Balkan endemic nephropathy: an update on its aetiology
Identifieur interne : 000049 ( Main/Exploration ); précédent : 000048; suivant : 000050Balkan endemic nephropathy: an update on its aetiology
Auteurs : Marie Stiborová [République tchèque] ; Volker M. Arlt ; Heinz H. Schmeiser [Allemagne]Source :
- Archives of Toxicology [ 0340-5761 ] ; 2016.
Abstract
Balkan endemic nephropathy (BEN) is a unique, chronic renal disease frequently associated with upper urothelial cancer (UUC). It only affects residents of specific farming villages located along tributaries of the Danube River in Bosnia-Herzegovina, Croatia, Macedonia, Serbia, Bulgaria, and Romania where it is estimated that ~100,000 individuals are at risk of BEN, while ~25,000 have the disease. This review summarises current findings on the aetiology of BEN. Over the last 50 years, several hypotheses on the cause of BEN have been formulated, including mycotoxins, heavy metals, viruses, and trace-element insufficiencies. However, recent molecular epidemiological studies provide a strong case that chronic dietary exposure to aristolochic acid (AA) a principal component of
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DOI: 10.1007/s00204-016-1819-3
PubMed: 27538407
PubMed Central: 5065591
Affiliations:
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Arlt</name><affiliation><nlm:aff id="Aff2">Analytical and Environmental Sciences Division, MRC-PHE Centre for Environmental and Health, King’s College London, 150 Stamford Street, London, SE1 9NH UK</nlm:aff><wicri:noCountry code="subfield">SE1 9NH UK</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff3">NIHR Health Protection Research Unit in Health Impact of Environmental Hazards at King’s College London in partnership with Public Health England, Franklin–Wilkins Building, 150 Stamford Street, London, SE1 9NH UK</nlm:aff><wicri:noCountry code="subfield">SE1 9NH UK</wicri:noCountry></affiliation></author><author><name sortKey="Schmeiser, Heinz H" sort="Schmeiser, Heinz H" uniqKey="Schmeiser H" first="Heinz H." last="Schmeiser">Heinz H. Schmeiser</name><affiliation wicri:level="3"><nlm:aff id="Aff4">Division of Radiopharmaceutical Chemistry (E030), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Radiopharmaceutical Chemistry (E030), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27538407</idno><idno type="pmc">5065591</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065591</idno><idno type="RBID">PMC:5065591</idno><idno type="doi">10.1007/s00204-016-1819-3</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000115</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000115</idno><idno type="wicri:Area/Pmc/Curation">000114</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000114</idno><idno type="wicri:Area/Pmc/Checkpoint">000044</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000044</idno><idno type="wicri:Area/Ncbi/Merge">000475</idno><idno type="wicri:Area/Ncbi/Curation">000475</idno><idno type="wicri:Area/Ncbi/Checkpoint">000475</idno><idno type="wicri:doubleKey">0340-5761:2016:Stiborova M:balkan:endemic:nephropathy</idno><idno type="wicri:Area/Main/Merge">000049</idno><idno type="wicri:Area/Main/Curation">000049</idno><idno type="wicri:Area/Main/Exploration">000049</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Balkan endemic nephropathy: an update on its aetiology</title><author><name sortKey="Stiborova, Marie" sort="Stiborova, Marie" uniqKey="Stiborova M" first="Marie" last="Stiborová">Marie Stiborová</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, 128 40 Prague 2, Czech Republic</nlm:aff><country xml:lang="fr">République tchèque</country><wicri:regionArea>Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, 128 40 Prague 2</wicri:regionArea><wicri:noRegion>128 40 Prague 2</wicri:noRegion></affiliation></author><author><name sortKey="Arlt, Volker M" sort="Arlt, Volker M" uniqKey="Arlt V" first="Volker M." last="Arlt">Volker M. Arlt</name><affiliation><nlm:aff id="Aff2">Analytical and Environmental Sciences Division, MRC-PHE Centre for Environmental and Health, King’s College London, 150 Stamford Street, London, SE1 9NH UK</nlm:aff><wicri:noCountry code="subfield">SE1 9NH UK</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff3">NIHR Health Protection Research Unit in Health Impact of Environmental Hazards at King’s College London in partnership with Public Health England, Franklin–Wilkins Building, 150 Stamford Street, London, SE1 9NH UK</nlm:aff><wicri:noCountry