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Das S, Thakur S, Korenjak M, Sidorenko VS, Chung FFL, Zavadil J. Aristolochic acid-associated cancers: a public health risk in need of global action. Nat Rev Cancer 2022; 22:576-591. [PMID: 35854147 DOI: 10.1038/s41568-022-00494-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/09/2022]
Abstract
Aristolochic acids (AAs) are a group of naturally occurring compounds present in many plant species of the Aristolochiaceae family. Exposure to AA is a significant risk factor for severe nephropathy, and urological and hepatobiliary cancers (among others) that are often recurrent and characterized by the prominent mutational fingerprint of AA. However, herbal medicinal products that contain AA continue to be manufactured and marketed worldwide with inadequate regulation, and possible environmental exposure routes receive little attention. As the trade of food and dietary supplements becomes increasingly globalized, we propose that further inaction on curtailing AA exposure will have far-reaching negative effects on the disease trends of AA-associated cancers. Our Review aims to systematically present the historical and current evidence for the mutagenicity and carcinogenicity of AA, and the effect of removing sources of AA exposure on cancer incidence trends. We discuss the persisting challenges of assessing the scale of AA-related carcinogenicity, and the obstacles that must be overcome in curbing AA exposure and preventing associated cancers. Overall, this Review aims to strengthen the case for the implementation of prevention measures against AA's multifaceted, detrimental and potentially fully preventable effects on human cancer development.
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Affiliation(s)
- Samrat Das
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer WHO, Lyon, France
| | - Shefali Thakur
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer WHO, Lyon, France
- BIOCEV, First Faculty of Medicine, Charles University, Vestec, Czech Republic
- Faculty of Science, Charles University, Prague, Czech Republic
| | - Michael Korenjak
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer WHO, Lyon, France
| | - Viktoriya S Sidorenko
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, NY, USA
| | - Felicia Fei-Lei Chung
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer WHO, Lyon, France.
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Petaling Jaya, Malaysia.
| | - Jiri Zavadil
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer WHO, Lyon, France.
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2
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Lukinich-Gruia AT, Nortier J, Pavlović NM, Milovanović D, Popović M, Drăghia LP, Păunescu V, Tatu CA. Aristolochic acid I as an emerging biogenic contaminant involved in chronic kidney diseases: A comprehensive review on exposure pathways, environmental health issues and future challenges. CHEMOSPHERE 2022; 297:134111. [PMID: 35231474 DOI: 10.1016/j.chemosphere.2022.134111] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/13/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Described in the 1950s, Balkan Endemic Nephropathy (BEN) has been recognized as a chronic kidney disease (CKD) with clinical peculiarities and multiple etiological factors. Environmental contaminants - aromatic compounds, mycotoxins and phytotoxins like aristolochic acids (AAs) - polluting food and drinking water sources, were incriminated in BEN, due to their nephrotoxic and carcinogenic properties. The implication of AAs in BEN etiology is currently a highly debated topic due to the fact that they are found within the Aristolochiaceae plants family, used around the globe as traditional medicine and they were also incriminated in Aristolochic Acid Nephropathy (AAN). Exposure pathways have been investigated, but it is unclear to what extent AAs are acting alone or in synergy with other cofactors (environmental, genetics) in triggering kidney damage. Experimental studies strengthen the hypothesis that AAI, the most studied compound in the AAs class, is a significant environmental contaminant and a most important causative factor of BEN. The aim of this review is to compile information about the natural exposure pathways to AAI, via traditional medicinal plants, soil, crop plants, water, food, air. Data that either supports or contradicts the AAI theory concerning BEN etiology was consolidated and available solutions to reduce human exposure were discussed. Because AAI is a phytotoxin with physicochemical properties that allow its transportation in environmental matrices from different types of areas (endemic, nonendemic), and induce CKDs (BEN, AAN) and urinary cancers through bioaccumulation, this review aims to shed a new light on this compound as a biogenic emerging pollutant.
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Affiliation(s)
- Alexandra T Lukinich-Gruia
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania.
| | - Joëlle Nortier
- Nephrology Department, Brugmann Hospital & Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Belgium.
| | - Nikola M Pavlović
- Kidneya Therapeutics, Klare Cetkin 11, 11070, Belgrade, Serbia; University of Niš, Univerzitetski Trg 2, 18106, Niš, Serbia.
| | | | - Miloš Popović
- Department for Biology and Ecology, Faculty of Natural Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia.
| | - Lavinia Paula Drăghia
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania.
| | - Virgil Păunescu
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania; Department of Immunology, University of Medicine and Pharmacy "Victor Babes", Eftimie Murgu Sq. 2, Timisoara, 300041, Romania.
| | - Călin A Tatu
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania; Department of Immunology, University of Medicine and Pharmacy "Victor Babes", Eftimie Murgu Sq. 2, Timisoara, 300041, Romania.
