On October 18, 2017, researchers from Singapore and Taiwan published a paper claiming that aristolochic acids (AA) and their derivatives are widely implicated in liver cancers in Taiwan and throughout Asia. In this article, the researchers note that A‐T‐specific mutations can be used as genetic fingerprints for AA exposure. We believe there is a lack of clarity on the causal role of AA in hepatocarcinogenesis.
Summary
What is Known and Objective
Aristolochic acid (AA) is an abundant compound in Aristolochia plants and various natural herbs. In the 1990s, a slimming formula used in Belgium that contains Aristolochia fangchi was reported to cause kidney damage and bladder cancer, and aristolochic acid nephropathy (AAN) is now well recognized worldwide. In October 2017, researchers reported an AA signature that is closely associated with hepatocellular carcinoma (HCC) worldwide.
Comment
There are differing opinions on the toxicity of AA, and different countries have taken different measures to address the issue. There is a lack of clarity on the causal role of AA in hepatocarcinogenesis and on the potential underlying mechanisms for the reported nephrotoxicity and carcinogenicity. The toxicity of AA differs depending on gender and age, and other risk factors that could explain the variability in the toxicity of AA remain to be identified.
What is New and Conclusion
Whether preparations containing AA, such as many Chinese medicines, should be used remains controversial, and this issue warrants further investigation before definite conclusions can be drawn.
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