马兜铃酸及其衍生物致癌性研究进展及应对措施  

Research Progress in and Countermeasures against Carcinogenicity of Aristolochic Acids and Their Derivatives

作　　者：柏兆方[1] 徐广 王伽伯[1] 肖小河[1] BAI Zhaofang;XU Guang;WANG Jiabo;XIAO Xiaohe(China Military Institute of Chinese Medicine, 302 Military Hospital, Beijing 100039, China)

机构地区：[1]解放军第三〇二医院全军中医药研究所,北京100039

出　　处：《药学进展》2018年第3期164-169,共6页Progress in Pharmaceutical Sciences

基　　金：国家自然基金青年基金(No.81503350);国家自然基金重点项目(No.81630100);国家"重大新药创制"科技重大专项(No.2018ZX09101002-001-002;No.2015ZX09501-004-001-008);国家公益性行业科研专项课题(No.201507004-04)

摘　　要：马兜铃酸(AA)诱发肾毒性和泌尿系统肿瘤已广为人知,原国家食品药品监督管理局也于2003—2004年对含AA的中药材与中成药提出了用药警戒并制定风险防控措施。2017年10月18日《科学-转化医学》杂志在线刊发了题目为"Aristolochic acids and their derivatives are widely implicated in liver cancers in Taiwan and throughout Asia"的文章,该研究通过基因测序发现亚洲肝癌患者基因谱中存在AA及其衍生物的特征突变位点和序列,据此首次提出了AA及其衍生物广泛关联亚洲肝癌发生的结论。国内外媒体对此争相转载并发表了系列对中药安全性及监管问题的质疑报道,一时成为了国内外舆论关注的热点,为AA安全性风险防控提出了新的挑战。为科学认知AA及其衍生物的致癌性,就AA及其衍生物致癌性的国内外研究进展和《科学-转化医学》杂志刊发文章的核心观点及存在的问题进行概述并提出应对措施。It has been widely accepted that aristolochic acids （AA） induces nephrotoxicity and urinary system tumors. During 2003-2004, the former State Food and Drug Administration also proposed medical alert for traditional Chinese medicinal materials and Chinese patent medicines that contain AA and developed risk prevention and control measures. On October 18, 2017, Science Translational Medicine published an online article titled ＂Aristolochic acids and their derivatives are widely implicated in liver cancers in Taiwan and throughout Asia＂, which found through gene sequencing that there were some characteristic mutation sites and sequences of AA and their derivatives in the gene spectrums of liver cancer patients in Asia. Accordingly, the conclusion that AA and their derivatives were widely implicated in the occurrence of liver cancer in Asia had been firstly proposed. Domestic and foreign media scrambled to reprint it and published a series of reports on the safety and regulatory issues of Chinese medicine, which became the focus of public opinion at home and abroad at that time and posed a new challenge for risk prevention and control of AA safety. In order to have scientific understanding of the carcinogenicity of AA and their derivatives, the domestic and foreign research progress in the carcinogenicity of AA and their derivatives as well as the core views and existing problems of the article published in Science Translational Medicine were summarized and countermeasures were proposed in this paper.

关 键 词：马兜铃酸 致癌性 基因突变 泌尿系统肿瘤 原发性肝癌 

分 类 号：R99[医药卫生—毒理学]