An Integrated View of Aristolochic Acid Nephropathy: Update of the Literature

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Abstract

The term “aristolochic acid nephropathy” (AAN) is used to include any form of toxic interstitial nephropathy that is caused either by ingestion of plants containing aristolochic acids (AA) as part of traditional phytotherapies (formerly known as “Chinese herbs nephropathy”), or by the environmental contaminants in food (Balkan endemic nephropathy). It is frequently associated with urothelial malignancies. Although products containing AA have been banned in most of countries, AAN cases remain regularly reported all over the world. Moreover, AAN incidence is probably highly underestimated given the presence of AA in traditional herbal remedies worldwide and the weak awareness of the disease. During these two past decades, animal models for AAN have been developed to investigate underlying molecular and cellular mechanisms involved in AAN pathogenesis. Indeed, a more-in-depth understanding of these processes is essential to develop therapeutic strategies aimed to reduce the global and underestimated burden of this disease. In this regard, our purpose was to build a broad overview of what is currently known about AAN. To achieve this goal, we aimed to summarize the latest data available about underlying pathophysiological mechanisms leading to AAN development with a particular emphasis on the imbalance between vasoactive factors as well as a focus on the vascular events often not considered in AAN.
Original languageEnglish
Article number297
JournalInternational Journal of Molecular Sciences
Volume18
Issue number2
DOIs
Publication statusPublished - 29 Jan 2017

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Keywords

  • Aristolochic acids
  • Balkan endemic nephropathy
  • Herbal remedies
  • Renal interstitial fibrosis
  • Urothelial carcinoma
  • Cell Transformation, Neoplastic/chemically induced
  • Kidney Neoplasms/etiology
  • Aristolochic Acids/adverse effects
  • Oxidative Stress
  • Humans
  • Nephritis, Interstitial/diagnosis
  • Drugs, Chinese Herbal/adverse effects
  • Balkan Nephropathy/diagnosis
  • Animals
  • Biopsy
  • Fibrosis

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