Jul 2026· Journal of Fungi· Vol 12, pp. 560· 0 citations· 43 references
Medicine
TL;DR
Chronic dietary aflatoxin exposure shows a consistent, statistically significant association with hepatocarcinogenesis across diverse etiological backgrounds in South America, highlighting an urgent need for integrated regional food safety surveillance and expanded prospective studies.
Abstract
Aflatoxin B1 (AFB1), a dietary mycotoxin classified as a Group 1 carcinogen and a risk factor for hepatocellular carcinoma (HCC), has seen limited biomarker-based evidence linking it to HCC in South America despite favorable regional contamination conditions. Utilizing a newly validated isotope-dilution HPLC–MS/MS method to quantify AFB1-Lysine (AFB1-Lys) adducts, we conducted a cross-sectional study involving 92 HCC patients and 70 healthy controls across six South American nations. The primary case–control analysis, focusing on 64 HCC patients and 70 controls from Argentina and Colombia, revealed that AFB1-Lys concentrations and positivity rates were significantly higher in HCC cases compared to controls (7.16 vs. 0.89 pg/mg albumin; 43% vs. 10%). Multivariable logistic regression demonstrated that detectable AFB1-Lys was significantly and independently associated with HCC (adjusted OR = 3.72), with associations most pronounced, though based on small subgroups, in viral hepatitis-related and cryptogenic HCC. Furthermore, broader regional analysis indicated higher AFB1-Lys positivity rates in HBV-positive patients than in HCV-positive or non-viral HCC cases. Ultimately, chronic dietary aflatoxin exposure shows a consistent, statistically significant association with hepatocarcinogenesis across diverse etiological backgrounds in South America, highlighting an urgent need for integrated regional food safety surveillance and expanded prospective studies.
Dietary exposure to mycotoxins—including aflatoxins (AFs), ochratoxin A (OTA), and citrinin (CIT)—represents an important health risk, particularly in low-resource settings with widespread food contamination. This study investigates mycotoxin exposure among 719 participants (433 women and 286 children) of a cluster-randomized trial in rural Bangladesh, using residual blood samples collected during the 2019 endline survey. A total of 712 whole blood and 578 serum samples were analyzed by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Serum aflatoxin B1 (AFB1)-lysine adducts were quantified following enzymatic digestion and solid-phase extraction. To evaluate potential health risks, we estimated probable daily intake (PDI) from blood concentrations of frequently detected mycotoxins. All whole blood samples contained at least two mycotoxins, and 84% of participants were co-exposed to at least three mycotoxins. Biomarkers for the main blood-relevant mycotoxins were frequently detected, with OTA detected in 100% of whole blood samples and its isomer, 2′R-ochratoxin A (2′R-OTA), detected in 98%, CIT in 91%, and Enniatin B (EnB) in 92%, while AFB1-lysine—a biomarker of chronic exposure to the potent carcinogen AFB1—was detected in nearly one-quarter of women and 4% of children with serum samples. Beauvericin was detected in 6% of samples. The PDI of OTA exceeded health-based guidance values in 80% of women and 99% of children, while the PDI of CIT was of concern for 12% of women and 27% of children. These findings demonstrate widespread co-exposure to multiple mycotoxins, with OTA, CIT, and AFB1 posing notable risks, underscoring the urgent need for targeted interventions to protect vulnerable populations.
N. Kyei, B. Cramer, H. Humpf et al.· Environmental Health· 0 citations
Aflatoxin B1 (AFB1) exposure is a major environmental health concern among vulnerable groups such as pregnant women, yet its determinants in coastal settings remain poorly understood. We aimed to quantify AFB1 exposure and examine its environmental, behavioral, and sociodemographic determinants among pregnant women in Kwale County, a predominantly rural area on Kenya’s southern Indian Ocean coast. In a facility-based cross-sectional study, serum AFB1–albumin adduct concentrations were measured by enzyme-linked immunosorbent assay in 298 pregnant women. Determinants were examined with a pre-specified multivariable linear regression of log-transformed concentrations using heteroscedasticity-consistent (HC3) standard errors, and a secondary Firth penalized logistic model of detectable versus non-detectable exposure. Adducts were detectable in 251 participants (84.2%); the median concentration was 28.1 pg/mL (IQR 13.7–68.7). Exposure was determined primarily by where women lived: it was lowest in the community closest to the coast and progressively higher in two drier, more inland communities (2.02-fold, 95% CI 1.44–2.85; and 3.02-fold, 95% CI 1.89–4.82). Single marital status was associated with modestly higher exposure (1.89-fold; 95% CI 1.17–3.05). Food source, flour storage, maternal education, and age did not predict exposure, and the penalized logistic model reproduced the same geographical pattern. Despite near-universal exposure, only 1.7% of participants had ever heard of aflatoxin. AFB1 exposure was widespread and geographically structured, pointing to place-based rather than individual-level drivers and supporting area-targeted food-safety interventions to protect maternal and fetal health. These findings have implications for food-safety strategies in other tropical regions where climate and subsistence agriculture contribute to chronic aflatoxin exposure.
