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A Novel Antilithiatic Protein from Tribulus terrestris Having Cytoprotective Potency

Authors:
  • Amity University Punjab Mohali

Abstract and Figures

Adhesion of calcium oxalate (CaOx) crystals to kidney cells is a key event in kidney stones associated with marked hyperoxaluria. As the propensity of stone recurrence and persistent side effects are not altered by surgical techniques available, phytotherapeutic agents could be useful as an adjuvant therapy. The present study is aimed at examining the antilithiatic potency of the protein biomolecules of Tribulus terrestris, a plant which is a common constituent of herbal marketed preparations to treat urolithiasis. Various biochemical methods with mass spectrometry were used to purify and characterize the purified protein. The protective potency of the protein was tested on the oxalate induced injury on renal epithelial cell lines (NRK 52E). An antilithiatic protein having molecular weight of ~ 60kDa was purified. This purified protein showed similarities with Carotenoid cleavage dioxygenase 7 (CCD7) of Arabidopsis thaliana after matching peptide mass fingerprints in MASCOT search engine. An EF hand domain was identified in CCD7 by SCAN PROSITE. Presence of an EF hand domain, a characteristic feature of calcium binding proteins and a role in the synthesis of retinol which is transported by retinol binding protein, a protein found in kidney stone matrix; of CCD7 support the role of TTP as an antilithiatic protein. The protective potency of TTP on NRK 52E was quite comparable to the aqueous extract of cystone. Our findings suggest that this purified protein biomolecule from Tribulus terrestris could open new vista in medical management of urolithiasis.
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812 Protein & Peptide Letters, 2012, 19, 812-819
A Novel Antilithiatic Protein from Tribulus terrestris Having Cytoprotec-
tive Potency
Anshu Aggarwala, Simran Tandona, Surinder Kumar Singlab and Chanderdeep Tandona,*
aDepartment of Biotechnology and Bioinformatics, Jaypee University of Information Technology, Waknaghat, Solan -
173234, Himachal Pradesh, India, bDepartment of Biochemistry, Panjab University, Chandigarh. India
Abstract: Adhesion of calcium oxalate (CaOx) crystals to kidney cells is a key event in kidney stones associated with
marked hyperoxaluria. As the propensity of stone recurrence and persistent side effects are not altered by surgical tech-
niques available, phytotherapeutic agents could be useful as an adjuvant therapy. The present study is aimed at examining
the antilithiatic potency of the protein biomolecules of Tribulus terrestris, a plant which is a common constituent of herbal
marketed preparations to treat urolithiasis. Various biochemical methods with mass spectrometry were used to purify and
characterize the purified protein. The protective potency of the protein was tested on the oxalate induced injury on renal
epithelial cell lines (NRK 52E). An antilithiatic protein having molecular weight of ~ 60kDa was purified. This purified
protein showed similarities with Carotenoid cleavage dioxygenase 7 (CCD7) of Arabidopsis thaliana after matching pep-
tide mass fingerprints in MASCOT search engine. An EF hand domain was identified in CCD7 by SCAN PROSITE.
Presence of an EF hand domain, a characteristic feature of calcium binding proteins and a role in the synthesis of retinol
which is transported by retinol binding protein, a protein found in kidney stone matrix; of CCD7 support the role of TTP
as an antilithiatic protein. The protective potency of TTP on NRK 52E was quite comparable to the aqueous extract of
cystone. Our findings suggest that this purified protein biomolecule from Tribulus terrestris could open new vista in
medical management of urolithiasis.
Keywords: Calcium oxalate, carotenoid cleavage dioxygenase 7, NRK 52E, Tribulus terrestris, urolithiasis
INTRODUCTION
Nephrolithiasis is quite common, affecting 10–12% of
the population in industrialized countries [1]. Calcareous
stones are the most commonly occurring ones to an extent of
60-80% followed by magnesium ammonium phosphate
(Struvite) to an extent of 10-15%, uric acid 5-10% and cys-
tine 0.5-1% [2]. The genesis of a calcium oxalate stone is a
complex process which would ensue from an imbalance be-
tween promoters and inhibitors of urinary crystallisation.
The natural progression of the urine chemistry leading to
stone development is urine saturation, urine supersaturation,
crystal nucleation, aggregation, the retention of crystals by
the urothelium, and the continued growth of the stone on the
retained crystals [3]. However, incompletely understood bio-
logical processes can anchor these crystals to the urothelium.
A widely held theory is that of Randall’s plaques, which
proposes that subepithelial interstitial calcium-based deposits
act as nuclei for stone formation [4].
Experiments with cultured renal cells indicate that ox-
alate can activate pathways that either trigger cell growth or
produce a cellular injury that can ultimately result in cell
death. Increase in oxalate concentration leads to the activa-
tion of lipid signalling pathways that produce arachidonic
acid, lysophospholipids, and ceramide. These lipids disrupt
mitochondrial function by increasing reactive oxygen species
*Address correspondence to this author at the Biotechnology and Bioinfor-
matics, Jaypee University of Information Technology, Waknaghat- 173234,
Solan, India; Emails: chanderdeep.tandon@juit.ac.in
(ROS), decreasing mitochondrial membrane potential, and
increasing mitochondrial permeability. The net response is
cytochrome C release, activation of caspases, and apoptosis
or necrosis [5].
Various surgical procedures introduced for the manage-
ment of renal stones like extracorporeal shock wave
lithotripsy (ESWL), ureteroscopy (URS), or percutaneous
nephrolithotomy (PNL) have not proved to be quite effective
and the propensity for stone recurrence is still high. In addi-
tion, ESWL might show some significant side effects such as
renal damage, ESWL induced hypertension or renal impair-
ment [6]. Literature suggests that phytotherapeutic agents
could be useful as either an alternative or a complementary
therapy in the management of urolithiasis. Plant medicines
are in great demand because of their wide biological and
medicinal activities, higher safety margin and lesser costs
[7].
