Are All Herbal Remedies Safe?

A new study published in the Proceedings of the National Academy of Science concluded that aristolochic acid (AA), a component of a plant.  used in herbal medicine may lead to kidney failure and upper urinary tract cancer (UUC) in those exposed to the toxin. Previous studies have also shown that AA is a powerful nephrotoxin and carcinogen associated with chronic kidney disease and upper urinary tract cancer. In a study of 151 UUC patients in Taiwan where the incidence is the highest of anywhere reported worldwide and where AA has been widely used the researchers concluded the exposure to AA is the primary contributor to the incidence of UUC in Taiwan. The researchers work builds on work previously carried out in the Balkans.

An analysis of National Health Insurance data in Taiwan over the years of 1997 and 2003 showed widespread use of AA in herbal medications. From a random sample of 200,000 of all insured people in Taiwan, about 1/3 of those prescribed medicines consumed herbs containing AA.

DNA was extracted from the 151 UUG patients believed to be associated with aristoloochic acid.  Researchers found a metabolite of AA bound to the DNA in the kidney cortex of 83 percent of the UUC patients. This caused alteration in the properties of genomic DNA that is a critical step in the development of cancer. In addition, TP53. a gene associated with many forms of cancer, was found in a majority of the UUC patients.  Researchers said the study clearly demonstrates that the presence of AL-DNA in the kidney cortex resulting from the reaction of the AA with the DNA, and the specific mutations in tumor tissue, are biomarkers of exposure to AA. They recommend public health efforts to eliminate aristolochic acid nephropathy and related upper urinary tract cancer.

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