Punicalagin

Pomegranate (Punica granatum L.) has been traditionally used in various cultures for its health benefits, particularly in promoting kidney health. Its rich composition of bioactive compounds, including polyphenols and flavonoids, has drawn attention for their potential protective effects against nephrotoxicity, a condition characterized by kidney damage due to various toxic agents.

This review aims to evaluate the efficacy of pomegranate and its active constituents in mitigating nephrotoxicity and promoting kidney health.

A literature review was conducted from 2010 to 2025, encompassing relevant in vitro and in vivo studies sourced from databases such as Scopus, Google Scholar, Web of Science, and PubMed. The focus was on the effects of pomegranate on nephrotoxicity and its underlying mechanisms.

The nephroprotective effects of pomegranate are attributed to its bioactive compounds, including ellagic acid, gallic acid, and punicalagin, which exhibit robust antioxidant properties and reduce inflammation, apoptosis, and fibrosis. These compounds suppress the TGF-β1/Smad pathway while enhancing protective regulators (SIRT1, SIRT6, TUG1, and Nrf2), contributing to antioxidant defense and cellular homeostasis. Furthermore, pomegranate mitigates nephrotoxicity by decreasing markers like MCP-1, NF-κB, LDH, HIF-1α, KIM-1, and NGAL, and it modulates renal transport proteins (OAT1 and OAT3). By preserving glomerular filtration rate, alleviating tubular damage, and promoting renal repair mechanisms, pomegranate demonstrates its protective actions against nephrotoxicity.

Pomegranate shows multifaceted nephroprotective properties through modulation of oxidative stress, inflammation, fibrosis, and apoptosis-related signaling pathways. However, further research is essential to confirm these findings, explore clinical applications, and evaluate safety profiles and potential interactions with other medications.

Punicalagin is a well-studied polyphenolic compound with a wide array of pharmacological effects. This review summarizes its potential mechanisms of action along with the pathogenic implications and molecular pathways associated with Enterotoxigenic Escherichia coli (ETEC). One primary mechanism by which punicalagin exerts its effects is through antibacterial activity that suppresses ETEC proliferation and mitigates intestinal infections. It further promotes the growth of beneficial microbiota, including bifidobacteria and lactic acid-producing bacteria, thereby improving the symbiotic balance of the gut microbiome and bolstering resistance to ETEC colonization. In addition, punicalagin has been shown to inhibit the activity of ETEC, thereby enhancing intestinal mucosal integrity and fortifying the intestinal barrier. This action reduces the permeability of harmful substances, ultimately protecting gut health. Moreover, punicalagin has the potential to chelate metals, leading to various biological activities and applications. This positions it as a candidate for further exploration as a novel therapeutic agent or a raw material in health products. In conclusion, this study offers preliminary insights into the potential application of punicalagin in managing ETEC-induced diarrhea, highlighting its pharmacological efficacy. However, it should be emphasized that current clinical evidence supporting its effectiveness for this specific use remains limited and preliminary, requiring validation through rigorous clinical trials.