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Balkan Endemic Nephropathy and the Causative Role of Aristolochic Acid

B. Jelaković, Ž. Dika, VM. Arlt, M. Stiborova, NM. Pavlović, J. Nikolić, JM. Colet, JL. Vanherweghem, JL. Nortier,

. 2019 ; 39 (3) : 284-296. [pub] -

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, práce podpořená grantem, přehledy

Perzistentní odkaz   https://www.medvik.cz/link/bmc20022769

Grantová podpora
101126/Z/13/Z Wellcome Trust - United Kingdom
101126/B/13/Z Wellcome Trust - United Kingdom

Balkan endemic nephropathy is a chronic tubulointerstitial disease with insidious onset, slowly progressing to end-stage renal disease and frequently associated with urothelial carcinoma of the upper urinary tract (UTUC). It was described in South-East Europe at the Balkan peninsula in rural areas around tributaries of the Danube River. After decades of intensive investigation, the causative factor was identified as the environmental phytotoxin aristolochic acid (AA) contained in Aristolochia clematitis, a common plant growing in wheat fields that was ingested through home-baked bread. AA initially was involved in the outbreak of cases of rapidly progressive renal fibrosis reported in Belgium after intake of root extracts of Aristolochia fangchi imported from China. A high prevalence of UTUC was found in these patients. The common molecular link between Balkan and Belgian nephropathy cases was the detection of aristolactam-DNA adducts in renal tissue and UTUC. These adducts are not only biomarkers of prior exposure to AA, but they also trigger urothelial malignancy by inducing specific mutations (A:T to T:A transversion) in critical genes of carcinogenesis, including the tumor-suppressor TP53. Such mutational signatures are found in other cases worldwide, particularly in Taiwan, highlighting the general public health issue of AA exposure by traditional phytotherapies.

Citace poskytuje Crossref.org

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$a Dika, Živka $u School of Medicine, University of Zagreb, Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.
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$a Arlt, Volker M $u Department of Analytical, Environmental and Forensic Sciences, Medical Research Council-Public Health England Centre for Environment and Health, King's College London, London, United Kingdom; National Institute for Health Research Unit, Health Impact of Environmental Hazards, King's College London, in partnership with Public Health England and Imperial College London, London, United Kingdom.
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$a Stiborova, Marie $u Department of Biochemistry, Faculty of Science, Charles University, Prague 2, Czech Republic.
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