Public health risks from heavy metals and metalloids present in traditional Chinese medicines

A near-infrared fluorescent probe for the detection of Cu2+ in Chinese herbal medicine and imaging in living cells

Copper is one of the common among the heavy metal pollution in Chinese herbal medicine (CHM). So, it is essential to develop rapid and accurate testing method to quantify the Cu2+ content in CHM. Herein, we prepared a coordination-based near-infrared fluorescent probe (NRh6G-FA) by introducing a hemicyanine dye in rhodamine 6G scaffold. NRh6G-FA had a high sensitivity, anti-interference performance, fast response (within 60 s), visualization (from light yellow to green) for Cu2+ and excellent sensing performance for the detection of Cu2+ at low concentrations (LOD = 0.225 μM). The most likely mechanism was verified on the basis of Job's plot, ESI-HRMS and DFT calculations. NRh6G-FA could be successfully applied for the detection and "naked eye" recognition of Cu2+ in CHM samples. Moreover, NRh6G-FA was used to visualize Cu2+ in living MCF-7 cells by confocal fluorescence imaging.

Bioaccessibility, exposure and risk assessment of potentially toxic elements and essential micronutrients in ayurvedic, traditional Chinese and Ghanaian medicines

Potentially toxic constituents in traditional medicines remain a concern due to health risks posed to consumers. Thirty-six traditional medicines (TM) consisting of 14 Indian Ayurvedic Medicines, 11 Chinese Traditional Medicines and eleven Ghanaian Traditional Medicines were evaluated using Total Reflection X-ray Fluorescence Spectrometer (T-XRF) after microwave assisted acid digestion. Physiologically Based Extraction Test (PBET) was used to obtain bioaccessible elemental concentrations. Merck XVI multi-element standard were used to evaluate the accuracy of the analytical method. The concentrations of the elements were quantified in (mg kg-1): Cr (0.01-698), Mn (0.01-1140), Fe (15-73300), Ni (1-1340), Cu (3-8160), Zn (0.01-224). The greatest bioaccessible concentrations of arsenic was 0.80 mg kg-1 and 0.44 mg kg-1 in the gastric and intestinal phases respectively. In order to evaluate the human health risks from ingesting these TM, the Acceptable Daily Intake (ADI) was calculated for each medicine based on element-specific bioaccessibility-adjusted concentrations and results compared with the United States Environmental Protection Agency (USEPA) Reference Dose (RfD) limits. The Acceptable Daily Intake (ADI) values for risks were within the USEPA RfD. Hazard quotients (HQ) of TM were < 1, meaning elemental concentrations do not pose non-carcinogenic risks to adult consumers. In summary the methods applied in the study gives a new insight on human health risks of potentially toxic and essential micronutrients elements in TM.

The ignored risk: heavy metal pollution of medicine and food homologous substances

A survey was conducted to investigate the effects of cadmium (Cd), arsenic (As), chromium (Cr), lead (Pb), and copper (Cu) in medicine and food homologous substances (MFHs) on human health. Nine common and typical MFHs (Dendrobium, Bulbus lilii, Poria, Semen nelumbinis, Radix puerariae, Gardenia jasminoides, Hordeum vulgare L, Semen coicis, and Ganoderma Karst) in the form of medicinal slices ready for decoction were purchased from pharmacies. Five among the MFHs (Dendrobium, Bulbus lilii, Poria, Semen nelumbinis, and Radix puerariae) were further obtained from a local field as raw materials for comparison. The results showed that raw materials of MFHs collected from the field had higher contents of heavy metal and greater health risks than medicinal slices purchased from pharmacy. Generally, the heavy metal residues in MFHs of different medicinal parts were different, and MFHs from roots or stems had significantly higher contents of heavy metals than those from fruits or seeds. Most importantly, the contents of Cd in Bulbus lilii and As in wild Poria from field were higher than the contents described in the Pharmacopoeia of the People's Republic of China (ChP). Non-carcinogenic and carcinogenic risk assessments revealed that Poria from field had larger non-carcinogenic and carcinogenic risks to human health; Bulbus lilii showed no non-carcinogenic risk but exhibited carcinogenic risks, whereas Cr showed carcinogenic risks in all samples. Given that MFHs are incorporated in regular foods, care should be taken to minimize health hazards caused by heavy metals to human. This study creates awareness on the safety issues associated with MFHs, and provides basic information for establishing the maximum allowable contents of medicinal and food substances in normal diets.

Composition of Three Common Chinese Herbal Medicines and the Influence of Preparation Types on the Bioaccessibility of Trace Elements

The high concentration of trace elements in Chinese herbal medicine (CHM) is an important research topic for quality control. This study investigated the total concentration of trace elements in three herbs used as both medicine and supplementary food, including Astragalus membranaceus, Glycyrrhiza, and Isatidis. Further, the effects of different preparation ways, such as decoct, granule, and oral liquid, on the bioaccessibility of trace elements in CHM were disclosed. Results indicated that the total concentrations of trace elements in these three herbs were lower than the medical standards, but the concentrations of As and Pb in CHMs were higher than the standards for supplementary food. Different preparations ways affect bioaccessibility. Powder and oral liquid show a high bioaccessibility possibly because of the grinding process and the repeated extraction with ethanol. Among the three different CHMs, Isatidis showed higher bioaccessibility of As, which may be related to the sulfur fumigation process of this CHM. The three investigated CHMs were found to be safe as medicine but presented risks as supplementary food. The apparent influence of preparation procedures on the bioaccessibility of trace elements indicated that it is necessary to appropriately regulate preparation processes for CHMs.

Integrating Multi-Type Component Determination and Anti-Oxidant/-Inflammatory Assay to Evaluate the Impact of Pre-Molting Washing on the Quality and Bioactivity of Cicadae Periostracum

Cicadae Periostracum (CP) is a traditional Chinese medicinal herb derived from the slough that is molted from the nymph of the insect Cryptotympana pustulata Fabricius. Washing with water to remove residual silt is a primary processing method of CP that is recommended by the Chinese Pharmacopoeia, but how washing methods affect the quality and bioactivity of CP is unknown. In this study, the quality and bioactivity of non-washed CP (CP-NW), post-molting-washed CP (CP-WAT), and pre-molting-washed CP (CP-WBT) were comparatively investigated. The quality of these CP samples was evaluated in terms of the UPLC-QTOF-MS/MS-based chemical profiling and semi-quantification of 39 N-acetyldopamine oligomers (belonging to six chemical types), the HPLC-UV-based quantification of 17 amino acids, the ICP-MS-based quantification of four heavy metals, and the contents of ash; the bioactivities of the samples were compared regarding their anti-oxidant and anti-inflammatory activities. It was found that, compared with CP-NW, both CP-WBT and CP-WAT had significantly lower contents of ash and heavy metals. Moreover, compared with CP-WAT, CP-WBT contained lower levels of total ash, acid-insoluble ash, and heavy metals and higher contents of N-acetyldopamine oligomers and amino acids. It also had enhanced anti-oxidant and anti-inflammatory activities. A Spearman's correlation analysis found that the contents of N-acetyldopamine oligomers and free amino acids were positively correlated with the anti-oxidant/-inflammatory activities of CP. All these results suggest that pre-molting washing can not only remove the residual silt but can also avoid the loss of the bioactive components and assure higher bioactivities. It is concluded that pre-molting washing could enhance the quality and bioactivity of CP and should be a superior alternative method for the primary processing of qualified CP.

