Aflatoxins are various poisonous carcinogens and mutagens that are produced by certain molds, particularly Aspergillus species. The fungi grow in soil, decaying vegetation and various staple foodstuffs and commodities such as hay, sweetcorn, wheat, millet, sorghum, cassava, rice, chili peppers, cottonseed, peanuts, tree nuts, sesame seeds, sunflower seeds, and various spices. In short, the relevant fungi grow on almost any crop or food. When such contaminated food is processed or consumed, the aflatoxins enter the general food supply. They have been found in both pet and human foods, as well as in feedstocks for agricultural animals. Animals fed contaminated food can pass aflatoxin transformation products into eggs, milk products, and meat. For example, contaminated poultry feed is the suspected source of aflatoxin-contaminated chicken meat and eggs in Pakistan.
Children are particularly affected by aflatoxin exposure, which is associated with stunted growth, delayed development, liver damage, and liver cancer. An association between childhood stunting and aflatoxin exposure has been reported in some studies but could not be detected in all. Furthermore, a causal relationship between childhood stunting and aflatoxin exposure has yet to be conclusively shown by epidemiological studies, though such investigations are under way. Adults have a higher tolerance to exposure, but are also at risk. No animal species is immune. Aflatoxins are among the most carcinogenic substances known. After entering the body, aflatoxins may be metabolized by the liver to a reactive epoxide intermediate or hydroxylated to become the less harmful aflatoxin M1.
Aflatoxin poisoning most commonly results from ingestion, but the most toxic aflatoxin compound, B1, can permeate through the skin.
The United States Food and Drug Administration (FDA) action levels for aflatoxin present in food or feed is 20 to 300 ppb. The FDA has had occasion to declare both human and pet food recalls as a precautionary measure to prevent exposure.
The term "aflatoxin" is derived from the name of the species Aspergillus flavus, in which some of the compounds first were discovered. The word was coined around 1960 after its discovery as the source of "Turkey X disease". Aflatoxins form one of the major groupings of mycotoxins, and apart from Aspergillus flavus various members of the group of compounds occur in species such as: Aspergillus parasiticus, Aspergillus pseudocaelatus, Aspergillus pseudonomius", and Aspergillus nomius".
Major types and their metabolitesEdit
Aflatoxin B1 is considered the most toxic and is produced by both Aspergillus flavus and Aspergillus parasiticus. Aflatoxin M1 is present in the fermentation broth of Aspergillus parasiticus, but it and aflatoxin M2 are also produced when an infected liver metabolizes aflatoxin B1 and B2.
- Aflatoxin B1 and B2 (AFB), produced by Aspergillus flavus and A. parasiticus
- Aflatoxin G1 and G2 (AFG), produced by some Group II A. flavus and Aspergillus parasiticus
- Aflatoxin M1 (AFM1), metabolite of aflatoxin B1 in humans and animals (exposure in ng levels may come from a mother's milk)
- Aflatoxin M2, metabolite of aflatoxin B2 in milk of cattle fed on contaminated foods
- Aflatoxicol (AFL): metabolite produced by breaking down the lactone ring
- Aflatoxin Q1 (AFQ1), major metabolite of AFB1 in in vitro liver preparations of other higher vertebrates
Aflatoxins are produced by both Aspergillus flavus and Aspergillus parasiticus, which are common forms of 'weedy' molds widespread in nature. The presence of those molds does not always indicate that harmful levels of aflatoxin are present, but does indicate a significant risk. The molds can colonize and contaminate food before harvest or during storage, especially following prolonged exposure to a high-humidity environment, or to stressful conditions such as drought.
