马兜铃酸为一类硝基菲羧酸。长期食用或服用含马兜铃酸的食物、中药等可导致泌尿系统和消化系统的病理学改变，造成脏器纤维化以及输尿管移行上皮细胞癌、结肠腺癌、浸润性导管乳腺癌等疾病。马兜铃酸I作为其主要毒性成分可直接引发间质性肾病或者脏器纤维化，其活性代谢产物可与DNA形成加和物，引起体内关键肿肿瘤抑制基因p53的突变，诱发癌症。本文主要综述了马兜铃酸的体内代谢过程，患病个体在代谢敏感性中的个性化特征以及马兜铃酸肾病和巴尔干地方性肾病的临床验证研究结果。揭示中药毒性成分的体内代谢过程、易感人群特征、潜在危险性、致病因素间的因果关系论证，提供了一个综述性范例。

Aristolochic acid is one kind of nitrophenanthrene organic acids. Long- term intake of foods or Chinese medicine contains aristolochic acid can cause pathological changes in the urinary system and digestive system. These changes will lead to a series of diseases, like fibrosis or ureteral transitional cell carcinoma, colon adenocarcinoma, invasive ductal mammary gland cancer and so on. Aristolochic acid I (AAI) is the major toxic component of AAs. Not only cause interstitial nephropathy or fibrosis directly. Its reactive intermediates binding to DNA forming AA-DNA adducts will induce mutation of tumor suppressor gene p53 which could be the main reasons of cancer. This article reviews the metabolic process of aristolochic acid and illustrate the individualized characteristics of patients in metabolic sensitivity. And the clinical validation results of aristolochic acid nephropathy (AAN) and Balkan endemic nephropathy (BEN) was Enumerated. This review could serve as a template for revealing causal relationship among the metabolic process in vivo, the characteristics of susceptible population, the potential risk and the pathogenic factors of toxic components in traditional Chinese medicine.

国家科技部"中医药现代化研究"重点专项（2017YFC1702000）:基于器官芯片技术的中药安全性有效性评价体系，负责人：杨凌；上海市科学技术委员会上海市优秀学术带头人计划（18XD1403600）:代谢酶介导的中药不良反应早期评价及预警体系的构建，负责人：葛广波；大连市科学技术局大连市支持高层次人才创新创业项目（2016RQ025）:羧酸酯酶I检测试剂盒的研发及其生物医学应用，负责人：葛广波。