Monitoring of Heavy Metals and Pesticide Residues of Herbal Decoctions in Traditional Korean Medicine Clinics in Korea

In this study, we investigated whether the levels of heavy metal and pesticide residues in herbal decoctions in Korea in 2019 were within normal limits. In total, 30 decoctions composed of multi-ingredient traditional herbs were sampled from traditional Korean medicine (TKM) clinics, TKM hospitals, and external herbal dispensaries in 2019. The decoctions were analyzed for heavy metal content such as lead, arsenic, and cadmium using inductively coupled plasma optical emission spectrometry. For mercury, an automatic mercury analyzer based on the gold amalgamation process was used. For pesticide residues, gas chromatography with electron capture detection and gas chromatography with mass selective detection were used for the analyses. Based on the testing, heavy metals were identified in most of the decoctions (Cd: 0.000–0.003 ppm, Pb: 0.003–0.023 ppm, As: 0.000−0.016 ppm, Hg: 0.000–0.002 ppm). Pesticide residues (e.g., total DDT, total BHC, aldrin, endrin, dieldrin) were not detected at all. All of these were no more than the limit values in preceding studies. Therefore, this study confirms that the contents of heavy metals and pesticides in herbal decoctions are within safe levels based on a previous study and provides evidence for establishing safety management standards for herbal decoctions in Korea.

Impacts of heavy metals and medicinal crops on ecological systems, environmental pollution, cultivation, and production processes in China

Heavy metals are widely distributed in the environment due to the natural processes and anthropogenic human activities. Their migration into no contaminated areas contributing towards pollution of the ecosystems e.g. soils, plants, water and air. It is recognized that heavy metals due to their toxicity, long persistence in nature can accumulate in the trophic chain and cause organism dysfunction. Although the popularity of herbal medicine is rapidly increasing all over the world heavy metal toxicity has a great impact and importance on herbal plants and consequently affects the quality of herbal raw materials, herbal extracts, the safety and marketability of drugs. Effective control of heavy metal content in herbal plants using in pharmaceutical and food industries has become indispensable. Therefore, this review describes various important factors such as ecological and environmental pollution, cultivation and harvest of herbal plants and manufacturing processes which effects on the quality of herbal plants and then on Chinese herbal medicines which influence human health. This review also proposes possible management strategies to recover environmental sustainability and medication safety. About 276 published studies (1988-2021) are reviewed in this paper.

Danshen (Salvia miltiorrhiza) on the Global Market: What Are the Implications for Products' Quality?

Background: Danshen (Radix et rhizoma Salviae miltiorrhizae; Salvia miltiorrhiza Bunge, Lamiaceae) is commonly used in Asia, including China, Japan, and Korea with markets in America and Europe growing substantially. It is included in multiple pharmacopeias and salvianolic acid B and tanshinone IIA are used as quality markers. However, on the markets, substitutes and different processing methods often are a concern. a concern regarding patients’ safety and expected outcomes.

Aims: This study aims at understanding the quality of Danshen-derived products on the market, and the relationship between the chemistry, biological activity and the processing and storage methods.

Methods: For heavy metal analysis, inductively coupled plasma optical emission spectrometry was used. High performance thin-layer chromatography and proton nuclear magnetic resonance coupled with principal component analysis were used to understand the variation of metabolite composition. MTT assay and LPS induced NO production assay were used to evaluate the cytotoxicity effect and anti-inflammatory activity, respectively.

Result and Discussion: Six out of sixty samples exceed the limits of cadmium according to the Chinese or United States Pharmacopoeia. Arsenic, lead and copper contents are all below pharmacopoeial thresholds. With more complex processing procedure, the risk of heavy metal contamination increases, especially with arsenic and cadmium. The metabolite compositions show a variability linked to processing and storage methods. Authenticated samples and Vietnamese primary samples contain higher salvianolic acid B, and their chemical compositions are more consistent compared to Chinese online store samples. Overall, a significant chemical variation can be observed in Danshen products directly linked to processing and storage method. In the MTT assay, fourteen samples show cytotoxicity while seven samples increase the proliferation of RAW264.7. In the LPS induced NO production of RAW 264.7, only seven samples show significant inhibitory effects.

Conclusion: This is the first interdisciplinary investigation focusing on understanding the current market and the quality of Danshen. The quality of Danshen products on the high street are inferior to the authenticated samples. The results of the bioassays selected is not useful to differentiate the quality and composition according to the current definition in the pharmacopoeias. Overall, this approach highlights the tremendous variability of the products linked to processing and the need for more systematic and stringent quality assurance.

Precision Harvesting of Medicinal Plants: Elements and Ash Content of Hyssop (Hyssopus officinalis L.) as Affected by Harvest Height

To investigate the effect of harvest height on the amassed elements and ash content of Hyssop (Hyssopus officinalis L.), an experiment was conducted in a randomized complete block design with three replications. Treatments included four harvest heights, i.e., 15, 25, 35, and 45 cm (from the tip of the plant) and the residual stalks. The dependent variables were the amassed content of elements N, K, P, Ca, Mg, Cu, Zn, and Pb in different heights of the plant and the associated ash content (total ash (TA), acid-insoluble ash (AA), and water-insoluble ash (WA)). The results showed that by moving from the upper shoots toward the ground, the amassed content of Mg, Ca, Cu, Zn, and Pb increased by 22.67%, 43.74%, 12.87%, 39.02%, and 85.04%, respectively. Further, a downward trend was observed for N (50.16%) and K (6.41%) content, while an upward trend reported for P (29.06%) content. As for the residual stalks, by moving from the upper shoots toward the ground, Mg, Ca, Cu, Zn, and Pb contents decreased by 1.01%, 21.03%, 9.11%, 17.02%, and 51.06%, respectively, while N and P contents increased by 60.59% and 3.15%, respectively, and a 34.74% increase was seen in P content. With increasing harvest height, TA, AA, and WA values increased by 33.48%, 27.03%, and 18.25%, respectively. As for the residues, these variables increased by 11.44%, 6.35%, and 5.22%, respectively. Our results showed that 15 cm harvest height had the highest quality with the lowest heavy metal content. Graphical Abstract.

Assessment of essential and non-essential elements in selected traditional medicines from India, Ghana and China

Traditional medicine (TM) also known as folk medicine consists of medical knowledge systems that were developed over generations in various countries before the era of modern medicine. Over the last few years, there has been a shift in universal trend from modern medicine to TM because it is believed that these medicines are non-toxic to humans, have little to no side-effects, are readily available and affordable. The purpose of this study was to investigate the essential and non-essential elemental concentrations of ayurvedic medicines (AM), Ghanaian traditional medicines (GTM) and Chinese traditional medicines (CTM). The results indicate that the mean elemental concentrations in TM varied greatly. The mean concentrations of copper and mercury in AM, GTM and CTM ranged from 4 to 45 mg/kg and 0.01 to 2 mg/kg, respectively. Multivariate statistical analyses applied to recognise inter-element associations indicated that at 0.05 significant level, there was a positive correlation between elements suggesting they may have originated from the same source. The study concludes by highlighting the need for monitoring of the elemental concentrations in commonly consumed traditional medicines regularly to detect contamination in these medicines since the occurrence of metals in these medicines above or below legally permissible limits can be harmful to consumers.

