Evaluation of Antiurolithiatic Effects of <i>Moringa oleifera</i> Lam. Leaves Extract: <i>In-vitro</i>, <i>in-silico</i> and <i>in-vivo</i> Approaches

<b>Objective:</b> <i>Moringa oleifera</i> Lam. (Moringaceae), has traditionally been used for various renal diseases including urolithiasis. Considering the therapeutic and nutritional values, the present study was designed to investigate the antiurolithiatic potential of <i>M. oleifera</i> leaves through <i>in-vitro</i>, <i>in-silico</i> and <i>in-vivo</i> approaches. <b>Methods:</b> Methanolic aqueous extract of <i>M. oleifera</i>. leaves (MoL.Cr) was prepared and screened for phytoconstituents through FTIR and HPLC analysis, while antioxidant potential was determined by DPPH assay. Crystal nucleation, aggregation and growth assays were carried out to ascertain the <i>in-vitro</i> inhibitory effects of MoL.Cr. Molecular docking was performed to analyze the interactions between phytoconstituents and targeted proteins (Glycolate oxidase, Albumin and Tamm-Horsfall). Whereas, ethylene glycol-induced urolithiasis model (1% ammonium chloride +0.75% ethylene glycol) was used for <i>in-vivo</i> study. Presence of alkaloids, phenols, glycosides and flavonoids was confirmed by FTIR and HPLC analysis. <b>Results:</b> MoL.Cr significantly inhibited the CaOx crystal nucleation, aggregation as well as growth and normalized urinary and serum parameters. Histological studies showed that MoL.Cr significantly restored hyperoxaluria-induced irregular epithelial lining, interstitial inflammation and dilated proximal tubules. <b>Conclusions:</b> Thus, <i>M. oleifera</i> demonstrated marked stone inhibiting potential which can be due to its antioxidant, lowering of urinary concentration of stone forming constituents and anti-crystallization effects.