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«Suspects» in Etiology of Endemic Nephropathy: Aristolochic Acid versus Mycotoxins
Department of Microbiology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Schrottova 39, HR-10000 Zagreb, Croatia
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Received: 13 May 2010; in revised form: 7 June 2010 / Accepted: 10 June 2010 / Published: 11 June 2010
(This article belongs to the Special Issue Ochratoxins
Abstract: Despite many hypotheses that have been challenged, the etiology of endemic nephropathy (EN) is still unknown. At present, the implications of aristolochic acid (AA) and mycotoxins (ochratoxin A—OTA and citrinin—CIT) are under debate. AA-theory is based on renal pathohistological similarities between Chinese herbs nephropathy (CHN) and EN, findings of AA-DNA adducts in EN and in patients with urinary tract tumors (UTT), as well as the domination of A:T→T:A transversions in the p53 mutational spectrum of UTT patients, which corresponds with findings of such mutations in AA-treated rats. However, exposure pathways of EN residents to AA are unclear. Experimental studies attempting to deduce whether nephrotoxins OTA and CIT appear at higher frequencies or levels (or both) in the food and blood or urine of EN residents support the mycotoxin theory. Also, some molecular studies revealed the presence of OTA-DNA adducts in the renal tissue of EN and UTT patients. In this review, data supporting or arguing against AA and mycotoxin theory are presented and discussed.
Keywords: endemic nephropathy; aristolochic acid; ochratoxin A; citrinin; DNA-adducts
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Pepeljnjak, S.; Šegvić Klarić, M. «Suspects» in Etiology of Endemic Nephropathy: Aristolochic Acid versus Mycotoxins. Toxins 2010, 2, 1414-1427.
Pepeljnjak S, Šegvić Klarić M. «Suspects» in Etiology of Endemic Nephropathy: Aristolochic Acid versus Mycotoxins. Toxins. 2010; 2(6):1414-1427.
Pepeljnjak, Stjepan; Šegvić Klarić, Maja. 2010. "«Suspects» in Etiology of Endemic Nephropathy: Aristolochic Acid versus Mycotoxins." Toxins 2, no. 6: 1414-1427.