In traditional chinese medicine several
Aristolochia species are used.
Aristolochia spp. contain a mixture of aristolochic acids (AAs), mainly AA I and AA II which are nephrotoxicants and carcinogens. After
AA-related nephropathy (AAN) and urothelial cancer were described in female patients in Belgium following intake of AA-contaminated
herbal preparations, herbs with AAs were prohibited worldwide. Confusing nomenclature can cause AA contamination of certain
Chinese traditional herbal preparations (THPs). Here we report the results of investigations by the Dutch Food and Consumer
Product Safety Authority (VWA) into the presence of AAs in THPs sampled on the Dutch market using a liquid-chromatography–-mass
spectrometry method. Between 2002 and 2006 we sampled 190 Chinese THPs using recent information on Chinese THPs potentially
containing AAs. AA I was found in 25 samples up to a concentration of 1,676 mg/kg. AA II was also found in 13 of these samples
up to 444 mg/kg. All 25 positive samples including Mu Tong, Fang Ji, Tian Xian Teng and Xi Xin were part of a group of 68 THPs
identified as possibly containing AAs. In a worst-case scenario, use of a sample of Mu Tong with the highest AA content over
a 7-day period would result in the same intake levels of AAs which significantly raised the cancer risk in the Belgian AAN
cases. Our results show that contaminated THPs still can be found on the market following worldwide publicity. Therefore,
it can be concluded that testing of possibly AA-contaminated THPs is still essential.
Figure Various Chinese Herbs
Keywords Chinese herb nephropathy - Aristolochic acid - Mu Tong - Traditional chinese medicine - Herbal remedies