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Food Research International (Ottawa,... Nov 2020The aflatoxins are hepatotoxic and carcinogenic metabolites produced by Aspergillus species during growth on crop products. In this regard, a systematic review to... (Meta-Analysis)
Meta-Analysis
The aflatoxins are hepatotoxic and carcinogenic metabolites produced by Aspergillus species during growth on crop products. In this regard, a systematic review to collect the quantitative data regarding the in vitro capacity of yeasts-based products to bind to aflatoxin B (AFB) and/or aflatoxin M (AFM) was performed. After screening, 31 articles which met the inclusion criteria was included and then the pooled decontamination of aflatoxins in the defined subgroups (the type of foods, pH, contact time, temperature, yeast species, and aflatoxin type) was calculated by the random effect model (REM). The overall binding capacity (BC) of aflatoxins by yeast was 52.05% (95%CI: 49.01-55.10), while the lowest and highest aflatoxins' BC were associated with Yeast Extract Peptone (2.79%) and ruminal fluid + artificial saliva (96.21%), respectively. Regarding the contact time, temperature, pH and type of aflatoxins subgroups, the binding percentages varied from 50.83% (>300 min) to 52.66% (1-300 min), 50.71% (0-40 °C) to 88.39% (>40 °C), 43.03% (pH: 3.1-6) to 44.56% (pH: 1-3) and 59.35% (pH > 6), and 48.47% (AFB) to 69.03% AFM, respectively. The lowest and highest aflatoxins' BC was related to C. fabianii (18.45%) and Z. rouxii (86.40%), respectively. The results of this study showed that variables such as temperature, yeast, pH and aflatoxin type can be considered as the effective factors in aflatoxin decontamination.
Topics: Aflatoxin B1; Aflatoxin M1; Aflatoxins; Aspergillus; Yeasts
PubMed: 33233146
DOI: 10.1016/j.foodres.2020.109505 -
Current Molecular Pharmacology 2021Exposure to mycotoxins may delay and/or negatively influence the development of neurological, gastrointestinal and inflammatory mechanisms in individuals with Autism...
BACKGROUND AND OBJECTIVE
Exposure to mycotoxins may delay and/or negatively influence the development of neurological, gastrointestinal and inflammatory mechanisms in individuals with Autism Spectrum Disorder (ASD). Therefore, there is a need to address the possible links between mycotoxins and the risk and prevalence of ASD to increase the understanding of the molecular mechanism underlying these links. In this context, the aim of this study was to investigate the molecular mechanism underpinning mycotoxin exposure and autism.
METHODS
The study was based on a systematic approach, which focused on the possible associations between mycotoxins and ASD in addition to the role of the mycotoxins on the risk and prevalence of ASD. The systematic review included all molecular mechanism studies examining mycotoxin exposure and autism, and was not limited to a specific period of time. A search was performed on the PubMed, Web of Science, Scopus, and Google Scholar databases.
RESULTS
The investigation of the literature revealed that a total number of 11 studies with a specific focus on the molecular mechanism of mycotoxin exposure and autism were published between 2008 and 2019. Out of these studies, 7 were research articles and 4 were review articles. In almost all the articles, possible links between mycotoxins and ASD were revealed.
CONCLUSION
The examination of the given studies provided data related to the links between mycotoxins and ASD. However, evidence related to these links needs to be investigated in larger samples, while the effects of separate mycotoxins and their metabolisms should also be examined.
Topics: Autism Spectrum Disorder; Autistic Disorder; Humans; Mycotoxins
PubMed: 32819265
DOI: 10.2174/1874467213999200819145942 -
International Journal of Molecular... Jul 2020The risk of liver injury associated with the use of herbal medicinal products (HMPs) is well known among physicians caring for patients under a HMP therapy, as...
