主题：请教:怎么给小孩喂药? -- 无漏

马兜铃酸的危害有很多，这篇论文指的是致癌性。

Aristolochic acid-associated urothelial cancer in Taiwan

Chung-Hsin Chen,a,b Kathleen G. Dickman,c,d Masaaki Moriya,c Jiri Zavadil,e Viktoriya S. Sidorenko,c Karen L. Edwards,f Dmitri V. Gnatenko,d Lin Wu,g Robert J. Turesky,h Xue-Ru Wu,i,j Yeong-Shiau Pu,a,1 and Arthur P. Grollmanc,d,1

Abstract.

Aristolochic acid, a potent human carcinogen produced by Aristolochia plants, is associated with urothelial carcinoma of the upper urinary tract (UUC). Following metabolic activation, aristolochic acid reacts with DNA to form aristolactam (AL)-DNA adducts. These lesions concentrate in the renal cortex, where they serve as a sensitive and specific biomarker of exposure, and are found also in the urothelium, where they give rise to a unique mutational signature in the TP53 tumor-suppressor gene. Using AL-DNA adducts and TP53 mutation spectra as biomarkers, we conducted a molecular epidemiologic study of UUC in Taiwan, where the incidence of UUC is the highest reported anywhere in the world and where Aristolochia herbal remedies have been used extensively for many years. Our study involves 151 UUC patients, with 25 patients with renal cell carcinomas serving as a control group. The TP53 mutational signature in patients with UUC, dominated by otherwise rare A:T to T:A transversions, is identical to that observed in UUC associated with Balkan endemic nephropathy, an environmental disease. Prominent TP53 mutational hotspots include the adenine bases of 5′AG (acceptor) splice sites located almost exclusively on the nontranscribed strand. A:T to T:A mutations also were detected at activating positions in the FGFR3 and HRAS oncogenes. AL-DNA adducts were present in the renal cortex of 83% of patients with A:T to T:A mutations in TP53, FGFR3, or HRAS. We conclude that exposure to aristolochic acid contributes significantly to the incidence of UUC in Taiwan, a finding with significant implications for global public health.

Keywords: upper urinary tract carcinoma, traditional Chinese medicine, transitional cell carcinoma, DNA damage, herbal medicine

特别是论文最后一句话“Because of the lifelong persistence of mutagenic DNA-AL-I adducts in target tissues and irreversible damage to the proximal renal tubules caused by AA, persons treated with Aristolochia herbal preparations at any time in their life are at significant risk of developing UUC or chronic renal disease, thereby creating an international public health problem of considerable magnitude.”

无论摄入多少马兜铃酸，都会造成永久的不可逆的损伤。做个类比，拔你一根头发，这头发很可能长出来，这个损伤是可逆的；用激光打坏一根头发的毛囊，头发以后就不会再长出来了，这个损伤虽然小但是不可逆。