Research Progress in and Countermeasures against Carcinogenicity of Aristolochic Acids and Their Derivatives

It has been widely accepted that aristolochic acids (AA) induces nephrotoxicity and urinary system tumors. During 2003-2004, the former State Food and Drug Administration also proposed medical alert for traditional Chinese medicinal materials and Chinese patent medicines that contain AA and developed risk prevention and control measures. On October 18, 2017, Science Translational Medicine published an online article titled "Aristolochic acids and their derivatives are widely implicated in liver cancers in Taiwan and throughout Asia", which found through gene sequencing that there were some characteristic mutation sites and sequences of AA and their derivatives in the gene spectrums of liver cancer patients in Asia. Accordingly, the conclusion that AA and their derivatives were widely implicated in the occurrence of liver cancer in Asia had been firstly proposed. Domestic and foreign media scrambled to reprint it and published a series of reports on the safety and regulatory issues of Chinese medicine, which became the focus of public opinion at home and abroad at that time and posed a new challenge for risk prevention and control of AA safety. In order to have scientific understanding of the carcinogenicity of AA and their derivatives, the domestic and foreign research progress in the carcinogenicity of AA and their derivatives as well as the core views and existing problems of the article published in Science Translational Medicine were summarized and countermeasures were proposed in this paper.