Scientists unravel cancers linked to herbal remedies containing Aristolochic Acid, a natural compound found in Aristolochia plants

Main Category: Cancer / Oncology
Also Included In: Complementary Medicine / Alternative Medicine;  Liver Disease / Hepatitis
Article Date: 14 Aug 2013 - 0:00 PDT Current ratings for:
Scientists unravel cancers linked to herbal remedies containing Aristolochic Acid, a natural compound found in Aristolochia plants

A team of scientists from the National Cancer Centre Singapore, Duke-NUS Graduate Medical School Singapore, and Taiwan's Chang Gung Memorial Hospital, LinKou, have made a breakthrough in understanding the cancer-promoting action of Aristolochic Acid (AA), a natural product of Aristolochia plants traditionally used in some Asian herbal remedies for weight loss and slimming. Using advanced DNA sequencing technologies, the team, led by Professors Teh Bin Tean, See-Tong Pang, Patrick Tan and Steve Rozen discovered that AA is the most potent carcinogen identified to date, causing more DNA mutations than cigarette smoke or ultraviolent light. The team also discovered that besides its previously known contribution to kidney failure and a form of kidney cancer, AA may also contribute to liver cancer. The team identified a "genetic fingerprint" of AA exposure that may pave the way to new approaches to detect AA presence in humans and the environment. The group is also affiliated with the Cancer Science Institute in Singapore, and the Genome Institute of Singapore.

AA is a natural compound found in Aristolochia plants commonly used in traditional herbal preparations for various health problems such as weight-loss, menstrual symptoms and rheumatism. It was officially banned in Europe and North America since 2001 and in Asia since 2003. However, its long-term impact is still being felt as patients with associated kidney failure and cancer are still being diagnosed, especially in Taiwan. In addition, certain AA-containing products are still permitted under supervision and products containing AA are still easily available worldwide, including over the internet.

The potent cancer-promoting activity of AA strongly warrants efforts to restrict the use of AA containing products, including health supplements. "We would like to call for greater public awareness on the adverse health effects of AA. It is therefore important to know the contents of herbal products before one consumes them." said Prof Pang. Reassuringly, in Singapore there is no cause for worry as under the Poisons Act since 1 January 2004, products and herbs sold and supplied in Singapore are not allowed to contain AA and the toxic constituents of Aristolochia herbs.

The Singapore-Taiwan study also reports that carcinogens can leave tell-tale "genetic fingerprints" of their exposure in the DNA of cancer cells, and provides a valuable demonstration of how such fingerprints can be used to identify other cancers not previously associated with that carcinogen. Dr Poon Song Ling, the lead author of the study, said: "AA's contributions to kidney failure and cancer have been documented, but AA's possible role in other cancer types was unknown. In this study, we found that the AA-related DNA fingerprint could be used to screen for the potential involvement of AA in other cancers, such as liver cancer." Such findings could lead to a new wave of DNA-based detection systems for monitoring carcinogen exposures in humans and the environment.

This breakthrough came after 1.5 years of intensive research and was recently published online in Science Translational Medicine, a publication that focuses on practical medical advances that result from all stages of translational medicine.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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The research was supported by grants from the Singapore National Medical Research Council, the Singapore Millennium Foundation, the Lee Foundation, the National Cancer Centre Research Fund, The Verdant Foundation, the Duke-NUS Graduate Medical School Singapore, the Cancer Science Institute of Singapore, the Chang Gung Memorial Hospital, LinKou, the Taiwan National Science Council, and the Wellcome Trust.

Mutational Signature of Aristolochic Acid Exposure as Revealed by Whole-Exome Sequencing

Margaret L. Hoang, Chung-Hsin Chen, Viktoriya S. Sidorenko, Jian He, Kathleen G. Dickman, Byeong Hwa Yun, Masaaki Moriya, Noushin Niknafs, Christopher Douville, Rachel Karchin, Robert J. Turesky, Yeong-Shiau Pu, Bert Vogelstein, Nickolas Papadopoulos, Arthur P. Grollman, Kenneth W. Kinzler, and Thomas A. Rosenquist. Sci Transl Med 7 August 2013 5:197ra102. DOI:10.1126/scitranslmed.3006200

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Potential risks of cold and hay fever remedies in early pregnancy

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Main Category: Pregnancy / Obstetrics
Also Included In: Pharma Industry / Biotech Industry
Article Date: 24 Jul 2013 - 8:00 PDT Current ratings for:
Potential risks of cold and hay fever remedies in early pregnancy

A new worry for pregnant women to add to their list may be the use of decongestants, after the publication of new research in the American Journal of Epidemiology. Researchers have found possible links between using over-the-counter decongestants during the first trimester and birth defects in the digestive tract, ear and heart - albeit these are rare defects.

The research team, led by Dr. Allen Mitchell, used data spanning 17 years from the Slone Epidemiology Center Birth Defects Study at Boston University. Analyzing 12,734 malformed infants and 7,606 nonmalformed control infants, the team embarked upon the first study to investigate risks of intranasal decongestants during pregnancy.

By interviewing mothers of babies with and without birth defects, nurses recorded answers about first-trimester decongestant use, which Mitchell and his team analyzed.

The authors note that decongestants, particularly pseudoephedrine, are the most commonly used over-the-counter (OTC) medications during pregnancy. Though they found some risks involved with taking decongestants while pregnant, they suggest that their findings should be kept in perspective:

"As one example, the baseline prevalence of endocardial cushion defect is about 0.34 per 1,000 live births; thus, even if phenylephrine exposure increased the risk eight-fold, the absolute risk of having an affected child still would be small (about 2.7 per 1,000 births; i.e., 0.27%)."

The researchers found the following relative increases in small absolute risks:

Use of phenylephrine (in Sudafed) is linked to an eight-fold increase in risk for endocardial cushion defect (heart)Use of phenylpropanolamine (in Acutrim) is likewise linked to an eight-fold increase in risk for defects of the ear and stomachUse of Pseudoephedrine (in Sudafed) is linked to a 3-fold increase in risk for limb reduction defectsUse of imidazolines (in nasal sprays and eye drops) is linked to a 2-fold increase in risk for abnormal connections between the trachea and esophagus.

The researchers did not find a link between the medications and other deformities that previous studies have suggested, such as clubfoot or eye and face defects.

Since many of these decongestants are available as OTC drugs, Dr. Mitchell warns that pregnant woman may assume they are safe to use. He told Reuters:

"The fact that medications such as decongestants are typically and widely available for use without a prescription and do not require consultation with a healthcare provider should not be assumed to mean they are safe with respect to the fetus, since there are still relatively few studies that examine the risks and relative safety of these 'over-the-counter' medications, which are more widely used in pregnancy than prescription medications."

Dr. Mitchell's study paper calls for his findings to be kept in perspective, however - and calls for more research. "Given the widespread use of decongestants by pregnant women," the study concludes, "there is continuing need to obtain further data on the risks and relative safety of specific decongestants in relation to the wide range of specific birth defects."

Written by Marie Ellis

Copyright: Medical News Today
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“Use of Decongestants During Pregnancy and the Risk of Birth Defects,” Wai-Ping Yau, Allen A. Mitchell, et al., American Journal of Epidemiology, doi: 10.1093/aje/kws427, published online 3 July 2013. Abstract

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