Aflatoxins are mutagenic hepatocarcinogenic fungal metabolites that contribute to chronic hepatitis B and C and viral cirrhosis, which can both evolve into hepatocellular carcinoma.Objective: To identify and quantify free aflatoxins and AFB 1 -N 7 -guanine (AFB 1 -N 7 -Gua) adducts (active carcinogen) in the urine of Mexican patients with chronic liver diseases.Methods: Urine samples from 210 Mexican patients with chronic liver diseases, hepatitis B or C, or viral cirrhosis and four control groups: 1) patients with alcoholic cirrhosis, 2) patients with no hepatic diseases, 3) patients with kidney failure, and 4) healthy persons, were analyzed for free aflatoxins and AFB 1 -N 7 -Gua adducts by Inhibitory Indirect ELISA and high performance liquid chromatography, and both methods produced similar results (R 2 =0.90). A questionnaire regarding foods with high risk of containing aflatoxins was applied to relate diet and disease.Results: Aflatoxin-positive samples were found from patients in the following groups: hepatitis B (50%), viral cirrhosis (26%), hepatitis C (16.6%), alcoholic cirrhosis (10%), healthy (10%), kidney failure (0.47%), and chronic nonhepatic diseases (0%), with R 2 =0.95. Risk groups had more AFB 1 -N 7 -Gua adducts than controls. High performance liquid chromatography identified free AFB 1 (exposure), types M 1 and P 1 (detoxification metabolites), and Inhibitory Indirect ELISA quantified AFB 1 -N 7 -Gua adduct (a DNA repair biomarker).High-risk foods related (P≤0.001) to hepatic diseases were maize, oil seeds, and dairy products.
Conclusion: Mexican patients with chronic liver diseases exhibited high concentrations of aflatoxins and Aflatoxin-N
7-Gua adducts, both of which showed high exposure and the last are significant biomarkers for the risk of liver diseases that predispose patients to liver cancer. and HCV markers.2. Chronic or terminal kidney failure (urea and creatinine tests), blood or chronic peritoneal dialysis substitution, and negative viral markers.3. Chronic non-hepatic diseases (CNHD) or gastric ulcers.4. Healthy individuals: normal hepatic functions and serological test.The sample size was the minimum size to ensure that the sample mean exhibited an approximately normal sampling distribution. Sex and age ranges of the risk and control groups are shown in Table 1.
Collection and urine sample analysisThis study focused on collecting AFB 1 -N 7 -Gua adducts in urine because this method is non-invasive and because chronic liver diseases are not treated through surgical operations in which samples could be collected; therefore, the collection of sampling tissues is possible only by biopsies and necropsies, and urine is easier to obtain. Each patient answered 200 questions about their diet, which were developed by the Dept. of Epidemiology of the Institute of Medical Sciences and Nutrition, and provided a 24-hour urine sample that was measured and homogenized by vortexing; an aliquot of urine was removed for colorimetric determination. To adjust urine concentrations and make ...