The risk of liver injury associated with the use of herbal medicinal products (HMPs) is well known among physicians caring for patients under a HMP therapy, as documented in case reports or case series and evidenced by using the Roussel Uclaf Causality Assessment Method (RUCAM) to verify a causal relationship. In many cases, however, the quality of HMPs has rarely been considered regarding potential culprits such as contaminants and toxins possibly incriminated as causes for the liver injury. This review aims to comprehensively assemble details of tentative hepatotoxic contaminants and toxins found in HMPs. Based on the origin, harmful agents may be divided according two main sources, namely the phyto-hepatotoxin and the nonphyto-hepatotoxin groups. More specifically, phyto-hepatotoxins are phytochemicals or their metabolites naturally produced by plants or internally in response to plant stress conditions. In contrast, nonphyto-hepatotoxic elements may include contaminants or adulterants occurring during collection, processing and production, are the result of accumulation of toxic heavy metals by the plant itself due to soil pollutions, or represent mycotoxins, herbicidal and pesticidal residues. The phyto-hepatotoxins detected in HMPs are classified into eight major groups consisting of volatile compounds, phytotoxic proteins, glycosides, terpenoid lactones, terpenoids, alkaloids, anthraquinones, and phenolic acids. Nonphyto-hepatotoxins including metals, mycotoxins, and pesticidal and herbicidal residues and tentative mechanisms of toxicity are discussed. In conclusion, although a variety of potential toxic substances may enter the human body through HMP use, the ability of these toxins to trigger human liver injury remains largely unclear.
Topics: Animals; Chemical and Drug Induced Liver Injury; Humans; Liver; Phytochemicals; Plant Preparations; Plants, Medicinal
PubMed: 32708570
DOI: 10.3390/ijms21145011 -
Clinical Toxicology (Philadelphia, Pa.) Nov 2020Amatoxin leads to the majority of deaths by mushroom poisoning around the world. Amatoxin causes gastrointestinal disturbances and multiple organ dysfunction, including...
Amatoxin leads to the majority of deaths by mushroom poisoning around the world. Amatoxin causes gastrointestinal disturbances and multiple organ dysfunction, including liver and renal failure. As a potential treatment for amatoxin poisoning, -acetylcysteine (NAC) has been used for decades but its benefit is still unproven. We undertook a systematic review to evaluate the performance and safety of -acetylcysteine on patients suffering amatoxin intoxication. We searched Pubmed, EMBASE, CENTRAL and SinoMed databases, from inception to August 31, 2019. Articles were eligible if there were five or more patients with amatoxin poisoning and -acetylcysteine was included in the therapeutic regimen. Mortality rate including liver transplant cases (MRLTi) was the primary outcome. Mortality rate not including liver transplant cases, liver and renal function, clinical complications, as well as any adverse reactions to intravenous NAC were secondary outcomes. Thirteen studies with a total of 506 patients were included. The MRLTi of amatoxin-poisoning patients with NAC treatment was 11% (57/506), and a MRLTe of 7.9% (40/506) and a liver transplantation rate of 4.3% (22/506). Transaminase concentrations generally peaked around 3 days after ingestion, prothrombin time/International Normalized Ratio (PT/INR) generally worsened during the first 3-4 days after ingestion before returning to normal four to 7 days after ingestion, and Factor V levels normalized in about 4-5 days after ingestion in patients treated with NAC. Renal failure was reported in 3% (3/101) and acute kidney injury was reported in 19% (5/27). Gastrointestinal bleeding occurred in 21% (15/71). Anaphylactoid reactions were the principle adverse reaction to NAC treatment in amatoxin-poisoning patients with an incidence of 5% (4/73). NAC treatment combined with other therapies appears to be beneficial and safe in patients with amatoxin poisoning. Until further data emerge, it is reasonable to use NAC in addition to other treatments for amatoxin poisoning.
Topics: Acetylcysteine; Acute Kidney Injury; Amanitins; Gastrointestinal Hemorrhage; Humans; Liver; Liver Transplantation
PubMed: 32609548
DOI: 10.1080/15563650.2020.1784428 -
BMC Pharmacology & Toxicology Jun 2020Liver cirrhosis is characterized by fibrosis and nodule formation in the liver, due to a chronic injury, and subsequent alteration of the normal architecture of the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Liver cirrhosis is characterized by fibrosis and nodule formation in the liver, due to a chronic injury, and subsequent alteration of the normal architecture of the liver. Even though there is a huge effort to elucidate the possible etiologic factors of liver cirrhosis, a significant number of cases are cryptogenic, especially in Sub Saharan Africa, where there is a high burden of aflatoxin exposure. Aflatoxins are known to cause hepatocellular carcinoma, which share similar etiologic factors with liver cirrhosis. This study aimed to assess the association between aflatoxin exposure and the risk of liver cirrhosis.
