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The involvement of mycotoxins in the development of endemic nephropathy

Maja Peraica1, Ana-Marija Domijan, Marica Miletić-Medved

  • 1Institute for Medical Research and Occupational Health, Zagreb, Croatia. mperaica@imi.hr

Wiener Klinische Wochenschrift
|August 30, 2008
PubMed

Insights

Endemic nephropathy, a kidney disease, may be caused by ochratoxin A (OTA) and other mycotoxins. Studies reviewed OTA in food and humans, finding potential synergistic effects and DNA damage, suggesting a link to urothelial tumors.

Area of Science:

  • Toxicology
  • Nephrology
  • Environmental Health

Background:

  • Endemic nephropathy (EN) is a poorly understood kidney disease prevalent in specific rural areas.
  • EN is associated with a high incidence of urothelial tumors, suggesting exposure to environmental nephrotoxic and carcinogenic agents.
  • Ochratoxin A (OTA), a mycotoxin with known nephrotoxic and carcinogenic properties, is strongly implicated in EN etiology.

Purpose of the Study:

  • To review existing studies on ochratoxin A (OTA) exposure in food, blood, and urine within endemic nephropathy (EN) regions.
  • To examine the co-occurrence of OTA with other nephrotoxic mycotoxins (citrinin, fumonisin B1) in food and assess human exposure data.
  • To present experimental findings on the synergistic effects of combined mycotoxin exposure and DNA adduct formation.

Main Methods:

  • Literature review of studies assessing ochratoxin A (OTA) levels in food, blood, and urine from endemic nephropathy (EN) areas.
  • Analysis of data on the co-occurrence of OTA with citrinin and fumonisin B1 in food samples.
  • Review of experimental studies using cultured cells and laboratory animals exposed to combinations of OTA and other mycotoxins.
  • Examination of data on OTA and aristolochic acid-DNA adducts.

Main Results:

  • Ochratoxin A (OTA) has been detected in food and biological samples from endemic nephropathy (EN) regions.
  • Co-occurrence of OTA with other nephrotoxic mycotoxins like citrinin and fumonisin B1 in food is documented.
  • Experimental studies indicate synergistic nephrotoxic and carcinogenic effects when OTA is combined with other mycotoxins.
  • Evidence of OTA and aristolochic acid-DNA adducts suggests genotoxic mechanisms.

Conclusions:

  • Ochratoxin A (OTA) is a significant factor in the etiology of endemic nephropathy (EN) and associated urothelial tumors.
  • The co-occurrence and synergistic effects of multiple mycotoxins likely contribute to the disease's pathogenesis.
  • Further research is needed on the co-occurrence of mycotoxins in humans and their combined toxicological impact in EN areas.

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