Arsenic intoxication: general aspects and chelating agents

Arsenic (As) is widely used in the modern industry, especially in the production of pesticides, herbicides, wood preservatives, and semiconductors. The sources of As such as contaminated water, air, soil, but also food, can cause serious human diseases. The complex mechanism of As toxicity in the human body is associated with the generation of free radicals and the induction of oxidative damage in the cell. One effective strategy in reducing the toxic effects of As is the usage of chelating agents, which provide the formation of inert chelator–metal complexes with their further excretion from the body. This review discusses different aspects of the use of metal chelators, alone or in combination, in the treatment of As poisoning. Consideration is given to the therapeutic effect of thiol chelators such as meso-2,3-dimercaptosuccinic acid, sodium 2,3-dimercapto-1-propanesulfonate, 2,3-dimercaptopropanol, penicillamine, ethylenediaminetetraacetic acid, and other recent agents against As toxicity. The review also considers the possible role of flavonoids, trace elements, and herbal drugs as promising natural chelating and detoxifying agents.

Tissue distribution of mercury and copper after Aarogyavardhini Vati treatment in rat model of CCl4 induced chronic hepatotoxicity

Background

Aarogyavardhini Vati is a classical Ayurvedic herbomineral formulation. It contains mercury and copper compounds as principal minerals along with other minerals and herbal ingredients. Aarogyavardhini Vati is indicated in chronic liver ailments. However, safety concerns are often raised regarding the use of mercury containing ayurvedic drugs in disease conditions due to the risk of mercury and copper toxicity.

Objective

This study was performed to address the safety concerns regarding mercury and copper toxicity from Ayurvedic herbomineral formulations by investigating accumulation of these minerals in tissues and subsequent toxicity in chronic hepatotoxicity rat model.

Materials and methods

Quantification of mercury and copper in Aarogyavardhini Vati was done. Chronic hepatotoxicity was induced in the Wistar rats by repeated administration of CCl₄ for 8 weeks. Animals were treated with Aarogyavardhini Vati for various durations. Post treatment of 8 weeks, serum biochemical marker estimations was done. Estimation of mercury and copper from the liver, kidney and brain tissues was done after animal sacrifice. Histopathology evaluation of visceral organs was also performed.

Results

Treatment with Aarogyavardhini Vati exhibited significant accumulation of mercury in the kidney but not in the brain and liver. Similarly, no significant accumulation of copper was observed in liver, kidney, and brain due to the treatment of Aarogyavardhini Vati. Serum biochemical and histopathological changes were not affected by the treatment with Aarogyavardhini Vati.

Conclusion

Aarogyavardhini Vati did not show any biologically significant potential to cause toxicity due to its mercury and copper content when administered for prolonged duration to rats with chronic hepatotoxicity.

Speciation analysis and dynamic absorption characteristics of heavy metals and deleterious element during growing period of Chinese peony

The heavy metals and deleterious element (Pd, Cd, Cu, As, and Hg) in Chinese peony (Paeonia lactiflora Pall.) were determined by Tessier's sequence extraction method. Pb mainly existed in carbonate fraction. The main fraction of Cd in different tissues and different month is quite different. Cu mainly exists as exchangeable carbonate fractions. Five forms of Hg all exist in leaf, stem, and root. The total absorbable fraction of Pd, Cd, Cu, As, and Hg was different in different tissues. The total content of heavy metals can migrate from different tissues and the content of different speciation of heavy metal also can change during the growing period of plants. The results showed that different parts of plants and different elements resulted in different distribution and mobility. Base on this, it is more scientific and reasonable to clarify the migration and enrichment and to analyses the speciation of heavy metals during growing period of plant medicine. It is more scientific and reasonable to clarify the migration and enrichment, and to analyses the speciation of heavy metals during growing period of plant medicine.

Angong Niuhuang Pill as adjuvant therapy for treating acute cerebral infarction and intracerebral hemorrhage: A meta-analysis of randomized controlled trials

ETHNOPHARMACOLOGICAL RELEVANCE

Angong Niuhuang Pill (ANP) is a well-known traditional Chinese patent medicine. This meta-analysis aimed to evaluate the efficacy and safety of ANP as an adjuvant therapy in patients with acute cerebral infarction (ACI) and acute intracerebral hemorrhage (AIH).

MATERIALS AND METHODS

We performed a literature search in Embase, Pubmed, Cochrane Library, CNKI, Wanfang, and VIP database from their inceptions to April 2018. Randomized controlled trials evaluating ANP as an adjuvant therapy for acute stroke were selected. Risk ratio (RR) or weighted mean difference (WMD) with their 95% confidence interval (CI) was calculated between with and without ANP therapy.

RESULTS

Eighteen trials involving 1,601 patients were identified and analyzed. Meta-analysis showed that ANP plus usual treatment significantly improved the total response rate in patients with ACI (RR 1.27; 95% CI 1.14-1.41) and AIH (RR 1.26; 95% CI 1.14-1.38) compared with the usual treatment alone. Adjuvant treatment with ANP also significantly reduced the neurologic deficit score in patients with ACI (WMD -3.64; 95% CI -4.97 to - 2.31) and AIH (WMD -3.52; 95% CI -5.51 to -1.54). Moreover, ANP significantly improved the Glasgow Coma Scale in patients with ACI (WMD 1.18; 95% CI 0.79-1.56) and AIH (WMD 2.28; 95% CI 1.37-3.19).

CONCLUSIONS

Adjuvant treatment with ANP appears to improve the total response rate and neurologic deficit score in patients with ACI and AIH. More well-designed trials are required due to the suboptimal methodological quality of the included trials.

Metals and metalloids in traditional medicines (Ayurvedic medicines, nutraceuticals and traditional Chinese medicines)

Traditional medicine (TM) including Ayurvedic medicines, traditional Chinese medicines and nutraceuticals are popular across the globe as dietary supplements and traditional and alternative medicines. Health risks from these remedies continue to present serious concerns, with occurrences of poisoning by metals and metalloids present at concentrations above acceptable regulatory standards. This review overviews the prevalence of TM use, cases of metal and metalloid poisoning following TM consumption, and forms of TM contamination and adulteration. The review summarises regulations by the World Health Organization (WHO) and other relevant bodies. Finally, the review recommends how to protect consumers.

Heavy metal pollution and potential health risks of commercially available Chinese herbal medicines

A survey was conducted to investigate the pollution and health risks of copper (Cu), cadmium (Cd), lead (Pb), arsenic (As), mercury (Hg) and zinc (Zn) in 60 Chinese herbal medicines (CHMs) collected from a market in Kunming City, Yunnan Province, China. Furthermore, eight CHMs (Cyathulae radix, Drynariae rhizoma, Peucedani radix, Homalomenae rhizoma, Dryopteris setosa, Polygonati rhizoma, Lilii bulbus, and Linderae radix) containing high Cd concentrations were selected to further analyse their Cd chemical forms. Additionally, the dissolution rates of six heavy metals in decoction liquid were also analysed for four CHMs (Typhonii rhizoma, Linderae radix, Homalomenae rhizoma, and Cyathulae radix), and the health risks of heavy metals in CHMs were evaluated. The results showed that the Cd, Hg and Cu concentrations in the 60 CHMs exceeded the limiting values of the "Green Trade Standards of Importing & Exporting Medicinal Plants & Preparations" (WM2-2001), with exceedance ratios of 38.8%, 8.3% and 1.7%, respectively. The majority of Cd was integrated with pectates and protein in CHMs, and the other five Cd chemical forms followed the order of water-soluble > insoluble heavy metal phosphates > oxalate > residual > inorganic form, indicating that Cd had relatively low bioactivity and toxicity. The average dissolution rates of Zn, Cu, Cd, Hg, As and Pb in the four CHMs were 47.4%, 33.8%, 20.5%, 6.1%, 5.4% and 4.8%, respectively. The calculation results of hazard quotients (HQs) for Cd and Hg showed that the CHMs did not pose a threat to human health.

