Regulation of herbal medicine use based on speculation? A case from Sri Lanka

10.1016/j.jtcme.2016.06.009

Wathsala Wijesinghe；Senaka Pilapitiya；Priyani Hettiarchchi；Buddhika Wijerathne；Sisira Siribaddana

Chronic kidney disease of unknown ； aetiology ； Aristolochia ； Herbal medicines ； Ayurveda ； Traditional medicine ； Sri Lanka

Journal of Traditional and Complementary Medicine

7卷2期（2017 / 04 / 01）

269 - 271

英文

Chronic Kidney Disease of Unknown aetiology is a significant public health problem in Sri Lanka. The final report by the WHO mission recommended regulation of herbal medicines containing aristolochic acid, which is an established nephrotoxin. The use of Complimentary and Alternative Medicine (CAM) has a history of more than 2500 years in Sri Lanka. Aristolochia species are rarely used in Ayurveda and traditional medicine in Sri Lanka. Before regulating the analysis of herbal preparations using Aristolochia, collecting data from CAM practitioners regarding the use of Aristolochia is necessary. Analysis of Ayurveda pharmacopeia shows the doses used are negligible and some preparations are used for external applications.

1. Bhattacharjee, P,Bhattacharyya, D(2013).Characterization of the aqueous extract of the root of Aristolochia indica: evaluation of its traditional use as an antidote for snake bites.J Ethnopharmacol.,145,220-226.
2. Chen, JK,Chen, TT(2001).Chinese Medical Herbology and Pharmacology.USA:Art of Medicine Press.
3. De Alwis ES. Vatikaprakarana or Beheth Guli Kalka Potha. Colombo: P Cooray; 1879.
4. De Broe, ME(2012).Chinese herbs nephropathy and Balkan endemic nephropathy: toward a single entity, aristolochic acid nephropathy.Kidney Int,81,513-515.
5. Debelle, FD,Vanherweghem, J-L,Nortier, JL(2008).Aristolochic acid nephropathy: a worldwide problem.Kidney Int.,74,158-169.
6. Department of Ayurveda. Colombo: Minister of Health, Nutrition and Indigenous Medicine; 2012 [cited 2016 May 15]. Available from: http://www.ayurveda.gov.lk
7. Department of Ayurvedha(1976).Ayurvedha Pharmacopoeia.Colombo:Department of Ayurvedha.
8. Deraniyagala, PEP(ed.)(1956).National Museum Sri Lanka - Olas Book Series. vol. 4.Colombo:State Printing Corporation.
9. Figueiredo, AC,Barroso, JG,Pedro, L,Scheffer, JJC(2008).Factors affecting secondary metabolite production in plants: volatile components and essential oils.Flavour Fragr J.,23,213-226.
10. Grollman, AP,Shibutani, S,Moriya, M(2007).Aristolochic acid and the etiology of endemic (Balkan) nephropathy.Proc Natl Acad Sci U S A.,104,12129-12134.
11. International Agency for Research on Cancer(2002).IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Some Taditional Herbal Medicines, Some Mycotoxins, Naphthalene and Styrene. vol. 82.Lyon:International Agency for Research on Cancer Press.
12. Jayasumana, C,Gajanayake, R,Siribaddana, S(2014).Importance of arsenic and pesticides in epidemic chronic kidney disease in Sri Lanka.BMC Nephrol.,15,124.
13. Jayasumana, C,Paranagama, P,Agampodi, S,Wijewardane, C,Gunatilake, S,Siribaddana, S(2015).Drinking well water and occupational exposure to herbicides is associated with chronic kidney disease, in Padavi-Sripura, Sri Lanka.Environ Health,14,6.
14. Jayatilake, N,Mendis, S,Maheepala, P,Mehta, FR(2013).Chronic kidney disease of uncertain aetiology: prevalence and causative factors in a developing country.BMC Nephrol,14,180.
15. Mathew, JE,Kaitheri, SK,Vachala, SD,Jose, M(2011).Anti-inflammatory, antipruritic and mast cell stabilizing activity of Aristolochia indica.Iran J Basic Med Sci.,14,422-427.
16. Mendis, S(2013).National CKDu ProjectNational CKDu Project,Geneva:.
17. Michl, J,Jennings, HM,Kite, GC,Ingrouille, MJ,Simmonds, MSJ,Heinrich, M(2013).Is aristolochic acid nephropathy a widespread problem in developing countries?.J Ethnopharmacol.,149,235-244.
18. Ministry of Environment(2012).The National Red List 2012 of Sri Lanka; Conservation Status of the Fauna and Flora.Colombo:Ministry of Environment.
19. Ministry of Indigenous Medicine IT Unit. Information and Statistics. Colombo: Ministry of Indigenous Medicine Sri Lanka [cited 2016 May 15]. Available from: http://www.indigenousmedimini.gov.lk/Statistics.html
20. Nortier, JL,Martinez, M-CM,Schmeiser, HH(2000).Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi).N Engl J Med.,342,1686-1692.
21. Parasuraman, S,Thing, G,Dhanaraj, S(2014).Polyherbal formulation: concept of ayurveda.Pharmacogn Rev,8,73.
22. Pilapitiya, S,Siribaddana, S(2013).Issues in clinical trials in complementary and alternative medicine (CAM).Curr Opin Pharmacol,13,311-312.
23. Ramakrishna, A,Ravishankar, GA(2011).Influence of abiotic stress signals on secondary metabolites in plants.Plant Signal Behav,6,1720-1731.
24. Russell, S(2005).Treatment-seeking behaviour in urban Sri Lanka: trusting the state, trusting private providers.Soc Sci Med.,61,1396-1407.
25. Vanherweghem, JL(2008).Misuse of herbal remedies: the case of an outbreak of terminal renal failure in Belgium (Chinese herbs nephropathy).J Altern Complement Med,4,9-13.
26. Weerasinghe, M,Fernando, D(2011).Access to care in a plural health system: concerns for policy reforms.J Coll Commun Phys Sri Lanka,14

1. Zohre Feyzabadi,Maryam Miri Ghale Novi,Marjan Mahjour,Arash Khoushabi(2017).Food strategies of renal atrophy based on Avicenna and conventional medicine.Journal of Traditional and Complementary Medicine,7(4),375-379.