The Protective Potential of Cardamom in an Experimental Bladder Ischemia-Reperfusion Model

Abstract

The Protective Potential of Cardamom in an Experimental Bladder Ischemia-Reperfusion Model

Abstract

Bladder ischemia-reperfusion (I/R) injury causes tissue damage through oxidative stress, inflammation, and cellular dysfunction. Cardamom (Elettaria cardamomum) has shown protective effects on various tissues due to its antioxidant and anti-inflammatory properties. However, its effects on bladder I/R injury have not been adequately investigated. This study aimed to investigate the biochemical and histopathological protective effects of cardamom extract against bladder I/R injury. Wistar albino rats were divided into three groups: I/R group, sham group, and cardamom treatment group. The I/R group underwent 30 minutes of ischemia followed by 30 minutes of reperfusion. The cardamom group received 50 mg/kg of cardamom extract via gavage 24 hours before the I/R process. Bladder tissues were collected for biochemical analysis of oxidative stress markers (MDA, SOD, CAT) and histopathological examination. In the cardamom-treated group, MDA levels were significantly lower, and SOD and CAT enzyme activities were significantly higher compared to the I/R group (p < 0.05). Histopathological analysis showed prominent inflammation, edema, and disruption of epithelial integrity in the I/R group, while the cardamom group exhibited notably reduced tissue damage and better-preserved epithelial integrity. Cardamom extract demonstrated a protective effect against bladder I/R injury by reducing oxidative stress and suppressing inflammation. Further clinical studies are needed to better understand the bladder-protective effects of cardamom.

Keywords

• Elettaria cardamomum
• Bladder
• Ischemia-Reperfusion

References

1. Park JM, Shin JH, Yang SW, et al. Metformin and sildenafil attenuate inflammation and suppress apoptosis after ischemia/reperfusion injuries in rat urinary bladder. Int Neurourol J 2021;25(4):285-295.
2. Altunkaynak-Camca HO, Yazihan N. The pretreatment of rats with nebivolol ameliorates bladder contractile dysfunction caused by ischemia-reperfusion injury. Low Urin Tract Symptoms 2021;13(1):183-188.
3. Wu YH, Chueh KS, Chuang SM, Long CY, Lu JH, Juan YS. Bladder hyperactivity induced by oxidative stress and bladder ischemia: a review of treatment strategies with antioxidants. Int J Mol Sci 2021;22(11):6014.
4. Juan YS, Chuang SM, Kogan BA, et al. Effect of ischemia/reperfusion on bladder nerve and detrusor cell damage. Int Urol Nephrol 2009;41(3):513-521.
5. Shin JH, Chun KS, Na YG, et al. Allopurinol protects against ischemia/reperfusion-induced injury in rat urinary bladders. Oxid Med Cell Longev 2015;2015:906787.
6. Birder LA, Wolf-Johnston AS, Zabbarova I, et al. Hypoxanthine induces signs of bladder aging with voiding dysfunction and lower urinary tract remodeling. J Gerontol A Biol Sci Med Sci 2024;79(1).
7. Yenilmez A, Kilic FS, Sirmagul B, Isikli B, Aral E, Oner S. Preventive effects of ginkgo biloba extract on ischemia-reperfusion injury in rat bladder. Urol Int 2007;78:167.
8. Can Güler M, Tanyeli A, Nur Ekinci Akdemir F, et al. An overview of ischemia-reperfusion injury: review on oxidative stress and inflammatory response. Eurasian J Med 2022;54:62.