Potential Health Risk Assessment of Different Heavy Metals in Wheat Products

In the present work, health risk of heavy metals such as As, Cd, Co, Cr, Cu, Hg, Ni, Pb, and Zn in Iranian urban and rural samples including wheat, wheat flour, bread, pasta and sweets were assessed. The real amount of heavy metals in target samples were determined by inductively coupled plasma-atomic emission spectrometry (ICP-AES) and atomic absorption spectroscopy (AAS). Wet ashing and hydride generation techniques were used in sample preparation step. Results demonstrated that heavy metal contaminations in cereal samples were significant. The average concentrations of heavy metals in wheat products were between 0.01 mg kg-1 to 46 mg kg-1. Finally, the health risk assessment results showed that heavy metal contents in rural samples were higher than those in urban samples. The risk of Cu and Zn was significant in two areas and risk of Cr and Cd was not significant.

Evaluation of the potential nephrotoxicity and mechanism in rats after long-term exposure to the traditional Tibetan medicine tsothel

CONTEXT

Tsothel, a traditional Tibetan medicine, is regarded as 'the king of essences'. Nevertheless, tsothel has aroused serious concern regarding its biosafety because its main component is HgS. Unfortunately, toxicological studies on tsothel are scarce.

OBJECTIVE

As inorganic mercury has high affinity for the kidney, the present investigation was designed to determine the potential nephrotoxicity and mechanism of tsothel.

MATERIALS AND METHODS

Sprague-Dawley rats were orally administered different doses of tsothel (0, 66.70, 33.35 and 16.68 mg/kg) daily for 180 days, followed by the withdrawal of tsothel for 120 days. Then, the related nephrotoxicity was examined by the ICP-MS, ELISA, colorimetric, RT-PCR, HE staining, immunohistochemical staining and flow cytometry methods.

RESULTS

Although tsothel administration led to a large accumulation of Hg (794.25 ± 464.30 ng/g in the 66.70 mg/kg group, 775.75 ± 307.89 ng/g in the 33.35 mg/kg group and 532.60 ± 356.77 ng/g in the 16.68 mg/kg group) in the kidney after 120 days of tsothel withdrawal, the blood CREA and BUN, urinary Kim-1, NAG, RBP and β2-MG, renal SOD, MDA, pathology, proliferation, apoptosis and cell cycle had no significant changes compared with the control group. Additionally, the high GSH content (318.87 ± 44.19 nmol/mL in the 33.35 mg/kg group) and the relative expression levels of Kim-1 (1.08 ± 0.11 in the 33.35 mg/kg group), MT-1 (1.46 ± 0.10 in the 66.70 mg/kg group, 1.61 ± 0.19 in the 33.35 mg/kg group and 1.57 ± 0.14 in the 16.68 mg/kg group) and GST-Pi (1.76 ± 0.89 in the 33.35 mg/kg group) mRNA recovered to normal after tsothel withdrawal. Interestingly, the change trend of GST-Pi gene expression was consistent with the change trend of GSH activity.

CONCLUSIONS

Overall, our study shows that tsothel administration did not induce overt nephrotoxicity but did have reversible stress-related effects. These results suggest that tsothel affects stress response mechanisms with the involvement of detoxifying enzyme systems. The formulation method and chemotype could play a role in the reduced toxicity potential of tsothel compared to common mercurials.

Physiochemical characterization and cytotoxicity evaluation of mercury-based formulation for the development of anticancer therapeuticals

BACKGROUND

The present study is aimed to evaluate the physiochemical properties and cytotoxicity of mercury-based formulation for the development of anticancer therapeuticals.

METHODS

The elemental and morphological features of the formulation were characterized by FE-SEM, XPS and EDS. The described formulation was evaluated for its cytotoxicity on Hek293 and MCF7 cell lines using MTT assay to study the in vitro effects. The in vivo developmental toxicity was also studied on zebrafish embryos and the lethal concentration (LC50) values were calculated as per the OECD regulations.

RESULTS

The elemental and morphological characterizations confirmed the presence of mercuric compounds. The particles were spherical and stable with the size ranges between 20 and 80nm. Although the PK formulation contains mercurials it was very effective only to cancerous cells (MCF-7) and it is less toxic to normal cells (HEK 293). The in vivo assessment of developmental toxicity on zebrafish embryo confirmed the safer dosage of 100μg/ml. However, a higher dosage of 1mg/ml led to the malformation of embryos such as pericardial, tail and yolk sac edema.

CONCLUSION

The physiochemical characterization of PK formulation confirmed the presence of HgS. The results of both in vitro and in vivo studies showed that the formulation is less toxic. Although the test sample contains mercurials it was very effective against cancerous cells (MCF-7) and it is less toxic to normal cells (HEK 293).

FUTURE STUDIES

Further studies on effectiveness of the formulation along with inflammatory response in mice models are to be conducted.

Blood mercury, lead and cadmium levels and determinants of exposure among newcomer South and East Asian women of reproductive age living in Vancouver, Canada

BACKGROUND

Biomarkers of the reproductive and neuro-developmental toxicants mercury (Hg), lead (Pb) and cadmium (Cd) have been found at higher concentrations in women born outside Canada than in Canadian-born women. We measured blood Hg, Pb and Cd in women ages 19 to 45years living in greater Vancouver (Canada) within five years of their arrival from South Asia (India) or East Asia (mainland China, Hong Kong and Taiwan) and related their biomarker concentration levels with exposures and behaviors since their coming to Canada.

METHODS

Participants were recruited through advertisements in relevant ethnic media, locations and groups. Concentrations of blood Hg, Pb and Cd were analyzed by inductively coupled plasma-mass spectrometry (ICP-Q-MS) and compared with population values. Biomarker concentrations were regressed against exposures and behaviors assessed by culturally-relevant questionnaire.

RESULTS

The study recruited 53 South and 111 East Asian women. Median (95th percentile) blood Pb in South Asians was 1.15 (2.71) μg/dL compared with 1.01 (1.81) μg/dL in East Asians. On the other hand, blood Hg at 2.5 (7.3) μg/L was higher in East Asians compared to 0.20 (0.83) μg/L in South Asians. Blood Cd was also higher in the East Asian group: East 0.53 (1.1) μg/L; South 0.27 (0.82) μg/L. Higher blood Hg was associated with seafood consumption, dental amalgams and traditional remedies; blood Pb with home renovations, sucking on metal jewelry, and cosmetics. Blood Pb and Cd concentrations were inversely associated with dairy consumption.

CONCLUSIONS

Asian women recently arrived in Vancouver had higher blood Hg, Pb and Cd concentrations than same-age Canadian women measured in a national survey. Among South Asian newcomer women of reproductive age, exposure to Cd may continue after arrival. Local exposures to Hg occur through seafood and potentially through ingestion of imported traditional remedies.

