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Urtica semen reduces serum creatinine levels

Authors:
1
Urtica semen reduces serum creatinine levels.
Jonathan Treasure
(reprinted from
The Journal of the American Herbalists Guild
2003, 4(2):22-25)
Introduction
Urtica dioica L. and Urtica urens L.,
(stinging nettles) have a long history of use
in folkloric and science based herbal
medicine. Traditionally used as a nutritive
and “blood cleanser” or alterative agent, a
substantial pharmacological and clinical
literature supports its use for arthritic and
allergic conditions (leaf/herb) and
improving urological symptoms of benign
prostatic hyperplasia (root). The available
literature is based on either the aerial parts
(folia/herba), or the root (radix). The root
is monographed by WHO, ESCOP and
Commission E, and the herb/leaf is
monographed by ESCOP and
Commission E.
1-4
However none of these,
or other pharmacopoeial sources identify
the seed (semen) as a medicinally distinct
plant part.
The literature on constituents or
pharmacology of nettle seeds is sparse. An
HPLC analysis of the lipid fraction
indicates the presence of a high
proportion of unsaturated fatty acids,
especially palmitic, and a small amount of
omega-3 unsaturated fatty acids.
5
Of
interest is the presence of a lectin in the
seeds of U. pilulifera, a Turkish stinging
nettle.
6
A lectin from the roots of U.
dioica known as Urtica dioica agglutinin
(UDA) is known as a novel T-Cell
mitogen with superantigenic properties.
7
UDA has an unique pattern of T-cell
activation and cytokine induction which
has led to its use as a probe in
investigations of superantigen activity.
8
Whether the seeds of U. dioica also
contain a lectin with UDA superantigenic
properties is unknown due to the absence
of research.
The clinical use of nettle seed extracts for
treatment of renal dysfunction represents
a novel indication for the herb, first
suggested by North American herbalist
David Winston and to date unsupported
by published reports.
9
The following two
cases involve the use of nettle seed extracts
in patients with serious renal challenges,
and utilize serum creatinine laboratory
values data to serially monitor the effects
of the extract.
Serum Creatinine
Serum creatinine is commonly measured
as an index of glomerular function.
Broadly speaking serum creatinine varies
inversely with the glomerular filtration
rate (GFR), other things being equal. A
number of non-renal factors may affect
creatinine levels, ranging from heavy
dietary meat ingestion, medications
including glucocorticoids and cimetidine,
and muscle mass decrease in chronic
illness. There is also a small but variable
degree of proximal tubule secretion of
creatinine, which declines as GFR
decreases and which may confound
interpretations of creatinine values. In
cases where renal function and GFR
require more accurate evaluation, inulin,
or radionuclide labelled molecules such as
125
I-iothalamate are used. Nonetheless,
creatinine remains a simple single measure
test of nephron function. Units of
2
measurement vary in laboratory reports,
upper limits for of normal serum
concentration in men are 1.2mg/dL
(conventional units), or 110 micromol/L
(SI units). Values for women are ~85%
men’s values.
Case One - Oncology Patient: status post-
nephrectomy.
A previously healthy 51-year-old male,
who had been diagnosed with aggressive
leiomyosarcoma with liver metastases in
1994 at age 43. Following the diagnosis,
he had debulking surgery including a
radical right nephrectomy, right
hepatectomy and adrenalectomy. Since
that time he had been pursuing various
treatment approaches for his cancer. He
received radiofrequency ablation of
hepatic lesions, assay driven
chemotherapy, local hypothermia, and
various immunotherapies, culminating in
two stem cell transplants. He had
successfully controlled his situation with
these approaches for eight years, and
initially consulted our practice because of
his interest in botanical therapies for
cancer.
It emerged that the patient’s serum
creatinine had been persistently elevated
since his nephrectomy. Serum laboratory
values were regularly monitored as part of
his standing order blood work. Although
there was a degree of variation in his
“normal” readings, the values were always
significantly above the accepted upper
normal level of <110 micromol/L,
averaging over a six-month period ~157.0
micromol/L, stable at 150 micromol/L
for two months prior to the start of
treatment. An initial one-month trial
period of treatment was commenced on
10/12/02. Nettle seed hydroethanolic
extract (1:5) extract was prescribed at a
dose of 5 ml t.i.d. Subsequent creatinine
values are shown below.