Fruits of Tribulus terrestris (Zygophyllaceae) locally
named as “gokhru” in India are commonly used in folklore
to treat urolithiasis. So far, its diuretic properties have been
documented in literature [8, 9] and it is actively used in vari-
ous drug formulations of kidney stone treatments like
Cystone and Uriflow. The present study is aimed at identifi-
cation of the most potent biomolecules(s) responsible for the
antilithiatic property of Tribulus terrestris and examining the
efficacy of the same on oxalate induced injury in NRK 52E
(rat renal tubular epithelial) cells.
-/12 $58.00+.00 © 2012 Bentham Science Publishers
Cytoprotective Effect of Tribulus terrestris Protein Protein & Peptide Letters, 2012, Vol. 19, No. 8 813
MATERIALS AND METHODS
Materials
The dried and matured fruits of Tribulus terrestris were
obtained from “Natural Remedies Pvt. Ltd.” at Bangalore in
India. A collection of voucher specimen is available with the
company. Other materials required were Macro Prep® 25 Q
Strong anion exchanger (Bio-Rad laboratories), Bio gel® P-
100 gel (Medium, 90-180 m), Molecular sieve support
(Bio-Rad laboratories), bovine serum albumin, Trypsin pro-
file IGD kit (Sigma, St. Lois, USA), Solvents used were of
HPLC grade. All other chemicals were of analytical grade.
Crystal Growth Inhibition
Inhibitory activity against CaOx crystal growth was
measured using the seeded, solution-depletion assay [10].
Briefly, CaOx crystal seed (from FTIR identified clinical
kidney stones) slurry, 1.5mg/ml were added to a solution
containing 1mM calcium chloride (CaCl2) and 1mM sodium
oxalate (Na2C2O4). The reaction between CaCl2 and Na2C2O4
would lead to deposition of CaOx on the crystal surface lead-
ing to the depletion in free oxalate that is detectable spectro-
photometry at 214 nm. When a protein is added into this
solution, the rate of depletion of free oxalate will decrease if
the protein inhibits CaOx crystal growth. Rate of reduction
of free oxalate was calculated using the baseline value and
the value after incubation with or without protein. The rela-
tive inhibitory activity was calculated as follows: % Relative
inhibitory activity = [(CS)/C] 100, where C is the rate of
reduction of free oxalate without any test protein and S is the
rate of reduction of free oxalate with a test protein.
Protein Purification
The active inhibitory protein was isolated as described by
Kaur et al [11]. Powdered Tribulus terrestris was extracted
with 50mM Tris-Cl buffer (pH 7.4), containing 0.25M NaCl,
1mM PMSF and 0.01% sodium azide for 24 h with gentle
stirring at 4oC. The slurry was centrifuged at 10,000g for 20
min at 4oC to recover the supernatant. Protein in the super-
natant was estimated using Lowry et al. The protein was
precipitated with ammonium sulphate (40-60% saturation) to
recover the pellet with CaOx inhibitory activity. The pellet
was dissolved in 50mM Tris-Cl buffer containing 50mM
NaCl (pH 7.4) and dialyzed against the same buffer before
fractionation on strong anion exchanger Macro Prep® 25 Q
column (20 X 1.5cm) pre-equilibrated with 20mM Tris
buffer with 0.1mM NaCl (pH 7.4) using Biologic LP system
(Bio-Rad). The elution was carried out with same buffer us-
ing a linear gradient of 0.1-1.0M NaCl at flow rate of
1.5ml/min. The fractions having anticalcifying activity were
pooled, dialyzed against 50mM Tris-Cl containing 50mM
NaCl and further fractionated on a Bio gel® P-100 gel mo-
lecular sieve column (70 X 2.5cm) equilibrated and eluted
with the 20mM Tris buffer (pH 7.4) at a flow rate of
0.1ml/min. The homogeneity of the active protein was
evaluated by electrophoresis. The purified protein was stored
at -80 0C for further analysis.
Electrophoresis
SDS/PAGE was carried out using 10% polyacrylamide
gels and stained with silver nitrate.
Peptide Mass Fingerprinting by MALDI-TOF MS
The protein band was excised and subjected to in-gel
tryptic digestion as using Trypsin profile IGD kit (Sigma).
The resulting peptide mixtures were, eluted on the sample
plate with the matrix solution (10 mg/ml of -cyano-
carboxycinnamic acid in 50% acetonitrile/0.1% trifluoroace-
tic acid) and then analyzed on Bruker Ultraflex MALDI
TOF/TOF mass spectrometer. Peptide matching was per-
formed using the MASCOT search engine
(http://www.matrixscience.com) assuming that peptides were
monoisotopic, carbamidomethylated at cysteine residues, and
oxidized at methionine residues. A mass tolerance was 1.2
Da, and only 1 maximal cleavage was allowed for peptide
matching. Proteins with probability based MOWSE scores
exceeding their threshold (P<0.05) were considered to be
positively identified [12].
Putative Function of Protein and Domain Identification
The amino acid sequences of protein were subjected to
BLASTp analysis to determine putative function and family
of protein at the National Center for Biotechnology Informa-
tion (www.ncbi.nlm.nih.gov/BLAST) using all non-
redundant GenBank CDS. Further to reveal presence of ac-
tive domains in the protein, SCAN PROSITE
(http://expasy.org/tools/scanprosite) was employed.
Cell Culture
Normal rat renal tubular (NRK 52E) epithelial cells were
obtained from National Centre of Cell Sciences (NCCS,
Pune). The cells were maintained as monolayers in Dul-
becco’s Modified Eagle’s Medium (DMEM) with 2.0 mM L-
glutamine adjusted to contain 3.7 g/L sodium bicarbonate,
4.5 g/L glucose. Media was supplemented with 1% Penicillin
(10,000 units/ml)-Streptomycin (10,000 g/ml) and 10%
fetal bovine serum. Cells were cultured in 25 cm2 tissue-
culture treated flasks at 37oC and 5% CO2 in humidified
chambers.
Preparation of the Tribulus terrestris Extract
For cell culture studies, the purified protein was dialysed
through amicon tube (3kDa) and was reconstituted in 0.22
filtered distilled water. This was treated as a stock solution of
the Tribulus terrestris protein.