Toxicity Potential of Nutraceuticals

By the turn of the twenty-first century, the use of nutraceuticals became increasingly popular in both humans and animals due to their easy access, cost-effectiveness, and tolerability with a wide margin of safety. While some nutraceuticals are safe, others have a toxic potential. For a large number of nutraceuticals, no toxicity/safety data are available due to a lack of pharmacological/toxicological studies. The safety of some nutraceuticals can be compromised via contamination with toxic plants, metals, mycotoxins, pesticides, fertilizers, drugs of abuse, etc. Knowledge of pharmacokinetic/toxicokinetic studies appears to play a pivotal role in safety and toxicity assessment of nutraceuticals. Interaction studies are essential to determine efficacy, safety, and toxicity when nutraceuticals and therapeutic drugs are used concomitantly. This chapter describes various aspects of nutraceuticals, particularly their toxic potential, and the factors influencing their safety.

Sources, distribution, bioavailability, toxicity, and risk assessment of heavy metal(loid)s in complementary medicines

The last few decades have seen the rise of alternative medical approaches including the use of herbal supplements, natural products, and traditional medicines, which are collectively known as 'Complementary medicines'. However, there are increasing concerns on the safety and health benefits of these medicines. One of the main hazards with the use of complementary medicines is the presence of heavy metal(loid)s such as arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg). This review deals with the characteristics of complementary medicines in terms of heavy metal(loid)s sources, distribution, bioavailability, toxicity, and human risk assessment. The heavy metal(loid)s in these medicines are derived from uptake by medicinal plants, cross-contamination during processing, and therapeutic input of metal(loid)s. This paper discusses the distribution of heavy metal(loid)s in these medicines, in terms of their nature, concentration, and speciation. The importance of determining bioavailability towards human health risk assessment was emphasized by the need to estimate daily intake of heavy metal(loid)s in complementary medicines. The review ends with selected case studies of heavy metal(loid) toxicity from complementary medicines with specific reference to As, Cd, Pb, and Hg. The future research opportunities mentioned in the conclusion of review will help researchers to explore new avenues, methodologies, and approaches to the issue of heavy metal(loid)s in complementary medicines, thereby generating new regulations and proposing fresh approach towards safe use of these medicines.

Comparative analysis of speciation and bioaccessibility of arsenic in rice grains and complementary medicines

In many countries, rice grains and complementary medicines are important sources of arsenic (As) consumption. The objective of this study was to compare the speciation and bioaccessibility of As in selected rice grains and complementary medicines. A number of rice grain samples, and a range of herbal and ayurvedic medicines were analyzed for total As, speciation of As using sequential fractionation and extended x-ray absorption fine structure (EXAFS) techniques, and bioaccessibility of As using an in vitro extraction test. The daily intake of As through the uptake of these As sources was compared with the safety guidelines for As. The results demonstrated higher levels of As in ayurvedic medicines compared to herbal medicines and rice grains. The sequential fractionation showed the dominance of organic-bound As species in rice grains and herbal medicines, however, inorganic-bound As species dominated the ayurvedic medicines. This implies that As is derived from plant uptake in herbal medicines and rice grains, and from inorganic mineral input in ayurvedic medicines. Arsenic bioaccessibility was higher in ayurvedic than herbal medicines and rice grains, suggesting that inorganic As added as a mineral therapeutic input is more bioaccessible than organic As species derived from plant uptake. This study also showed a positive relationship between soluble As fractions and bioaccessibility indicating that solubility is an important factor controlling bioaccessibility. The daily intake values for As as estimated by total As content are likely to exceed the safe threshold level in rice grains that are enriched with As.

Accumulation of Arsenic Speciation and In Vivo Toxicity Following Oral Administration of a Chinese Patent Medicine Xiao-Er-Zhi-Bao-Wan in Rats

Realgar-containing traditional Chinese medicines such as Xiao-Er-Zhi-Bao-Wan (XEZBW), have been widely used for thousands of years. However, events associated with arsenic-induced ailments have increasingly become a public concern. To address the toxicity of XEZBW, we studied the histopathology and blood biochemistry of rats exposed to XEZBW using technology like high-performance liquid chromatography-inductively coupled mass spectrometry to determine arsenic speciation. Our results demonstrated that dimethylarsinic acid (DMA) increased from 18.57 ± 7.45 to 22.74 ± 7.45 ng/g in rat kidney after oral administration for 7 and 14 days, which was 10-fold higher than the levels observed in controls. Trivalent arsenite As(III) showed a large increase on day 7 (26.99 ± 1.98 ng/g), followed by a slight decrease on day 14 (13.67 ± 6.48 ng/g). Total arsenic levels on day 7 (185.52 ± 24.56 ng/g) and day 14 (198.57 ± 26.26 ng/g) were nearly twofold higher than that in the control group (92.77 ± 14.98 ng/g). Histopathological analysis showed mild injury in the liver and kidney of rats subjected to oral administration of realgar for 14 days. As in the XEZBW groups, a mild injury in these organs was observed after administration for 14 days. This study inferred that the toxicity of arsenic was concentration- and time-dependent. The accumulation of DMA, a byproduct of choline metabolism, was responsible for inducing higher toxicity. Therefore, we concluded that measuring the levels of DMA, instead of total arsenic, might be more suitable for evaluating the toxicity of realgar-containing traditional Chinese medicines.

Structural and elemental characterization of traditional Indian Siddha formulation: Thalagak karuppu

Background

The traditional Indian medicine ‘Siddha’ uses metals, metalloids and minerals including toxic ones with no proven toxicity. Thalagak karuppu (TK) is remarkably stable over a century and used for treating Suram (Fever), Kaasam (Cough), Elai (Tuberculosis) and Eraippu Erumal (Bronchial Asthma).

Objective

The present study addresses elemental and morphological characterization of therapeutic Siddha formulation: Thalagak karuppu (TK).

Materials and methods

TK was purchased from the Indian Medical Practitioners Co-operative Pharmacy and Stores (IMCOPS) Ltd, Chennai, Tamilnadu, India. The physicochemical properties were evaluated using UV–visible spectrophotometer, Fourier Transform Infrared Spectrometer (FTIR), Scanning Electron Microscope (SEM) with Energy Dispersive X-ray analysis (EDX), Zeta sizer and X-ray diffractometer (XRD).

Results

The mixed nature of arsenic was analyzed using UV–visible spectroscopy. The fingerprint region for arsenic derivatives was inferred from IR spectroscopy and X-ray diffraction patterns. The shape and size heterogeneity in the anisotropic mixture was observed in SEM images and the polydispersity was analyzed by Zeta sizer.

Conclusions

The structural, elemental and morphological analyses suggests that the arsenic may predominantly exist either as orpiment (As₂S₂) or realgar (As₂S₄) form. The possibility is less for the toxic arsenolite. Hence, the formulation may be considered safe.

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The formulation exhibits the characteristic peak at 290 nm.

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The average grain size is found to be 30.11 nm.

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The shape and size heterogeneity was also observed in SEM images and confirmed by their polydispersity index.

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The presence of As, As₂S₃, As₂O₃ may also be responsible for the shape and size heterogeneity in the SEM images.

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These results suggest that arsenic may predominantly exist either As₂S₂ or As₂S₄, but the possibility is less for As₂O₃.

