Research Paper Preventive treatment of calcium oxalate crystal deposition with immortal flowers Nilüfer Orhan a,n , Metin Onaran b , İlker Şen b , İpek Işık Gönül c , Mustafa Aslan a Q1 a Department of Pharmacognosy Q2 , Faculty of Pharmacy, Gazi University, 06330 Ankara, Turkey b Department of Urology, Faculty of Medicine, Gazi University, 06560 Ankara, Turkey c Department of Pathology, Faculty of Medicine, Gazi University, 06560 Ankara, Turkey article info Article history: Received 29 August 2014 Received in revised form 24 November 2014 Accepted 7 January 2015 Keywords: Calcium oxalate crystallization Helichrysum Asteraceae Immortal flowers Kidney stone Urolithiasis abstract Ethnopharmacological relevance: A number of medicinal plants are used for their diuretic, urolithiatic and anti-inflammatory effects on urinary system problems in Turkey and the most common traditional remedy for kidney stones is the tea of immortal flowers. To evaluate the Q4 preventive effect of infusions prepared from capitulums of Helichrysum graveolens (M.Bieb.) Sweet (HG) and Helichrysum stoechas ssp. barellieri (Ten.) Nyman (HS) on formation of kidney stones. Materials and method: Sodium oxalate (Ox-70 mg/kg intraperitoneally) was used to induce kidney stones on Wistar albino rats. At the same time, two different doses of the plant extracts (HG: 62.5 and 125 mg/ kg; HS: 78 and 156 mg/kg) were dissolved in the drinking water and administered to animals for 5 days. Potassium citrate was used as positive control in the experiments. During the experiment, water intake, urine volume and body weights of the animals were recorded. At the end of the experiments, liver, kidney and body weights of the animals were determined; biochemical analysis were conducted on urine, blood and plasma samples. Histopathological changes in kidney tissues were examined and statistical analysis were evaluated. Results: HS extract showed the highest preventive effect at 156mg/kg dose (stone formation score: 1.16), whereas a number of kidney stones were maximum in sodium oxalate group (stone formation score: 2.66). Helichrysum extracts decreased urine oxalate and uric acid levels and increased citrate levels significantly. In addition, Helichrysum extracts regulated the negative changes in biochemical and hematological parameters occurred after Ox injection. Conclusions: We conclude that Helichrysum extracts could reduce the formation and growth of kidney stones in Ox-induced urolithiasis and can be beneficial for patients with recurrent stones. In addition, this is the first study on the preventive effect of immortal flowers. & 2015 Published by Elsevier Ireland Ltd. 1. Introduction Urolithiasis is a growing health problem in industrialized countries and often correlated with habits such as hypertension, high purine intakes, diabetes, obesity, and metabolic syndrome (Rosa et al., 2013). Unexpectedly, 12% of the world's population is affected by urinary system stone disease (Pak, 1998; Basavaraj Q5 et al., 2007). Urolithiasis is formation of kidney stones in urine- collecting spaces of the kidneys. Under certain conditions, sub- stances normally dissolved in the urine can separate out as crystals and accumulate to form a solid mass called kidney stone. Stones can migrate into the ureters, the bladder and finally be evacuated in the urine. Even surgical procedures, drug treatment, extracorporeal shock wave lithotripsy and endoscopic techniques are commonly used to treat stones; none of these options inhibit formation of new kidney stones. It is established than the recurrence rate of calcium oxalate stones is 10.5% in the first year; but it reaches 50% at the tenth year (Menon et al., 1998). Thus, after treatment, there is a great demand for nonsurgical methods to prevent the recurrence of urolithiasis. In recent years, beside drug treatment, herbal medicines and their components have been widely investigated (Rosa et al., 2013). Data from in-vitro, in-vivo and clinical trials revealed that phytotherapeutic agents could be usefull as either an alternative or a complementary therapy in the management of urolithiasis (Butterweck and Khan, 2009). Therewithal, various plants and herbal preparations have been used for treatment of kidney stones since ancient times. Among these, infusions prepared from capitulums of Helichrysum species are 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/jep Journal of Ethnopharmacology http://dx.doi.org/10.1016/j.jep.2015.01.009 0378-8741/& 2015 Published by Elsevier Ireland Ltd. n Corresponding author Q3 . Tel.: þ90 312 2023176; fax: þ90 312 2235018. E-mail address: nsendogdu@gazi.edu.tr (N. Orhan). Please cite this article as: Orhan, N., et al., Preventive treatment of calcium oxalate crystal deposition with immortal flowers. Journal of Ethnopharmacology (2015), http://dx.doi.org/10.1016/j.jep.2015.01.009i Journal of Ethnopharmacology ∎ (∎∎∎∎) ∎∎∎–∎∎∎