Oxalate-induced Cell Injury
NRK 52E cells were incubated in DMEM containing 1
mM sodium oxalate in the presence of different concentra-
tions of cystone as the positive control (1g/ml, 2g/ml and
4g/ml) and that of the plant purified protein (1g/ml,
2g/ml and 4g/ml) for 72 h [13, 14]. Cell injury was as-
sessed by measuring the cell viability through trypan blue
and monitoring the lactate dehydrogenase (LDH) leakage
into the medium.
814 Protein & Peptide Letters, 2012, Vol. 19, No. 8 Aggarwal et al.
CYTOTOXICITY
Trypan Blue Assay
The cytotoxicity of the purified protein of T. terrestris
was assessed by cell viability using trypan blue exclusion
method. For the determination of cell viability, cells were
plated at the density of 4 104 cells/well and cultured for 72
h. The medium was replaced with serum-free medium and
the cells were treated with various concentrations of cystone
(1g/ml, 2g/ml and 4g/ml) and the purified protein of the
plant (1g/ml, 2g/ml and 4g/ml) for a further 72 h. The
percentage viability for the cells was calculated as (live
cells/total cells) x100.
Lactate Dehydrogenase (LDH) Leakage Assay
Lactate dehydrogenase (LDH) leakage assay was per-
formed by the method described by Wagner et al. [15].
Briefly, 6.6 mM NADH and 30 mM sodium pyruvate were
prepared in Tris (0.2M, pH 7.3). Reaction was initiated with
the addition of 50 l of the test sample and the disappearance
of NADH was monitored at 340nm, for 5 min at an interval
of 1 min. The percentage of LDH release was calculated by
dividing the activity of LDH in the supernatant by the total
LDH activity measured after complete cell lysis achieved by
sonication.
Statistical Analysis
Data were expressed as mean values of three independent
experiments (each in triplicate) and analyzed by the analysis
of variance (p<0.05) to estimate the differences between
values of extracts tested.
RESULTS
Purification of Potential Inhibitor (Antilithiatic Protein)
of CaOx Crystal Growth
The maximum inhibitory activity was recovered in the
fraction precipitating at 40-60% ammonium sulphate satura-
tion. The pellet so obtained was desalted by dialysis and
loaded on to anion exchanger. The fractions under the peak
were pooled and the protein content was determined. The
fractions which were obtained between conductivity 71.13
mS/cm and 85.99 mS/cm (Fig. 1), had protein concentration
of 100g/ml and showed the maximum inhibitory activity
(51.6%) towards CaOx growth. The pooled fractions were
analyzed by SDS PAGE, which revealed two bands signify-
ing it as a mixture of proteins (figure not shown). Further the
pooled fraction of anion exchange chromatography was par-
titioned by molecular sieve chromatography on Bio gel (P-
100 gel) column. The fractions under the peak (Fig. 2) which
was eluted in a time span of 890.23 min to 998.70 min show-
ing inhibitory potency (78.3%) was pooled and stored at -
80oC till further use. The SDS profile of this fraction re-
vealed a single band of molecular mass of 60kDa (approxi-
mate) giving an idea that the protein isolated was purified
(Fig. 3). Table 1 shows the protein concentration and the
inhibitory activity of the isolated fraction after each step of
purification.
Peptide Mass Fingerprinting
MALDI TOF analysis spectrum of Tribulus terrestris
protein is shown in Figure 4. MASCOT search engine
showed highest similarity (score: 41) of this protein with
carotenoid cleavage dioxygenase 7 (CCD7) of Arabidopsis
thaliana (CCD7_ARATH) having 17% sequence coverage.
Figure 1. Purification of active protein from Tribulus terrestris. Elution profile of the protein sample loaded on anion exchange chromatog-
raphy column after ammonium sulphate precipitation. The eluting proteins were detectable at 280nm.
Cytoprotective Effect of Tribulus terrestris Protein Protein & Peptide Letters, 2012, Vol. 19, No. 8 815
Figure 3. SDS PAGE of Tribulus terrestris protein showing a sin-
gle band of molecular mass of 60kDa.
Putative Function and Domain Prediction
The BLASTp analysis of CCD7 of Arabidopsis thaliana
showed its similarity with NP_182026.4 (9-cis-epoxycaro-
tenoid dioxygenase [Arabidopsis thaliana]), ACY01408.1
(Carotenoid cleavage dioxygenase 7 [Petunia hybrid]),
NP_001183928.1 (Carotenoid cleavage dioxygenase [Zea
mays] showing that the purified protein belong to carotenoid
cleavage dioxygenase family. Figure 5 shows domains in the
purified protein of Tribulus terrestris by SCAN PROSITE.
This protein has EF hand calcium binding domain from 228-
240.
Reduction of Oxalate-induced Renal Tubular Epithelial
cell injury by Purified Protein of Tribulus terrestris
Figure 6 depicts the protective effect of the purified pro-
tein towards the renal tubular epithelial cells, NRK 52E. The
oxalate induced a significant injury to the cells as it reduced
the viability from 100% in the untreated cells (control) to
75.1%. The purified protein proved to be protective towards
oxalate induced injury as it increased the viability signifi-
cantly in a concentration dependent manner from 1g/ml to
4g/ml. The percentage viability obtained with the purified
Table 1. Summary of Purification of Inhibitory Protein from the Fruits of Tribulus terrestris. %Age Inhibition of CaOx Represents
Results as Mean of Three Independent Experiments.
Purification Steps Amount of Protein Yield (%) %Age Inhibition of CaOx Growth
Tris-Cl Buffer Extract 286 mg 100 37.56
40-60% Ammonium sulphate precipitate (dial-
ysed) 118.5 mg 41.4 38.61
Anion Exchange Chromatography 1.5 mg 0.5 51.61
Molecular Sieve Chromatography 0.74 mg 0.3 78.26
Figure 2. Purification of active protein from Tribulus terrestris. Elution profile of the protein sample loaded on molecular sieve chromatog-
raphy column after anion exchange chromatography column. The eluting proteins were detectable at 280nm.
