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Table 5 Summary of published ethnopharmacology, in vivo, in vitro studies, side effects and toxicity of the most frequently recommended plants for treatment of urinary tract diseases

From: Ethnopharmacological survey of medicinal plants practiced by traditional healers and herbalists for treatment of some urological diseases in the West Bank/Palestine

Urinary tract diseases Plant species Ethnopharmacological usage for treatment of various urinary tract diseases and country with reference source In-vitro and in-vivo studies on plants used for treatment of various urinary tract diseases with reference source Side effects and toxicity of plants used for treatment of various urinary tract diseases with reference source
Kidney stones Paronychia argentea Turkey [30] Jordan [26, 31, 32], Palestine [33, 34], Spain [35], Egypt [36], and Algeria [37]. In-vitro study on wistar rats it prevented and reduced the growth of kidney stones in experimental calcium oxalate nephrolithiasis [38]. In-vitro study proved that P. argentea extract had low hemolytic effect [39] as well as the butanolic extract of P. argentea can prevent or slow down the oxidative damage induced by organophosphorus pesticide, chloropyriphos ethyl in rats [38].
Plantago ovata No references found about its folk usage for treatment of kidney stones. In vitro study on rats proved that intake of a P. ovata husk-supplemented diet prevented endothelial dysfunction [40]. Arabinoxylan from Plantago ovata husks had been proven its safety scientifically on rats and rabbits [41].
Punica granatum India and North Africa [42,43,44,45]. On male rats experiment proved that the administration of P. granatum induced urolithiatic rats resulted in removal of deposition of calcium oxalate crystals into kidneys and improving renal histology [46].
In another experiment on rats showed the protective effect of p. granatum in the ethylene glycol induced crystal depositions in kidneys [47].
No references
Taraxacum syriacum No references No references No references
Morus alba Bulgaria and Italy [48]. Ethanlic leaves extract showed significant anti-nephrolithiatic effect in wistar rats [49]. No reference
Foeniculum vulgare United Kingdom [50], Palestine [51], Italy [52], Turkey [53], Bosnia [54], Serbia [55], Iran [10, 56, 57], Pakistan [58], India [59], and Bolivia [60]. Herbal beverage of F. vulgare inhibited of calcium oxalate renal crystals formation in rats [61]. In most toxicity experiments carried out on F. vulgare, no signs of toxicity were observed [62].
Urinary tract infections Capsella bursa-pastoris In Jordan, [32] Turkey [63], Bulgaria [64], India [65], and Uzbekistan [66]. The crude extract of C. bursa-pastoris showed antibacterial activity against five Gram-positive and four Gram-negative bacteria.
Among them Escherichia coli which is the mainly cause of urinary tract infections [67, 68].
C. bursa-pastoris extracts have been reported to exhibit low toxicity in mice, furthermore the plant is contraindicated in case of pregnancy [69], but used as an edible vegetable, eaten raw or cooked in some countries [70, 71].
Ammi visnaga Italy, Tunisia [72], Palestine [51], Lybia [73], Sudan [74], Egypt [75], Pakistan [76], and Peru [77]. A. visnaga has antifungal, antibacterial and antiviral activities due the presence of khellin and visnagin [78]. Overdose or longer use of A. visnaga can lead to queasiness, dizziness, loss of appetite, headache, sleep disorders and it should be avoided during pregnancy [79].
Ammi majus Italy, [80] Jordan [81] and Morocco [82]. The extract of A. majus has shown good inhibition in all the bacterial strains used specially Escherichia coli [83]. In vitro study on Geese showed severe liver damage in these birds which fed A. majus and exposed to sunlight [84].
Renal failure Portulaca oleracea India [85, 86] and Sri Lanka [87]. The ethanolic extract of the plant aerial parts showed significant anti-inflammatory and analgesic after intraperitoneal and topical applications but not oral administration when compared with the synthetic drug, diclofenac sodium as the active control [88].
Also its aqueous extract attenuates diabetic nephropathy through inhibition of renal fibrosis and inflammation in mice [89]. Although aqueous and ethanolic extracts of P. oleracea showed potential activity against cisplatin induced acute renal toxicity was studied in rats [90].
Due to the huge a mounts of oxalic acid and nitrate in the plant, a high consumption is harmful [91, 92].
Enuresis Curcuma longa No reference No reference No reference
Crocus sativus No references No references Histological studies indicated that saffron has not any toxic effect on liver [93], heart and spleen on mice and rats [94, 95].
Benign prostate hyperplasia (BPH) Juglans regia Palestine [96]. No reference Juglone compound when isolated from all plant parts has multiple effects on cells such as the reduction of p53 protein levels, induction of DNA damage, inhibition of transcription and induction of cell death [97].
Quercus infectoria No reference Contains quercetin which is at 500 mg 2 times daily gave significant symptomatic improvement to most patients, particularly those with negative expressed prostatic secretions cultures [98]. The aqueous extract of Q. infectoria has significant toxic effect in Wistar rats for over 180 consecutive days of consumption [99].
Sambucus ebulus Turkey [100], and Bosnia [101]. The plant extract produced significant inhibition of edema induced by carrageenan at all doses when compared to the control rats group [102]. The plant extract showed severe toxicity (in particular severe liver abscess) in all mice at all tested doses [102].
Zea mays Algeria, [103] Guatemala [104], Serbia, [105] Cameroon [106], Peru [107], Australia [108], Brazil [109], and Turkey [110]. Crude ethanolic extract of corn silk (stigma of Zea mays) exhibited a significant activity in anti-inflammatory herbal drugs for TNF (tumor factor-alpha) antagonistic activity. [111]. No adverse effects have been noticed with the consumption of corn silk which support the safety of corn silk for humans [112].