Abstract
Recently, Translational Medicine reported on the toxicities of aristolochic acid (AA) in its cover story, which once again caused the public to question the safety of genus Aristolochia herbs. This article started with the case report of herbal nephropathy, and combed the discovery process of nephropathy and Balkan endemic nephropathy as well as the relationship among the three. At the same time, the mechanism of nephrotoxicity was analyzed based on the following aspects: clinical in vivo studies have confirmed that AA caused renal tubular epithelial cell damage; animal in vivo and in vitro studies have shown that AA interfered with microRNA; and endoplasmic reticulum stress or oxidative stress led to renal cell apoptosis and AA-mediated inflammatory injury, etc, which introduced the enlightenment from the AA nephrotoxicity events, in order to expect further strengthening supervision of Chinese herbs containing AA at all levels of drug regulatory authorities of our country, and carrying out new clinical epidemiological studies to update the incidences of AA hepatotoxicity and nephrotoxicity caused by the Chinese herbal medicine genus Aristolochia in China. Key words: Aristolochic acid; Aristolochic acid nephropathy; Genus Aristolochia; Nephrotoxicity
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