The trial administration coincided with a
sharp fall in serum creatinine, but
following the end of the trial period, there
was a slight increase again. A second
period of administration of nettle seed
extract commenced on 12/23/02. Serum
levels dropped again. The total period of
administration of the extract was eight
weeks, over two one month courses.
Serum creatinine values remained stable at
a lower mean for several months following
the second administration. (mean 120
micromol/L).
3
Case Two – Lupus patient - Status renal
allograft.
A 24 year old female status renal allograft,
presenting in 1998 with vaginal
candidiasis, irritable bowel, multiple
dermopathies, dysglycemia, seasonal
allergies, pruritus and CIN II cervical
dysplasia. Following a history of three
progressively severe episodes of lupus
related uremia culminating in renal
failure, she was recipient of renal allograft
from maternal donor in 1995.
Immunosuppression initially was
maintained by prednisone, cyclosporine
and azathioprine. Family history was
notable for Raynaud’s, SLE, diabetes and
lung cancer. Over the first two years, the
patient was treated successfully with
numerous botanical prescriptions and
supplements, leading to resolution of
cervical dysplasia, candidiasis, allergies,
digestive and skin issues. She was also
prescribed a general renal protective
protocol (Sig. 5ml t.i.d. with Omega -3
Oils (Max EPA) 6gms q.d see Protocol 1)
to ameliorate the nephrotoxic effects of
cyclosporine. Serial laboratory tests
included serum creatinine and BUN, and
U/A with microscopy, together with
serum cyclosporine levels.
Protocol One - Renal Protection Rx
Ginkgo biloba FE 30 ml
Silybum marianum FE 30 ml
Salvia multiorhizza 1:2 30 ml
Panax ginseng 1:3 10 ml
In 2000, her previously “high normal”
creatinine level of 1.2mg/dL began a
persistent climb culminating in a very
rapid rise in May 2000 to peak at a level
of 2.0mg/dL. Needle biopsy confirmed an
acute graft rejection, and
immunosuppression was intensified by the
transplant physicians, including high dose
prednisone pulse. A second biopsy
revealed persistent mononucleocyte
infiltration and tacrolimus (Prograf™)
was added to the immunosuppressive
regime, this time resulting in reversal of
acute rejection, survival of the graft and a
reduction of the elevated serum creatinine.
After stabilization , immunosuppression
was changed to prednisone, MMF
(CellCept™) and tacrolimus (Prograf™).
The prednisone was tapered, during which
time licorice root support for the
withdrawal from steroids was added.
4
she was advised by the transplant team
that this was her “new normal” level of
renal function. Commencing September
12
th
, nettle seed extract, in combination
with extract of couchgrass (Agropyron
repens) rhizome (3:1 Urtica: Agropyron
)was prescribed at a dose of 5 ml t.i.d. and
the serum creatinine levels began to
decline. The formula was replaced by
nettle seed monotherapy on October 28
th
and administration continued for three
month period. Creatinine levels
renormalized at 1.2 mg/dL. (Chart 2)
Discussion
This two case series suggests a potential
beneficial effect of nettle seed extracts on
compromised glomerular function as
measured by serum creatinine levels.
Elevated serum creatinine levels only
appear when significant glomerular
function has been lost. In both cases a
long-term reduction in previously
sustained elevated levels was achieved that
extended well beyond the period of
administration of the extract. Two
biopsies were performed on the renal graft
patient that demonstrated significant
histopathology, and the acute graft versus
host rejection was reversed with immuno-
suppressive drugs, not herbs. However in
terms of herbal therapeutics there appear
to be grounds for considering nettle seed
as a possible functional renal
“trophorestorative”, since in both patients
lower creatinine levels were regained in
following administration of the herbal
extract.
Herbal treatment of serious kidney
conditions is controversial. The lack of
remedies in the traditional materia medica
to directly address loss of glomerular
function has led some authors to take a
pessimistic view of the benefits of herbal
treatment of renal dysfunction.
