Integrated strategy for the assessment of kidney toxicity: the case of aristolochic acids

Summary

Aristolochic acids (AAs) are natural food-borne nephrotoxic, genotoxic and carcinogenic chemicals. This study aimed to demonstrate the potential of an integrated testing strategy using in vitro assays with physiologically based kinetic (PBK) modeling based-reverse dosimetry to predict in vivo toxicity of AAs without animal testing. The results obtained show that this approach provides a useful research tool for studies on kidney toxicity and genotoxicity of AAs. Furthermore, a risk assessment of plant food supplements (PFS) and herbal products containing AAs purchased via online markets was performed and revealed that, in spite of the ban on AA-containing products since 2001, consumers can still be exposed to AAs, which raises concern, especially for people who frequently use these products. Altogether, this study presents further support for the use of combined in vitro-PBK modeling-based alternative tools for risk assessment and revealed the continued risks posed by AAs present in PFS and herbal products.