Recent developments in detoxication techniques for aristolochic acid-containing traditional Chinese medicines

Aristolochic acids (AAs) have attracted significant attention because they have been proven to be the culprits in the mass incidents of AA nephropathy that occurred in Belgium in 1993. From then on, the door to sales of medicines containing AAs has been closed. As aristolochic acid (AA)-containing traditional Chinese medicine (TCM) has a potent therapeutic effect on some diseases, research into detoxication techniques for AA-containing traditional Chinese medicines (TCMs) should be considered to be absolutely essential. Therefore, in this paper, the use of AA-containing TCMs has been investigated and detoxication techniques, such as, processing (Paozhi, Chinese name), compatibility (Peiwu, Chinese name), pressurized liquid extraction (PLE) and supercritical fluid extraction (SFE), have been reviewed in detail. A large number of relevant studies have been reviewed and it was found that processing with honey or alkaline salts is the most widely used method in practical production. As the AAs are a group of weak acids, relatively speaking, processing with alkaline salts can achieve a high rate of reduction of the AAs. Meanwhile, it is necessary to consider the compatibility of AA-containing TCMs and other herbal medicines. In addition, PLE and SFE can also achieve an excellent reducing rate for AAs in a much shorter processing time. Therefore, the promotion of alkaline salt processing technology should be strengthened in the future. At the same time, some advanced modern extraction technologies also have good potential and should be further studied.