Thearticle I will be critiquing is called Aristolochicacids and their derivatives are widely implicated in liver cancers in Taiwanand throughout Asia.
The article had many contributions from a variety ofdifferent authors and has an impact factor of 37.205 in 2016. This articlelooks to find evidence on whether or not the exposure of Aristolochic acids(AA) would decrease, following the ban in Taiwan for herbal remedies containingthe AA signature. Although the evidence of a decrease in the AA signature wasnot the result.
Turns out that the exposure to AA had stayed about the same.Why would this be? Well the authors to the article had a few ideas for this.One reason being the fact that many of these AA containing herbal remedies werecontinued to be used by many even following the ban.
There were also reportsthat Chinese medical practitioners continued to prescribe their patients withsome of these AA containing herbal remedies during the first year the ban tookplace. It is apparent that plants containing high dosages of AA are widelyavailable for purchase online and often are mislabeled. But Aristolochic acidsaren’t the only concern.
There is also aristolactams. There isn’t to muchresearch on them but are thought to be mutagenic metabolites of AA and interactwith DNA directly. Thereis also evidence that supports the theory that the signatures being observed iscaused by AA, or possibly even with the help of other related/unrelatedcompounds. Studies conducted on animals have shown evidence that AA adductsalong with AA mutagenesis occur within the liver.
The exposure of AA in Taiwanwas more prevalent compared to other areas. Aristocholoic acids were also foundin certain groups of Asian countries. This goes to show the prevalence of AAand how they are spread throughout different areas of the world. The authorencourages opportunities for primary and secondary prevention when it comes toregulating such AA containing plants. Although China and Taiwan only choose toregulate specific plants containing AA. It is also interesting to note that thesale of AA containing plants is not prohibited within the United States eventhough evidence shows that it is dangerous. Although the herbs must becorrectly labeled and not detailing any health benefits from ingesting such asubstance.
Whatdoes this mean? AA containing plants can easily be bought online and accessed anumerous of other ways. The author hopes to discourage the use of these AAcontaining plants by providing evidence of its harmfulness. Also, that labelingof these herbs tend to get pretty difficult for supplier to know exactly whichmultiherb substances contain AA. The author offers a suggestion for morethorough measures be taken to identifying herbal products in an attempt forprimary prevention. The author also offers a suggestion for secondaryprevention, for those who have already resulted in exposure to AA, this wouldbe in the form of advanced screenings that would be able to detect AA-associated cancers.Overall, I would say thatthe article has succeeded in providing public awareness on the seriousness ofAristocholoic acids and how dangerous they can be. The authors writing stylewas clear and concise, while also be easy to follow.
I like the authors ideas whenit comes to primary and secondary prevention. The regulation of AA containingplants is lacking in many countries, including our own. Meaning that untilthere is some type of regulations put in place for these AA containing plants,one can only spread the word until there is something done about it. Based onthe evidence provided within this study, I’m curious to why these plants havenot been banned completely in all areas of the world.
Out of everything I readwithin the article I was in particularly intrigued on the lack of a decrease inexposure of the AA signature following the ban in Taiwan back in 2003. It seemsto me that many people continued to use these AA contain herbs even followingthe ban. I am curious to why somebody would continue to use something that wasgoing to cause you cancer. But access to such plants are still widely available.Perhaps the lack of regulation is the reason to blame for the continued use ofsuch plants. It seems to me that they understand the potential dangers thatcome along with the plants, but the countries refuse to completely do away withthem. It may be more time consuming to try to regulate these types of herbswhen it comes to mixed varieties, but it is essential to prevent exposure tosuch plants. I believe that this article is important for providing evidence tosupport the connection between the AA signature mutation found with some herbsand liver cancer.
I enjoyed reading this article and thought that it providedvaluable information on the prevalence along with the dangers of AA relatedherbs.