10
Others,
confronted by the clinical reality of
patients with renal grafts, have taken a
more considered view of the possibilities
presented by botanicals for renal
protection and support.
11
While caution is
warranted in all cases of kidney disease, it
is possible that nettle seed may fill a much
needed gap in the materia medica of the
genitourinary system as a renal
trophorestorative. It would also appear
that there is potential for integrative
medical management of such cases. Given
the high cost of dialysis, the use of Urtica
semen extracts as a possible agent to
restore glomerular function should be
further investigated.
Postscript 2004
Both patients were impressed with the
effects of the Urtica semen. Both
continued to do well with apparently
stable renal function unaided by
continued herbal support. The
nephrectomy patient recently experienced
an increase in creatinine levels following
major surgical procedure. The allograft
patient continues to pursue an active
career in performing arts in the Pacific
Northwest.
* Nettle seed extract
The extract of nettle seed used in the
above case series was a standard tincture
1:5, 30% EtOH, supplied by Herbalist &
Alchemist Inc. 51 S Wandling Avenue,
Washington, NJ. 07882-3537.
References
1. Blumenthal M, Busse W, Goldberg A
et al. Stinging Nettle Herb and Leaf,
Stinging Nettle Root. The Complete
German Commission E Monographs.
Austin: American Botanical Council:
Integrative Medicine
Communications; 1998:685.
5
2. ESCOP. Urticae Radix. ESCOP
Monographs on the Medicinal Uses of
Plant Drugs. Fascicule 2 vol. Exeter,
UK: ESCOP; 1996.
3. ESCOP. Urticae Folium/Herba.
ESCOP Monographs on the Medicinal
Uses of Plant Drugs. Fascicule 4 vol.
Exeter, UK: ESCOP; 1997.
4. WHO. Radix Urticae. WHO
Monographs on Selected Medicinal
Plants. 2 vol. Geneva: World Health
Organization; 2002:329-341.
5. Guil-Guerrero JL, Rebolloso-Fuentes
MM, Isasa MET. Fatty acids and
carotenoids from Stinging Nettle
(Urtica dioica L.). Journal of Food
Composition and Analysis
2003;16:111-119.
6. Kavalali G, Tuncel H, Goksel S,
Hatemi HH. Hypoglycemic activity
of Urtica pilulifera in streptozotocin-
diabetic rats. J Ethnopharmacol
2003;84:241-245.
7. Galelli A, Truffa-Bachi P. Urtica
dioica agglutinin. A superantigenic
lectin from stinging nettle rhizome. J
Immunol 1993;151:1821-1831.
8. Musette P, Galelli A, Chabre H et al.
Urtica dioica agglutinin, a V beta 8.3-
specific superantigen, prevents the
development of the systemic lupus
erythematosus-like pathology of MRL
lpr/lpr mice. Eur J Immunol
1996;26:1707-1711.
9. Winston D. Little-known Uses of
Common Medicinal Plants.
Proceedings of Southwest Conference on
Botanical medicine. Tempe, Arizona:
Southwest College of Naturopathic
Medicine and Health Sciences;
2001:113-115.
10. Mills S. Herbs and The Kidney:
Prospects and Cautions. Medicines
From The Earth:Tenth Anuual
Symposium on Botanical Medicine.
Blue Ridge Assembly, Black
Mountain, NC.: Gaia Herbs Inc.;
2002.
11. Tilgner S. The Contented Kidney.
Herbal Transitions 1998;3:2-9.
Version 3.0,
©2004 Jonathan Treasure
... Nephrotoxicity is characterized by morphological destruction of intracellular organelles, necrosis, and functional alterations such as depletion of antioxidant defense system and mitochondrial damage [39]. Oxidative damage is thought to be one of the major mechanisms involved in nearly all chronic renal pathologies [40][41][42]. Reports on the beneficial effects of C. lanatus seed abound, but little or nothing is known about its nephrotoxic effect. This study investigated the nephrotoxic and in vivo antioxidant effects of C. lanatus seed extract. ...