METHODS
Relevant studies were identified through systematic searches conducted in Ovid MEDLINE, PubMed and Google Scholar. Also, by searching the references of retrieved articles. The abstracts and full text were screened for eligibility and the risk of bias was assessed for each study using Joanna Briggs Institute (JBI) critical appraisal checklist for observational studies. The extracted data from included studies using Microsoft Excel were exported to Stata software version 15.0 for analyses. The overall pooled estimation of outcomes was calculated using a random-effects model of DerSimonian-Laird method at a 95% confidence level. The heterogeneity of studies was determined using I2 statistics. The presence of publication bias between studies was evaluated using the Begg's and Egger's tests and funnel plot. The protocol of this systematic review and meta-analysis was registered in the Prospero database with reference number ID: CRD42019148481.
RESULTS
A total of 5 studies published between the years 2005 and 2018 that met the pre-defined inclusion and exclusion criteria were included. The meta-analysis showed that a significant increase in the risk of liver cirrhosis is associated with aflatoxin exposure (unadjusted pooled odds ratio (OR) = 3.35, 95% CI: 2.74-4.10, p = 0.000; I = 88.3%, p = 0.000; adjusted OR = 2.5, 95% CI: 1.84-3.39, p = 0.000; I = 0%, p = 0.429).
CONCLUSIONS
The present meta-analysis suggests that aflatoxin exposure is associated with a higher risk of liver cirrhosis.
Topics: Aflatoxins; Environmental Exposure; Humans; Liver Cirrhosis; Risk Factors
PubMed: 32487162
DOI: 10.1186/s40360-020-00420-7 -
The Cochrane Database of Systematic... Apr 2020Aflatoxins are carcinogenic mycotoxins that contaminate many food crops. Maize and groundnuts are prone to aflatoxin contamination, and are the major sources of human... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Aflatoxins are carcinogenic mycotoxins that contaminate many food crops. Maize and groundnuts are prone to aflatoxin contamination, and are the major sources of human exposure to aflatoxins, due to their high intake as staple foods, particularly in low- and middle-income countries (LMICs). Observational studies suggest an association between dietary exposure to aflatoxins during pregnancy and early childhood and linear growth in infants and young children.
OBJECTIVES
To assess the effects on pre- and postnatal growth outcomes when agricultural and nutritional education interventions during the post-harvest period that aim to reduce aflatoxin exposure are compared to usual support or no intervention. We assessed this in infants, children, and pregnant and lactating women at the household or community level in LMICs.
SEARCH METHODS
In July and August 2019, we searched: CENTRAL, MEDLINE, Embase, CINAHL, Web of Science Core Collection, Africa-Wide, LILACS, CAB Abstracts, Agricola, and two trials registers. We also checked the bibliographies of the included studies and contacted relevant mycotoxin organisations and researchers for additional studies.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) and cluster-RCTs of agricultural education and nutritional education interventions of any duration, at the household or community level, aimed at reducing aflatoxin intake by infants, children, and pregnant and lactating women, in LMICs during the post-harvest period, compared to no intervention or usual support. We excluded studies that followed participants for less than four weeks. We assessed prespecified prenatal (at birth) and postnatal growth outcomes (during infancy, childhood, and adolescence), with linear growth (as the primary outcome), infectious disease morbidity, and unintended consequences.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed study eligibility using prespecified criteria, extracted data, and assessed risk of bias of included RCTs. We evaluated the certainty of the evidence using GRADE, and presented the main results in a 'Summary of findings' table.