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Thangavelu M, Ismail A, Zakaria A, Elmansy H, Shahrour W, Prowse O, Kotb A. Aristolochic acid: What urologists should know. Arch Ital Urol Androl 2022; 94:123-125. [PMID: 35352538 DOI: 10.4081/aiua.2022.1.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/19/2022] [Indexed: 11/22/2022] Open
Abstract
To the Editor, Aristolochic acid is one of major causes for upper tract urothelial carcinoma, especially in younger population. While it is mentioned as a cause in guidelines, little is actually known about the toxin by urologists. We are aiming in our letter to provide some direct and clear information to ourselves that would help us to know more about that toxin and how it can adversely affect our patients [...].
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Affiliation(s)
| | - Asmaa Ismail
- Northern Ontario School of Medicine, Thunder Bay, Ontario.
| | - Ahmed Zakaria
- Northern Ontario School of Medicine, Thunder Bay, Ontario.
| | - Hazem Elmansy
- Northern Ontario School of Medicine, Thunder Bay, Ontario.
| | - Walid Shahrour
- Northern Ontario School of Medicine, Thunder Bay, Ontario.
| | - Owen Prowse
- Northern Ontario School of Medicine, Thunder Bay, Ontario.
| | - Ahmed Kotb
- Northern Ontario School of Medicine, Thunder Bay, Ontario.
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Qu M, Xu H, Chen J, Xu B, Li Z, Ma B, Guo L, Ye Q, Xie J. Differential comparison of genotoxic effects of aristolochic acid I and II in human cells by the mass spectroscopic quantification of γ-H2AX. Toxicol In Vitro 2022; 81:105349. [DOI: 10.1016/j.tiv.2022.105349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/17/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
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Drăghia LP, Lukinich-Gruia AT, Oprean C, Pavlović NM, Păunescu V, Tatu CA. Aristolochic acid I: an investigation into the role of food crops contamination, as a potential natural exposure pathway. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:4163-4178. [PMID: 33796971 DOI: 10.1007/s10653-021-00903-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
Aristolochic acid I (AAI) is a potent nephrotoxic and carcinogenic compound produced by plants of the Aristolochiaceae family and thoroughly investigated as a main culprit in the etiology of Balkan endemic nephropathy (BEN). So far, the AAI exposure was demonstrated to occur through the consumption of Aristolochia clematitis plants as traditional remedies, and through the contamination of the surrounding environment in endemic areas: soil, food and water contamination. Our study investigated for the first time the level of AAI contamination in 141 soil and vegetable samples from two cultivated gardens in non-endemic areas, A. clematitis being present in only one of the gardens. We developed and validated a simple and sensitive ultra-high-performance liquid chromatography-ion trap mass spectrometry method for qualitative and quantitative AAI analysis. The results confirmed the presence of AAI at nanogram levels in soil and vegetable samples collected from the non-endemic garden, where A. clematitis grows. These findings provide additional evidence that the presence of A. clematitis can cause food crops and soil contamination and unveil the pathway through which AAI could move from A. clematitis to other plant species via a common matrix: the soil. Another issue regarding the presence of AAI, in a non-endemic BEN area from Romania, could underlie a more widespread environmental exposure to AAI and explain certain BEN-like cases in areas where BEN has not been initially described.
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Affiliation(s)
- Lavinia Paula Drăghia
- Department of Functional Sciences, University of Medicine and Pharmacy 'Victor Babes', Eftimie Murgu Sq. 2, 300041, Timisoara, Romania.
- Department of Chemistry and Toxicology, OncoGen Centre, County Hospital 'Pius Branzeu', Blvd. Liviu Rebreanu 156, 300736, Timisoara, Romania.
| | - Alexandra Teodora Lukinich-Gruia
- Department of Chemistry and Toxicology, OncoGen Centre, County Hospital 'Pius Branzeu', Blvd. Liviu Rebreanu 156, 300736, Timisoara, Romania.