... About 90 % of urea produced is excreted through the kidneys [41]. Creatinine, a waste product of muscle catabolism, is excreted exclusively via the kidneys [42]. Therefore, renal damage reduces the kidney's capacity to excrete both urea and creatinine, thereby making them to accumulate in the blood. ...
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... The effect may be due to the compound proanthocyanidins present in the plant extract showing angiotensin-converting enzyme (ACE) inhibition effects (Wagner and Elbl, 1992). A study showed that Urtica dioica L. seed might be an effective herbal treatment for renal failure patients, as it lowers the serum creatinine levels and also reduces the symptoms (Treasure, 2003). Roots of Andrographis paniculata (Burm.f.) Nees significantly reduced blood proteinemia and uremia (Rao, 2006). ...
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... To corroborate the nephrotoxicity in terms of functional parameters of the kidney, serum creatinine, urea and cholesterol levels were determined. Creatinine is commonly measured as an index of glomerular function 22 . High levels of serum creatinine can indicate kidney damage/failure 23 . ...
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... Meanwhile the rat groups fed on diet had contained Urtica dioica leaves at 5 and 10% in basal diet were decreased to 0.77 and 0.70 mg/dl compared with positive control. Treasure (2003) showed that nettle leaves can be quite effective for reducing serum creatinine levels in patients with chronic renal failure. Moreover, nettle leaves appear to also be hepatoprotective based on studies in rodents and also, the clinical experimental are could be definitely warranted with this completely safe herbal medicine (Kanter et al., 2003). ...
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The V beta 8.3-specific superantigenic lectin Urtica dioica agglutinin (UDA) was used to delete the V beta 8.3+ T cells in MRL lpr/lpr mice. In contrast to the systemic lupus erythematosus-like pathology which progresses with age in the phosphate-buffered saline-injected MRL lpr/lpr controls, UDA-treated animals did not develop overt clinical signs of lupus and nephritis. The pathogenic T cell clones thus reside within the V beta 8.3+ T cell population, which includes an expanded T cell clone described previously. Finally, UDA alters the production of autoantibodies in a sex-dependent manner.
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The hypoglycemic activity of lectin isolated from Urtica pilulifera L. seeds (Urticaceae) was investigated in streptozotocin (STZ) induced diabetic rats. Significant hypoglycemic effect was found at the dose of 100 mg/kg after i.p. administration for 30 days. Blood glucose (BG) level, food and fluid intake, body weight (BW) loss and histopathologic findings of the normal and diabetic animals were evaluated. The group treated with UPSL (U. pilulifera seed lectin) was also compared against glipizide (oral antidiabetic agent, Carlo-Erba) as a standard.
Arizona: Southwest College of Naturopathic Medicine and Health Sciences Mills S. Herbs and The Kidney: Prospects and Cautions. Medicines From The Earth:Tenth Anuual Symposium on Botanical Medicine. Blue Ridge Assembly
  • D Winston
Winston D. Little-known Uses of Common Medicinal Plants. Proceedings of Southwest Conference on Botanical medicine. Tempe, Arizona: Southwest College of Naturopathic Medicine and Health Sciences; 2001:113-115. 10. Mills S. Herbs and The Kidney: Prospects and Cautions. Medicines From The Earth:Tenth Anuual Symposium on Botanical Medicine. Blue Ridge Assembly, Black Mountain, NC.: Gaia Herbs Inc.; 2002. 11. Tilgner S. The Contented Kidney. Herbal Transitions 1998;3:2-9.
American Botanical Council: Integrative Medicine Communications
  • Austin
Austin: American Botanical Council: Integrative Medicine Communications; 1998:685.
  • Who. Radix Urticae
WHO. Radix Urticae. WHO Monographs on Selected Medicinal Plants. 2 vol. Geneva: World Health Organization; 2002:329-341.
ESCOP Monographs on the Medicinal Uses of Plant Drugs
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ESCOP. Urticae Radix. ESCOP Monographs on the Medicinal Uses of Plant Drugs. Fascicule 2 vol. Exeter, UK: ESCOP; 1996.
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