Richard Wodah-Seme, Gibson Omwansa Javes, J. Changoma et al.· Tropical Medicine and Health· 0 citations
Aflatoxin B₁ (AFB₁ ) remains one of the most potent and widely distributed mycotoxins found in global food systems, especially within warm, humid regions where fungal growth is favourable. It is a toxic secondary metabolite predominantly produced by Aspergillus flavus, a fungus known to contaminate a broad range of agricultural commodities including maize, rice, groundnuts, cereals and other staple foods. This study evaluated Aflatoxin B₁ (AFB₁ ) contamination, dietary exposure, margin of exposure (MOE), and hepatocellular carcinoma (HCC) risk associated with consumption of contaminated maize, millet, cowpea, and peanut across selected areas of Borno and Yobe States, Northeastern Nigeria. Monthly sampling was conducted between November 2024 and February 2025 across major markets, followed by HPLC quantification of AFB₁ and subsequent risk evaluation. Results showed strong seasonal variation, with January exhibiting the highest contamination levels in peanuts with concentration of (69.12 μg/kg) and followed by maize with 27.26 μg/kg. Estimated Daily Intake (EDI) values for both adults and children exceeded the provisional maximum tolerable daily intake (PMTDI) threshold during peak months, while MOE values consistently fell far below the safety benchmark of 10,000, indicating significant public health concern. Potential liver cancer burden estimations also revealed heightened risk, particularly among children in Damaturu and Gashua were found to be the hotspots. Overall, the findings of this study demonstrate significant potential AFB₁ related health risks in northeastern Nigeria, underscoring the urgent need for improving post-harvest handling, storage interventions, stronger regulatory oversight, and public-health risk mitigation strategies, therefore, there is an urgent need for regulatory enforcement on AFB1 limits within food supply chains and strengthen post-harvest drying and storage in Nigeria.
B. U., U. A.· Biological and Environmental...· 0 citations
Tibolone, a synthetic steroid with estrogenic, progestogenic, and androgenic activity, is widely prescribed for menopausal symptoms, but its association with hepatocellular carcinoma (HCC) remains unclear. Using data from 117,271 women aged ≥ 45 years in the Korean National Health Insurance Service-Health Screening Cohort, we evaluated tibolone use between 2003 and 2007 and identified incident HCC from 2009 through 2019, implementing a 1-year lag period. Participants were propensity score-matched (1:10) by demographic, lifestyle, and metabolic factors. During a median 11-year follow-up, women with ≥ 180 cumulative days of tibolone use showed a higher HCC risk compared with non-users (hazard ratio [HR], 1.88; 95% CI, 1.07-3.29), which persisted after adjustment for key covariates (adjusted hazard ratio [aHR], 1.74; 95% CI, 0.99-3.06). A dose-response trend was observed (P for trend = 0.043). These findings suggest a possible link between sustained tibolone use and HCC risk, warranting confirmation in larger populations and longer follow-up, ideally through well-designed prospective studies.
Ji-Min Lee, Hye Jun Kim, Sun Jae Park et al.· International Journal of Can...· 0 citations
Background: A foodborne mycotoxin, aflatoxin B1, is known to be hepatotoxic and hepatocarcinogenic. Experimental studies suggest renal toxicity due to oxidative stress and apoptosis, but human epidemiologic evidence is limited in humans. Objective: In the context of NHANES 1999-2000, this study evaluated whether measurable serum aflatoxin B1-lysine adducts were related to markers of renal function among adults.Methods: This 1999-2000 exploratory analysis of NHANES data investigates the relationship between aflatoxin B1 and kidney function, and other health and demographic factors. Study subjects consisted of adults aged 20 years or older with data on any variable pertaining to aflatoxin exposure. Detectable aflatoxin was defined in the laboratory comment code. The serum creatinine was standardized using the calibration equation for NHANES 1999–2000, estimated glomerular filtration rate was calculated using the CKD-EPI 2021 creatinine equation, and urine albumin-creatinine ratio was calculated from urine albumin–creatinine. The outcomes included creatinine, eGFR, blood urea nitrogen, natural-log UACR, albuminuria, lower eGFR, and any one-visit kidney abnormality. To estimate descriptive statistics from weighted data, we used non-parametric comparisons, weighted linear models with robust standard errors, exact tests for binary outcomes, and bootstrap median-difference intervals. Results: In an analysis of 1,258 adults, only sixteen were found to have measurable serum aflatoxin B1-lysine, which pertains to a weighted detectable prevalence of 1.10%. The presence of detectable aflatoxin wasn’t related to any of these tests after adjusting for age, sex, race, and poverty income ratio. Estimates of the fully adjusted beta were -0.022 mg/dL for creatinine, -0.219 mL/min/1.73 m2 (eGFR), 0.293 mg/dL for BUN, and -0.486 log-UACR, all with p values >0.05. Aflatoxin detectability did not significantly differ by binary kidney outcomes.Conclusion: In this adult U.S. sample, detectable serum aflatoxin B1-lysine was rare and not associated with markers of kidney dysfunction. The small size of the exposed group means that the findings are inconclusive rather than definitive evidence of no renal effect.
A. Alkhatib· Journal of Clinical Nephrolo...· 0 citations
This review showed that in Côte d’Ivoire, peanut paste had 100% AFB1 contamination, with levels of 4535 µg/kg (AFB1) and 8094 µg/kg (total aflatoxins), and 99% of samples exceeded European Union limits.
Gudisa Bereda· Genes and Environment· 0 citations
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