A Case of Bowen’s Disease and Small-Cell Lung Carcinoma: Long-Term Consequences of Chronic Arsenic Exposure in Chinese Traditional Medicine

Lee, Linda; Bebb, Gwyn

doi:10.1289/ehp.7200

Cited by 22 publications

(17 citation statements)

References 40 publications

(43 reference statements)

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“…Therefore, it is not uncommon to find excessive quantities of toxic elements in such formulations (53,70,(73)(74)(75). Moreover, lead, thallium, mercury, arsenic, gold, copper, and cadmium poisoning from consumption of these products have been reported on a number of occasions (72,(76)(77)(78)(79)(80).…”

Section: Toxic Elementsmentioning

confidence: 99%

Contaminants of Medicinal Herbs and Herbal Products

Kosalec

Cvek

Tomić

2009

Archives of Industrial Hygiene and Toxicology

155

123

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Medicinal plants have a long history of use in therapy throughout the world and still make an important part of traditional medicine. Thus, medicinal plants and herbal products must be safe for the patient (consumer). This review addresses biological contaminants (microbes and other organisms) and chemical contaminants (mycotoxins, toxic elements such as heavy metals, and pesticide residues) as major common contaminants of medicinal herbs and herbal products. To prevent and screen for contamination and ensure safety and conformity to quality standards, medicinal herbs and herbal products should be included in appropriate regulatory framework.

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Section: Toxic Elementsmentioning

confidence: 99%

Contaminants of Medicinal Herbs and Herbal Products

Kosalec

Cvek

Tomić

2009

Archives of Industrial Hygiene and Toxicology

155

123

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“…Arsenic-induced cancers of other internal organs are reported to associate with As-BD lesions [10,11,76]. Individuals with documented As-BD are considered for more aggressive screening for long-term complications, especially the development of malignancies in the lung and urinary bladder [77][78][79][80]. It was indicated that As-BD started within 10 years, invasive skin cancer after 20-30 years [81], and pulmonary cancer after 30 years following the suspected arsenic exposure [76].…”

Section: Arsenic and Skin Cancermentioning

confidence: 99%

Arsenic Carcinogenesis in the Skin

2006

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SummaryChronic arsenic poisoning is a world public health issue. Long-term exposure to inorganic arsenic (As) from drinking water has been documented to induce cancers in lung, urinary bladder, kidney, liver and skin in a dose-response relationship. Oxidative stress, chromosomal abnormality and altered growth factors are possible modes of action in arsenic carcinogenesis. Arsenic tends to accumulate in the skin. Skin hyperpigmentation and hyperkeratosis have long been known to be the hallmark signs of chronic As exposure. There are significant associations between these dermatological lesions and risk of skin cancer. The most common arsenic-induced skin cancers are Bowen's disease (carcinoma in situ), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Arsenic-induced Bowen's disease (As-BD) is able to transform into invasive BCC and SCC. Individuals with As-BD are considered for more aggressive cancer screening in the lung and urinary bladder. As-BD provides an excellent model for studying the early stages of chemical carcinogenesis in human beings. Arsenic exposure is associated with G2/M cell cycle arrest and DNA aneuploidy in both cultured keratinocytes and As-BD lesions. These cellular abnormalities relate to the p53 dysfunction induced by arsenic. The characteristic clinical figures of arsenic-induced skin cancer are: (i) occurrence on sun-protected areas of the body; (ii) multiple and recrudescent lesions. Both As and UVB are able to induce skin cancer. Arsenic treatment enhances the cytotoxicity, mutagenicity and clastogenicity of UV in mammalian cells. Both As and UVB induce apoptosis in keratinocytes by caspase-9 and caspase-8 signaling, respectively. Combined UVB and As treatments resulted in the antiproliferative and proapoptotic effects by stimulating both caspase pathways in the keratinocytes. UVB irradiation inhibited mutant p53 and ki-67 expression, as well as increased in the number of apoptotic cells in As-BD lesions which resulted in an inhibitory effect on proliferation. As-UVB interaction provides a reasonable explanation for the rare occurrences of arsenical cancer in the sun-exposed skin. The multiple and recurrent skin lesions are associated with cellular immune dysfunction in chronic arsenism. A decrease in peripheral CD4+ cells was noticed in the inhabitants of arsenic exposure areas. There was a decrease in the number of Langerhans cells in As-BD lesion which results in an impaired immune function on the lesional sites. Since CD4+ cells are the target cell affected by As, the interaction between CD4+ cells and epidermal keratinocytes under As affection might be closely linked to the pathogenesis of multiple occurrence of arsenic-induced skin cancer. In this

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“…In the US, TCM herbal preparations or supplements are considered a form of CAM or even at times a nutritional supplement, but are for the most part unregulated by the Food and Drug Administration (FDA). Such ambiguity and paucity in the regulation of TCMs evokes ruminations of the hazards and ill effects of ingesting unknown and unregulated substances [63].…”

Section: Future Directionsmentioning

confidence: 99%

Novel Considerations about Diabetes Management Strategies in Chinese Immigrants in America: Possible Corollaries of the Use of Traditional Chinese Medicines

et al. 2017

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Worldwide, the prevalence of type 2 diabetes mellitus (T2DM) and its related management costs have increased over time. The latest predictions anticipate this trend to continue during the next few decades. As individuals with T2DM in the United States (US) are burdened with escalating prescription drug expenses, the appeal and use of cost effective alternatives may also increase. Herbal supplements are an example of such an alternative, but are unregulated and mostly lacking scientific evidence of advertised claims. In general, plant based herbal preparations are often advertised as ‘natural’, ‘less-toxic’, ‘medicines’ and are widely available from public retailers throughout the country. Over half of the US adult population report the use of supplements. Eastern countries, and especially China, have a long history of the use of herbal preparations as traditional medicine to prevent and treat diabetes. Recently the US has experienced a growth in the number imports of herbal supplements and other Traditional Chinese Medicines (TCM) to the country as well as the most rapid population growth in individuals who identify themselves as Asian. To date, little is known about the prevalence TCM use in the management of T2DM either alone or in combination with prescription medicines in the US. Knowledge of possible implications to patient safety (e.g., interactions, adverse effects) with concurrent use of both TCM and prescription medicines is also lacking. This review begins with summaries of the T2DM management strategies employed in traditional modern medicine (TMM) and Chinese medicine (TCM). A review of literature follows where the most commonly used TCM herbal preparations and their ingredients are identified and found along with any published reports of their proposed mechanisms of action, efficacy, adverse effects, and contraindications. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. Type: Review

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A Case of Bowen’s Disease and Small-Cell Lung Carcinoma: Long-Term Consequences of Chronic Arsenic Exposure in Chinese Traditional Medicine

Cited by 22 publications

References 40 publications

Contaminants of Medicinal Herbs and Herbal Products

Contaminants of Medicinal Herbs and Herbal Products

Arsenic Carcinogenesis in the Skin

Novel Considerations about Diabetes Management Strategies in Chinese Immigrants in America: Possible Corollaries of the Use of Traditional Chinese Medicines

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