816 Protein & Peptide Letters, 2012, Vol. 19, No. 8 Aggarwal et al.
protein was comparable to the cystone (positive control). The
percentage viability with 1μg/mL, 2μg/mL and 4μg/mL of
the protein was 77.1, 80.9 and 85.9 respectively.
The release of lactate dehydrogenase (LDH), a stable
cytosolic enzyme, was estimated to check the cell injury
(Fig. 7). In the cells injured with the exposure of oxalate,
LDH release was significantly high (217.9%). The LDH re-
lease was significantly reduced in the cells which had the
exposure of different concentrations of the purified protein
with oxalate in a concentration dependent manner to 115.9%
Figure 4. The peptide mass fingerprinting by MALDI TOF MS obtained from trypsinised Tribulus terrestris protein.
Figure 5. Domain identified in Carotenoid cleavage Dioxygenase 7(CCD7) of Arabidopsis thaliana by SCAN PROSITE. The sequence of
the EF hand domain is represented.
Figure 6. Effect of Tribulus terrestris on the % viability. Data are mean ± SEM of three independent observations. * p < 0.05 versus un-
treated control, ** p < 0.05 versus oxalate control.
Cytoprotective Effect of Tribulus terrestris Protein Protein & Peptide Letters, 2012, Vol. 19, No. 8 817
with 4g/ml protein sample. The LDH release in the pres-
ence of test protein was quite comparable with that of the
positive control, cystone.
DISCUSSION
Urolithiasis can be traced to the earliest antiquity of hu-
man history though the mechanism governing the induction
of various physicochemical events leading to stone formation
still remain speculative. The medical management therapies
available are quite costly and in most cases are invasive and
with serious side effects. Therefore, it is worthwhile to look
for an alternative to these conventional methods by using
medicinal plants or phytotherapy [1]. Till date, many plants
have been studied by various groups to reduce the incidence
of calcium stone deposition both in vitro and in vivo [7] but
the identification of naturally occurring CaOx inhibitory
biomolecules from plants was hampered in the past by the
limitation of the purification methods.
Many plants are also known to produce CaOx as crystal-
line deposits, having an organic matrix constituting of differ-
ent proteins [16, 17]. Recently, it was observed that water
soluble protein matrix associated with calcium oxalate crys-
tals from bean seed coat (Phaseolus vulgaris) contains many
polypeptides out of which two proteins were isolated and
they showed strong inhibition towards nucleation of CaOx in
a concentration dependent manner [18]. Calsequestrinlike
calcium binding protein was isolated from calcium accumu-
lating cells of Pistia stratiotes [19]. Recently our group has
also purified two anticalcifying proteins each from Dolichos
biflorus [20] and Trachyspermum ammi [11] with high con-
tent of acidic amino acids. The purified protein from Trachy-
spermum ammi was also found to be effective against in-
duced kidney stones in vivo [21]. Aspartic acid and glutamic
acid are quoted to play a vital role in the antilithiatic potency
of Tribulus terrestris by disintegrating the stone outer shell,
according to the datasheet of an herbal composition “Uri-
flow” marketed by Bioneutrix. So, it is worthwhile to look
for a CaOx inhibitory protein from the fruits of Tribulus ter-
restris since it showed strong anticalcifying properties in
vitro [22].
In the present study, an antilithiatic protein was isolated
from the fruits of Tribulus terrestris inhibiting calcium ox-
alate crystallisation. The protein was purified through am-
monium sulphate precipitation, anionic adsorption and fi-
nally molecular size separation. This isolated purified protein
had a molecular weight of around 60kDa. The diuretic po-
tency of Tribulus terrestris has been explored by various
groups in vitro and in vivo but the purification of active bio-
molecules is still not done [8, 9]. The inhibitory potency of
the purified protein was found to be as high as 78.3% and the
presence of an EF hand domain in a homologous protein
indicates that this protein probably imparts its inhibitory ef-
fect by binding to calcium ions and thus minimizing the
availability of calcium for the formation of CaOx crystals.
The isolated protein was subjected to MALDI-TOF fol-
lowed by peptide mass fingerprinting analysis and MASCOT
search engine, which showed the maximum similarity (17%
sequence coverage) with carotenoid cleavage dioxygenase 7
(CCD7) of Arabidopsis thaliana with a molecular weight of
65kDa and pI 6.01. BLASTp analysis of CCD7 showed
similar hits, further verifying the hit obtained from MAS-
COT.
CCD7 belong to a family of dioxygenases which possess
characteristic five conserved histidines spread throughout
their primary protein sequence, secondly, they require Fe2+
ions thought to be coordinated by the five histidine residues
and they contain a conserved polypeptide segment at their
carboxy terminus that minimally constitutes a signature se-
quence for the family [23]. Histidine is said to play a role in
urolithiasis as histidine coordinated manganese is critical for
Figure 7. Effect of Tribulus terrestris on the %LDH release. Data are mean ± SEM of three independent observations. * p < 0.05 versus
untreated control, ** p < 0.05 versus oxalate control.
818 Protein & Peptide Letters, 2012, Vol. 19, No. 8 Aggarwal et al.
substrate recognition and is directly involved in the catalysis
action of oxalate decarboxylase, enzyme involved is conver-
sion of oxalate to formic acid and CO2 [24].
CCD7 cleaves its substrates specifically at the 9,10 dou-
ble bond asymmetrically [25]. With -carotene as a sub-
strate, which is also called as provitamin A, CCD7 produces
one -ionone product and the C27 product, 10’-apo--
carotenal that is required for the normal inhibition of shoot
growth from axillary meristems. Another significant member
of this family is carotene 15, 15’ monooxygenase (BCO),
formerly known as -carotene 15,15’-dioxygenase, based on
biochemical and amino acid sequence data [26, 27]. This
enzyme shares 58% homology with CCD7 of Arabidopsis
thaliana as established through BLASTp. BCO catalyzes the
first step in the synthesis of retinol from dietary carotenoids.