| | - Camelia Oprean
- Department of Chemistry and Toxicology, OncoGen Centre, County Hospital 'Pius Branzeu', Blvd. Liviu Rebreanu 156, 300736, Timisoara, Romania
- Department of Environmental and Food Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy 'Victor Babes', Eftimie Murgu Sq. 2, 300041, Timisoara, Romania
| | | | - Virgil Păunescu
- Department of Functional Sciences, University of Medicine and Pharmacy 'Victor Babes', Eftimie Murgu Sq. 2, 300041, Timisoara, Romania
- Department of Chemistry and Toxicology, OncoGen Centre, County Hospital 'Pius Branzeu', Blvd. Liviu Rebreanu 156, 300736, Timisoara, Romania
| | - Călin Adrian Tatu
- Department of Functional Sciences, University of Medicine and Pharmacy 'Victor Babes', Eftimie Murgu Sq. 2, 300041, Timisoara, Romania
- Department of Chemistry and Toxicology, OncoGen Centre, County Hospital 'Pius Branzeu', Blvd. Liviu Rebreanu 156, 300736, Timisoara, Romania
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Chen J, Kong A, Shelton D, Dong H, Li J, Zhao F, Bai C, Huang K, Mo W, Chen S, Xu H, Tanguay RL, Dong Q. Early life stage transient aristolochic acid exposure induces behavioral hyperactivity but not nephrotoxicity in larval zebrafish. AQUATIC TOXICOLOGY (AMSTERDAM, NETHERLANDS) 2021; 238:105916. [PMID: 34303159 PMCID: PMC8881052 DOI: 10.1016/j.aquatox.2021.105916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 05/12/2023]
Abstract
Aristolochic acids (AA) are nitrophenanthrene carboxylic acids found in plants of the Aristolochiaceae family. Humans are exposed to AA by deliberately taking herbal medicines or unintentionally as a result of environmental contamination. AA is notorious for its nephrotoxicity, however, fewer studies explore potential neurotoxicity associated with AA exposure. The developing nervous system is vulnerable to xenobiotics, and pregnant women exposed to AA may put their fetuses at risk. In the present study, we used the embryonic zebrafish model to evaluate the developmental neurotoxicity associated with AA exposure. At non-teratogenic concentrations (≤ 4 µM), continuous AA exposure from 8 to 120 hours post fertilization (hpf) resulted in larval hyperactivity that was characterized by increased moving distance, elevated activity and faster swimming speeds in several behavioral assays. Further analysis revealed that 8-24 hpf is the most sensitive exposure window for AA-induced hyperactivity. AA exposures specifically increased motor neuron proliferation, increased apoptosis in the eye, and resulted in cellular oxidative stress. In addition, AA exposures increased larval eye size and perturbed the expression of vision genes. Our study, for the first time, demonstrates that AA is neurotoxic to the developmental zebrafish with a sensitive window distinct from its well-documented nephrotoxicity.
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Affiliation(s)
- Jiangfei Chen
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325035, PR China; Institute of Environmental Safety and Human Health, Wenzhou Medical University, Wenzhou 325035, PR China..
| | - Aijun Kong
- Institute of Environmental Safety and Human Health, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Delia Shelton
- Sinnhuber Aquatic Research Laboratory, Department of Environmental & Molecular Toxicology, Oregon State University, Corvallis, OR 97333, United States
| | - Haojia Dong
- Institute of Environmental Safety and Human Health, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Jiani Li
- Institute of Environmental Safety and Human Health, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Fan Zhao
- Institute of Environmental Safety and Human Health, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Chenglian Bai
- Institute of Environmental Safety and Human Health, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Kaiyu Huang
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Wen Mo
- Zhejiang rehabilitation medical center, Hangzhou 310051, PR China
| | - Shan Chen
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Hui Xu
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325035, PR China
| | - Robyn L Tanguay
- Sinnhuber Aquatic Research Laboratory, Department of Environmental & Molecular Toxicology, Oregon State University, Corvallis, OR 97333, United States
| | - Qiaoxiang Dong
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325035, PR China; Institute of Environmental Safety and Human Health, Wenzhou Medical University, Wenzhou 325035, PR China..
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Chan W, Ham YH. Probing the Hidden Role of Mitochondrial DNA Damage and Dysfunction in the Etiology of Aristolochic Acid Nephropathy. Chem Res Toxicol 2021; 34:1903-1909. [PMID: 34255491 DOI: 10.1021/acs.chemrestox.1c00175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Aristolochic acid nephropathy (AAN) is a unique type of progressive renal interstitial fibrotic disease caused by prolonged exposure to aristolochic acids (AAs) through AA-containing herbal medicines or AA-tainted food. Despite decades of research and affecting millions of people around the world, the pathophysiology of AAN remains incompletely understood. In this study, we tested the potential causative role of mitochondrial dysfunction in AAN development. Our findings revealed AA exposure induces an exposure concentration and duration dependent lowering of adenosine triphosphate in both cultured human kidney and liver cells, highlighting an AA exposure effect on mitochondrial energy production in the kidney and liver, which both are highly metabolically active and energy-demanding organs. Analysis with liquid chromatography-tandem mass spectrometry coupled with stable isotope dilution method detected high levels of mutagenic 8-oxo-2'-deoxyguanosine and 7-(deoxyadenosine-N6-yl)-aristolactam adduct on mitochondrial DNA isolated from AA-treated cells, unmasking a potentially important causative, but previously unknown role of mitochondrial DNA mutation in the pathophysiology of AAN development.