code="subfield">SE1 9NH UK</wicri:noCountry></affiliation></author><author><name sortKey="Schmeiser, Heinz H" sort="Schmeiser, Heinz H" uniqKey="Schmeiser H" first="Heinz H." last="Schmeiser">Heinz H. Schmeiser</name><affiliation wicri:level="3"><nlm:aff id="Aff4">Division of Radiopharmaceutical Chemistry (E030), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Radiopharmaceutical Chemistry (E030), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author></analytic><series><title level="j">Archives of Toxicology</title><idno type="ISSN">0340-5761</idno><idno type="eISSN">1432-0738</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Balkan endemic nephropathy (BEN) is a unique, chronic renal disease frequently associated with upper urothelial cancer (UUC). It only affects residents of specific farming villages located along tributaries of the Danube River in Bosnia-Herzegovina, Croatia, Macedonia, Serbia, Bulgaria, and Romania where it is estimated that ~100,000 individuals are at risk of BEN, while ~25,000 have the disease. This review summarises current findings on the aetiology of BEN. Over the last 50 years, several hypotheses on the cause of BEN have been formulated, including mycotoxins, heavy metals, viruses, and trace-element insufficiencies. However, recent molecular epidemiological studies provide a strong case that chronic dietary exposure to aristolochic acid (AA) a principal component of <italic>Aristolochia clematitis</italic> which grows as a weed in the wheat fields of the endemic regions is the cause of BEN and associated UUC. One of the still enigmatic features of BEN that need to be resolved is why the prevalence of BEN is only 3–7 %. This suggests that individual genetic susceptibilities to AA exist in humans. In fact dietary ingestion of AA along with individual genetic susceptibility provides a scenario that plausibly can explain all the peculiarities of BEN such as geographical distribution and high risk of urothelial cancer. For the countries harbouring BEN implementing public health measures to avoid AA exposure is of the utmost importance because this seems to be the best way to eradicate this once mysterious disease to which the residents of BEN villages have been completely and utterly at mercy for so long.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Aleckovi, M" uniqKey="Aleckovi M">M Alecković</name></author><author><name sortKey="Mesi, E" uniqKey="Mesi E">E Mesić</name></author><author><name sortKey="Trnacevi, S" uniqKey="Trnacevi S">S Trnacević</name></author><author><name sortKey="Stipanci, Z" uniqKey="Stipanci Z">Z Stipancić</name></author><author><name sortKey="Hamidovi, D" uniqKey="Hamidovi D">D Hamidović</name></author><author><name sortKey="Hasanovi, E" uniqKey="Hasanovi E">E Hasanović</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anandagoda, N" uniqKey="Anandagoda N">N 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Turesky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zhu, S" uniqKey="Zhu S">S Zhu</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Jin, J" uniqKey="Jin J">J Jin</name></author><author><name sortKey="Guan, C" uniqKey="Guan C">C Guan</name></author><author><name sortKey="Li, M" uniqKey="Li M">M Li</name></author><author><name sortKey="Xi, C" uniqKey="Xi C">C Xi</name></author><author><name sortKey="Ouyang, Z" uniqKey="Ouyang Z">Z Ouyang</name></author><author><name sortKey="Chen, M" uniqKey="Chen M">M Chen</name></author><author><name sortKey="Qiu, Y" uniqKey="Qiu Y">Y Qiu</name></author><author><name sortKey="Huang, M" uniqKey="Huang M">M Huang</name></author><author><name sortKey="Huang, Z" uniqKey="Huang Z">Z Huang</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>République tchèque</li></country><region><li>Bade-Wurtemberg</li><li>District de Karlsruhe</li></region><settlement><li>Heidelberg</li></settlement></list><tree><noCountry><name sortKey="Arlt, Volker M" sort="Arlt, Volker M" uniqKey="Arlt V" first="Volker M." last="Arlt">Volker M. Arlt</name></noCountry><country name="République tchèque"><noRegion><name sortKey="Stiborova, Marie" sort="Stiborova, Marie" uniqKey="Stiborova M" first="Marie" last="Stiborová">Marie Stiborová</name></noRegion></country><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Schmeiser, Heinz H" sort="Schmeiser, Heinz H" uniqKey="Schmeiser H" first="Heinz H." last="Schmeiser">Heinz H. Schmeiser</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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