Prevalence of urothelial cancers among patients with Chinese herb nephropathy

Following the previously described case reports of rare urothelial tumours among some patients who had suffered end-stage renal disease after consumption of Chinese herbs, other patients were offered a bilateral removal of their native kidneys and ureters. High prevalence of urothelial cancers was documented in two series. In the first series (Cosyns et al., 1999), nephroureterectomies were performed in 10 renal-grafted Chinese herb nephropathy patients. The patients were all women and had a...

Origin type and botanical data

Aristolochia species refers to several members of the genus (family Aristolochiaceae) (WHO, 1997) that are often found in traditional Chinese medicines, e.g., Aristolochia debilis, A. contorta, A. manshuriensis and A. fangchi, whose medicinal parts have distinct Chinese names. Details on these traditional drugs can be found in the Pharmacopoeia of the People's Republic of China (Commission of the Ministry of Public Health, 2000), except where noted. This Pharmacopoeia includes the following...

Info

Shaw (1998) has discussed the safety aspects of herbal remedies in the United Kingdom. The legal status of herbal remedies medicines in the United Kingdom can be broadly divided into three categories (i) Most herbal products are unlicensed and therefore no medicinal claims can be made. These are regarded as food supplements and come under food legislation (Ministry of Agriculture, Fisheries and Food (MAFF), 1998). (ii) Licensed medicinal products require evidence of quality, safety and efficacy...

Laxatives based on naturally occurring anthraquinone derivatives

Herbs containing anthraquinone derivatives (rhubarb, senna, frangula, cascara, aloe) are used as laxatives. A meta-analysis of 11 studies dealing with colorectal cancers and laxative use showed that use of laxatives carried an increased risk (odds ratio, 1.5 95 CI, 1.3-1.6) for colorectal cancer (Sonnenberg & M ller, 1993). A more recent and very large study among nurses in the USA found no association between colorectal cancer and laxative use (Dukas et al., 2000). The relevance of this...

Toxic effects

Aristolochic acid I purity not specified was given by infusion to 20 patients having various malignant tumours, at different dose schedules ranging from 0.1 mg kg bw per day for five days to a single dose of 2 mg kg bw. The compound was too toxic to the kidneys for further trial (Jackson et al., 1964). The so-called Stephania tetrandra powder, first introduced in a slimming regimen in a Belgian clinic in early 1990, was withdrawn from the Belgian market at the end of 1992. Altogether, 1500-2000...

International exposure estimates

In 1997, the Joint Food and Agriculture Organization World Health Organization (FAO WHO) Expert Committee on Food Additives (JECFA) performed an exposure estimate for aflatoxins (JECFA, 1998). This report summarized the results of monitoring and available national estimates of intake of aflatoxins in order to provide a framework for estimating increments in intake of aflatoxins. Estimates were based on the results of available monitoring data. Total intake of aflatoxins based on the GEMS...

References

Bauch, H.J. amp Leistner, E. 1978 Aromatic metabolites in cell suspension cultures of Galium mollugo L. Planta med., 33, 105-123 Blomeke, B., Poginsky, B., Schmutte, C., Marquardt, H. amp Westendorf, J. 1992 Formation of genotoxic metabolites from anthraquinone glycosides present in Rubia tinctorum L. Mutat. Res, 265, 263-272 Blumenthal, M., Busse, W.R., Goldberg, A., Gruenwald, J., Hall, T., Riggins, C.W. amp Rister, R.S., eds 1998 The Complete German Commission E Monographs Therapeutic Guide...