These types of news are common in the media and mislead the public that Ayurveda is bad for the country. Most of the herbs that contain aristolochic acid (AA) are Chinese herbs and only one Ayurvedic drug contains AA. However drugs can be adulterated with AA containing herbs. Unless authenticated and proved, these types of researches by UK journals are nothing but a direct attack on Ayurveda.
Aristolochic acid (AA) nephropathy is an interstitial nephritis first described in 1991. A high incidence of cellular atypia and transitional cell cancer of the renal pelvis, ureter, and bladder is associated with this disease.
AA in combination with the vasoconstrictive appetite suppressants, fenfluramine and diethylpropion, diuretics, and other potential nephrotoxins may underlie AA nephropathy. Stimulation of the intrarenal renin-angiotensin system likely contributes to the lesion.
Risk factors include women, toxin dose and a genetically determined predisposition. Patients present with kidney insufficiency and normal or only mildly elevated blood pressure.
In the disease, urinary protein excretion is moderately increased and the sediment reveals only a few red and white cells. Corticosteroids may slow the rate of loss of renal function. Renal transplantation is an effective modality.
It is not clear if AA has been part of the herbal preparations used by all patients in most studies. AA (0.15 mg/tablet) has been used as an immunomodulatory drug for 20 years inGermanyby thousands of patients, sometimes in doses comparable to that found in AA-containing slimming regimens; despite this exposure, there is no report relating chronic tubulointerstitial nephritis to AA in Germany.
Fast-developing chronic tubulointerstitial renal disease is caused by combined exposure to both a potent nephrotoxic substance, AA, and to renal vasoconstrictors, fenfluramine/diethylpropion.
Chinese herbs with AA: Aristolochia species of the family Aristolochiaceae are often found in traditional Chinese medicines, e.g. Aristolochia debilis, A. contorta, A. manshuriensis, and A. fangchi. The medicinal parts of each plant (stem, root, fruit) have distinct Chinese names like fangchi (Root) Guang Fang Ji; Aristolochia manshuriensis (Stem) Guan Mu Tong; Aristolochia contorta (Fruit) Ma Dou Ling; Aristolochia debilis (Fruit) Ma Dou Ling; Aristolochia contorta (Herb) Tian Xian Teng; Aristolochia debilis (Herb) Tian Xian Teng and Aristolochia debilis (Root) Qing Mu Xiang.
In Ayurveda, the herb is ARISTOLOCHIA BRACTEOLATA from family ARISTOLOCHIACEAE, SANSKRIT name Keetmari, Dhumrapatra, Kitamari, Visanika and HINDI names: Kiramar, Kitamar, Aulosa, Hukka-bel, Kalipaad.
In April 2001, the FDA identified botanicals known of suspected to contain aristolochic acid, and others as potentially adulterated with species containing aristolochic acid. This potential adulteration can occur when an aristolochic acid containing herb is mistakenly identified as an herb that does not contain aristolochic acid.
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