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Clinical and safety outcomes associated with aristolochic acid exposure: a systematic review and meta-analysis

Ting Cui1,2, Shumei Che1, Xingxu Yan1

  • 1School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

Toxicology Mechanisms and Methods
|January 23, 2025
PubMed

Insights

Aristolochic acid (AA) exposure significantly increases the risk of overall disease, kidney disease, urinary tract cancer, and liver cancer. This meta-analysis provides evidence for AA-related health risks.

Area of Science:

  • Toxicology
  • Oncology
  • Nephrology

Background:

  • Aristolochic acid (AA) is a known nephrotoxin and carcinogen.
  • Previous studies indicate a link between AA exposure and various diseases, including kidney disease, liver cancer, and urinary tract cancer (UTC).
  • A systematic analysis integrating these findings is lacking.

Purpose of the Study:

  • To systematically analyze and integrate existing evidence on the association between aristolochic acid (AA) exposure and the risk of overall disease and specific AA-related cancers.
  • To provide a comprehensive overview of AA's safety outcomes.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, EMBASE, Web of Science, Cochrane Library) up to April 2024.
  • Meta-analysis was performed to calculate odds ratios (OR) and confidence intervals (CI) for the association between AA exposure and various diseases.

Main Results:

  • AA exposure was significantly associated with an increased incidence of overall AA-related disease (OR: 1.289, 95% CI: 1.183-1.404).
  • Significant associations were found for kidney disease (OR: 1.279, 95% CI: 1.029-1.590), UTC (OR: 1.842, 95% CI: 1.376-2.465), and liver cancer (OR: 1.146, 95% CI: 1.040-1.262).
  • No significant association was observed for brain disease (OR: 1.161, 95% CI: 0.989-1.362).

Conclusions:

  • Aristolochic acid exposure is a significant risk factor for kidney disease, urinary tract cancer, and liver cancer.
  • This systematic review underscores the importance of understanding and mitigating AA exposure for public health.
  • Findings support the development of targeted prevention strategies and improved clinical management for AA-related conditions.
Keywords:
Aristolochic acidclinicalmeta-analysissafetysystematic review

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