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Affiliation(s)
- Wan Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Yat-Hing Ham
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
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Aristolochic acid IVa forms DNA adducts in vitro but is non-genotoxic in vivo. Arch Toxicol 2021; 95:2839-2850. [PMID: 34223934 DOI: 10.1007/s00204-021-03077-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/06/2021] [Indexed: 10/20/2022]
Abstract
Aristolochic acids (AAs) are a family of natural compounds with AA I and AA II being known carcinogens, whose bioactivation causes DNA adducts formation. However, other congeners have rarely been investigated. This study aimed to investigate genotoxicity of AA IVa, which differs from AA I by a hydroxyl group, abundant in Aristolochiaceae plants. AA IVa reacted with 2'-deoxyadenosine (dA) and 2'-deoxyguanosine (dG) to form three dA and five dG adducts as identified by high-resolution mass spectrometry, among which two dA and three dG adducts were detected in reactions of AA IVa with calf thymus DNA (CT DNA). However, no DNA adducts were detected in the kidney, liver, and forestomach of orally dosed mice at 40 mg/kg/day for 2 days, and bone marrow micronucleus assay also yielded negative results. Pharmacokinetic analyses of metabolites in plasma indicated that AA IVa was mainly O-demethylated to produce a metabolite with two hydroxyl groups, probably facilitating its excretion. Meanwhile, no reduced metabolites were detected. The competitive reaction of AA I and AA IVa with CT DNA, with adducts levels varying with pH of reaction revealed that AA IVa was significantly less reactive than AA I, probably by hydroxyl deprotonation of AA IVa, which was explained by theoretical calculations for reaction barriers, energy levels of the molecular orbits, and charges at the reaction sites. In brief, although it could form DNA adducts in vitro, AA IVa was non-genotoxic in vivo, which was attributed to its low reactivity and biotransformation into an easily excreted metabolite rather than bioactivation.
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Kang YC, Chen MH, Lin CY, Lin CY, Chen YT. Aristolochic acid-associated urinary tract cancers: an updated meta-analysis of risk and oncologic outcomes after surgery and systematic review of molecular alterations observed in human studies. Ther Adv Drug Saf 2021; 12:2042098621997727. [PMID: 33815744 PMCID: PMC7989132 DOI: 10.1177/2042098621997727] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/03/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The risk of primary aristolochic acid (AA)-associated urothelial carcinoma (AA-UC) has been summarized by a 2013-published meta-analysis. Given that additional evidence has been continuously reported by original studies, an updated meta-analysis is needed. Meanwhile, to complete the whole picture, a systematic review of molecular alterations observed in AA-urinary tract cancers (AA-UTC) was also performed. METHODS We searched PubMed, Embase and four Chinese databases up to October 2020. Observational studies comparing risk or oncologic outcomes of UTC between patients with and without AA exposure were eligible for systematic review and meta-analysis. Studies investigating molecular alterations in AA-UTC using human tissue samples were eligible for systematic review. RESULTS In total, 38 and 20 studies were included in the systematic review and meta-analysis, respectively. Exposure to AA led to an overall increased risks of primary UTC [UC and renal cell carcinoma (RCC)] (OR 6.085, 95% CI 3.045-12.160) and postoperatively recurrent UC (RR 1.831, 95% CI 1.528-2.194). Subgroup analysis of postoperative primary AA-upper tract UC (AA-UTUC) showed increased risks of bladder recurrence (adjusted RR 1.949, 95% CI 1.462-2.597) and contralateral UTUC recurrence (crude RR 3.760, 95% CI 2.225-6.353), worse overall survival (adjusted HR 2.025, 95% CI 1.432-2.865) and worse disease-specific survival (adjusted HR 3.061, 95% CI 1.190-7.872), but no effect on cancer-specific survival (adjusted HR 0.772, 95% CI 0.269-2.215). High mutation load with AA mutational signature presenting largely in the putative driver genes was observed in AA-UTUC. In contrast, AA mutational signature is rarely found in the mutated RCC driver genes and the mutation load in AA-RCC is low. Therefore, AA has different roles in the genesis of UTUC and RCC. CONCLUSIONS Implementing effective strategies to completely protect people from exposure to AA is urgently needed. Additionally, more effort should be made in identifying the precise carcinogenic mechanisms of AA to determine the future treatment strategies. PLAIN LANGUAGE SUMMARY Risk, recurrence and survival outcomes after surgery and molecular changes possibly involved in the genesis of aristolochic acid-associated urinary tract cancers Background: The association between aristolochic acid (AA) and primary urothelial carcinoma (UC) has been summarized by a 2013-published meta-analysis. Given that additional evidence has been reported in the past 7 years, an updated meta-analysis is needed. Meanwhile, to complete the whole picture, a systematic review of molecular changes possibly involved in AA-mediated urinary tract carcinogenesis was also