Chromium Accumulation in Medicinal Plants Growing Naturally on Tannery Contaminated and Non-contaminated Soils

Herbal preparations used to treat human ailments globally can be contaminated with various heavy metals (HMs) originating from the raw materials or from the manufacturing processes. Therefore, we assessed 22 medicinal plants growing naturally on tannery pollutant contaminated (Site-C) and non-contaminated (Site-NC) sites for their ability to accumulate chromium (Cr). The Cr contents in soil and various plant parts were estimated using an atomic absorption spectrophotometer. Translocation and bioconcentration factors were calculated. The soil at Site-C had 27-fold higher concentration of total Cr than at Site-NC. Chromium accumulation is reported for the first time in 50 % of the medicinal plants examined and varied significantly among the sites. Shoots of Ricinus communis and Amaranthus viridis had maximum concentrations of Cr at Site-C, whereas in Site-NC, none of the plants had Cr accumulation >30 ppm. Ricinus communis, Amaranthus viridis, and Amaranthus spinosus had translocation factor (TF) greater than the one in the Site-C and Lantana camara had TF >1 in Site-NC. The bioconcentration factor (BCF) was >1 only for Ricinus communis at both the sites. The majority of the medicinal plants at Site-NC had Cr content exceeding the permissible limit of 2 ppm suggested for herbal raw material. The results of the study clearly emphasize the need for screening plants of therapeutic value for the presence of HMs even when collected from non-contaminated soils. Moreover, proportional allocation of Cr in different plant parts provided an insight on the safety of these parts when specifically used in herbal preparations.

High Cadmium Levels in Cured Meat Products Marketed in Nigeria - Implications for Public Health

Heavy metals are known to disrupt important physiological processes in living cells, and have been responsible for various pathological conditions with possible contributions to cancer development. Food contamination have been identified as one of the ways humans are exposed to heavy metals. In developing countries like Nigeria, the regulatory framework for enforcing compliance with globally acceptable exposure to deleterious contaminants is poor. In the current study, thirteen samples of cured meat products of diverse origin marketed in South-west Nigeria were evaluated for lead, cadmium, chromium and nickel contents using the atomic absorption spectroscopy technique. All the samples analysed contained cadmium between 0.35 and 1.20 ppm, levels considered higher than acceptable limits in consumable products. Lead, chromium and nickel were not detected in any of the samples. As known cumulative poisons, there is the need for stringent regulatory control of these heavy metals in cured meat products imported into or produced indigenously in the country in order to minimize the risks to public health.

Speciation and bioavailability of lead in complementary medicines

Complementary medicines have associated risks which include toxic heavy metal(loid) and pesticide contamination. The objective of this study was to examine the speciation and bioavailability of lead (Pb) in selected complementary medicines. Six herbal and six ayurvedic medicines were analysed for: (i) total heavy metal(loid) contents including arsenic (As), cadmium (Cd), Pb and mercury (Hg); (ii) speciation of Pb using sequential fractionation and extended x-ray absorption fine structure (EXAFS) techniques; and (iii) bioavailability of Pb using a physiologically-based in vitro extraction test (PBET). The daily intake of Pb through the uptake of these medicines was compared with the safety guidelines for Pb. The results indicated that generally ayurvedic medicines contained higher levels of heavy metal(loid)s than herbal medicines with the amount of Pb much higher than the other metal(loid)s. Sequential fractionation indicated that while organic-bound Pb species dominated the herbal medicines, inorganic-bound Pb species dominated the ayurvedic medicines. EXAFS data indicated the presence of various Pb species in ayurvedic medicines. This implies that Pb is derived from plant uptake and inorganic mineral input in herbal and ayurvedic medicines, respectively. Bioavailability of Pb was higher in ayurvedic than herbal medicines, indicating that Pb added as a mineral therapeutic input is more bioavailable than that derived from plant uptake. There was a positive relationship between soluble Pb fraction and bioavailability indicating that solubility is an important factor controlling bioavailability. The daily intake values for Pb as estimated by total and bioavailable metal(loid) contents are likely to exceed the safe threshold level in certain ayurvedic medicines. This research demonstrated that Pb toxicity is likely to result from the regular intake of these medicines which requires further investigation.

Cinnabar induces renal inflammation and fibrogenesis in rats

The purpose of this study was to investigate whether cinnabar causes renal inflammation and fibrosis in rats. Rats were dosed orally with cinnabar (1 g/kg/day) for 8 weeks or 12 weeks. The control rats were treated with solvent (5% carboxymethylcellulose solution) over the same time periods, respectively. Renal mercury (RHg), urinary mercury (UHg), serum creatinine (SCr), urine kidney injury molecule 1 (KIM-1), renal pathology, and renal mediators were examined. At both 8 weeks and 12 weeks, RHg, UHg, and urine KIM-1 were significantly higher in the cinnabar group than in the control group, although SCr was unchanged. Kidney lesions in the cinnabar-treated rats occurred mainly in the tubules and interstitium, including vacuolization, protein casts, infiltration of inflammatory cells, and slight increase in interstitial collagen. In addition, mild mesangial proliferation was observed in glomeruli. Moreover, the expression of inflammatory and fibrogenic mediators was upregulated in the cinnabar group. In conclusion, cinnabar may cause kidney damage due to the accumulation of mercury, and renal inflammation and slight fibrogenesis may occur in rats. In the clinic, the potential risk of renal injury due to the prolonged consumption of cinnabar should be considered even though the agent is relatively nontoxic.

Health risk assessment of ambient air concentrations of benzene, toluene and xylene (BTX) in service station environments

A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted as Cumulative Probability Distributions (CPD) plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ) at 50% (CEXP50) and 95% (CEXP95) exposure levels. HQ50 and HQ95 > 1 were obtained with benzene in the scenario for service station attendants and mechanics repairing petrol dispensing pumps indicating a possible health risk. The risk was minimized for service stations using vapour recovery systems which greatly reduced the benzene exposure levels. HQ50 and HQ95 < 1 were obtained for all other scenarios with benzene suggesting minimal risk for most of the exposed population. However, HQ50 and HQ95 < 1 was also found with toluene and xylene for all scenarios, suggesting minimal health risk. The lifetime excess Cancer Risk (CR) and Overall Risk Probability for cancer on exposure to benzene was calculated for all Scenarios and this was higher amongst service station attendants than any other scenario.

Arsenic speciation in Chinese Herbal Medicines and human health implication for inorganic arsenic

Rice and drinking water are recognized as the dominant sources of arsenic (As) for human intake, while little is known about As accumulation and speciation in Chinese Herbal Medicines (CHMs), which have been available for many hundreds of years for the treatment of diseases in both eastern and western cultures. Inorganic arsenic was the predominant species in all of CHMs samples. The levels of inorganic arsenic in CHMs from fields and markets or pharmacies ranged from 63 to 550 ng/g with a mean of 208 ng/g and 94 to 8683 ng/g with a mean of 1092 ng/g, respectively. The highest concentration was found in the Chrysanthemum from pharmacies. It indicates that the risk of inorganic As in CHMs to human health is higher in medicines from markets or pharmacies than that collected directly from fields. Some CHMs may make a considerable contribution to the human intake of inorganic arsenic.

Safety evaluation of an Ayurvedic medicine, Arogyavardhini vati on brain, liver and kidney in rats

ETHNOPHARMACOLOGICAL RELEVANCE

Arogyavardhini vati, an Ayurvedic polyherbal formulation has been used for liver and skin disorders in the Ayurvedic system of medicine. However, toxicity due to the presence of heavy metals in this traditional medicine is a matter of concern.

