scholarly journals Molecular Markers in Upper Urothelial Carcinoma Associated to Balkan Endemic Nephropathy. Aristolochic Acid as the Major Risk Factor of the Worldwide Disease

2009 ◽  
Vol 9 ◽  
pp. 1360-1373 ◽  
Author(s):  
Ljubinka Jankovic Velickovic ◽  
Takanori Hattori ◽  
Vladisav Stefanovic
Keyword(s):  
Regression Analysis ◽  
Urothelial Carcinoma ◽  
Growth Stage ◽  
Aristolochic Acid ◽  
Balkan Endemic Nephropathy ◽  
Specific Cell ◽  
Ki 67 ◽  
High Stage ◽  
Endemic Nephropathy

The role of aristolochic acid in the etiology of Balkan endemic nephropathy (BEN) and associated upper urothelial carcinoma (UUC) was recently confirmed. The aim of this study was to determine the marker(s) specific for BEN-associated UUC. A total of 82 patients with UUC (38 from the BEN region and 44 control tumors) were included in the study. The Ki-67 index in BEN tumors correlated with the grade and multifocality (p< 0.05), but in regression analysis, only the grade of BEN tumor. The p53 index was significantly higher in BEN than in control tumors (p< 0.05), as well as the alteration of p53 (p< 0.05). BEN low-stage tumors, tumors without limphovascular invasion (LVI), and tumors of the renal pelvis had a higher p53 index than the control tumors (p< 0.05, 0.01, 0.05, respectively). The Ki-67 index was higher in control tumors with high-stage and solid growth than in BEN UUC (p < 0.050, 0.005). The Ki-67 correlated with the grade, growth, stage, LVI, and multifocality of UUC on the best way, but not with the group. In regression analysis, only multifocality of UUC had predictive influence on Ki-67 activity (p< 0.001). P53 correlated with the grade, growth, and group (p< 0.05). This investigation identifies the p53 pathway as the specific cell cycle marker involved in BEN-associated UUC.

scholarly journals Balkan Endemic Nephropathy and the Causative Role of Aristolochic Acid

2019 ◽  
Vol 39 (3) ◽  
pp. 284-296 ◽  
Author(s):  
Bojan Jelaković ◽  
Živka Dika ◽  
Volker M. Arlt ◽  
Marie Stiborova ◽  
Nikola M. Pavlović ◽  
...  
Keyword(s):  
Aristolochic Acid ◽  
Balkan Endemic Nephropathy ◽  
Causative Role ◽  
Endemic Nephropathy

scholarly journals Ochratoxin A and Aristolochic Acid Involvement in Nephropathies and Associated Urothelial Tract Tumours

2009 ◽  
Vol 60 (4) ◽  
pp. 465-483 ◽  
Author(s):  
Annie Pfohl-Leszkowicz
Keyword(s):  
Ochratoxin A ◽  
Aristolochic Acid ◽  
Adduct Formation ◽  
Dna Adduct ◽  
Balkan Endemic Nephropathy ◽  
Aristolochic Acids ◽  
The World ◽  
Main Culprit ◽  
Endemic Nephropathy

Ochratoxin A and Aristolochic Acid Involvement in Nephropathies and Associated Urothelial Tract TumoursThis review addresses the unresolved aetiology of several nephropathies and associated upper tract tumours diagnosed all over the world, but especially in the Balkan regions. Studies conducted over the last 35 years point to mycotoxins, mainly ochratoxin A (OTA) as the main culprit. Recent theories however have implicated aristolochic acids (AA). The aim of this review is to put forward arguments in favour of the mycotoxin theory and to show the incoherence of the AA theory. It discusses the differences between the epidemiology of Balkan endemic nephropathy (BEN) and aristolochic acid nephropathy (AAN); OTA and AA carcinogenicity; clinical and pathological effects induced by OTA and AA; sources of OTA contamination (food, air, drinking water); OTA- and AA-DNA adduct formation; the role of genetic polymorphisms; and the risk for young children.

scholarly journals Balkan endemic nephropathy: Role of ochratoxins A through biomarkers

2006 ◽  
Vol 50 (6) ◽  
pp. 519-529 ◽  
Author(s):  
Marcel Castegnaro ◽  
Delphine Canadas ◽  
Terry Vrabcheva ◽  
Theodora Petkova-Bocharova ◽  
Ivan N. Chernozemsky ◽  
...  
Keyword(s):  
Balkan Endemic Nephropathy ◽  
Endemic Nephropathy

E-cadherin expression in upper urothelial carcinoma in Balkan Endemic Nephropathy and non-endemic regions

2009 ◽  
Vol 205 (10) ◽  
pp. 682-689 ◽  
Author(s):  
Ljubinka Jankovic Velickovic ◽  
Takanori Hattori ◽  
Milan Visnjic ◽  
Irena Dimov ◽  
Mariola Stojanovic ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Balkan Endemic Nephropathy ◽  
Endemic Nephropathy ◽  
E Cadherin

scholarly journals Arterial Stiffness in Balkan Endemic Nephropathy, an Environmental Form of Aristolochic Acid Nephropathy

2018 ◽  
Vol 5 ◽  
Author(s):  
Vedran Premužić ◽  
Vanja Ivković ◽  
Ninoslav Leko ◽  
Želimir Stipančić ◽  
Sandra Karanović ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Aristolochic Acid ◽  
Balkan Endemic Nephropathy ◽  
Aristolochic Acid Nephropathy ◽  
Endemic Nephropathy

Aristolochic acid nephropathy caused by ingestion of herbal medicinal products

2015 ◽  
Author(s):  
M. Refik Gökmen ◽  
Graham M. Lord
Keyword(s):  
Aristolochic Acid ◽  
Herbal Medicines ◽  
Balkan Endemic Nephropathy ◽  
Herbal Products ◽  
Herbal Medicinal Products ◽  
Aristolochic Acid Nephropathy ◽  
Endemic Nephropathy ◽  
Risk Of Malignancy ◽  
Urothelial Malignancy ◽  
Mechanisms Of Carcinogenesis

Aristolochic acid nephropathy (AAN) is a rapidly progressive renal disease caused by the ingestion of plant products containing aristolochic acid (AA), first described in connection with the use of Chinese herbal medicines. Although the true worldwide extent of this disease is unknown, it is likely to represent a significant cause of chronic kidney disease (CKD) in many parts of the world. Furthermore, recent data have also demonstrated that AA is also the primary aetiological agent in Balkan endemic nephropathy. AAN is notable in its association with urothelial malignancy, with the mechanisms of carcinogenesis now well characterized. Aside from a possible role for corticosteroid therapy in slowing disease progression in selected patients, no disease-specific treatments have yet been shown to alter the course of this nephropathy. Therefore, prevention of exposure to AA and, in affected patients, effective management of the risk of malignancy are key principles in the approach to this condition. Although preparations containing Aristolochia spp. and herbs that can be confused or substituted for Aristolochia have been banned in many countries, other herbal products containing AA have continued to be available to consumers long after these bans have been instituted, highlighting the ongoing need for awareness of this disease.

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