Upper urinary tract urothelial cancers: where it is A:T.

Despite a ban on the use of plants of the Aristolochia genus in herbal medicine, as they contain known carcinogens, urothelial carcinoma attributable to the use of this plant seems to be more common than previously thought.

Intoxicação espontânea por larvas de Perreyia flavipes (Pergidae) em suínos no estado de Santa Catarina / Spontaneous poisoning by larvae of Perreyia flavipes (Pergidae) in pigs in the state of Santa Catarina

Descreve-se um surto de intoxicação espontânea por Perreyia flavipes em suínos. O surto ocorreu no final de maio de 2009, na cidade de Urubici, planalto serrano do Estado de Santa Catarina, Brasil. A propriedade tinha aproximadamente 50 animais criados extensivamente e desses 10 animais adoeceram. Esses suínos apresentavam anorexia, apatia, movimento constante de cabeça e bater de orelhas, dificuldade de caminhar, cambaleio, ranger de dentes e a agitação aumentava mediante ruídos e movimentos próximos. Na necropsia as alterações observadas foram a marcada evidenciação do padrão lobular hepático e a presença de larvas de P. flavipes misturadas ao conteúdo estomacal. Microscopicamente observou-se necrose de coagulação dos hepatócitos, com distribuição centrolobular a massiva que era acompanhada de congestão e hemorragia acentuada, restando uma ou duas camadas de hepatócitos com degeneração vacuolar na região portal. Os aspectos clínicos, epidemiológicos e as lesões caracterizaram hepatite tóxica por larvas de P. flavipes em suínos.

The study reports an outbreak of spontaneous poisoning by Perreyia flavipes in pigs. The outbreak occurred at the end of May 2009, in the municipality of Urubici, plateau of Santa Catarina, Brazil. The farm had about 50 pigs reared extensively and 10 animals got sick. The clinical signs were anorexia, apathy, constant movement of the head and hitting the ears, difficulty to walk and stagger, gnashing of teeth and agitation that increased with noise and movement nearby. At necropsy, pronounced hepatic lobular pattern and P. flavipes larvae mixed with the stomach content were observed. Microscopically, hepatocellular centrilobular to diffuse coagulation necrosis with severe congestion and hemorrhage was observed, with vacuolar degeneration in one or two layers of hepatocytes in the portal zones. Clinical signs, epidemiology and lesions in the pigs were characteristic of toxic hepatitis by larvae of P. flavipes.

Endemic nephropathy: the case for chronic poisoning by aristolochia.

AIM: To explore the hypothesis that chronic dietary poisoning by aristolochic acid could account for the unique geographical distribution, specific pattern of tubulointerstitial fibrosis, occurrence of chronic renal insufficiency, and an increased risk of developing upper urothelial cancer, all of which are associated with endemic nephropathy. METHODS: This case-controlled epidemiologic study consisted of three groups of subjects residing in an endemic region of Croatia: (a) patients meeting WHO criteria for endemic nephropathy (n=28), (b) individuals who have been treated for renal insufficiency secondary to other forms of renal disease (n=30), and (c) apparently healthy residents of the endemic village (n= 30). A detailed questionnaire, designed to collect information on demographics, exposure to potentially toxic substances, diet, agricultural practices, and other factors potentially impacting endemic nephropathy was administered to the three study groups. The seeds of Aristolochia clematitis, obtained from plants growing in the endemic region, were extracted with ethanol and analyzed by high-performance liquid chromatography for their aristolochic acid content. RESULTS: The majority of subjects, including 90% of endemic nephropathy patients, recall that the plant Aristolochia clematitis (birthwort, vucja stopa in Croatian) was frequently found in local meadows and wheat fields between 20 and 30 years ago. At that time, endemic nephropathy patients encountered Aristolochia clematitis significantly more frequently than controls (P=0.035). Since then, all three study groups reported a significant increase in the use of herbicides (P<0.001) and reduction in the prevalence of Aristolochia clematitis (P<0.001). Chemical analysis established that the seeds of A. clematitis contain 0.65% aristolochic acid. It is likely that the harvesting process used by local farmers permitted the seeds of A. clematitis to mingle with the wheat grain. CONCLUSION: Flour used to bake bread, a dietary staple in the endemic region of Croatia, is derived from wheat grain which, in the past, is likely to have been contaminated with seeds of A. clematitis during harvesting. This observation supports the hypothesis that aristolochic acid, a major constituent of the seeds, plays a central role in the development of endemic nephropathy.

Toxicity of the Chinese herb mu tong (Aristolochia manshuriensis). What history tells us.

Plant sources of some traditional Chinese herbs may have changed over time. History records of herbal toxicity should be viewed critically when different plants might have been used under the same name in earlier eras. The current main source of the Chinese herb Mu Tong is Aristolochia manshuriensis. Examination of classical Chinese herbal literature revealed that until the mid 17th century the original source plants of Mu Tong had been several Akebia species. From the 17th century until the early 20th century Clematis species were the main source of Mu Tong. A manshuriensis has only been widely used since the 1950s. Renal failure due to ingestion of large doses of A. manshuriensis has been reported in China and other countries while no such toxicity has been recorded in traditional Chinese herbal texts. Documentation of traditional Chinese herbal literature should help to ensure the safe use of Chinese herbs.