Ketosteroid Standardized Cissus quadrangularis L. Extract and its Anabolic Activity: Time to Look Beyond Ketosteroid?

Background: Cissus quadrangularis (CQ) L. reported to contain 3‑ketosteroids and have bone health benefits. Aim: This study aimed at establishing the relationship between the ketosteroid content and anabolic as well as bone health‑promoting activities of various Cissus extracts in well‑established orchidectomized (ORX) rat model. Materials and Methods: Supercritical carbon dioxide, ethyl acetate, and aqueous extracts (AE) of CQ L. were prepared and standardized for ketosteroid content by two methods used in commerce. Moreover, ketosteroid standardized extracts of this plant were evaluated for anabolic activity in rats in well‑established ORX rat model. Results: The increase in the absolute weight was appreciable in the CQ‑AE treated group. Similarly, with respect to bone parameters, a similar trend was seen. The mean bone density, strength, and calcium content were found to be highest in the group treated with CQ‑AE compared to groups treated with other extracts. This study reveals for the first time that 3‑ketosteroids are not linked to the beneficial activities on bone and highlights the need for extensive characterization of biological active principles from CQ L. Conclusion: In light of the above estimation studies, we believe that current standardization of Cissus extraction “3‑ketosteroids” is incorrect. We also did not find any report suggesting the presence of androgenic steroids in this plant and hence the characterization based on “3‑ketosteroids” is scientifically incorrect. This study highlights the insufficient understanding of biological active principles from CQ L. and underlines the need for extensive bioactivity guided studies.