Bi publisher pdf template repeating group11/20/2022 ![]() ![]() In 1992, a high prevalence of kidney disease accompanied by urothelial carcinoma in female patients ingesting slimming pills raised worldwide attention to the high nephrotoxic and carcinogenic potential of AAs. More strict precautions should be taken to protect the public from AA exposure.Īristolochic acids (AAs) are identified as a group of toxins that can cause end-stage renal failure associated with urothelial carcinoma. ![]() Therefore, the use of AA-containing herbal remedies and the consumption of food contaminated by AAs still carry high risk. However, AA-related adverse events still occur, especially in the Asian and Balkan regions. ![]() Because of several warnings on the toxic effects of AAs by the US Food and Drug Administration and the regulatory authorities of some other countries, the sale and use of AA-containing products have been banned or restricted in most countries. The progressive lesions and mutational events initiated by AAs are irreversible, and no effective therapeutic regimen for AAN and AA-induced UTUC has been established until now. ![]() In addition, various enzymes and organic anion transporters are involved in AA-induced adverse reactions. AA-derived DNA adducts are recognized as specific biomarkers of AA exposure, and a mutational signature predominantly characterized by A→T transversions has been detected in AA-induced UTUC tumor tissues. The underlying mechanisms of AAN and AA-induced UTUC have been extensively investigated. Since the 1990s, AA-induced nephropathy (AAN) and upper tract urothelial carcinoma (UTUC) have been reported in many countries.
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