The native habitat of Aspergillus is in soil, decaying vegetation, hay, and grains undergoing microbiological deterioration, but it invades all types of organic substrates whenever conditions are favorable for its growth. Favorable conditions for production of aflatoxins include high moisture content (at least 7%) and temperatures from 55 °F (13 °C) to 104 °F (40 °C) [optimum 27 to 30 °C (81 to 86 °F)]. Aflatoxins have been isolated from all major cereal crops, and from sources as diverse as peanut butter and cannabis. The staple commodities regularly contaminated with aflatoxins include cassava, chilies, corn, cotton seed, millet, peanuts, rice, sorghum, sunflower seeds, tree nuts, wheat, and a variety of spices intended for human or animal consumption. Aflatoxin transformation products are sometimes found in eggs, milk products, and meat when animals are fed contaminated grains.
A primary means of limiting risk from aflatoxins in the food supply is food hygiene in the commercial commodity supply chain, such as rejecting moldy grain for use in food processing plants and testing of batches of ingredients for aflatoxin levels before adding them to the mix. Regulatory agencies such as the FDA set limits on acceptable levels. Grain drying itself, which is necessary for viable combine harvesting in many regions, lays the fundamentals for this effort by preventing stored grain from being too damp in the first place.
There is very limited evidence to show that agricultural and nutritional education can reduce exposure to aflatoxin in low to middle income countries.
No animal species is known to be immune to the acute toxic effects of aflatoxins. Adult humans have a high tolerance for aflatoxin exposure and rarely succumb to acute aflatoxicosis, but children are particularly affected, and their exposure can lead to stunted growth and delayed development, in addition to all the symptoms mentioned below.
High-level aflatoxin exposure produces an acute hepatic necrosis (acute aflatoxicosis), resulting later in cirrhosis or carcinoma of the liver. Acute liver failure is made manifest by bleeding, edema, alteration in digestion, changes to the absorption and/or metabolism of nutrients, and mental changes and/or coma.
Chronic, subclinical exposure does not lead to symptoms so dramatic as acute aflatoxicosis. Chronic exposure increases the risk of developing liver and gallbladder cancer, as aflatoxin metabolites may intercalate into DNA and alkylate the bases through epoxide moiety. This is thought to cause mutations in the p53 gene, an important gene in preventing cell cycle progression when there are DNA mutations, or signaling apoptosis (programmed cell death). These mutations seem to affect some base pair locations more than others, for example, the third base of codon 249 of the p53 gene appears to be more susceptible to aflatoxin-mediated mutations than nearby bases. As with other DNA-alkylating agents, Aflatoxin B1 can cause immune suppression, and exposure to it is associated with an increased viral load in HIV positive individuals.
The expression of aflatoxin-related diseases is influenced by factors such as species, age, nutrition, sex, and the possibility of concurrent exposure to other toxins. The main target organ in mammals is the liver, so aflatoxicosis primarily is a hepatic disease. Conditions increasing the likelihood of aflatoxicosis in humans include limited availability of food, environmental conditions that favour mould growth on foodstuffs, and lack of regulatory systems for aflatoxin monitoring and control.
There is no specific antidote for aflatoxicosis. Symptomatic and supportive care tailored to the severity of the liver disease may include intravenous fluids with dextrose, active vitamin K, B vitamins, and a restricted, but high-quality protein diet with adequate carbohydrate content.
In other animalsEdit
In dogs, aflatoxin has potential to lead to liver disease. Low levels of aflatoxin exposure require continuous consumption for several weeks to months in order for signs of liver dysfunction to appear. Some articles have suggested the toxic level in dog food is 100–300 ppb and requires continuous exposure or consumption for a few weeks to months to develop aflatoxicosis. No information is available to suggest that recovered dogs will later succumb to an aflatoxin-induced disease.
Turkeys are extremely susceptible to aflatoxicosis. Recent studies have revealed that this is due to the efficient cytochrome P450 mediated metabolism of aflatoxin B1 in the liver of turkeys and deficient glutathione-S-transferase mediated detoxification.