9. Erkanli Senturk G, Erkanli K, Aydin U, et al. The protective effect of oxytocin on ischemia/reperfusion injury in rat urinary bladder. Peptides 2013;40:82.
10. Averbeck MA, de Lima NG, Motta GA, et al. Oxidative stress in the bladder of men with LUTS undergoing open prostatectomy: a pilot study. Int Braz J Urol 2018;44:1182.
11. Aslankoç R, Demirci D, İnan Ü, et al. The role of antioxidant enzymes in oxidative stress - superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX). Med J SDU 2019;26:362.
12. Bicer S, Suleyman B, Mammadov R, et al. Effect of anakinra, tocilizumab, and the combination thereof on bladder ischemia-reperfusion damage in albino Wistar-type rats. Invest Clin 2023;64:368.
13. Tınay I, Sener T, Cevık O, et al. Antioxidant agent quercetin prevents impairment of bladder tissue contractility and apoptosis in a rat model of ischemia/reperfusion injury. LUTS 2017;9:117.
14. Das I, Acharya A, Berry DL, et al. Antioxidative effects of the spice cardamom against non-melanoma skin cancer by modulating nuclear factor erythroid-2-related factor 2 and NF-κB signalling pathways. Br J Nutr2012;108(6):984-997.
15. Kannappan R, Gupta SC, Kim JH, Reuter S, Aggarwal BB. Neuroprotection by spice-derived nutraceuticals: you are what you eat! Mol Neurobiol 2011;44(2):142-159.
16. Zheng W, Wang SY. Antioxidant activity and phenolic compounds in selected herbs. J Agric Food Chem2001;49(11):5165-5170.
17. Nameni G, Moradi Y, Zaroudi M, Jamshidi S. Effect of cardamom supplementation on a number of metabolic factors: a systematic review and meta-analysis. Diabetes Metab Syndr 2022;16(6):102523.
18. Sarawi WS, Attia HA, Alzoubi A, et al. Cardamom extract alleviates tamoxifen-induced liver damage by suppressing inflammation and pyroptosis pathway. Sci Rep 2025;15(1):4744.
19. Li S, Li Z, Wang J, Han X, Zhang L. Cardamom synergizes with cisplatin against human osteosarcoma cells by mTOR-mediated autophagy. Cancer Gene Ther 2025.
20. Sharma H, Yang H, Sharma N, An SSA. Multivalent neuroprotective activity of Elettaria cardamomum (cardamom) and Foeniculum vulgare (fennel) in H₂O₂-induced oxidative stress in SH-SY5Y cells and acellular assays. Pharmaceuticals (Basel) 2024;18(1):2.
21. Swartz HM, Mason RP, Hogg N, et al. Free radicals and medicine. Biomedical EPR, Part A: Free Radicals, Metals, Medicine, and Physiology 2005;23:25-74.
22. Kalogeris T, Baines CP, Krenz M, Korthuis RJ. Cell biology of ischemia/reperfusion injury. Int Rev Cell Mol Biol 2012;298:229-317.
23. Yağmur I, Kurutaş EB, Öztürk P. Low-density lipoprotein receptor-related protein-1 and nitrative stress in psoriasis vulgaris: a cross-sectional study. Arch Dermatol Res 2025;317(1):699.
24. Zhang M, Liu Q, Meng H, et al. Ischemia-reperfusion injury: molecular mechanisms and therapeutic targets. Signal Transduct Target Ther 2024;9(1):12.
25. Çomaktekin E. The protective effect of cardamom plant in a breast cancer model induced by 7,12-DMBA. Master's Thesis. Kahramanmaraş Sütçü İmam University, Institute of Health Sciences, Kahramanmaraş, 2018.
26. Matsui T, Oka M, Fukui T, et al. Suppression of bladder overactivity and oxidative stress by the phytotherapeutic agent, Eviprostat, in a rat model of atherosclerosis-induced chronic bladder ischemia. Int J Urol 2012;19(7):669-675.
27. Lin WY, Chen CS, Wu SB, Lin YP, Levin RM, Wei YH. Oxidative stress biomarkers in urine and plasma of rabbits with partial bladder outlet obstruction. BJU Int 2011;107(11):1839-1843.
28. Da Costa LA, Badawi A, El-Sohemy A. Nutrigenetics and modulation of oxidative stress. Ann Nutr Metab2012;60(Suppl 3):27-36.
29. Callaghan CM, Schuler C, Leggett RE, Levin RM. Effect of severity and duration of bladder outlet obstruction on catalase and superoxide dismutase activity. Int J Urol 2013;20(11):1130-1135.
30. Sun S, Bai Y, Yang H, Yang HW. Investigation on lower urinary tract symptoms (LUTS) in elderly patients with prostate cancer (PC) received endocrine therapy. Arch Gerontol Geriatr 2015;60(3):535-537.
31. Pinggera GM, Mitterberger M, Steiner E, et al. Association of lower urinary tract symptoms and chronic ischaemia of the lower urinary tract in elderly women and men: assessment using colour Doppler ultrasonography. BJU Int 2008;102(4):470-474.
32. Alexandre EC, Calmasini FB, de Oliveira MG, et al. Chronic treatment with resveratrol improves overactive bladder in obese mice via antioxidant activity. Eur J Pharmacol 2016;788:29-36.
33. Juan YS, Li S, Levin RM, et al. The effect of ischemia/reperfusion on rabbit bladder--role of Rho-kinase and smooth muscle regulatory proteins. Urology 2009;73(5):1126-1130.
34. Andreadou I, Iliodromitis EK, Lazou A, et al. Effect of hypercholesterolaemia on myocardial function, ischaemia-reperfusion injury and cardioprotection by preconditioning, postconditioning and remote conditioning. Br J Pharmacol 2017;174(12):1555-1569.