Asia and southern to northern Australia. The whole plant or the mature spore or the roots of Lygodium japonicum are used in Chinese traditional medicine to treat skin eczema, dysuria, male urodynia, nephritis, urinary calculus, and urinary tract infection [14, 15]. The chemical constituents on the genus are mainly flavones, phenolic acid and sterosides [16–18]. However, no scientific data are available to establish the beneficial effect of this plant on urolithiasis. The present study investigated the antiurolithiatic effect of an ethanol extract of Lygodii Spora in an ethylene glycol (EG)-induced urolithiasis model of rats.
Materials and methods Plant materials Lygodii Spora was purchased from Kwangmyungdang Pharmacy Co. Ltd. (Ulsan, Korea) and graciously identified by the College of Korean Medicine, Woosuk University. The spores were powdered and dried. Then, 100 g of the prepared powder was mixed with a sufficient volume of 95 % ethanol and extracted with a Soxhlet apparatus for 24 h at room temperature. The filtered ethanol was concentrated under reduced pressure using a rotator vacuum evaporator (NE-2001) at a temperature
