Study of an epidemic of venoocclusive disease in India.

Tandon, Radhika; Tandon, B. N.; Hd, Tandon; Bhatia, M. L.; Bhargava, Satish; Lal, Pyare; Arora, Richa

doi:10.1136/gut.17.11.849

Cited by 47 publications

(38 citation statements)

References 10 publications

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“…Several authors report about on outbreak of HVOD in 1975 in central India (Tandon et al, 1976;Krishnamachari et al, 1977). Staple millet (Panicum miliare) was found to be contaminated with seeds of Crotalaria species.…”

Section: Outbreaksmentioning

confidence: 99%

“…by grain crops contaminated with seeds of Heliotropium species in India, USSR and Afghanistan (Mattocks, 1986;WHO-IPCS, 1988) and later in Tadjikistan (Prakash et al, 1999). In central India an outbreak of HVOD, in which 42 % of the 67 recorded cases were fatal, was probably caused by the consumption of cereals mixed with seeds of a Crotalaria species (Tandon et al, 1976). Afghanistan has recently been afflicted by HVOD associated with the contamination of wheat with the seeds of weeds locally called 'charmac' or 'charmak' (Heliotropium popovi) (WHO, 2001;IRIN, 2008;Kakar et al, 2010).…”

Section: Observations In Humansmentioning

confidence: 99%

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Scientific Opinion on Pyrrolizidine alkaloids in food and feed

2011

EFS2

224

130

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The European Food Safety Authority (EFSA) was asked by the European Commission to deliver a scientific opinion on pyrrolizidine alkaloids (PA) in food and feed. PAs are toxins exclusively biosynthesised by plants. To date, approximately 600 different PAs are known. Results for 13,280 bulk honey and 1324 retail honey samples were provided to EFSA by one Member State and 351 feed samples were provided by a second Member State. The EFSA Panel on Contaminants in the Food Chain (CONTAM Panel) performed estimates of both acute and chronic exposure to PAs through honey for three different age groups. Although there might be other sources of PA exposure, due to lack of data the CONTAM Panel was not able to quantify dietary exposure from food other than honey. A number of PAs were identified as being of particular importance for food and feed. Based on the present knowledge of metabolism, activation, DNA adduct-formation, genotoxicity and carcinogenicity, the CONTAM Panel concluded that 1,2-unsaturated PAs may act as genotoxic carcinogens in humans. Therefore, the CONTAM Panel decided to apply the Margin of Exposure (MOE) approach. A benchmark dose lower confidence limit for a 10 % excess cancer risk (BMDL 10 ) of 70 µg/kg b.w. per day for induction of liver haemangiosarcomas by lasiocarpine in male rats was calculated as the reference point for comparison with the estimated dietary exposure. The CONTAM Panel concluded that there is a possible health concern for those toddlers and children who are high consumers of honey. There is generally a low risk of PA poisoning in livestock and companion animals in the EU as most PA poisonings reported recently are due to accidental exposure. © European Pyrrolizidine alkaloids in food and feedEFSA Journal 2011;9(11):2406 2 SUMMARYFollowing a request from the European Commission, the Panel on Contaminants in the Food Chain (CONTAM Panel) was asked to deliver a scientific opinion on the risks to human and animal health related to the presence of pyrrolizidine alkaloids (PA) in food and feed. PAs are toxins exclusively biosynthesised by plants. They are typical plant secondary metabolites against herbivores. It has been estimated that approximately 6000 plant species world wide, representing 3 % of all flowering plants, may contain pyrrolizidine alkaloids. PAs are mainly found in the distantly related angiosperm families of the Boraginaceae (all genera), Asteraceae (tribes Senecioneae and Eupatorieae) and Fabaceae (genus Crotalaria). The PA-content of plant material depends on a large number of factors (species, plant organ, harvest, storage, extraction procedures). Reported contents vary from trace amounts up to 19 % based on dry weight. The name pyrrolizidine is the chemical description of two-fused 5-membered rings with a nitrogen atom at the bridgehead. This motif is the central structure of a variety of PAs. PAs generally consist of an amino alcohol which is referred to as necine or necine base and an acid part which is called a necic acid. Most of the known PAs are este...

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Section: Outbreaksmentioning

confidence: 99%

Section: Observations In Humansmentioning

confidence: 99%

Scientific Opinion on Pyrrolizidine alkaloids in food and feed

2011

EFS2

224

130

View full text Add to dashboard Cite

show abstract

“…of food, medication or contaminations of food and feed. Outbreaks of PA poisoning in humans due to PA-contaminated grain have been reported for instance for India and Afghanistan (Kakar et al, 2010;Krishnamachari et al, 1977;Mohabbat et al, 1976;Tandon et al, 1976). Affected people showed hepatic veno-occlusive disease (HVOD) as well as massive ascites and emaciation.…”

Section: Discussionmentioning

confidence: 94%

Disturbance of gene expression in primary human hepatocytes by hepatotoxic pyrrolizidine alkaloids: A whole genome transcriptome analysis

Luckert

Hessel

Lenze

et al. 2015

Toxicology in Vitro

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“…The disease had occurred in the former Soviet Union (63). From 1975 to 1977, three outbreaks of the disease were reported from South Asia, two from India, and one from Afghanistan (64)(65)(66). Until the advent of chemotherapy in 1950, ingestion of herbal teas or food sources contaminated with pyrrolizidine alkaloids was the only cause of VOD.…”

Section: Sinusoidal Obstruction Syndromementioning

confidence: 99%

Hepatic Venous Outflow Obstruction: Suggestion of a New Classification

Shrestha¹

2017

jrenhep

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Hepatic venous outflow obstruction (HVOO) is common in developing countries. It is a serious condition that clinically manifests with ascites from sinusoidal hypertension, and carries the risk of high mortality or development of liver cirrhosis. In the past, the eponym Budd-Chiari Syndrome (BCS) was used synonymously for HVOO. In the West, hepatic vein (HV) thrombosis caused by prothrombotic disorders is the main cause of HVOO. In the East, obliterative disease of hepatic portion of inferior vena cava induced by bacterial infection, now renamed hepatic vena cava syndrome, is the common cause of HVOO. These two diseases with different etiology, epidemiology, and natural history are at present grouped together under BCS causing much confusion. Sinusoidal obstruction syndrome, another important cause of HVOO at the level of the sinusoid and terminal HV, was left out in the classification of HVOO. In this article, the pathophysiology of sinusoidal hypertension is described, the term BCS is redefined, and a new classification of HVOO is suggested.

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Study of an epidemic of venoocclusive disease in India.

Cited by 47 publications

References 10 publications

Scientific Opinion on Pyrrolizidine alkaloids in food and feed

Scientific Opinion on Pyrrolizidine alkaloids in food and feed

Disturbance of gene expression in primary human hepatocytes by hepatotoxic pyrrolizidine alkaloids: A whole genome transcriptome analysis

Hepatic Venous Outflow Obstruction: Suggestion of a New Classification

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