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Toxics. 2019 Mar 19;7(1). pii: E14. doi: 10.3390/toxics7010014.

Aristolochic Acids: Newly Identified Exposure Pathways of this Class of Environmental and Food-Borne Contaminants and its Potential Link to Chronic Kidney Diseases.

Author information

1
Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong. ckchanak@connect.ust.hk.
2
Environmental Science Programs, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong. yliuee@connect.ust.hk.
3
Clinic of Nephrology, Clinical Centre Niš, Niš 18000, Serbia. nikpavster@gmail.com.
4
Medical Faculty, University of Niš, Niš 18000, Serbia. nikpavster@gmail.com.
5
Serbian Medical Society, Branch Niš, Niš 18000, Serbia. nikpavster@gmail.com.
6
Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong. chanwan@ust.hk.
7
Environmental Science Programs, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong. chanwan@ust.hk.
8
Division of Environment & Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong. chanwan@ust.hk.

Abstract

Aristolochic acids (AAs) are nitrophenanthrene carboxylic acids naturally produced by Aristolochia plants. These plants were widely used to prepare herbal remedies until AAs were observed to be highly nephrotoxic and carcinogenic to humans. Although the use of AA-containing Aristolochia plants in herbal medicine is prohibited in countries worldwide, emerging evidence nevertheless has indicated that AAs are the causative agents of Balkan endemic nephropathy (BEN), an environmentally derived disease threatening numerous residents of rural farming villages along the Danube River in countries of the Balkan Peninsula. This perspective updates recent findings on the identification of AAs in food as a result of the root uptake of free AAs released from the decayed seeds of Aristolochia clematitis L., in combination with their presence and fate in the environment. The potential link between AAs and the high prevalence of chronic kidney diseases in China is also discussed.

KEYWORDS:

Balkan endemic nephropathy; aristolochic acid nephropathy; aristolochic acids; chronic kidney disease; environmental pollution; food contamination; root uptake

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