performed. Methods: We searched PubMed, Embase and four Chinese databases for human studies up to October 2020. Studies comparing the risk of urinary tract cancer (UTC) between patients with and without AA exposure and studies investigating the molecular changes in AA-associated UTC (AA-UTC) using human tissue samples were eligible for inclusion. Thirty-eight studies were finally included. Results: The results showed that exposure to AA was associated with a 6-fold increased risk of primary UTC (UC and renal cell carcinoma, RCC) and a 1.8-fold increased risk of postoperatively recurrent UC. After studies reporting primary AA-upper tract UC (AA-UTUC) were analyzed, a 1.9-fold increased risk of bladder recurrence and a 3.8-fold increased risk of contralateral UTUC recurrence was observed. Additionally, exposure to AA worsened the postoperative survival of patients with UTUC by a 2-fold increased risk of overall death and a 3-fold increased risk of death from other diseases and recurrences. However, there was no effect on death due to cancer. Lastly, AA seemed to play different roles in the etiology of UTUC and RCC based on the observations of different mutation loads and different distributions of AA-induced mutations in AA-UTUC and AA-RCC samples. Conclusions: Implementing effective strategies to completely protect people from exposure to AA is urgently needed. Moreover, more effort should be made in identifying the precise carcinogenic mechanisms of AA-UTC to determine the future treatment strategies.
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Affiliation(s)
- Yu-Chan Kang
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung
| | - Ming-Hong Chen
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Chih-Yun Lin
- Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung
| | - Yen-Ta Chen
- Division of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, No.123, Ta-Pei Road, Niao-Sung District, Kaohsiung City 83301
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Solid-Phase Extraction of Aristolochic Acid I from Natural Plant Using Dual Ionic Liquid-Immobilized ZIF-67 as Sorbent. SEPARATIONS 2021. [DOI: 10.3390/separations8020022] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
(1) Background: ZIF-67 is one of the most intriguing metal–organic frameworks already applied in liquid adsorption. To increase its adsorption performance, dual ionic liquids were immobilized on ZIF-67 in this research; (2) Methods: The obtained sorbent was used to adsorb aristolochic acid I (AAI) in standard solutions. Then, the sorbent was applied in solid-phase extraction to remove AAI from Fibraurea Recisa Pierre extracted solution. (3) Results: By analyzing the adsorption models, the highest adsorption capacity of immobilized sorbent (50.9 mg/g) was obtained at 25 °C within 120 min. In the SPE process, 0.02 mg of AAI was removed per gram of herbal plant, the adequate recoveries were in the range of 96.2–100.0%, and RSDs were 3.5–4.0%; (4) Conclusions: The provided experimental data revealed that ZIF-67@EIM-MIM was an excellent potential sorbent to adsorb and remove AAI from herbal plant extract, and the successful separation indicated that this sorbent could be an ideal material for the pretreatment of herbal plants containing AAI.
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Chan CK, Chan KKJ, Liu N, Chan W. Quantitation of Protein Adducts of Aristolochic Acid I by Liquid Chromatography-Tandem Mass Spectrometry: A Novel Method for Biomonitoring Aristolochic Acid Exposure. Chem Res Toxicol 2021; 34:144-153. [PMID: 33410325 DOI: 10.1021/acs.chemrestox.0c00454] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Emerging evidence suggests that chronic exposure to aristolochic acids (AAs) is one of the etiological pathways leading to chronic kidney disease (CKD). Due to the traditional practice of herbal medicine and AA-containing plants being used extensively as medicinal herbs, over 100 million East Asians are estimated to be at risk of AA poisoning. Given that the chronic nephrotoxicity of AAs only manifests itself after decades of exposure, early diagnosis of AA exposure could allow for timely intervention and disease risk reduction. However, an early detection method is not yet available, and diagnosis can only be established at the end stage of CKD. The goal of this study was to develop a highly sensitive and selective method to quantitate protein adducts of aristolochic acid I (AAI) as a biomarker of AA exposure. The method entails the release of protein-bound aristolactam I (ALI) by heat-assisted alkaline hydrolysis, extraction of ALI, addition of internal standard, and quantitation by liquid chromatography-tandem mass spectrometric analysis. Accuracy and precision of the method were critically evaluated using a synthetic ALI-containing glutathione adduct. The validated method was subsequently used to detect dose-dependent formation of ALI-protein adducts in human serum albumin exposed to AAI and in proteins isolated from the tissues and sera of AAI-exposed rats. Our time-dependent study showed that ALI-protein adducts remained detectable in rats even at 28 days postdosing. It is anticipated that the developed method will fill the technical gap in diagnosing AA intoxication and facilitate the biomonitoring of human exposures to AAs.