In 2005, Diamond Pet Foods discovered aflatoxin in a product manufactured at their facility in Gaston, South Carolina. In 23 states, Diamond voluntarily recalled 19 products formulated with corn and manufactured in the Gaston facility. Testing of more than 2,700 finished product samples conducted by laboratories confirmed that only two date codes of two adult dog formulas had the potential to be toxic.
Detection in humansEdit
There are two principal techniques that have been used most often to detect levels of aflatoxin in humans.
The first method is measuring the AFB1-guanine adduct in the urine of subjects. The presence of this breakdown product indicates exposure to aflatoxin B1 during the past 24 hours. This technique measures only recent exposure, however. Due to the half-life of this metabolite, the level of AFB1-guanine measured may vary from day to day, based on diet, it is not ideal for assessing long-term exposure.
Another technique that has been used is a measurement of the AFB1-albumin adduct level in the blood serum. This approach provides a more integrated measure of exposure over several weeks or months.
List of outbreaksEdit
This section needs expansion. You can help by adding to it. (December 2014)
International sources of commercial peanut butter, cooking oils (e.g. olive, peanut and sesame oil), and cosmetics have been identified as contaminated with aflatoxin. In some instances, liquid chromatography–tandem mass spectrometry (LC–MS/MS), and other analytical methods, revealed a range from 48% to 80% of selected product samples as containing detectable quantities of aflatoxin. In many of these contaminated food products, the aflatoxin exceeded the safe limits of the U.S. Food and Drug Administration (FDA), or other regulatory agency.
- 2003 Kenya: acute poisoning, 120 confirmed deaths.
- February–March 2013: Romania, Serbia, Croatia imported into western Europe - 2013 aflatoxin contamination.
- February 2013: Iowa contamination.
- 2014 (ongoing): Nepal and Bangladesh, neonatal exposures, found in umbilical cord blood.
- 2019 Kenya: five brands of maize flour recalled due to contamination.
- 2021 USA: Contamination of pet food manufactured by Midwestern Pet Food, causing the deaths of at least 70 dogs.
- Fratamico PM, Bhunia AK, Smith JL (2008). Foodborne Pathogens: Microbiology and Molecular Biology. Norofolk, UK: Horizon Scientific Press. ISBN 978-1-898486-52-7.
- Iqbal SZ, et al. (2014). "Natural incidence of aflatoxins, ochratoxin A and zearalenone in chicken meat and eggs". Food Control. 43: 98–103. doi:10.1016/j.foodcont.2014.02.046.
- Khlangwiset P, Shephard GS, Wu F (October 2011). "Aflatoxins and growth impairment: a review". Critical Reviews in Toxicology. 41 (9): 740–55. doi:10.3109/10408444.2011.575766. PMID 21711088. S2CID 19262759.
- Abbas HK (2005). Aflatoxin and Food Safety. CRC Press. ISBN 978-0-8247-2303-3.
- Smith LE, Prendergast AJ, Turner PC, Mbuya MN, Mutasa K, Kembo G, Stoltzfus RJ (December 2015). "The Potential Role of Mycotoxins as a Contributor to Stunting in the SHINE Trial". Clinical Infectious Diseases. 61 Suppl 7: S733–7. doi:10.1093/cid/civ849. PMC 4657594. PMID 26602301.
- Voth-Gaeddert LE, Stoker M, Torres O, Oerther DB (April 2018). "Association of aflatoxin exposure and height-for-age among young children in Guatemala". International Journal of Environmental Health Research. 28 (3): 280–292. doi:10.1080/09603123.2018.1468424. PMID 29706087. S2CID 23510545.
- Turner PC, Collinson AC, Cheung YB, Gong Y, Hall AJ, Prentice AM, Wild CP (October 2007). "Aflatoxin exposure in utero causes growth faltering in Gambian infants". International Journal of Epidemiology. 36 (5): 1119–25. doi:10.1093/ije/dym122. PMID 17576701.