AIM OF THE STUDY

To evaluate the safety of Arogyavardhini vati on brain, liver and kidney in rats.

MATERIALS AND METHODS

Arogyavardhini vati at doses of 50, 250 and 500mg/kg (1, 5 and 10 times of human equivalent dose respectively), mercury chloride (1mg/kg) and normal saline were administered orally to male Wistar rats for 28 days. Behavioral parameters were assessed on day 1, 7th, 14th and 28th using Morris water maze, passive avoidance, elevated plus maze and rota rod. Biochemical parameters (acetyl-cholinesterase activity, malondialdehyde, reduced glutathione), histopathology and mercury level in brain, liver, kidney were assessed at the end of the experiment.

RESULTS

There was no significant change in behavioral parameters, acetyl-cholinesterase activity, liver function (ALT, AST, ALP and bilirubin) and kidney (serum urea and creatinine) function tests at all doses of Arogyavardhini vati (50, 250 and 500mg/kg) as compared to normal control. However, significant change was observed in mercury chloride treated group. Mercury chloride treated group as well as Arogyavardhini vati treated groups (50, 250 and 500mg/kg) showed increased levels of mercury in brain, liver and kidney as compared to normal control. Histopathological results showed significant cytoarchitectural changes in brain, liver and kidney architecture in mercury chloride treated group. Whereas, normal cytoarchitecture was observed at all doses of Arogyavardhini vati.

CONCLUSION

The finding of the present study suggests that Arogyavardhini vati in the doses equivalent up to 10 times of the human dose administered to rats for 28 days does not have appreciable toxicological effects on brain, liver and kidney.

Toxicology evaluation of realgar-containing niu-huang-jie-du pian as compared to arsenicals in cell cultures and in mice

Niu-Huang-Jie-Du Pian (NHJD) is a widely used traditional Chinese medicine containing realgar (As₄S₄). Realgar has been included in many traditional medicines, but is often taken as arsenite for risk assessment. To evaluate true risk of realgar and realgar-containing NHJD, their toxicity was compared with common arsenicals. In cultured cells, the LC₅₀ for NHJD (1200 μM) and realgar (2000 μM) was much higher than arsenite(35 μM), arsenic trioxide (280 μM), and arsenate (400 μM). Acute toxicity in mice showed more severe liver and kidney injury after arsenite or arsenate, but was mild after realgar and NHJD, corresponding to cellular and tissue arsenic accumulation. The expressions of arsenic-sensitive stress gene metallothionein-1 were increased 3–7-folds after arsenite or arsenate, but were unaltered after NHJD and realgar. Thus, realgar and NHJD are much less toxic than arsenite and arsenate. The use of total arsenic to evaluate the safety of realgar and realgar-containing NHJD is inappropriate.

Heavy metal and pesticide content in commonly prescribed individual raw Chinese Herbal Medicines

Heavy metal and pesticide contamination has previously been reported in Chinese Herbal Medicines (CHMs), in some cases at potentially toxic levels. This study was conducted to determine general patterns and toxicological significance of heavy metal and pesticide contamination in a broad sample of raw CHMs. Three-hundred-thirty-four samples representing 126 species of CHMs were collected throughout China and examined for arsenic, cadmium, chromium, lead, and mercury. Of the total, 294 samples representing 112 species were also tested for 162 pesticides. At least 1 metal was detected in all 334 samples (100%) and 115 samples (34%) had detectable levels of all metals. Forty-two different pesticides were detected in 108 samples (36.7%), with 1 to 9 pesticides per sample. Contaminant levels were compared to toxicological reference values in the context of different exposure scenarios. According to a likely scenario of CHM consumption, only 3 samples (1%) with heavy metals and 14 samples (5%) with pesticides were found with concentrations that could contribute to elevated background levels of contaminant exposure. According to the most conservative scenario of CHM consumption, 231 samples (69%) with heavy metals and 81 samples (28%) with pesticides had contaminants that could contribute to elevated levels of exposure. Wild collected plants had higher contaminant levels than cultivated samples. Cadmium, chromium, lead, and chlorpyrifos contamination showed weak correlations with geographic location. Based on our assumptions of the likely mode of consumption of raw CHMs, the vast majority (95%) of the 334 samples in this study contained levels of heavy metals or pesticides that would be of negligible concern. However, given the number of samples with detectable contaminants and the range between the more likely and more conservative scenarios of contaminant exposure, more research and monitoring of heavy metals (especially cadmium and chromium) and pesticide residues (especially chlorpyrifos) in raw CHMs are advised.

Analytical methods for heavy metals in herbal medicines

INTRODUCTION

It is estimated that about 70-80% of the world's population relies on non-conventional medicine, mainly of herbal origin. However, owing to the nature and sources of herbal medicines, they are sometimes contaminated with toxic heavy metals such as lead, arsenic, mercury and cadmium, which impose serious health risks to consumers. It is critical to analyse source materials for heavy metals in order to ensure that their concentrations meet the related standards or regulations limiting their concentrations in herbal medicines. In this review, different analytical methods for analysis of heavy metals in herbal medicines are discussed.

OBJECTIVE

To provide a comprehensive review of the current state of the art in analytical methods used to detect heavy metals in herbal medicines.

METHODOLOGY

We systematically searched and reviewed the research articles regarding analytical methods for heavy metals in herbal medicine from various databases, such as Medline/PubMed, ScienceDirect, SciFinder, Google Scholar, EBSCO, Gale InfoTrac, Ingenta, Ovid, ProQuest and ISI Web of Knowledge.

RESULTS

In this review, we discuss in detail several commonly used and sensitive analytical techniques, including atomic absorption spectrometry, inductively coupled plasma optical emission spectrometry or mass spectrometry, X-ray fluorescence spectrometry, high-performance liquid chromatography, differential pulse polarography, neutron activation analysis and anodic stripping voltammetry. We also provide some application examples of these analytical techniques for heavy metals in herbal medicines.

Chemical form of metals in traditional medicines underlines potential toxicity in cell cultures

ETHNOPHARMACOLOGICAL RELEVANCE

Mercury (Hg) and arsenic (As) are frequently found in traditional medicines as sulfides, such as cinnabar (HgS) and realgar (As(4)S(4)). There is a general perception that any medicinal use of such metal-containing remedies is unacceptable. An opposing opinion is that different chemical forms of arsenic and mercury have different toxic potentials.

AIM OF THE STUDY

To clarify this question, cinnabar, realgar, and cinnabar- and realgar-containing traditional medicine An-Gong-Niu-HuangWan (AGNH), were compared to well-known mercurials (HgS, HgCl(2) and MeHg) and arsenicals (As(2)S(2), As(2)O(3), NaAsO(2), and Na(2)HAsO(4)) for their cytotoxicity in human and rodent cell lines.

MATERIALS AND METHOD

Cultured cells derived from target organs such as brain (HAPI) and liver (Hep3B, HepG2 and TRL1215) were treated with chemicals for 48 h and cytotoxicity was determined by the MTS assay.

