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Liu Liang - One of the best experts on this subject based on the ideXlab platform.

  • fatal renal failure due to the chinese herb guanmu tong Aristolochia Manshuriensis autopsy findings and review of literature
    Forensic Science International, 2010
    Co-Authors: Zhu Shaohua, Sunnassee Ananda, Yuan Ruxia, Ren Liang, Chen Xiaorui, Liu Liang
    Abstract:

    Abstract Herbal remedies have been used since ancient times and it is now known that they are not completely free of adverse effects. We present the case of a 41-year-old Chinese man, who died in renal failure because he consumed a herbal preparation called “Fen Qing Wu Lin Wan”, having GuanMu Tong as main ingredient, for about 1 month. GuanMu Tong is derived from the plant Aristolochia Manshuriensis which contains aristolochic acid. Aristolochic acid is being reported as the causative agent of what is now called aristolochic acid nephropathy (AAN) which includes Chinese herb nephropathy (CHN) and Balkan endemic nephropathy (BEN), all having renal impairment as hallmark for the disease. The gross autopsy showed multiple punctate hemorrhages over the limbs, pleural effusion, and edematous lungs with consolidation, mild myocardial hypertrophy and normal-looking kidneys. Microscopic renal tissue examination showed severe degeneration, necrosis and desquamation of renal tubular epithelial cells, presence of protein cast and a widened, edematous interstitium with interstitial fibrosis. We also provide the clinical presentation of the deceased as reported in the medical records and briefly review the literature pertinent to similar cases.

Jian-guo Jiang - One of the best experts on this subject based on the ideXlab platform.

  • Renal toxic ingredients and their toxicology from traditional Chinese medicine
    Expert opinion on drug metabolism & toxicology, 2016
    Co-Authors: Lin-jiang Yang, Jian-guo Jiang
    Abstract:

    ABSTRACTIntroduction: There have been increasing concerns regarding adverse reactions and toxicity incidents caused by traditional Chinese medicines (TCMs), among which the nephrotoxicity is particularly worrying.Areas covered: This review summarizes the ingredients with renal toxicity from some TCMs through searching the relevant literature published over the past two decades. Renal toxicity components from TCMs include aristolochic acids (AAS), alkaloids, anthraquinones and others. TCM renal toxicity is most commonly caused by AAS and some alkaloids. AAS mainly come from Aristolochia contorta Bunge, Aristolochia Manshuriensis Kom, Clematis Chinensis Osbeck, Aristolochia cathcartii Hook. Some renal toxic alkaloids are derived from Tripterygium regelii Sprague et Takeda, Stephania tetrandra S. Moore, Strychnos nux-vomica Linn. and Aconitum carmichaeli Debx. A few kinds of anthraquinones, flavonoids, and glycosides from TCMs also cause renal toxicity. All of these renal toxicity components and their associ...

Quanxi Mei - One of the best experts on this subject based on the ideXlab platform.

  • studies on the toxicity of Aristolochia Manshuriensis guanmuton
    Toxicology, 2004
    Co-Authors: Hongqi Zhang, Kelvin Chan, Quanxi Mei
    Abstract:

    Abstract Aims: (1) To study the acute and chronic toxicity of stem of Aristolochia Manshuriensis (AMA Guanmuton) which is a Chinese medicinal herb in order to provide basis for safe clinical use. (2) To investigate the possibility of reducing toxicity of the herb combined with Rhizoma Coptidis (Huanglian). Methods: The 70% ethanol extract of the herb was fed to mice via gastric tube for 8 weeks. The blood was collected to assess liver and renal functions. The tissue samples of the liver, kidney and bladder were collected from executed animals for pathology examination. Results: The LD50 with a 95% average trustable probability (P=0.95) of AMA from Hanzhong (HZ) is 29.2±3.71 g/kg. The weight of animals in the treatment group at a dose of 4 g/kg raw drug, equivalent to 40 times of normal human dose in clinical prescription, remained the same as the control group (P>0.05). On pathological examination, there were no morphological changes under light microscope in the liver and bladder. For the kidney, the renal toxicity was significantly reduced after using ethanol extract of R. coptidis to process HZ AMA in that there were no interstitial inflammation, formation of hyaline cast or regeneration of renal tubules.

