Critique Article

Jordan Brewer

November 28th, 2017

Indiana University East










article I will be critiquing is called Aristolochic
acids and their derivatives are widely implicated in liver cancers in Taiwan
and throughout Asia. The article had many contributions from a variety of
different authors and has an impact factor of 37.205 in 2016. This article
looks to find evidence on whether or not the exposure of Aristolochic acids
(AA) would decrease, following the ban in Taiwan for herbal remedies containing
the AA signature. Although the evidence of a decrease in the AA signature was
not the result. Turns out
that the exposure to AA had stayed about the same. Why would this be? Well the
authors to the article had a few ideas for this. One reason being the fact that
many of these AA
containing herbal remedies were continued to be used by many even following the
ban. There were
also reports that
Chinese medical practitioners continued to prescribe their patients with some
of these AA containing herbal remedies during the first year the ban took
place. It is apparent that plants containing high dosages of AA are widely
available for purchase online and often are mislabeled. But Aristolochic acids
aren’t the only concern. There is also aristolactams. There isn’t to much
research on them but are thought to be mutagenic metabolites of AA and interact
with DNA directly.

There is also evidence that supports
the theory that the signatures being observed is caused by AA, or possibly even
with the help of other related/unrelated compounds. Studies conducted on
animals have shown evidence that AA adducts along with AA mutagenesis occur
within the liver. The exposure of AA in Taiwan was more prevalent compared to
other areas. Aristocholoic acids were also found in certain groups of Asian
countries. This goes to show the prevalence of AA and how they
are spread throughout different areas of the world. The author encourages
opportunities for primary and secondary prevention when it comes to regulating
such AA containing plants. Although China and Taiwan only choose to regulate
specific plants containing AA. It is also interesting to note that the sale of
AA containing plants is not prohibited within the United States even though
evidence shows that it is dangerous. Although the herbs must be correctly
labeled and not detailing any health benefits from ingesting such a substance.

does this mean? AA containing plants can easily be bought online and accessed a
numerous of other ways. The author hopes to discourage the use of these AA
containing plants by providing evidence of its harmfulness. Also, that labeling
of these herbs tend to get pretty difficult for supplier to know exactly which
multiherb substances contain AA. The author offers a suggestion for more
thorough measures be taken to identifying herbal products in an attempt for
primary prevention. The author also offers a suggestion for secondary
prevention, for those who have already resulted in exposure to AA, this would
be in the form of advanced screenings that would be able to detect AA-
associated cancers.

I would say that the article has succeeded in providing public awareness on the
seriousness of Aristocholoic acids and how dangerous they can be. The authors
writing style was clear and concise, while also be easy to follow. I like the
authors ideas when it comes to primary and secondary prevention. The regulation
of AA containing plants is lacking in many countries, including our own.
Meaning that until there is some type of regulations put in place for these AA
containing plants, one can only spread the word until there is something done
about it. Based on the evidence provided within this study, I’m curious to why
these plants have not been banned completely in all areas of the world. Out of
everything I read within the article I was in particularly intrigued on the
lack of a decrease in exposure of the AA signature following the ban in Taiwan
back in 2003. It seems to me that many people continued to use these AA contain
herbs even following the ban. I am curious to why somebody would continue to
use something that you knew would potentially cause liver cancer. But access to
such plants are still widely available. Perhaps the lack of regulation is the
reason to blame for the continued use of such plants. It seems to me that they
understand the potential dangers that come along with the plants, but the
countries refuse to completely do away with them. It may be more time consuming
to try to regulate these types of herbs when it comes to mixed varieties, but
it is essential to prevent exposure to such plants. I believe that this article
is important for providing evidence to support the connection between the AA
signature mutation found with some herbs and liver cancer. I enjoyed reading
this article and thought that it provided valuable information on the
prevalence along with the dangers of AA related herbs.






Ng, A. W., Poon, S. L., Huang, M. N., Lim, J. Q., Boot, A.,
Yu, W., . . . Rozen, S. G. (2017, October 18). Aristolochic acids and their
derivatives are widely implicated in liver cancers in Taiwan and throughout
Asia. Retrieved November 28, 2017, from





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