背景:马兜铃菌与马兜铃酸肾病(AAN)有关,肾间质纤维化和上尿路癌(UUC)。马兜铃酸肾病已在10个国家报道,但其真实发病率尚不清楚,很可能被低估。通过结合民族植物学和植物化学方法,我们为孟加拉国发生AAN的风险提供了证据。更具体地说,我们评估了来自孟加拉国的药用马兜铃菌样品中马兜铃酸类似物的种内变异。
方法:从孟加拉国不同研究地点的16名kavirajes(传统治疗师)收集了民族植物学信息。植物样本是从本地栖息地获得的,植物园,草药市场和制药公司。使用70%甲醇提取样品,并使用LC-DAD-MS和(1)H-NMR进行分析。
结果:根和叶子通常用于治疗诸如蛇咬伤和性问题等症状。在信息提供者中,有关毒性或副作用的知识非常有限,马兜铃菌通常以非常高的剂量给药。用其他药用植物如蛇形草替代马兜铃菌(L.)第十。前库尔兹很常见。马兜铃样品中含有多种马兜铃酸类似物,如马兜铃酸I、马兜铃酸II,头孢拉迪酮A和相关化合物。
结论:AAN病例可能在孟加拉国发生,需要提高对使用马兜铃菌和其他马兜铃菌作为草药相关健康风险的认识。
BACKGROUND: Species of Aristolochia are associated with aristolochic acid nephropathy (AAN), a renal interstitial fibrosis and upper urinary tract cancer (UUC). Aristolochic acid nephropathy has been reported in ten countries but its true incidence is unknown and most likely underestimated. By combining an ethnobotanical and phytochemical approach we provide evidence for the risk of AAN occurring in Bangladesh. More specifically, we assess the intra-specific variation of aristolochic acid analogues in medicinally used Aristolochia indica samples from Bangladesh.
METHODS: Ethnobotanical information was collected from 16 kavirajes (traditional healers) in different
study locations in Bangladesh. Plant samples were obtained from native habitats, botanical gardens, herbal markets and pharmaceutical companies. The samples were extracted using 70% methanol and were analysed using LC-DAD-MS and (1)H-NMR.
RESULTS: Roots as well as leaves are commonly used for symptoms such as snake bites and sexual problems. Among the informants knowledge about toxicity or side effects is very limited and Aristolochia indica is often administered in very high doses. Replacement of Aristolochia indica with other medicinal plants such as Rauvolfia serpentina (L.) Benth. ex Kurz was common. Aristolochia indica samples contained a variety of aristolochic acid analogues such as aristolochic acid I, aristolochic acid II, cepharadione A and related compounds.
CONCLUSIONS: AAN cases are likely to occur in Bangladesh and more awareness needs to be raised about the health risks associated with the use of Aristolochia indica and other species of Aristolochia as herbal medicines.