- Mitchell NJ, Hsu HH, Chandyo RK, Shrestha B, Bodhidatta L, Tu YK, Gong YY, Egner PA, Ulak M, Groopman JD, Wu F (2017). "Aflatoxin exposure during the first 36 months of life was not associated with impaired growth in Nepalese children: An extension of the MAL-ED study". PLOS ONE. 12 (2): e0172124. Bibcode:2017PLoSO..1272124M. doi:10.1371/journal.pone.0172124. PMC 5315312. PMID 28212415.
- Chen C, Mitchell NJ, Gratz J, Houpt ER, Gong Y, Egner PA, Groopman JD, Riley RT, Showker JL, Svensen E, Mduma ER, Patil CL, Wu F (March 2018). "Exposure to aflatoxin and fumonisin in children at risk for growth impairment in rural Tanzania". Environment International. 115: 29–37. doi:10.1016/j.envint.2018.03.001. PMC 5989662. PMID 29544138.
- Smith LE, Prendergast AJ, Turner PC, Mbuya MN, Mutasa K, Kembo G, Stoltzfus RJ (December 2015). "The Potential Role of Mycotoxins as a Contributor to Stunting in the SHINE Trial". Clinical Infectious Diseases. 61 Suppl 7 (Suppl 7): S733–7. doi:10.1093/cid/civ849. PMC 4657594. PMID 26602301.
- Hoffmann, V.; Jones, K.; Leroy, J. L. (2018). "The impact of reducing dietary aflatoxin exposure on child linear growth: a cluster randomised controlled trial in Kenya". BMJ Global Health. 3: e000983. doi:10.1136/bmjgh-2018-000983. PMID 30588341.
- Hoffmann V, Jones K, Leroy J (December 2015). "Mitigating aflatoxin exposure to improve child growth in Eastern Kenya: study protocol for a randomized controlled trial". Trials. 16: 552. doi:10.1186/s13063-015-1064-8. PMC 4669614. PMID 26634701.
- Hudler GW (1998). Magical Mushrooms, Mischievous Molds: The Remarkable Story of the Fungus Kingdom and Its Impact on Human Affairs. Princeton University Press. ISBN 978-0-691-07016-2.
- Boonen J, Malysheva SV, Taevernier L, Diana Di Mavungu J, De Saeger S, De Spiegeleer B (November 2012). "Human skin penetration of selected model mycotoxins". Toxicology. 301 (1–3): 21–32. doi:10.1016/j.tox.2012.06.012. PMID 22749975.
- "Guidance for Industry: Action Levels for Poisonous or Deleterious Substances in Human Food and Animal Feed". Food and Drug Administration. August 2000. Retrieved November 14, 2020.
- Wannop CC (March 1961). "The Histopathology of Turkey "X" Disease in Great Britain". Avian Diseases. 5 (4): 371–381. doi:10.2307/1587768. JSTOR 1587768.
- J. Varga, J.C. Frisvad, R.A. Samson: "Two new aflatoxin producing species, and an overview of Aspergillus section Flavi", Stud Mycol. 2011 Jun 30; 69(1): 57–80. doi: 10.3114/sim.2011.69.05
- Geiser DM, Dorner JW, Horn BW, Taylor JW (December 2000). "The phylogenetics of mycotoxin and sclerotium production in Aspergillus flavus and Aspergillus oryzae". Fungal Genetics and Biology. 31 (3): 169–79. doi:10.1006/fgbi.2000.1215. PMID 11273679.
- Aflatoxin M2 product page from Fermentek
- Smith JE, Sivewright-Henderson R (1991). Mycotoxins and animal foods. CRC Press. p. 614. ISBN 978-0-8493-4904-1.
- Neal GE, Eaton DL, Judah DJ, Verma A (July 1998). "Metabolism and toxicity of aflatoxins M1 and B1 in human-derived in vitro systems". Toxicology and Applied Pharmacology. 151 (1): 152–8. doi:10.1006/taap.1998.8440. PMID 9705898.