Retinol, also referred to as vitamin A, is a fat-soluble poly-
isoprenoid essential for tissue development, growth, and
vision. Retinol can be either ingested or synthesized within
the body from dietary carotenoids. The major substrate for
the in vivo synthesis of retinol is the plant carotenoid -
carotene. Of the more than 600 different carotenoids isolated
from nature, almost 50 possess biological activity; hence,
these compounds are termed provitamin A carotenoids [28].
Kidney is said to play a vital role in retinol metabolism
by managing the levels of Retinol Binding Protein (RBP4).
The serum retinol level in the lithiatic patients was found to
be low [29]. The mechanism by which retinol (vitamin A)
deficiency causes calculus formation is still unclear. The
squamous metaplasia of the urinary tract can result in keratin
debris which promotes calculus formation. Histological
analysis showed squamous metaplasia that was confined to
urinary tract [30]. Vitamin A deficiency caused important
changes in urine composition and there was a decrease in the
concentration of urinary glycoaminoglycans and zinc. Le-
sions of cuboidal epithelia covering the papillae in rats
treated with vitamin A deficient diet were severe. It was
studied that in urolithiatic humans too, there is an increase in
Vit E/Vit A ratio. These results could be related to the possi-
ble deficit of vitamin A in kidney of stone formers, this be-
ing one factor for urolith development. Moreover, deficit of
important urinary crystallization inhibitors in stone formers
(pyrophosphate and phytate) can also be related to presence
of low levels of renal vitamin A which prevents enzymatic
degradation of such inhibitors [31].
Since, CCD7 belong to the same family as BCO [27] and
retinol happens to be a product of BCO which as cited in
literature is known to possess antilithiatic potency [30, 31],
we hypothesize that in the light of above findings, even the
product of CCD7 i.e. 10’ apo -carotenal might be having a
key role to play in preventing kidney stone formation. This
study has to be further undertaken.
CCD7 homologous to the purified protein from Tribulus
terrestris is also shown to contain an EF hand domain (228 –
240) which is a characteristic of Ca2+ binding proteins. It is
common calcium binding helix-loop-helix motif. Most of the
kidney stone inhibitory proteins like nephrocalcin, os-
teonectin and calgranulin have EF hand domain [32].
We tested the protective potency of the purified protein
towards oxalate induced cell injury on NRK 52E. In the pre-
sent study, oxalate exposure resulted in a significant increase
of LDH release and decreased the cell viability. The cellular
injury potentiates calcium oxalate crystal formation and re-
tention [5]. In the presence of the plant protein, the cell vi-
ability and LDH release were significantly normalised. The
percentage viability and the LDH release with 4g/ml pro-
tein in the presence of 1mM oxalate were quite comparable
with the 50g/ml crude aqueous extract as reported earlier
[22]. This data further validates the high potency of the puri-
fied protein in playing a crucial role in protecting the renal
epithelia cells against oxalate damage.
CONCLUSION
In conclusion, a plant protein, anionic in nature, from the
fruits of Tribulus terrestris was shown to attain the ability of
inhibiting CaOx crystallization in vitro. This protein had
similarity with CCD7 of Arabidopsis thaliana which belongs
to the family of proteins known to form retinol that plays a
significant role in preventing calculi formation. The presence
of EF hand domain in this protein signifies its calcium bind-
ing properties which is a feature of most of the kidney stone
inhibitors. Activity of this plant protein from T. terrestris
adds a new vista to study plant proteins for their therapeutic
use to treat kidney stones.
ACKNOWLEDGEMENT
The authors would like to thank Department of Biotech-
nology (DBT), Government of India and Jaypee University
of Information Technology, Solan, India for funding this
research work.
CONFLICT OF INTEREST
None declared.
ABBREVIATIONS
NRK 52E = Normal rat kidney epithelial cell line
CaOx = Calcium Oxalate
MALDI TOF MS = Matrix-assisted laser desorp-
tion/ionization time of flight mass
spectroscopy
BLAST = Basic local alignment search tool
LDH = Lactate dehydrogenase
CCD7 = Carotenoid Cleavage Dioxygenase 7
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Received: September 26, 20 11 Rev ised: February 6, 2012 Accepted: February 22 , 2012
... Ștefănescu et al. also credited TT's antioxidant activity to its polyphenols and flavonoids [8]. Studies concentrating on the therapeutic effects of TT have assessed its potential effects on sexual enhancement [12], fertility [13], urinary tract stones [14,15], diabetes [16,17], cardiovascular diseases [18,19], regarding its antioxidant [20,21], and anti-inflammatory properties [22,23]. Although a wide range of clinical studies has assessed the effects of TT on the enhancement of health [12][13][14][15][16][17][18][19][20][21][22][23], there are few randomized clinical trials on the effects of TT on athletes [24] and physically active individuals [25], and also, there is no randomized controlled trial on recreational runners. ...
... Studies concentrating on the therapeutic effects of TT have assessed its potential effects on sexual enhancement [12], fertility [13], urinary tract stones [14,15], diabetes [16,17], cardiovascular diseases [18,19], regarding its antioxidant [20,21], and anti-inflammatory properties [22,23]. Although a wide range of clinical studies has assessed the effects of TT on the enhancement of health [12][13][14][15][16][17][18][19][20][21][22][23], there are few randomized clinical trials on the effects of TT on athletes [24] and physically active individuals [25], and also, there is no randomized controlled trial on recreational runners. Therefore, this study has been designed to assess the efficacy of TT supplement on the nutritional, oxidative, inflammatory, and anti-inflammatory status and sports performance of recreational runners. ...
