拮抗马兜铃酸肝毒性的策略：从基础研究到临床应用进展

Aristolochic acid(AA), a nitro-phenanthrene carboxylic acid compound present in Aristolochiaceae plants, exhibits significant nephrotoxicity and hepatotoxicity. It can induce DNA adduct formation, leading to hepatocyte damage, fibrosis, and even hepatocellular carcinoma. In recent years, substantial progress has been made in developing antagonistic strategies against AA-induced hepatotoxicity. Fundamental studies indicate that interventions such as antioxidants, anti-inflammatory agents, and modulation of CYP450 metabolic enzymes and transporters can effectively mitigate AA-induced oxidative stress and mitochondrial dysfunction. Additionally, natural products including berberine, grape seed proanthocyanidins, and silibinin have demonstrated notable protective effects. Clinically, early identification of AA exposure history, combined with biomarker monitoring and individualized hepatoprotective therapies, has been progressively implemented in the management of high-risk populations. Future research, leveraging multiomics technologies for mechanistic elucidation and targeted intervention strategies, holds promise for translating AA hepatotoxicity prevention and treatment from laboratory settings to precision clinical applications.