Aristolochic acids in herbal medicine: Public health concerns for consumption and poor regulation of botanical products in Nigeria and West Africa

Abstract

Aristolochic acids are naturally occurring biomolecules found in plants of the genus Aristolochia and Asarum belonging to the family Aristolochiaceae. They are reported to be carcinogenic and nephrotoxic; and are implicated in kidney diseases, aristolochic acid nephropathy (AAN) which may result in kidney failure, other health complications and possibly death. Aristolochic acids are highly genotoxic and are linked to upper urothelial cancer in animals and humans. Some Aristolochia species are used in traditional medicine practice in Nigeria and other West African countries without regard to safety concerns. Several countries, especially in the Western world, have banned the use and importation of herbal products containing aristolochic acids. There is need for warning and strict regulation on the importation and consumption of aristolochic acids-containing botanical products in Nigeria. This study aims to review the availability of aristolochic acids, their toxicity, circulation, as well as the quantitative analytical techniques and regulations. It analyzes the herbal products containing aristolochic acids, and aristolochaceae plants grown in Nigeria in respect to public health implications. It highlights the importance of doing an extensive study on indigenous plants producing aristolochic acids and imported herbal products used as weight loss supplements marketed in Nigeria. There is need to emphasize the labeling of herbal products containing aristolochic acids.

Effects of ethanolic extract of <i>Aristolochia repens</i> on biochemical and histological changes in high-fat diet and streptozotocin-induced rats

“…Based on phytochemical study, the primary bioactive ingredients in this plant are various forms of aristolochic acid. These include aristolochic acid I, aristolochic acid II, and aristolochic acid IV (Okhale et al, 2019). Although this plant has been reported to be used in the treatment of a number of illnesses, little is known about its hypoglycaemic properties or its ability to modulate certain biochemical changes associated with diabetes mellitus.…”

Determination of Aristolochic Acid Using Isocratic RP-HPLC Method

“…In France, four cases have been documented and were linked to the use of slimming tablets. S. tetrandra was listed on the label, but it included A. fangchi [17] . Furthermore, there were two cases reported in the United Kingdom due to the consumption of herbal products containing Mu Tong for treating eczema.…”

“…There was a case reported in Germany about the use of Chinese herbal medicine for hyperuricemia, and one case was reported in Australia involving the treatment of psoriasis using Chinese herbal medicine [16] . One case was reported in Spain due to the consumption of herbal tea consisting of Aristolochia pistolochia and one in the USA due to the consumption of herbal medicine for low back pain [17] .…”