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Background High intensity and endurance exercises lead to exercise-induced oxidative stress (EIOS), exercise-induced muscle damage (EIMD), and inflammation, which are the influencing factors on muscle soreness, localized swelling, and sports performance decrease. Therefore, the purpose of this study is to determine the effectiveness of Tribulus terrestris (TT) as an herbal supplement with antioxidant and anti-inflammatory properties on the nutritional, oxidative, inflammatory, and anti-inflammatory status, as well as the sports performance of recreational runners. Methods/design This study is a double-blind, randomized, placebo-controlled trial, which will be conducted among recreational runners of Tabriz stadiums, Iran. Thirty-four recreational runners will be selected, and participants will be assigned randomly to two groups: to receive 500 mg TT supplement or placebo capsules twice daily for 2 weeks. Both groups will do high-intensity interval training (HIIT) workouts during the study. Baseline and post-intervention body composition, muscle pain, and aerobic and anaerobic performance will be assessed. In addition, assessment of malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid (UA), 8-iso-prostaglandin F2α (8-iso-PGF2α), protein carbonyl (PC), catalase (CAT), glutathione (GSH), nitric oxide (NO), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), creatine kinase (CK), myoglobin (MYO), lactate dehydrogenase (LDH), insulin-like growth factor-1 (IGF-1) irisin, cortisol, and brain-derived neurotrophic factor (BDNF) will be done during three blood samplings. Changes in oxidative stress, anti/inflammatory biomarkers, and sports performance will be assessed as primary outcomes. Discussion This study will be the first to assess the potential effects of TT on recreational runners. Our results will contribute to the growing body of knowledge regarding TT supplementation on the nutritional, oxidative, inflammatory, and anti-inflammatory status and sports performance in recreational runners. Trial registration Iranian Registry of Clinical Trials ( www.irct.ir ) (ID: IRCT20150205020965N8 ). Registration date: 13 February 2021.
... It has been reported that aqueous extract of Tribulus terrestris, could decrease oxidative stress induced by hyperoxaluria. Moreover, it could reduce oxalate, calcium, and phosphate secretion that this protein might be responsible for preventing the adhesion of calcium oxalate crystals to kidney cells and the formation of kidney stones (27). ...
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Kidney stone as a third important disease of the urinary tract is a common disease affecting 10-15% of the world population. Effective medical treatment for the disease is not yet well established. On the other hand, there is an increasing global demand to manage and control various diseases with natural medi‌cine and medicaments originating from Complementary and Alternative Medicine. Traditional Persian Medicine (TPM) is one of the most popular schools in the field of complementary and alternative medicine. There are numerous natural and clinical interventions for kidney stones, reported in TPM medical and pharmaceutical manuscripts. This review provides various related compound formulations for kidney stones from the standpoints of Persian scholars. These remedies have been cited in a series of traditional pharmaceutical manuscripts of Persian medicine, namely Qarābādin or prescription. With a view to the positive pharmacological or biological activities of the constituents of filtered formulations, many of those can be re-formulated and either experimentally or clinically evaluated to be introduced as new natural remedies in this field.
... The concentration of BUN remained within normal range (7-21 mg/dL) and most likely reflected muscle destruction increments due to high-volume training [22]. In this line, studies in rats [50] and renal epithelial cell lines (NRK-52E) [51], TT showed significant dose-dependent protection against elevation of biochemical parameters in urine. This premise would add new perspective of TT on the maintenance in physiological range of renal biomarkers that are increased after exercise. ...
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Tribulus terrestris L. (TT) is a plant used in traditional Chinese medicine, Ayurvedic medicine, and sports nutrition to improve health and performance. However, no conclusive evidence exists about the potential beneficial effects of TT on sport and health biomarkers in physically active adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the modified McMaster Critical Review Form for methodological quality assessment, we systematically reviewed studies indexed in Web of Science, Scopus, and PubMed, to assess the effects of TT on immunological, hematological, biochemical, renal, lipidic, hormonal behavior, and anti-inflammatory response in physically active adult males. Among 340 records identified in the search, a total of 7 studies met the inclusion and exclusion criteria. Overall, participants supplemented with TT displayed significant improvements in lipid profile. Inflammatory and hematological biomarkers showed moderate beneficial effects with no significant changes on renal biomarkers. No positive effects were observed on the immune system response. Additionally, no TT-induced toxicity was reported. In conclusion, there was no clear evidence of the beneficial effects of TT supplementation on muscle damage markers and hormonal behavior. More studies are needed to confirm the benefits of TT due to the limited number of studies available in the current literature.
... [10] A novel antilithiatic protein having cytoprotective potency was isolateded from Tribulus terrestris. [11] Quercetin and kaempherol present in Tribulus terrestris not only has the potential to inhibit nucleation and growth of calcium oxalate crystals but also has a cytoprotective role. It also inhibits the activity of glycolate oxidase, which is the principal enzyme involved in oxalate synthesis. ...
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Background: Renal calculi or kidney stone disease is a common painful urologic disease causing significant social and financial burden. It has high recurrence rate of nearly fifty (50%) percentage. Ayurveda textual references mention specific diuretic, lithotriptic medicines for Asmari (Renal Calculi) which can provide safe, effective and economical treatment. Aim: To evaluate the combined efficacy of Patala kṣhara (an alkaline powder prepared from ash of Stereospermum chelonoides) and Gokshurdi churna (herbal powder) in the disintegration and expulsion of renal calculus. Materials and Methods: The study was a pre and post clinical trial with 30 patients in a single group selected on the basis of specific inclusion and exclusion criteria (Ultrasonography [USG] evidence of renal calculi up to 8 mm size). They were imparted 500 mg Paṭala kshara capsule with lukewarm water and 6 g Gokshuradi churna with honey internally twice daily after food for a period of 30 days. Assessment were done on 15th, 30th and 60th day for subjective parameters (pain, haematuria, burning micturition and increased frequency of micturition) and on 30th day for objective parameters like size and number of stones and epidermal growth factor receptor. Results: Pain, dysuria, size and number of calculus is statistically significant with P < 0.000. Haematuria showed significance with P < 0.046, burning micturition and increased frequency of micturition were significant with P < 0.008. Conclusion: On analysing the results it can be concluded that Patala kshara and Gokshuradi churna are effective in disintegrating and expelling renal calculus. It is effective in reducing the size and number of stones as well as the clinical symptoms.