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Affiliation(s)
- Chi-Kong Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Kwan-Kit Jason Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Ning Liu
- Central Laboratory, The Second Hospital of Jilin University, Key Laboratory of Zoonosis Research, Ministry of Education, Jilin University, Changchun, China
| | - Wan Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
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Chan CK, Pan G, Chan W. Analysis of aristolochic acids in Houttuynia cordata by liquid chromatography-tandem mass spectrometry. JOURNAL OF MASS SPECTROMETRY : JMS 2020; 56:e4652. [PMID: 32975339 DOI: 10.1002/jms.4652] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/09/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
Houttuynia cordata (H. cordata) is a popular vegetable in Asian countries and is also used extensively as herbal medicine in treating various diseases. H. cordata contains aristolactams, which have a similar Chinese name as aristolochic acids (AAs); hence, an emerging concern in the greater China region has arisen about the potential linkage between H. cordata and aristolochic acid nephropathy (AAN). However, only a single study has tested for the presence of AAs in H. cordata samples, and the analysis was limited by the analytical sensitivity of the method. Thus, further analysis of AAs in H. cordata using analytical method of higher sensitivity is needed to alleviate public anxiety over the use of this popular vegetable. In this study, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to analyze H. cordata samples for the natural existence of aristolochic acid I (AA-I) and aristolochic acid II (AA-II), which are the most carcinogenic and nephrotoxic compounds in the AA family. After evaluating the method performance by fortifying blank samples with three concentrations of AAs, the validated method was applied to identify AA-I and AA-II in both fresh and sun-dried H. cordata samples (n = 20) collected from different cities in China. The LC-MS/MS method achieved method detection limits (MDLs) as low as 2 ng/g of AAs in H. cordata. Analysis of the collected fresh and sun-dried H. cordata samples revealed that AA-I and AA-II either do not exist naturally in H. cordata or exist at concentrations below the MDLs. Therefore, it is not very likely that consumption of H. cordata will result in AAN because AA-I and AA-II, the nephrotoxic and carcinogenic culprits of AAN, are not produced naturally in the plant or are produced at levels that do not pose a risk of AAN.
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Affiliation(s)
- Chi-Kong Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Guanrui Pan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Wan Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
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Au CK, Zhang J, Chan CK, Li C, Liu G, Pavlović NM, Yao J, Chan W. Determination of Aristolochic Acids in Vegetables: Nephrotoxic and Carcinogenic Environmental Pollutants Contaminating a Broad Swath of the Food Supply and Driving Incidence of Balkan Endemic Nephropathy. Chem Res Toxicol 2020; 33:2446-2454. [DOI: 10.1021/acs.chemrestox.0c00229] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | - Cui Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, P.O. Box 2871, Beijing 100085, China
| | - Guorui Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, P.O. Box 2871, Beijing 100085, China
| | | | - Jing Yao
- Department of Mathematics, Southern University of Science and Technology, Shenzhen 518055, China
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Chan CK, Tung KK, Pavlović NM, Chan W. Remediation of aristolochic acid-contaminated soil by an effective advanced oxidation process. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 720:137528. [PMID: 32143041 DOI: 10.1016/j.scitotenv.2020.137528] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/19/2020] [Accepted: 02/22/2020] [Indexed: 06/10/2023]
Abstract
Aristolochic acids (AAs) are persistent soil pollutants in the agricultural fields of the Balkan Peninsula that are endemic for Aristolochia clematitis L. This class of carcinogenic and nephrotoxic phytotoxins is taken up by crops through root absorption and contaminates staple foods across the peninsula. Human exposure to AAs via dietary intake has recently been recognized as a cause of Balkan endemic nephropathy. For the sake of public health, human exposure to AAs from all sources should be minimized in a timely manner. However, currently, there is no available remediation method to remove AAs from soil. In this study, we developed the first soil remediation method for AAs using Fenton's reagent (FR), a combination of ferrous ion and hydrogen peroxide, and optimized factors, including pH, temperature, time, and dose of FR, to achieve the best degradation performance. The maximum AA degradation efficiency was found to be >97% in soil with 500 μg kg-1 of AAs. We anticipate that this developed method, mediated via Fenton reaction, will be useful to effectively eliminate AAs from the Balkan farmlands.