- "Risk of aflatoxin contamination increases with hot and dry growing conditions | Integrated Crop Management". crops.extension.iastate.edu. Retrieved 2021-06-13.
- "Storing nuts at a low temperature (refrigeration) reduces aflatoxin levels and mold and yeast counts for 3-6 months | News | Postharvest - Fruits, Vegetables and Ornamentals". www.postharvest.biz. Retrieved 2021-06-13.
- Pradeepkiran JA (December 2018). "Analysis of aflatoxin B1 in contaminated feed, media, and serum samples of Cyprinus carpio L. by high-performance liquid chromatography". Food Quality and Safety. 2 (4): 199–204. doi:10.1093/fqsafe/fyy013.
- No chance for aflatoxins Archived October 17, 2015, at the Wayback Machine Rural 21, the International Journal for Rural Development, 3 April 2013. -- The Aflacontrol project was conducted by IFPRI with scientists from CIMMYT, the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Directorate of Groundnut Research and other organizations. It sought to provide evidence of the cost-effectiveness of aflatoxin risk-reduction strategies along maize and groundnut value chains in Africa, and to understand what prevented adoption of these control strategies.
- Tosun H, Arslan R (2013). "Determination of aflatoxin B1 levels in organic spices and herbs". TheScientificWorldJournal. 2013: 874093. doi:10.1155/2013/874093. PMC 3677655. PMID 23766719.
- Visser ME, Schoonees A, Ezekiel CN, Randall NP, Naude CE (April 2020). "Agricultural and nutritional education interventions for reducing aflatoxin exposure to improve infant and child growth in low- and middle-income countries". The Cochrane Database of Systematic Reviews. 4: CD013376. doi:10.1002/14651858.cd013376.pub2. PMC 7141997. PMID 32270495.
- Williams JH, Phillips TD, Jolly PE, Stiles JK, Jolly CM, Aggarwal D (November 2004). "Human aflatoxicosis in developing countries: a review of toxicology, exposure, potential health consequences, and interventions". The American Journal of Clinical Nutrition. 80 (5): 1106–22. doi:10.1093/ajcn/80.5.1106. PMID 15531656.
- Nogueira L, Foerster C, Groopman J, Egner P, Koshiol J, Ferreccio C (May 2015). "Association of aflatoxin with gallbladder cancer in Chile". JAMA. 313 (20): 2075–7. doi:10.1001/jama.2015.4559. PMC 7169945. PMID 26010638.
- Aguilar F, Hussain SP, Cerutti P (September 1993). "Aflatoxin B1 induces the transversion of G-->T in codon 249 of the p53 tumor suppressor gene in human hepatocytes". Proceedings of the National Academy of Sciences of the United States of America. 90 (18): 8586–90. Bibcode:1993PNAS...90.8586A. doi:10.1073/pnas.90.18.8586. PMC 47402. PMID 8397412.
- Jolly PE, Inusah S, Lu B, Ellis WO, Nyarko A, Phillips TD, Williams JH (2013). "Association between high aflatoxin B1 levels and high viral load in HIV-positive people". World Mycotoxin Journal. 6 (3): 255–261. doi:10.3920/WMJ2013.1585. PMC 6750767. PMID 31534557.
- "Common food fungus can accelerate onset of AIDS". digitaljournal.com. September 1, 2013.
- Machida M, Gomi K, eds. (2010). Aspergillus: Molecular Biology and Genomics. Caister Academic Press. ISBN 978-1-904455-53-0.
- Peterson S, Lampe JW, Bammler TK, Gross-Steinmeyer K, Eaton DL (September 2006). "Apiaceous vegetable constituents inhibit human cytochrome P-450 1A2 (hCYP1A2) activity and hCYP1A2-mediated mutagenicity of aflatoxin B1". Food and Chemical Toxicology. 44 (9): 1474–84. doi:10.1016/j.fct.2006.04.010. PMID 16762476.
