Monday, March 10, 2014

Follow-up from the Herbal Supplements Lecture

I received a delightful e-mail from Arthur Grollman, world expert on Aroistocholic Acid.

Dear Dr Topf, 
I congratulate you on assembling and sharing this very nice presentation and, wisely, connecting it to the problems associated with politicians, supplements and DSHEA.  We have written some articles about this connection as well. 
I give a similar lecture to medical students and another focussed on BEN [ed: Balkan Endemic nephropathy] and aristolochic acid nephropathy for Medical and Nephrology Grand Rounds as most of the research being done on that subject since 2005 has been done in our lab. 
A few comments on the historical sequence:
  • JP Cosyns is the Belgian pathologist who first recognized the similarity to BEN but did not follow up the lead
  • Tjassa Hranjec, a medical student at Stony Brook, doing a summer fellowship conducted the personal  interview with the farmer you attributed to me. She
  • was doing a pilot epi study, under my direction, to determine how we should investigate BEN
  • The first experimental evidence for the role of AA in AAN and UTUC appears  in our 2007 PNAS paper
  • The Serbs and the Bosnians still believed that their BEN was a different disease, so we expanded the number of cases and included those countries in the cover story paper in KI in 2012.  DeBroe wrote a commentary to accompany our paper which convinced any remaining skeptics of the validity of our guiding hypothesis: AAN = CHN = BEN
  • Wondering how Aristolochia herbs could have been used throughout the world for 2000 years without one mention of toxicity or urothelial cancer, we conducted the study in Taiwan, where one in three people have ingested the Aristolochia herb according to the prescription database.  The results are in our 2012 PNAS paper.
We continue to work on this fascinating nephrotoxin/carcinogen for which, as you see has a "signature mutation" and is likely to affect tens of millions of people in China.  And the road to its recognition started exactly as you said in your talk, with the two
Belgian women in Vanderwegen's clinic. He told me that his own clue came when he walked from his office to the clinic and found a number of women talking to each other which was unusual. He asked them how they knew each other which led immediately to the identification of the spa. 
With best regards 
Arthur P. Grollman M.D.
Distinguished Professor of Pharmacological Sciences
Evelyn Glick Professor of Experimental Medicine
Director: Laboratory of Chemical Biology
Health Sciences Center BST-8-160
Stony Brook University

The e-mail included some great images. Two covers from nephrology journals:

Gorgeous picture of DNA Adducts
Grollman won the 2011 Environmental Mutagen Society Award. As part of that award he wrote an invited review on aristocholic acid nephropathy. I'm looking forward to reading it. It has some great drawings. Take a look at the figure below the abstract. Wow.

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