The wellbeing of those in Asia may be at risk due to a commonly used complementary wellness therapy. The herbal remedy has already been banned in the US and many European countries, but the plant birthwort may still be harming users in Asia.
Since an epidemic of kidney disease among Belgium women was detected in the 1990s, and herbal medicines from a weight loss clinic were found to be the culprit, scientists have monitored the remedy for other potential health risks. The kidney problems were traced back to aristolochic acid (AA), found in the group of plants called birthwort or Dutchman’s pipe. Many people used these plants to improve their wellness, in terms of asthma or arthritis treatment or as a weight loss device, but AA herbs have since been banned for medical use in many countries.
However, researchers at King’s College London now report in the Annals of Internal Medicine that millions of people are still being exposed to herbs with aristolochic acid, especially in Asia. Led by Graham Lord, the director of the National Institute for Health Research Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, the investigators found that the herbal medicines can still be purchased online, as well as being found in China and other Asian countries.
According to Lord, ‘The reason we wrote this paper is to provide a diagnostic classification for aristolochic acid nephropathy (AAN) [the type of kidney failure associated with the agent]. For countries that haven’t asked the question of whether this is present, here is diagnostic criteria. We just don’t know what the levels of exposure are throughout the world.’ Lord’s team has developed guidelines to help doctors to recognize cases of AAN, as well as treat the disease’s symptoms, after reviewing 42 case studies and one trial related to caring for the disease.
The study authors wrote, ‘We see an urgent need for research addressing many key areas, including determining the true worldwide extent of exposure; defining genetic variants that might confer increased sensitivity or resistance to the nephrotoxic effects of AA; testing the accuracy and utility of diagnostic criteria and optimum screening strategies, including the use of noninvasive biomarkers; and developing therapeutic agents that can reverse or delay progression of the disease.’