Blockbuster paper again to aristolochic acid as the strong carcinogen, the restricted or banned?

15 years ago, aristolochic acid are classified as class 1 carcinogen. Including Europe, the United States, China, Taiwan and Hong Kong have banned the use of traditional Chinese medicine (TCM) containing aristolochic acid, but many families in China have proprietary Chinese medicine containing aristolochic acid.


caijing reporter Xu Jing/wen wang/editor

a blockbuster of aristolochic acid paper, board the authority medical journal “Science Translation Medicine” on the cover, the study showed that toxic herbs containing aristolochic acid, is one of the important causes of liver cancer in Asia. That is to say, traditional Chinese medicine (TCM) containing aristolochic acid, is Chinese easy to blame for liver cancer.

aristolochic acid is found in some Chinese herbal medicine in the chemical composition, it can induce cells to produce a very special mutation, now as long as through genetic testing, you can judge the right now is there a link between cancer and aristolochic acid. Researchers did genetic tests of Asia liver samples, found that 47% of mainland and Taiwan’s 78%, southeast Asia 56% of the samples are clearly show liver cancer associated with the cell mutation induced by aristolochic acid.

are known to contain more than 30 kinds of Chinese medicinal materials of aristolochic acid. As early as September 2013 caijing magazine published the article points out that prove to be strong carcinogens of aristolochic acid in Europe, the United States, China, Taiwan and Hong Kong are disabled, but is still in China for prescription management and application.

in the past 4 years, in many families have reserves containing aristolochic acid composition of proprietary Chinese medicine, to be used for cold, cough, etc. The new research conclusion, not only make the reliability of the traditional Chinese medicine (TCM) has been questioned again, and at the national long-term threats to health.

& ndash; & ndash; Editor’s note

aristolochic acid legacy

actually, in early August 2013, Singapore’s national cancer center, professor zeng exhibition and others in Science Translational Medicine (Science Translational Medicine) on the published papers, said containing aristolochic acid in Chinese herbal Medicine gene mutations can lead to kidney, leading to kidney cancer. The researchers also noted that aristolochic acid is likely are associated with liver cancer.

the end of August, the British administration of medicines and health products (MHRA) in website issued a warning to remind people carefully chosen without Britain officially registered by traditional Chinese medicine (TCM), the reason is that the traditional Chinese medicine (TCM) has a high content of harmful toxins.

in 1997, Britain was on medicines containing aristolochic acid ingredients prescription management, and then completely disabled. But in three years ago, according to BBC reports, a 48-year-old Chinese female physicians were sold to a British medicines containing aristolochic acid composition, lead to kidney failure, the patient first then develop cancer. The judge was of the opinion that the case shows that the lack of management on the safety of traditional Chinese medicine.

in 2004 promulgated the eu directive in traditional plant medicine registration procedure, requirements on the eu market sales of proprietary Chinese medicine must be finished on April 30, 2011, registration, otherwise not allowed to sell. Although relatively simplified application of regulatory documents, to register for the traditional Chinese medicine (TCM) is completely equivalent to chemical drugs, but so far no one by the European Union to register of Chinese enterprises. Beijing famous st intellectual property agency co., LTD partner Li Chunxuan believes that the fda ban on proprietary Chinese medicine part in this.

the latest studies have a doubt that aristolochic acid has strong carcinogenic, but containing aristolochic acid in mainland China is still in the sales of Chinese herbal medicine. Management has realized the risk of these drugs, so will contain aristolochic acid drugs in prescription management, and usage. However, clinical dose but difficult to master.

strong carcinogenic

linkou chang gung memorial hospital is Taiwan’s largest tumor hospital. Feng Si back from Sweden at the end of 2003 in Taiwan, that is, director of urology oncology in the courtyard, on the research of focus kidney disease and treatment. Feng Si found that patients with kidney disease in Taiwan and Europe is a big difference.

in Taiwan, kidney cancer occurs in the urinary tract, including the renal pelvis and ureter. & other; These cases around the world are not common, more common are the lower urinary tract lesions. Throughout the &; Feng Si said.

smoking has long been regarded as trigger factors of urinary tract cancer, but in Taiwan female smoking rate is not high, middle-aged women rates significantly higher than the male. The study concluded that aristolochic acid for this phenomenon is the main culprit.

the safety of aristolochic acid in the early 1990 s questioned by the researchers in Belgium. At the time, some women taking diet pills in renal failure, and these pills is a traditional Chinese medicine (TCM) containing aristolochic acid. To 2000, Belgium has more than 100 patients from 1990 to 1992 confirmed to take the same clinic opened a plant medicine, there are at least 70 patients need a kidney transplant or hemodialysis treatment.

confirmed by the medical profession, aristolochic acid is cause the kidney, and found to induce cancer mutations of p53.

Singapore’s national cancer center, professor zeng exhibition, led the team engaged in the research of aristolochic acid carcinogenicity, its and Feng Si met in Sweden in the 1990 s, when two people in the same laboratory is engaged in the research related to kidney cancer. Since then, two people gradually initiation thoughts, hope full coverage of aristolochic acid kidney caused by gene mutations.

there are nine cancer patients took part in their experiment, the use of whole genome sequencing methods, the sequencing and comparison are made on the normal and diseased cells, look for patterns.

the researchers found that aristolochic acid can cause damage to the far more than previously expected, the cause of urothelial carcinoma and 150 per million genes can cause mutation points, destructive power than to ultraviolet radiation causes skin melanoma, 111 and eight smoking caused lung cancer.

at the same time, the researchers from these mutations summarized the law of aristolochic acid A nucleic acid of genes can be rewritten into T nucleic acid, errors in the gene in the process of replication, and gradually evolved into A cancer.

