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Zhongguo Zhong Yao Za Zhi. 2017 Nov;42(21):4049-4053. doi: 10.19540/j.cnki.cjcmm.2017.0160.

[Study and opinion on toxicity of aristolochic acid].

[Article in Chinese]

Author information

Institute of Radiation Medicine Sciences, Academy of Military Medical, Academy of Military Sciences, Beijing 100850, China.
China Military Institute of Chinese Materia Medica, 302 Military Hospital, Beijing 100039, China.
China Academy of Chinese Medical Sciences, Beijing 100700, China.
Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.


On October 18th, 2017, a research article named "Aristolochic acids and their derivatives are widely implicated in liver cancers in Taiwan and throughout Asia" was published on Science Translational Medicine. This article pointed out that herbs containing aristolochic acids could cause liver cancer by inducing the specific "aristolochic acids mutational signature". The public was also suggested to avoid the intake of herbs containing aristolochic acids. Since 2000, CFDA has gradually abolished the medicinal standards for herbs containing aristolochic acids such as caulis aristolochiae manshuriensis, aristolochia heterophylla and radix aristolochiae. Related drugs have been strengthened supervision since then. Chinese Pharmacopoeia has also removed the records of a series of related herbs. State Administration of Traditional Chinese Medicine held a conference on the "toxicity" of aristolochic acids as soon as the article was published. After a discussion of the studies on the toxicity of aristolochic acids, experts attending the meeting discovered several problems, including the unclearness of exposure history, tumor-producing dose and latent period, the absence of some key factors such as hepatitis B, the small sample size, miscellaneous factors, incomplete evidence chains, the missing of analyses between data with huge differences, the insufficiency of fundamental research arguments, etc. In order to understand the toxicity of aristolochic acids and the carcinogenic risks, as well as guide clinical safe medication, the experts suggested that:①Complete the systematical evaluation of aristolochic acids carcinogenicity as soon as possible. Scientifically elucidate the relationship between aristolochic acids and the genesis of liver cancer. ②Establish medication risk warnings of aristolochic acids and strengthen the supervision. ③Make an in-depth study of the toxicity of traditional Chinese medicine. Find out the adverse effects of all traditional Chinese medicine step by step.


aristolochic acid ; gene mutation ; liver cancer ; toxicity

[Indexed for MEDLINE]

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