RESULTS

MeHg was most toxic with LC(50) of 4-20μM, followed by NaAsO(2) (LC(50), 25-250 μM) and HgCl(2) (LC(50,) 50-100 μM), Na(2)HAsO(4)(LC(50), 60-400μM), As(2)O(3)(LC(50), 30-900 μM), and As(2)S(2) (LC(50), 100-500 μM). In comparison, the LC(50) of realgar ranged from 250 to1500 μM; whereas cinnabar or HgS were approximately 20,000 μM and the toxicity of AGNH was in the range of 1500-8000 μM. Approximately 5000-fold differences exist between MeHg and HgS, and over 10-fold differences exist between NaAsO(2) and As(4)S(4).

CONCLUSIONS

Chemical forms of metals are important factor in determining their toxicity in traditional medicines, both cinnabar and realgar are much less toxic than well-known mercurial and arsenicals.

Realgar, cinnabar and An-Gong-Niu-Huang Wan are much less chronically nephrotoxic than common arsenicals and mercurials

Realgar (As(4)S(4)) and cinnabar (HgS) are frequently included in traditional Chinese medicines and Indian Ayurvedic medicines. Both As and Hg are well known for toxic effects, and their safety is of concern. The aim of this study was to compare chronic nephrotoxicity of An-Gong-Niu-Huang Wan (AGNH), realgar and cinnabar with common arsenicals and mercurials. Mice were orally administrated with AGNH (3 g/kg, 6-fold of clinical dose), cinnabar (0.3 g/kg, amount in AGNH) and realgar (0.3 g/kg, amount in AGNH), HgCl(2) (0.118 mmol/kg, 1/10 of cinnabar), MeHg (0.012 mmol/kg, 1/100 of cinnabar), NaAsO(2) (As(3+) 0.028 mmol/kg, 1/100 of realgar) or Na(2)HAsO(4) (As(5+) 0.056 mmol/kg, 1/50 of realgar), daily for six weeks, and nephrotoxicity was examined. Animal body weights were decreased by MeHg and HgCl(2). Blood urea nitrogen and creatinine levels were elevated by MeHg. Renal pathology was severe in the MeHg and HgCl(2) groups, moderate in the arsenite, arsenate and realgar groups and mild in the cinnabar and AGNH groups. Renal Hg accumulation in the MeHg and HgCl(2) groups was 50-200 folds higher than the cinnabar group. Expressions of metallothionein-1 and heme oxygenase-1, biomarkers for metal toxicity, were increased 2-5 folds by arsenite, arsenate, MeHg and HgCl(2), but not by realgar, cinnabar and AGNH. The chemokine and glutathione-S transferase-α4, markers for inflammation, were also increased by MeHg and HgCl(2). Expressions of cell adhesion gene S100a9 and E-cadherin were altered by HgCl(2), arsenite and realgar. Taken together, chemical forms of mercury and arsenic are major determinants in their disposition and toxicity.

Realgar and realgar-containing Liu-Shen-Wan are less acutely toxic than arsenite and arsenate

ETHNOPHARMACOLOGICAL RELEVANCE

Liu-Shen-Wan (LSW) is a widely-used traditional Chinese medicine containing realgar (As(4)S(4)).

AIM OF THE STUDY

Realgar has been included in many traditional medicines, and is often taken as arsenite for risk assessment in realgar-containing traditional remedies. Is realgar toxicologically similar to arsenite?

MATERIALS AND METHOD

Mice were orally given LSW (60 and 200mg/kg; 200mg LSW contains 27 mg realgar), realgar (30 mg/kg, equivalent to 21 mg As/kg), and the equivalent As dose as sodium arsenite (NaAsO(2)), or as arsenate (Na(2)HAsO(4)). Acute toxicity and tissue As accumulation were determined 8h later.

RESULTS

Arsenite and arsenate increased serum alanine aminotransferase (ALT) levels, indicative of liver injury; blood urea nitrogen (BUN) was also increased by arsenite and arsenate, indicative of nephrotoxicity. No elevations of ALT and BUN were observed in LSW and realgar groups. Histopathology showed more damage in arsenite- and arsenate-treated liver and kidneys, while in realgar- and LSW- treated animals, only mild alterations were seen. Hepatic and renal As contents were dramatically increased to 6200 and 3350ng/g, respectively, after arsenite, but only increased to 260 and 180 ng/g after LSW. The expressions of arsenic-sensitive stress genes, namely metallothionein-1 and heme oxygenase-1, were increased after arsenite or arsenate by 3-10-folds, but were unaltered after LWS and realgar.

CONCLUSIONS

Realgar and LSW are much less toxic than arsenite and arenate. The use of total As content to evaluate the safety of realgar-containing traditional medicines is not scientifically sound.

A case-control study of multiple system atrophy in Korean patients

A few case-control studies of multiple system atrophy (MSA) have been reported in Western populations. In this study, we included various epidemiological factors to evaluate whether the risk factors for MSA differed in Korean and Western populations. A total of 100 consecutive MSA patients and 104 controls at two referral hospitals participated. Information was obtained through face-to-face interviews using a structured questionnaire: history of living area, occupational history, food habits, alcohol and tobacco consumption, and use of drugs. Odds ratios and 95% confident intervals (OR [95% CI]) were computed using logistic regression. The multivariate logistic regression analysis revealed that use of antihypertensive medication (OR = 0.30 [0.12-0.78]) and vitamins (OR = 0.30 [0.14-0.64]) and consumption of meat and poultry (OR = 0.27 [0.13-0.56]) were associated with decreasing risk for MSA, whereas use of herbal medications (OR = 3.17 [1.28-7.84]) was associated with increasing risk for MSA. In univariate analysis adjusted for age, sex, education level, and recruitment center, use of aspirin (OR = 0.21 [0.07-0.61]) and coffee consumption (OR = 0.44 [0.23-0.84]) were significantly less frequent in MSA patients than in controls, whereas heavy smoking (≥40 pack-years) was significantly more prevalent in MSA patients than in controls (OR = 3.44 [1.05-11.23]). There was no difference in living area, participation in farming, or exposure to agrichemicals and solvents between groups. This study showed that MSA in Korea is characterized by risk factors that are both similar to and different from those affecting Western populations and that herbal medicines constitute a new MSA risk factor for the Korean population.

Nephrotoxicity of mercuric chloride, methylmercury and cinnabar-containing Zhu-Sha-An-Shen-Wan in rats

Cinnabar (HgS) is used in traditional medicines, and total Hg content is used for risk assessment of cinnabar-containing traditional medicines such as Zhu-Sha-An-Shen-Wan (ZSASW). Is ZSASW or cinnabar toxicologically similar to common mercurials? Adult Sprague-Dawley rats were gavaged with ZSASW (1.4 g/kg), cinnabar (0.2g/kg), HgCl(2) (0.02 g/kg), MeHg (0.001 g/kg), or saline daily for 60 days, and toxicity was determined. Animal body-weight gain was decreased by HgCl(2) and MeHg. Blood urea nitrogen (BUN) was increased by MeHg. Histology showed severe kidney injury following MeHg and HgCl(2) treatments, but mild after ZSASW and cinnabar. Renal Hg contents were markedly increased in the HgCl(2) and MeHg groups but were not elevated in the ZSASW and cinnabar groups. The expression of kidney injury molecule-1 was increased 50-fold by MeHg, 4-fold by HgCl(2), but was unaltered by ZSASW and cinnabar; the expression of matrilysin was increased 3-fold by MeHg. In contrast, the expression of N-cadherin was decreased by HgCl(2). Thus, ZSASW and cinnabar are much less nephrotoxic than HgCl(2) and MeHg, indicating that chemical forms of mercury underlie their disposition and toxicity.