Serhat Gürocak1, Bora Küpeli. 1. Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
Abstract
PURPOSE: Recent years have shown a dramatic expansion in the knowledge of molecular mechanism of phytotherapeutic agents used to treat urolithiasis. The discovery and elucidation of the mechanism of action, in particular the clinical role of these herbal remedies, has made an important contribution to treatment for urinary stone disease as an alternative or adjunct therapy. Thus, the potential clinical application of these folk medicines to urolithiasis is discussed. MATERIALS AND METHODS: The literature on phytotherapeutic agents with scientifically determined efficiency and historically consumed agents was reviewed using MEDLINE after 1940 to the present. RESULTS: Although information on the complete mechanism of action of each remedy is lacking, commonly known extracts exert antilithogenic properties by altering the ionic composition of urine or by expressing diuretic activity. Also, some of them contain saponins that can disaggregate suspensions of mucoproteins, which are actually promoters of crystallization and some herbal remedies have antimicrobial properties that protect the anti-adherent layer of the mucosa, which acts as a protective barrier against urinary stone disease. CONCLUSIONS: Although phytotherapeutic extracts are popular in folk culture, because of the absence of scientific data on the exact clinical role, efficacy and side effects of these herbs the potential consumption of this alternative medical therapy as an alternative or adjunct to classic therapy remains to be determined. In this respect scientific research designed to determine the exact mechanism of action of these drugs would be fruitful for willing investigators.
PURPOSE: Recent years have shown a dramatic expansion in the knowledge of molecular mechanism of phytotherapeutic agents used to treat urolithiasis. The discovery and elucidation of the mechanism of action, in particular the clinical role of these herbal remedies, has made an important contribution to treatment for urinary stone disease as an alternative or adjunct therapy. Thus, the potential clinical application of these folk medicines to urolithiasis is discussed. MATERIALS AND METHODS: The literature on phytotherapeutic agents with scientifically determined efficiency and historically consumed agents was reviewed using MEDLINE after 1940 to the present. RESULTS: Although information on the complete mechanism of action of each remedy is lacking, commonly known extracts exert antilithogenic properties by altering the ionic composition of urine or by expressing diuretic activity. Also, some of them contain saponins that can disaggregate suspensions of mucoproteins, which are actually promoters of crystallization and some herbal remedies have antimicrobial properties that protect the anti-adherent layer of the mucosa, which acts as a protective barrier against urinary stone disease. CONCLUSIONS: Although phytotherapeutic extracts are popular in folk culture, because of the absence of scientific data on the exact clinical role, efficacy and side effects of these herbs the potential consumption of this alternative medical therapy as an alternative or adjunct to classic therapy remains to be determined. In this respect scientific research designed to determine the exact mechanism of action of these drugs would be fruitful for willing investigators.
Authors: Mitra R de Cógáin; Michael P Linnes; Hyo Jung Lee; Amy E Krambeck; Julio Cezar de Mendonça Uchôa; Sung-Hoon Kim; John C Lieske Journal: Urolithiasis Date: 2015-02-05 Impact factor: 3.436