MAIN RESULTS
We included three recent cluster-RCTs reporting the effects of agricultural education plus post-harvest technologies, compared to usual agricultural support or no intervention. The participants were pregnant women and their children, lactating women and their infants (< 6 months), women of childbearing age, and young children (< 59 months), from rural, subsistence maize-farming communities in Kenya, Zimbabwe, and Tanzania. Two trials randomised villages to the intervention and control groups, including a total of at least 979 mother-child pairs from 60 villages. The third trial randomised 420 households, including 189 mother-child pairs and 231 women of childbearing age. Duration of the intervention and follow-up ranged between five and nine months. Due to risk of attrition bias, the overall risk of bias was unclear in one trial, and high in the other two trials. None of the included studies addressed the effects of nutritional education on pre- and postnatal growth. One trial reported outcomes not prespecified in our review, and we were unable to obtain unpublished growth data from the second trial, even after contacting the authors. The third trial, in lactating women and their infants in Tanzania, reported on the infants' weight-for-age z-score (WAZ) after six months. This trial found that providing agricultural education aimed at changing farmers' post-harvest practices to reduce aflatoxin exposure, by using demonstrations (e.g. handsorting, de-hulling of maize, drying sheets, and insecticides), may improve WAZ in infants from these farmers' households, on average, by 0.57 (95% confidence interval (CI) 0.16 to 0.98; 1 study; 249 participants; very low-certainty evidence), compared to infants from households where the farmers received routine agricultural extension services. Another way of reporting the effect on WAZ is to compare the proportion of underweight infants (WAZ > 2 SD below the reference median value) per group. This trial found that the intervention may reduce the proportion of underweight infants in the intervention households by 6.7% (95% CI -12.6 to -1.4; 249 participants; very low-certainty evidence) compared to control households. No studies reported on unintended effects of agricultural and nutritional education.
AUTHORS' CONCLUSIONS
Evidence on the effects on child growth in LMICs of agricultural or nutritional education interventions that reduce aflatoxin exposure was very limited; no included study reported on linear growth. Very low-certainty evidence suggested that agricultural education aimed at changing farmers' post-harvest practices to reduce aflatoxin exposure by using demonstrations, may result in an increase in WAZ, when compared to usual or no education.
Topics: Adult; Aflatoxins; Agriculture; Breast Feeding; Child, Preschool; Developing Countries; Female; Food Contamination; Growth; Humans; Infant; Kenya; Pregnancy; Prenatal Exposure Delayed Effects; Randomized Controlled Trials as Topic; Tanzania; Thinness; Zimbabwe
PubMed: 32270495
DOI: 10.1002/14651858.CD013376.pub2 -
Toxins Feb 2020This manuscript reviews the state-of-the-art regarding human biological monitoring (HBM) of mycotoxins in plasma serum and blood samples. After a comprehensive and...
This manuscript reviews the state-of-the-art regarding human biological monitoring (HBM) of mycotoxins in plasma serum and blood samples. After a comprehensive and systematic literature review, with a focus on the last five years, several aspects were analyzed and summarized: a) the biomarkers analyzed and their encountered levels, b) the analytical methodologies developed and c) the relationship between biomarker levels and some illnesses. In the literature reviewed, aflatoxin B1-lysine (AFB1-lys) and ochratoxin A (OTA) in plasma and serum were the most widely studied mycotoxin biomarkers for HBM. Regarding analytical methodologies, a clear increase in the development of methods for the simultaneous determination of multiple mycotoxins has been observed. For this purpose, the use of liquid chromatography (LC) methodologies, especially when coupled with tandem mass spectrometry (MS/MS) or high resolution mass spectrometry (HRMS), has grown. A high percentage of the samples analyzed for OTA or aflatoxin B1 (mostly as AFB1-lys) in the reviewed papers were positive, demonstrating human exposure to mycotoxins. This review confirms the importance of mycotoxin human biomonitoring and highlights the important challenges that should be faced, such as the inclusion of other mycotoxins in HBM programs, the need to increase knowledge of mycotoxin metabolism and toxicokinetics, and the need for reference materials and new methodologies for treating samples. In addition, guidelines are required for analytical method validation, as well as equations to establish the relationship between human fluid levels and mycotoxin intake.
Topics: Biological Monitoring; Biomarkers; Humans; Mycotoxins
PubMed: 32121036
DOI: 10.3390/toxins12030147 -
Mycotoxin Research May 2020Mycotoxin exposure from food occurs globally but is more common in hot humid environments, especially in low-income settings, and might affect pregnancy outcomes. This...
