Aristolochic acids are a family of carcinogenic, mutagenic, and nephrotoxic phytochemicals commonly found in the flowering plant family Aristolochiaceae (birthworts). Aristolochic acid (AA) I is the most abundant one. The family Aristolochiaceae includes the genera Aristolochia and Asarum, which are commonly used in Chinese herbal medicine. Although these compounds are widely associated with kidney problems, liver and urothelial cancers, the use of AA-containing plants for medicinal purposes has a long history. The FDA has issued warnings regarding consumption of AA-containing supplements.
Asarum is a genus of plants in the birthwort family Aristolochiaceae, commonly known as wild ginger.
Hyperuricaemia or hyperuricemia is an abnormally high level of uric acid in the blood. In the pH conditions of body fluid, uric acid exists largely as urate, the ion form. Serum uric acid concentrations greater than 6 mg/dL for females, 7 mg/dL for men, and 5.5 mg/dL for youth are defined as hyperuricemia. The amount of urate in the body depends on the balance between the amount of purines eaten in food, the amount of urate synthesised within the body, and the amount of urate that is excreted in urine or through the gastrointestinal tract. Hyperuricemia may be the result of increased production of uric acid, decreased excretion of uric acid, or both increased production and reduced excretion.
Kidney disease, or renal disease, technically referred to as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by blood tests. Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to nephritic syndrome and nephrotic syndrome respectively. Kidney disease usually causes a loss of kidney function to some degree and can result in kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option.
Aristolochia is a large plant genus with over 500 species that is the type genus of the family Aristolochiaceae. Its members are commonly known as birthwort, pipevine or Dutchman's pipe and are widespread and occur in the most diverse climates. Some species, like A. utriformis and A. westlandii, are threatened with extinction.
Diabetic nephropathy, also known as diabetic kidney disease, is the chronic loss of kidney function occurring in those with diabetes mellitus. Diabetic nephropathy is the leading causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) globally. The triad of protein leaking into the urine, rising blood pressure with hypertension and then falling renal function is common to many forms of CKD. Protein loss in the urine due to damage of the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) so called nephrotic syndrome. Likewise, the estimated glomerular filtration rate (eGFR) may progressively fall from a normal of over 90 ml/min/1.73m2 to less than 15, at which point the patient is said to have end-stage renal disease. It usually is slowly progressive over years.
Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function. There are various forms, and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.
Aristolochia californica, the California pipevine, California Dutchman's-pipe, or California snakeroot is a perennial woody vine of western North America.
Ochratoxin A—a toxin produced by different Aspergillus and Penicillium species — is one of the most-abundant food-contaminating mycotoxins. It is also a frequent contaminant of water-damaged houses and of heating ducts. Human exposure can occur through consumption of contaminated food products, particularly contaminated grain and pork products, as well as coffee, wine grapes, and dried grapes. The toxin has been found in the tissues and organs of animals, including human blood and breast milk. Ochratoxin A, like most toxic substances, has large species- and sex-specific toxicological differences.
Balkan endemic nephropathy (BEN) is a form of interstitial nephritis causing kidney failure. It was first identified in the 1920s among several small, discrete communities along the Danube River and its major tributaries, in the modern countries of Croatia, Bosnia and Herzegovina, Serbia, Kosovo, Romania, and Bulgaria. It is caused by small long-term doses of aristolochic acid in the diet. The disease primarily affects people 30 to 60 years of age. Doses of the toxin are usually low and people moving to endemic areas typically develop the condition only when they have lived there for 10–20 years. People taking higher doses of aristolochic acid have developed kidney failure after shorter durations of exposure.
Uromodulin (UMOD), also known as Tamm–Horsfall protein (THP), is a zona pellucida-like domain-containing glycoprotein that in humans is encoded by the UMOD gene. Uromodulin is the most abundant protein excreted in ordinary urine.
Asarum caudatum is a plant native to rich moist forests of western North America. It has heart-shaped leaves and a three-lobed purplish flower.
Stephania tetrandra is a herbaceous perennial vine of the family Menispermaceae native to China and Taiwan. It grows from a short, woody caudex, climbing to a height of around three meters. The leaves are arranged spirally on the stem, and are peltate, i.e. with the leaf petiole attached near the centre of the leaf. Its root is used in traditional Chinese medicine (TCM).
Aristolochia grandiflora, the pelican flower, is a deciduous vine with one of the world's largest flowers that emits an odor that smells like rotting meat, attracting flies.
Aristolochia indica is a creeper plant found in Southern India and also Sri Lanka. It Is known as 'sapsada' in Sri Lanka and is critical to the survival of the southern birdwing and common birdwing, as well as crimson and common rose butterflies. It reaches a height of several metres on trees and cover the branches with thick foliage. It is commonly found in forest floor, rocky hillslopes. It flowers once a year to produce seeds. It can also be propagated by roots. The plant has a number of historical medicinal uses.
Aristolochia didyma, or yawar panga is a plant found in South America of the genus Aristolochia. It is a powerful purgative, sometimes used in traditional rites to purify the body a few days before an Ayahuasca session.
Aristolochia paucinervis is a herbaceous plant in the family Aristolochiaceae endemic to the western Mediterranean Basin.
Uddanam nephropathy is a chronic kidney disease (CKD) that is endemic in the Indian region of Uddanam in Andhra Pradesh. Nephropathy on an endemic scale was first reported in Andhra Pradesh in the 1990s. In 2015, over 34,000 cases of kidney disease were recorded in the region, and it was estimated that at least 4,500 people had died from it in the last ten years. Its cause has not been found yet, and according to the WHO, it is "the least understood and the least publicized" nephropathy of unknown origin.
Aristolochia fangchi, is a species of flowering plant in the family Aristolochiaceae, native to Vietnam and southeast and south-central China.