  • Studies on the toxicity of Aristolochia Manshuriensis (Guanmuton).
    Toxicology, 2004
    Co-Authors: Hongqi Zhang, Kelvin Chan, Quanxi Mei
    Abstract:

    (1) To study the acute and chronic toxicity of stem of Aristolochia Manshuriensis (AMA Guanmuton) which is a Chinese medicinal herb in order to provide basis for safe clinical use. (2) To investigate the possibility of reducing toxicity of the herb combined with Rhizoma Coptidis (Huanglian). The 70% ethanol extract of the herb was fed to mice via gastric tube for 8 weeks. The blood was collected to assess liver and renal functions. The tissue samples of the liver, kidney and bladder were collected from executed animals for pathology examination. The LD50 with a 95% average trustable probability (P=0.95) of AMA from Hanzhong (HZ) is 29.2+/-3.71 g/kg. The weight of animals in the treatment group at a dose of 4 g/kg raw drug, equivalent to 40 times of normal human dose in clinical prescription, remained the same as the control group (P>0.05). On pathological examination, there were no morphological changes under light microscope in the liver and bladder. For the kidney, the renal toxicity was significantly reduced after using ethanol extract of R. coptidis to process HZ AMA in that there were no interstitial inflammation, formation of hyaline cast or regeneration of renal tubules.

Lin-jiang Yang - One of the best experts on this subject based on the ideXlab platform.

  • Renal toxic ingredients and their toxicology from traditional Chinese medicine
    Expert opinion on drug metabolism & toxicology, 2016
    Co-Authors: Lin-jiang Yang, Jian-guo Jiang
    Abstract:

    ABSTRACTIntroduction: There have been increasing concerns regarding adverse reactions and toxicity incidents caused by traditional Chinese medicines (TCMs), among which the nephrotoxicity is particularly worrying.Areas covered: This review summarizes the ingredients with renal toxicity from some TCMs through searching the relevant literature published over the past two decades. Renal toxicity components from TCMs include aristolochic acids (AAS), alkaloids, anthraquinones and others. TCM renal toxicity is most commonly caused by AAS and some alkaloids. AAS mainly come from Aristolochia contorta Bunge, Aristolochia Manshuriensis Kom, Clematis Chinensis Osbeck, Aristolochia cathcartii Hook. Some renal toxic alkaloids are derived from Tripterygium regelii Sprague et Takeda, Stephania tetrandra S. Moore, Strychnos nux-vomica Linn. and Aconitum carmichaeli Debx. A few kinds of anthraquinones, flavonoids, and glycosides from TCMs also cause renal toxicity. All of these renal toxicity components and their associ...

Yunhai Zhang - One of the best experts on this subject based on the ideXlab platform.

  • Comparative 28-day repeated oral toxicity of Longdan Xieganwan, Akebia trifoliate (Thunb.) koidz., Akebia quinata (Thunb.) Decne. and Caulis Aristolochiae Manshuriensis in mice.
    Journal of ethnopharmacology, 2008
    Co-Authors: Xiang Xue, Ying Xiao, Likun Gong, Shuhong Guan, Yongzhen Liu, Yunhai Zhang
    Abstract:

    Abstract Ethnopharmacological relevance Longdan Xieganwan, which contains Aristolochia species, is a traditional Chinese prescription. It has been used for thousands of years to “enhance liver”. However, many cases of Longdan Xieganwan induced nephropathy were reported recently. Aim of the study This study was designed to compare the possible toxic effects of Longdan Xieganwan and three different Aristolochia species, i.e. Akebia trifoliate (Thunb.) koid (Akebia trifoliate), Akebia quinata (Thunb.) Decne. (Akebia quinata) and Caulis Aristolochiae Manshuriensis (Aristolochia Manshuriensis). Materials and methods Mice were orally administered these drugs for 28 days. Clinical signs, body weights, serum biochemistry, organ weights and histopathology were examined. Results Significantly decreased body weights and obvious nephropathy were noticed in the Aristolochia Manshuriensis groups at doses higher than 0.24 g/kg/d. A few endothelial cell degenerations in renal glomerulus were observed in the Akebia trifoliate group at a high-dose of 2.00 g/kg/d. No significant changes were observed in the other groups. Conclusions The no-observed-adverse-effect levels (NOAELs) for Aristolochia Manshuriensis, Akebia trifoliate, Akebia quinata and Longdan Xieganwan in this study for mice were 0.06 g/kg/d, 0.40 g/kg/d, higher than 3.00 g/kg/d and higher than 10.00 g/kg/d, which were equivalent to 0.25 times, 5 times, 25 times and 10 times of normal human dose in clinical prescription, respectively.