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Affiliation(s)
- Chi-Kong Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Ka-Ki Tung
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | | | - Wan Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong.
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Biomarkers of Environmental Toxicants: Exposure and Biological Effects. TOXICS 2020; 8:toxics8020037. [PMID: 32456001 PMCID: PMC7356252 DOI: 10.3390/toxics8020037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/22/2020] [Indexed: 12/11/2022]
Abstract
Biomarkers of environmental toxicants are measures of exposures and effects, some of which can serve to assess disease risk and interindividual susceptibilities.[...].
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Chan CK, Chan KKJ, Pavlović NM, Chan W. Liquid chromatography-tandem mass spectrometry analysis of aristolochic acids in soil samples collected from Serbia: Link to Balkan endemic nephropathy. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2020; 34 Suppl 1:e8547. [PMID: 31392776 DOI: 10.1002/rcm.8547] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/04/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
RATIONALE Over the past six decades, residents of farming villages in multiple countries of the Balkan peninsula have been suffering from a unique type of chronic renal disease, Balkan endemic nephropathy (BEN). It was speculated that environmental pollution by aristolochic acids (AAs) produced naturally by Aristolochia clematitis L., a weed that grows in the area, was causing the disease. However, the human exposure pathway to this class of phytotoxin remains obscure. Knowledge of the sink and stability of AAs in the environment would assist in the formulation of policy reducing exposure risk. METHODS Using our newly developed liquid chromatography/tandem mass spectrometry method of high sensitivity and selectivity, we analysed over 130 soil samples collected from cultivation fields in southern Serbia for the presence of AAs. The environmental stability of AAs was also investigated by incubating soil samples spiked with AAs at various temperatures. RESULTS The analysis detected AA-I in over two-fifths of the tested samples at sub-μg/kg to μg/kg levels, with higher concentrations observed in more acidic farmland soil. Furthermore, analysis of soil samples incubated at various temperatures revealed half-lives of over 2 months, indicating that AAs are relatively resistant to degradation. CONCLUSIONS Cultivation soil in southern Serbia is being extensively contaminated with AAs released from the decomposition of A. clematitis weeds. Since AAs are resistant to degradation, it is possible that AAs could have been taken up by root absorption and transported to the edible part of food crops. Prolonged exposure to AA-contaminated food grown from polluted soil could be one of the main aetiological mechanisms of BEN observed in the area.
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Affiliation(s)
- Chi-Kong Chan
- Department of Chemistry, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - K K Jason Chan
- Department of Chemistry, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | | | - Wan Chan
- Department of Chemistry, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
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Au CK, Chan CK, Tung KK, Zhang J, Chan W. Quantitation of DNA Adducts of Aristolochic Acids in Repair-Deficient Cells: A Mechanistic Study of the DNA Repair Mechanism. Chem Res Toxicol 2020; 33:1323-1327. [DOI: 10.1021/acs.chemrestox.0c00004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Chun-Kit Au
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Chi-Kong Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Ka-Ki Tung
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Jiayin Zhang
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Wan Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
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Zhang J, Chan CK, Ham YH, Chan W. Identifying Cysteine, N-Acetylcysteine, and Glutathione Conjugates as Novel Metabolites of Aristolochic Acid I: Emergence of a New Detoxification Pathway. Chem Res Toxicol 2020; 33:1374-1381. [DOI: 10.1021/acs.chemrestox.9b00488] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Jiayin Zhang
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Chi-Kong Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Yat-Hing Ham
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Wan Chan
- Department of Chemistry, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
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Tung KK, Chan CK, Zhao Y, Chan KKJ, Liu G, Pavlović NM, Chan W. Occurrence and Environmental Stability of Aristolochic Acids in Groundwater Collected from Serbia: Links to Human Exposure and Balkan Endemic Nephropathy. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:1554-1561. [PMID: 31884786 DOI: 10.1021/acs.est.9b05337] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Aristolochic acids (AAs) have been known as potent nephrotoxins since the use of AA-containing herbal medicines was linked with a series of sporadic renal fibrotic nephropathy cases, and yet an estimated 100 million people worldwide are still at risk today because of continued use of similar medicines. However, a similar nephropathic condition is endemic in the rural Balkan regions (e.g., Serbian farming villages) and AAs were again found to be the causative agents. In the case of this Balkan endemic nephropathy, AAs were found to have originated from a widespread local weed Aristolochia clematitis L. In this study, we tested the hypothesis that AAs released from decomposition of A. clematitis were also being leached into groundwater, thus polluting the drinking water of local residents. We initiated the study by developing a dispersive solid-phase extraction-based sample preparation method for water samples suspected of AA contamination. The validated method was then coupled with a liquid chromatography-tandem mass spectrometric method to measure AAs in groundwater samples collected from Serbia. Our study revealed for the first time that groundwater in Serbia is extensively contaminated with AA-I, at ng/L levels. Results also showed that AAs are long-lived water contaminants, with no observable concentration changes over a 2-month period of sample storage.