... The leaves, seeds, and fruits of TT are used for therapeutic purposes; however, studies indicate that the highest amount of active ingredients are found in its fruit (6, 8). Studies concentrating on the therapeutic effects of TT have assessed its potential effects regarding sexual enhancement (9), fertility (10), urinary tract stones (11,12), diabetes (13,14), cardiovascular disease (15,16), antioxidant properties (17,18), anti-in ammatory properties (19,20). Therefore, a wide range of clinical studies has assessed TT effects. ...
Preprint
Full-text available
Background: High intensity and endurance exercises lead to exercise-induced oxidative stress (EIOS), exercise-induced muscle damage (EIMD), and inflammation, which are the influencing factors on muscle soreness, localized swelling, and sport performance. Therefore, the purpose of this study is to determine the effectiveness of Tribulus terrestris (TT) as an herbal supplement with antioxidant and anti-inflammatory properties on the nutritional, oxidative stress, and anti/inflammatory status, as well as the sport performance of recreational runners. Methods/design: This study is a double-blind, randomized, placebo-controlled trial, which will be conducted among recreational runners of Tabriz stadiums, Iran. Thirty-four recreational runners will be selected, and participants will be assigned randomly to two groups: to receive 500 mg TT supplement or placebo capsules twice daily for two weeks. Both groups will do the high-intensity interval training (HIIT) workouts during the study. Baseline and post-intervention body composition, muscle fatigue, and soreness parameters will be assessed. In addition, assessment of malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), creatine kinase (CK), lactate dehydrogenase (LDH), insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF) will be done during three blood samplings. Discussion: This study will be the first to assess the potential effects of TT in recreational runners. Our results will contribute to the growing body of knowledge regarding TT supplementation on the nutritional, oxidative stress, anti/inflammatory status and sport performance in recreational runners. Trial registration: Iranian Registry of Clinical Trials (www.irct.ir) (ID: IRCT20150205020965N8). Registration date: 13 February 2021.
... Inhibition of COM crystals growth was observed by tribulus terrestris extract. [12] Antimicrobial activity ...
... It is used for the management of various disorders related to urinary system including urolithiasis [48][49][50]. ...
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Gokharu; a commonly available weed which possess substantial therapeutic value in the field of traditional systems of medicine, viz. Ayurveda, Chinese, Siddha, and Unani. It is well known medicinal plants in the folk medicine of many countries for a number of diseases i.e. diuretic, aphrodisiac, antiurolithic, immunomodulatory, antihypertensive, antihyperlipidemic, antidiabetic, hepatoprotective, anticancer, anthelmintic, antibacterial, analgesic, anti-inflammatory, antihyperlipidemic, and cardioprotective activity.
... The activity of Tribulus terrestris on the nucleation and growth of calcium oxalate (CaOx) crystals as well as on oxalate-induced cell injury of renal epithelial cells was evaluated. The experiments revealed that Tribulus terrestris extract not only has a potential to inhibit nucleation and growth of the CaOx crystals but also has a cytoprotective role [43] . ...
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Full-text available
Tribulus terrestris Linn is one of the most important medicinal plants traditionally used for various health purposes. The fruit, leaves, stem and root of the plant are therapeutically used. The fruits are greenish to grey in color with faintly aromatic odour and slightly acidic taste. While the roots are light brown in color with aromatic odour and sweetish astringent taste. The dried fully ripe fruit of this plant is known as Khar-e-Khasak Khurd in Unani System of medicine. It acts as diuretic and useful in dysuria and gonorrohea. Traditionally it has been used for boosting hormone production in men and women. The herb is found in Mediterranean, subtropical and desert climate regions around the world. The plant is common in sandy soil throughout India. The plant grows more or less throughout the years. The plant is described in detail in ethnobotanical and scientific literature and various actions have been reported to possess by this. A number of studies have also been carried out on Tribulus terrestris in recent years showing that it possesses diverse biological and pharmacological activities. It has been used in Unani Medicine (Tibb-e-Unani) and other traditional system of medicine from time immemorial. Keeping in view the high medicinal importance of the drug in Unani Medicine, this review provides available information on its traditional uses, phytochemistry and pharmacological properties.
... -Tribulus terrestris showed its urolithiasis preventing capacity on different examples of sodium glycolate and ethylene glycol induced stone formation [21] . -Glycolate oxidase (GOX) which is one of the main enzymes required for oxalate formation is prevented by Tribulus terrestris and its antiurolithiac activity is attributed to this property. ...
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Tribulus terrestris (T. terrestris) is an herb that has been used in various traditional medicine practices since ancient times. More recently, the pronounced health benefits of this herb have been evaluated within a wide scope, without properly acknowledging its nutraceutical value. Therefore, this article intends to provide an integrated overview on the nutraceutical potential of T. terrestris in the area of human health promotion. This review discusses the potential employability of T. terrestris and its derived products as nutraceuticals in prevention, treatment, and management of prevalent human diseases and associated conditions. The outcomes of several in vitro and in vivo studies elaborate on the ability of T. terrestris supplements and different fractions to act as antioxidant, anti-inflammatory, anticancer, antidiabetic, testosterone boosting, and cardio, renal and liver protective agents. Many studies reveal that T. terrestris would act as an excellent nutraceutical that prevents harmful impacts to the human body. Its bioactivities are driven by various factors, and it has been suggested to be used to replace certain pharmaceuticals and synthetic drugs. In-depth clinical studies on the herbal pharmacodynamics are needed and would broaden the scope of nutraceutical applications of T. terrestris.
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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. 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. 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. The current data suggests that Tribulus terrestris extract not only has a potential to inhibit 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.