- Bingham AK, Phillips TD, Bauer JE (March 2003). "Potential for dietary protection against the effects of aflatoxins in animals". Journal of the American Veterinary Medical Association. 222 (5): 591–6. doi:10.2460/javma.2003.222.591. PMID 12619837.
- Bastianello SS, Nesbit JW, Williams MC, Lange AL (December 1987). "Pathological findings in a natural outbreak of aflatoxicosis in dogs". The Onderstepoort Journal of Veterinary Research. 54 (4): 635–40. PMID 3444619.
- Rawal S, Yip SS, Coulombe RA (August 2010). "Cloning, expression and functional characterization of cytochrome P450 3A37 from turkey liver with high aflatoxin B1 epoxidation activity". Chemical Research in Toxicology. 23 (8): 1322–9. doi:10.1021/tx1000267. PMID 20707407.
- Rawal S, Coulombe RA (August 2011). "Metabolism of aflatoxin B1 in turkey liver microsomes: the relative roles of cytochromes P450 1A5 and 3A37". Toxicology and Applied Pharmacology. 254 (3): 349–54. doi:10.1016/j.taap.2011.05.010. PMID 21616088.
- Goldblatt L (2012-12-02). Aflatoxin: Scientific Background, Control, and Implications. ISBN 9780323148498.
- FDA Inspection Report-Diamond Gaston SC Plant 12/21/2005-1/19/2006.
- 2005 Recall, FDA
- AKC Standard Article Contaminated Diamond Pet Food Products and 'Best By' Dates Narrowed Akcstandard.com Archived July 7, 2011, at the Wayback Machine
- Medicine, Center for Veterinary (2021-01-12). "FDA Alert: Certain Lots of Sportmix Pet Food Recalled for Potentially Fatal Levels of Aflatoxin". FDA.
- Tyko, Kelly. "Dog food recall expands: More than 70 dogs have died and 80 pets sick after eating Sportsmix pet food". USA TODAY. Retrieved 2021-01-13.
- Bao L, Trucksess MW, White KD (2010). "Determination of aflatoxins B1, B2, G1, and G2 in olive oil, peanut oil, and sesame oil". Journal of AOAC International. 93 (3): 936–42. doi:10.1093/jaoac/93.3.936. PMID 20629398.
- Li FQ, Li YW, Wang YR, Luo XY (May 2009). "Natural occurrence of aflatoxins in Chinese peanut butter and sesame paste". Journal of Agricultural and Food Chemistry. 57 (9): 3519–24. doi:10.1021/jf804055n. PMID 19338351.
- Mahoney N, Molyneux RJ (April 2010). "Rapid analytical method for the determination of aflatoxins in plant-derived dietary supplement and cosmetic oils". Journal of Agricultural and Food Chemistry. 58 (7): 4065–70. doi:10.1021/jf9039028. PMC 2858461. PMID 20235534.
- Leong YH, Ismail N, Latiff AA, Manaf NA, Rosma A (1 January 2011). "Determination of aflatoxins in commercial nuts and nut products using liquid chromatography tandem mass spectrometry". World Mycotoxin Journal. 4 (2): 119–127. doi:10.3920/WMJ2010.1229.
- "Aflatoxin threat in Nepal, Bangladesh". SciDev.Net South Asia. 2014-12-17. Archived from the original on 2016-03-03. Retrieved 2016-10-17.
- "Eastern and Southern Africa 2011 Highlights" (PDF). ICRISAT. 2012. Retrieved 17 October 2016.
- "Dog food recall underscores toxic danger in drought-hit U.S. corn". Reuters. February 25, 2013.
- Mutahi B (2019-11-15). "How safe is Kenya's staple food?". Retrieved 2019-11-15.
- "US pet food recalled after 70 dogs die and others fall sick". BBC News. 2021-01-14. Retrieved 2021-01-14.