Evaluation of the nephrotoxicity and safety of low-dose aristolochic acid, extending to the use of Xixin (Asurum), by determination of methylglyoxal and d-lactate

Most Aristolochiaceae plants are prohibited due to aristolochic acid nephropathy (AAN), except Xixin (Asarum spp.). contains trace amounts of (AA) and is widely used in Traditional Chinese Medicine. Methylglyoxal d-lactate regarded as biomarkers for nephrotoxicity. The use spp.) essential controversial. This study aimed evaluate tubulointerstitial injury interstitial renal fibrosis by determining urinary methylglyoxal after withdrawal low-dose AA a chronic mouse model. C3H/He mice the group (n = 24/group) were given ad libitum access distilled water containing 3 μg/mL (0.5 mg/kg/day) 56 days drinking from 57 84. severity evaluated using histological score (TIHS) Masson's trichrome staining. Urinary serum determined high-performance liquid chromatography (HPLC); column-switching HPLC. After withdrawal, increased day (429.4 ± 48.3 μg/L) 84 (600.2 99.9 μg/L), peaked on 70 (878.3 171.8 μg/L; p < 0.05); TIHS exhibited similar patterns. was high (3.522 1.061 μg), declined (1.583 0.437 μg) (2.390 0.130 μg). Moreover, elevated (82.10 18.80 higher (201.10 90.82 (193.28 61.32 induced AA-induced injury, so excretion metabolism may be detoxification repair strategy. A low cumulative dose key factor that limits helps repair. Thus, AA-containing herbs, especially Xixin, should at doses short durations (less than one month).