TP53 and Balkan nephropathy: Slade et al. (2009) also reported finding aristolochic-DNA adducts and the A to T transversion p53 mutations in the tumor tissue from patients with BEN in Croatia and Bosnia. A literature search neither found in vitro studies which reported OTA induced A to T transversions nor other mutagenic responses in human p53; however, activation of p53 was reported to inhibit OTA-induced apoptosis in monkey and human kidney epithelial cells (Li et al., 2011).