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Affiliation(s)
| | | | | | | | - Guorui Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , P.O. Box 2871, Beijing 100085 , China
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Riffault-Valois L, Wattez C, Langrand J, Boucaud-Maitre D, Gaslonde T, Colas C, Nossin E, Blateau A, Michel S, Cachet X. Health risk associated with the oral consumption of "Chiniy-tref", a traditional medicinal preparation used in Martinique (French West Indies): Qualitative and quantitative analyses of aristolochic acids contained therein. Toxicon 2019; 172:53-60. [PMID: 31704310 DOI: 10.1016/j.toxicon.2019.10.241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/10/2019] [Accepted: 10/30/2019] [Indexed: 12/15/2022]
Abstract
"Chiniy-tref" (CT) is a traditional preparation used in folk medicine in Martinique Island (French West Indies) that is nowadays mainly taken orally to prevent or act against any "manifestation of evil". CT is easily prepared at home by macerating larvae of the endemic swallowtail Battus polydamas (ssp.) cebriones (Dalman, 1823), sometimes accompanied by a leaf of its host-plant Aristolochia trilobata L., in commercial rum. We have previously reported the detection of nephrotoxic and carcinogenic aristolochic acids (AAs) I and II in CT, leading the Regional Health Agency (ARS) of Martinique to issue an alert regarding the potential risks associated with its consumption in 2015. In order to complete the toxicity risk assessment for oral consumption of CT, a full qualitative analysis of AAs and their analogues (AAAs) was performed, as well as a quantitative determination of the major AAs, namely AAs I and II. The phytochemical profiling of AAAs present in CT, that also corresponds to that of B. polydamas cebriones larvae feeding on A. trilobata, has been established for the first time by ultra-high performance liquid chromatography/electrospray ionization quadrupole time of-flight tandem mass spectrometry. AAs I and II were quantified in a small panel of tinctures by using a validated UHPLC/UV method, allowing us to estimate the probable daily intakes of these toxins by CT consumers. The results proved the existence of a real risk of renal toxicity and carcinogenicity associated with the chronic oral consumption of CT in Martinique, and more generally of similar "snake bottles" throughout the Caribbean.
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Affiliation(s)
- Ludivine Riffault-Valois
- UMR 8038 CiTCoM CNRS, Faculté de pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75006, France
| | - Camille Wattez
- UMR 8038 CiTCoM CNRS, Faculté de pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75006, France
| | - Jérôme Langrand
- Centre Antipoison de Paris, AP-HP Hôpital Lariboisière-Fernand Widal, Paris, F-75010, France
| | - Denis Boucaud-Maitre
- Dispositif de Toxicovigilance Antilles, Centre Hospitalier de la Basse-Terre, Basse-Terre, F-97100, France; Direction de la Recherche Clinique et de l'Innovation, Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, F-97110, France
| | - Thomas Gaslonde
- UMR 8038 CiTCoM CNRS, Faculté de pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75006, France
| | - Cyril Colas
- Institut de Chimie Organique et Analytique, ICOA UMR 7311 CNRS Université d'Orléans, Orléans, F-45071, France; Centre de Biophysique Moléculaire, CBM UPR 4301 CNRS, Orléans, F-45071, France
| | - Emmanuel Nossin
- Pharmacie Préchotaine, Le Prêcheur, F-97250, Martinique, France
| | - Alain Blateau
- Agence régionale de santé de Martinique, Fort de France, F-97200, Martinique, France
| | - Sylvie Michel
- UMR 8038 CiTCoM CNRS, Faculté de pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75006, France
| | - Xavier Cachet
- UMR 8038 CiTCoM CNRS, Faculté de pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, F-75006, France.
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