& other; Can we make this a specific variation as genetic fingerprints of aristolochic acid. Throughout the &; Zeng show, for example, like the thief left after the crime fingerprint, fingerprint can be used to determine the gene, cancer is caused by aristolochic acid.

drug metabolism after liver detoxification first, and then excreted by the kidneys. After taking drugs containing aristolochic acid also passes through the metabolic process, and then whether aristolochic acid also left in the liver and other Genetic fingerprints & throughout; ?

on the one hand, in order to verify, on the one hand, out of curiosity, zeng exhibition, and according to the judgment of a Feng Si also found on the liver of aristolochic acid & other; Fingerprint & throughout; . & other; It was all a windfall. Throughout the &; Zeng said. Through the database data comparison, the researchers believe that at least 10% of cases of liver cancer associated with aristolochic acid. However, the researchers still need to further solid both relation in the future.

disable or limited to

the latest research results further clearly confirm the aristolochic acid can cause the number of genetic mutations to reach a few million.

zeng show even argue that aristolochic acid can occupy the strongest carcinogens.

mainland no plan will disable all these medicines containing aristolochic acid. As early as in 2002, the international agency for research on cancer has the traditional Chinese medicine for cancer risk assessment, aristolochic acid as class 1 carcinogen, namely has confirmed its be carcinogenic to humans. Including Europe, the United States, China, Taiwan and Hong Kong have banned the use of traditional Chinese medicine (TCM) containing aristolochic acid, but China has not done so.

aristolochic acid in Chinese medicine has a special meaning. Administration of state food and drug supervision and administration of drug evaluation center Xia Dongsheng analysis of aristolochic acid cause kidney damage event was reported by the media in 2003, broke the traditional Chinese medicine (TCM) & other; No side effects & throughout; Traditional ideas, make people to the understanding of the toxicity of traditional Chinese medicine (TCM) has a larger twist, the medical profession began to re-examine the safety of traditional Chinese medicine (TCM).

in 2001, the state administration of traditional Chinese medicine, Chinese medicine safety evaluation lab to do the traditional Chinese medicine (TCM) containing aristolochic acid (close also, wide acutum and gentian purging liver pills) safety evaluation studies. The conclusion is that all medicinal herbs containing aristolochic acid should be banned or restricted, and actively looking for substitution.

however, in 2005 the newly revised national pharmacopoeia only disables the wide acutum, radix aristolochiae, close also the three considered medicines containing aristolochic acid is higher. The rest of traditional Chinese medicines containing aristolochic acid has been listed as prescription management, hoping to reduce or standardize the use of medicines containing aristolochic acid.

backfire. Dingxi city, gansu province people’s hospital urology department staff yu-xia li, according to a paper published in 2004 & ndash; 2008 dose of pharmacy, containing aristolochic acid drug usage increased year by year.

Feng Si that & other; The measures to control the risk of aristolochic acid in poor effectiveness & throughout; In Taiwan, any containing aristolochic acid in Chinese herbal medicine has all be disabled. Despite the clear stipulation, still some people could not be identified, taking these drugs, without knowing that aristolochic acid banned today, ten years later, still can see the patient by the harm. Mainland area, make patient for easy access to the aristolochic acid and physical damage.

in containing aristolochic acid ingredients of traditional Chinese medicine, aristolochiaceae plants asarum usage, the largest and the most extensive. Express the efficacy of traditional Chinese medicine for, & other; Both can scatter cold outside, and inside can remove Yin cold, at the same time, analgesic, antitussive effect is better. Throughout the &;

& other; Asarum roots than in leaves, stems, and aristolochic acid content is low, the root is therefore be used as a medicine. Throughout the &; A researcher at the Chinese academy of traditional Chinese medicine the reactions. Now as long as doctors prescribe drugs, can obtain asarum in TCM pharmacy. Incomplete statistics, China has approved drugs containing asarum there are 176 species of medicinal materials.

the original wang, director of the office of the state administration of traditional Chinese medicine for caijing reporter said, there are some plants which are beneficial to human body, there are some plants have harm to the human body. Exquisite compatibility taboo, fujin made of traditional Chinese medicine, predecessors is through thousands of years of practical experience, and other After five or six kinds of herbs, for example, compatibility, or decoction, or through other processing after processing, it will change the pharmacological function of side effects will decrease. Throughout the &;

however, yet studies have shown that limit aristolochic acid in what scope, can prevent the occurrence of kidney damage, and, because the researchers did not find ways to cure genetic damage caused by aristolochic acid. & other; Genetic damage is difficult to repair, in this case, the disabled should be the best way. Throughout the &; Feng Si said.

there is no domestic relevant epidemiological investigation, according to number of aristolochic acid nephropathy, which makes the damage can not be understand by the public.

wan-qing Chen said, deputy director of the national cancer registry data lack of one of the reasons is that the clinical has not yet set up a scientific diagnostic method to distinguish the aristolochic acid caused by cancer, & other; Although aristolochic acid mainly lead to urinary tract cancer, but it is not as a judgment of strict & throughout; . null

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