Mycotoxin exposure from food occurs globally but is more common in hot humid environments, especially in low-income settings, and might affect pregnancy outcomes. This study aimed to synthesize the evidence from epidemiological studies on the relationship between maternal or fetal exposure to different mycotoxins and the occurrence of adverse pregnancy outcomes. Multiple databases were systematically searched up to December 2018 to identify studies that assessed the association between mycotoxin exposure in pregnant women or fetuses and at least one pregnancy outcome. Studies were appraised and results were synthesized using standard methods for conducting systematic reviews. This review identified and included 17 relevant studies. There is some evidence to suggest that exposure to various Aspergillus mycotoxins (e.g., aflatoxin) during pregnancy may impair intrauterine fetal growth and promote neonatal jaundice. Findings were inconclusive concerning the influence of aflatoxin exposure on perinatal death and preterm birth. Only two studies assessed effects of maternal exposure to Fusarium mycotoxins (e.g., fumonisin) on adverse pregnancy outcomes. These studies found that maternal fumonisin exposure may be associated with hypertensive emergencies in pregnancy and with neural tube defects. Studies using grain farming and weather conditions as a proxy measure for mycotoxin exposure found that such exposure was associated with an increased risk of preterm birth and late-term miscarriage. In conclusion, there is already some evidence to suggest that exposure to mycotoxins during pregnancy may have detrimental effects on pregnancy outcomes. However, given the limited number of studies, especially on effects of Fusarium mycotoxins, more studies are needed for a more comprehensive understanding of the effects of different mycotoxins on maternal and fetal health and to guide public health policies and interventions.
Topics: Aflatoxins; Dietary Supplements; Female; Fumonisins; Humans; Maternal Exposure; Mycotoxins; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth
PubMed: 31989413
DOI: 10.1007/s12550-019-00384-6 -
Food Chemistry Apr 2020Major databases were searched until January 2019 and 77 eligible studies were included in the meta-analysis to estimate the overall mean of AFM1 in milk in Iran. The... (Meta-Analysis)
Meta-Analysis
Major databases were searched until January 2019 and 77 eligible studies were included in the meta-analysis to estimate the overall mean of AFM1 in milk in Iran. The mean of AFM1 levels was obtained 55.97 ng/kg (95% CI: 50.09-61.84). However, the pooled estimated mean of AFM1 levels in milk were 94.58 (95% CI: 70.24-118.92), 59.19 (95% CI: 51.84-66.54) and 35.23 ng/kg (95% CI: 31.53-38.92), considering 4, 55 and 18 TLC, ELISA and HPLC-based studies (including 354, 9224 and 2606 samples), respectively. Also, there is a wide variation of AFM1 levels among different geographical regions which were the highest in northern (88.77 ng/kg). The AFM1 contamination of milk taken from the areas with humid climate was higher than the arid climate. AFM1 Levels were the highest in winter (48.70 ng/Kg). The level of AFM1 in pasteurized, raw, and UHT milk were 49.76, 55.08 and 94.81 ng/kg, respectively.
Topics: Aflatoxin M1; Animals; Chromatography, High Pressure Liquid; Chromatography, Thin Layer; Climate; Enzyme-Linked Immunosorbent Assay; Food Contamination; Iran; Limit of Detection; Milk; Pasteurization; Seasons
PubMed: 31846793
DOI: 10.1016/j.foodchem.2019.125848 -
Critical Reviews in Food Science and... 2020The aim of this study was to systematically review associations between dietary mycotoxins exposure and child growth and morbidity of children aged 5 years or younger....
The aim of this study was to systematically review associations between dietary mycotoxins exposure and child growth and morbidity of children aged 5 years or younger. Peer-reviewed literature was searched in MEDLINE, EMBASE, COCHRANE, CINAHL, Web of Science, and PsycINFO. Experimental and observational studies were considered. The exposures were dietary mycotoxins during pregnancy, lactation and childhood, and mycotoxins concentrations in the diet, breast milk, urine, and blood. From a total of 4869 references, 86 full-text papers were extracted of which 50 were included in this review. The methodological quality and risk of bias were evaluated and quality of the collective evidence was assessed using GRADE. Uncertainty remains whether mycotoxins exposure affects child growth, immunity and mortality and the overall quality of the evidence is very low. Overall however, we cannot rule out a possible association between dietary mycotoxins, in particular, AF and FUM and child malnutrition. Our analyses were limited by the reporting quality, difference in findings, heterogeneity of outcomes, mycotoxins detection methods, and the observational nature of most studies. Robust study designs with adequate sample size, use of validated biomarkers of exposure and assessment of co-occurrence of mycotoxins and their synergistic effects are required to provide the further evidence regarding a potential effect of dietary mycotoxins exposure on child growth and immunity.
Topics: Child; Child, Preschool; Diet; Female; Humans; Immune System; Lactation; Milk, Human; Mycotoxins; Pregnancy
PubMed: 31694387
DOI: 10.1080/10408398.2019.1685455