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Abstract Tribulus Terrestris (Fruit) Has Been Used Widely In The Ayurvedic System Of Medicine For The Treatment Of Various Urinary Disorders Including Urolithiasis. In Order To Evaluate The Therapeutic Claims Made For This Plant In Traditional Medicine, The Ethanol Extract Of T. Terrestris (Fruit) Was Tested For Activity Against Artificially Induced Urolithiasis In Albino Rats. The Extract Was Administered At Daily Oral Doses Of 25, 50 and 100 Mg/Kg For 4 Months. It Exhibited Dose-Dependent Antiurolithiatic Activity and Almost Completely Inhibited Stone Formation. Other Biochemical Parameters In Urine and Serum, and The Histopathology Of Urinary Bladder, Which Were Altered During The Process Of Stone Formation, Were Also Normalized By The Plant Extract In A Dose-Dependent Manner. These Observations Thus Substantiate The Traditional Claim. Further Detailed Study Is In Progress To Isolate The Active Principle(S) and To Establish Their Mode(S) Of Action.
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Calcium oxalate crystal formation in plants appears to play a central role in a variety of important functions, including tissue calcium regulation, protection from herbivory, and metal detoxification. Evidence is mounting to support ascorbic acid as the primary precursor to oxalate biosynthesis. The ascorbic acid utilized in oxalate biosynthesis is synthesized directly within the calcium oxalate crystal-accumulating cell, called the crystal idioblast. Several unique features of the crystal idioblast have been proposed as factors that influence calcium oxalate formation. These features include an abundance of endoplasmic reticulum (ER), acidic proteins, cytoskeletal components, and the intravacuolar matrix. A number of mutants defective in different aspects of calcium oxalate crystal formation have been isolated. Cellular and biochemical characterizations of the various mutants have revealed mutations affecting crystal nucleation, morphology, distribution, and/or amount. Such mutants will be useful tools in continued efforts to decipher the pathways of crystal formation and function in plants.
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The effects of vitamin A deficiency on urolithiasis were investigated in male rats. A vitamin A-deficient diet caused important changes in the composition of the urine of the treated rats when compared with controls. One of the main effects was a decrease in the concentration of urinary glycosaminoglycans and zinc in the rats receiving the vitamin A-deficient diet. Significant differences were also found in plasma vitamin E and in the relation of vit E/vit A between treated and control groups but, in general, with no important differences in vitamin A. Nevertheless, significant differences in kidney content of vitamin A were observed between both groups. On the other hand, lesions of the cuboidal epithelium that covers the papillae in rats treated with the vitamin A-deficient diet were severe when compared with controls. The vitamin A and E plasma levels in urolithiasic humans were also investigated and compared with those found in a control group. No significant differences were observed in plasma vitamin A levels; nevertheless a significant increase in vitamin E and in the vit E/vit A ratio was clearly observed. These results could be related to a possible deficit of vitamin A in kidneys of stone formers, this being one of the diverse factors that can contribute to urolith development. Moreover, the deficit of important urinary crystallization inhibitors normally found in stone-formers, such as pyrophosphate and phytate, can also be related to the presence of low levels of renal vitamin A which prevents the enzymatic degradation of such inhibitors.
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Carotenoids are pigments found in plants and microorganisms, but not synthesized in animals. Fewer than 10% of the carotenoids can function as vitamin A precursors in mammals. Carotenoids and retinoids have chemical and metabolic similarities and differences, and some overlap in biological activities. Carotenoids in tissues reflect food choices. Carotenoids exhibit biological activities as antioxidants, affect cell growth regulation, and modulate gene expression and immune response. Epidemiologic evidence links higher carotenoid intakes and tissue concentrations with reduced cancer and cardiovascular disease risk, although results from clinical trials do not support beta-carotene supplementation as a strategy to reduce risk. Continued research in this area is likely to stimulate better intervention strategies with clinical and public health applications.
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Female Sprague-Dawley rats (n = 100; age, 3 wk) were fed diets that included a vitamin premix and either albumin or milk powder. Rats fed the albumin diet gained weight more slowly than did the other group. Between 19 and 28 wk of being fed the albumin diet, 12 rats died of bacterial cystitis and pyelonephritis. In addition, 2 more rats from the same dietary group developed peritonitis after ovariohysterectomy. Examination of the 44 rats fed the albumin diet that completed the 34-wk experiment revealed pyelonephritis in 68%, cystitis in 66%, urolithiasis in 27%, and nephrolithiasis in 5%. Squamous metaplasia of the transitional epithelium was present in all 44 rats, although other epithelia were histologically normal. Vitamin A deficiency was diagnosed after analyses of blood and liver samples. Analysis of the vitamin premix revealed approximately 25% of the expected amount of vitamin A. Because the milk powder contained sufficient vitamin A, deficiency did not occur in rats fed the milk powder diet. The major consequences of vitamin A deficiency in the rats were squamous metaplasia, bacterial infection, and calculus formation within the urinary tract. This report illustrates the importance of careful formulation and storage of vitamin premixes used in experimental diets. Vitamin A deficiency should be considered in rats with decreased weight gain and urinary tract disease even if ocular lesions are not present.
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Many medicinal plants have been employed during ages to treat urinary stones though the rationale behind their use is not well established. Recently, we have successfully purified an anticalcifying protein from the seeds of Trachyspermum ammi (L.) Sprague ex Turril (Umbelliferae) using oxalate depletion assay and deciphered its inhibitory activity against calcium oxalate crystal growth. In this report, the antilithiatic activity of Trachyspermum ammi anticalcifying protein (TAP) was studied in urolithiatic rat model. Urolithiasis was induced by exposure of 0.4% ethylene glycol (EG) and 1.0% ammonium chloride (NH(4)Cl) for 9 days. The efficacy of TAP was studied in another group given same dose of EG and NH(4)Cl in addition to 2mg/kg body weight of TAP. Further, we evaluated ability of TAP to inhibit the attachment of calcium oxalate (CaO(x)) crystal in kidney tissue and studied the consequences of CaO(x) adhesion on renal functioning and tissue integrity. The antilithiatic potential of TAP was confirmed by its ability to maintain renal functioning, reduce renal injury and decrease crystal excretion in urine and retention in renal tissues. Thus, the present investigation suggests the potential of TAP in preventing calcium oxalate deposition and forms the basis for the development of antilithiatic drug interventions against urolithiasis.