Protective Interventions to Prevent Aflatoxin-Induced Carcinogenesis in Developing Countries

Abstract

The public health impact of aflatoxin exposure is pervasive in economically developing countries; consequently, we need to design intervention strategies for prevention that are practicable for these high-risk populations. The adverse health consequences of aflatoxins in populations are quite varied, eliciting acute effects, such as rapid death, and chronic outcomes, such as hepatocellular carcinoma. Furthermore, a number of epidemiological studies describe a variety of general adverse health effects associated with aflatoxin, such as impaired growth in children. Thus, the magnitude of the problem is disseminated across the entire spectrum of age, gender, and health status in the population. The aflatoxins multiplicatively increase the risk of liver cancer in people chronically infected with hepatitis B virus (HBV), which illustrates the deleterious impact that even low toxin levels in the diet can pose for human health. Thus other aflatoxin interactions, which likely contribute to the diesease burden, still remain to be identified. Therefore, many diverse and appropriate strategies for disease prevention are needed to decrease the incidence of aflatoxin carcinogenesis in developing countries.

Risk Factors for Hepatocellular Carcinoma in India

“…45 The risk of HCC is greatly increased in chronic viral carriers exposed to other recognized risk factors, including exposure to aflatoxin B1 (AFB1). 66,67 Aflatoxins, a secondary metabolite produced by Aspergillus flavus and Aspergillus parasiticus, are potent human carcinogens implicated in HCC 68 and also it is proved to Figure 2 Spectrum of relationship between NAFLD and diabetes. 64 have a significant association with HCC in India.…”

“…The impact seems to be a cumulative process, as revealed by the AFB1 deposits in HCC liver tissue, even though the serum levels were undetectable. 68 Specific P450 enzymes in the liver metabolize aflatoxin into a reactive oxygen species (aflatoxin-8,9-epoxide), which may then bind to proteins and cause acute toxicity (aflatoxicosis) or to DNA to cause lesions that over time increase the risk of HCC. 69 A causative role for aflatoxins in hepatocarcinogenesis in humans has been strongly suggested based on various epidemiological data.…”

Perspective: Time to face the fungal threat

“…People whose livers are already compromised by infection with hepatitis B virus (HBV) are particularly susceptible to aflatoxininduced liver cancer 3 . Studies by my team 1,2 suggest that up to 172,000 cases of HCC per year can be attributed to exposure to aflatoxin in the diet, and most of these individuals are infected with HBV.…”

Climate change impacts on mycotoxin risks in US maize

“…Aflatoxins, produced by the fungi Aspergillus flavus and Aspergillus parasiticus, are among the most potent naturally occurring chemical liver carcinogens known (Groopman et al, 2008). Aflatoxins can contaminate many food and feed stuffs (Bandyopadhyay et al, 2007), including maize, peanuts, tree nuts, cottonseed, and various spices.…”