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Biomonitoring of mycotoxins and exposomics-informed profiling in extreme preterm infants from the NeoVIP cohort
Kolawole I Ayeni1, Tina Rajkovic2, Magdaléna Krausová2
1Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria.
Insights
Extremely premature infants show low mycotoxin exposure but high levels of plastics-related chemicals like PFAS and BPA. Further research is needed on these environmental contaminants and their health impacts.
Area of Science:
- Environmental Health
- Neonatal Medicine
- Analytical Chemistry
Background:
- Extremely premature infants are vulnerable to environmental and dietary contaminants.
- Assessing xenobiotic exposure is crucial for understanding infant health trajectories.
Purpose of the Study:
- To assess xenobiotic exposures, focusing on mycotoxins, in extremely premature infants.
- To characterize broader chemical exposures using non-targeted analysis.
Main Methods:
- Dual analytical approach combining targeted LC-MS/MS and non-targeted HR-MS.
- Analysis of breast milk, plasma, urine, and stool samples from 26 infants.
- Quantification of mycotoxins and identification of other chemicals.
Main Results:
- Most mycotoxin biomarkers were absent; ochratoxin A was detected in all breast milk and plasma.
- Alternariol monomethyl ether and citrinin were detected in various samples.
- Non-targeted analysis identified PFAS, bisphenol A, cotinine, and phthalates.
Conclusions:
- Extremely premature infants are exposed to a mixture of contaminants.
- Low mycotoxin exposure contrasts with high levels of plastics- and industry-related chemicals.
- Detected chemicals warrant further investigation for potential health implications.
Abstract:
Extremely premature infants are a highly vulnerable patient group that might be exposed to a vast number of dietary and environmental contaminants, which may impact their health trajectories. This study assessed xenobiotic exposures in 26 extremely premature infants, with a special focus on dietary mycotoxins, using a dual analytical approach combining four sensitive, targeted LC-MS/MS methods and one non-targeted high-resolution mass spectrometry (HR-MS) assay. A total of 187 matched biological samples comprising breast milk (n = 35), plasma (n = 48), urine (n = 52), and stool (n = 52) collected at 7 and 28 days post-partum were subjected to mycotoxin analysis by quantitative LC-MS/MS. In addition, the LC-HRMS workflow using data-dependent MS2 acquisition was applied to a small subset of 20 selected plasma samples to provide first insights into a broader chemical exposure characterization through suspect screening and non-targeted analysis (NTA). The targeted analyses revealed that most mycotoxin exposure biomarkers were absent in the samples. However, ochratoxin A was quantified in all breast milk and plasma samples (median values of 43 ng/L and 135 ng/L) and in 27% of urine samples (median: 20 ng/L). Citrinin was detected in 34% of breast milk and 6% of stool samples (median values of 10 ng/L and 2.5 ng/g). Alternariol monomethyl ether was detected in 94% of breast milk, 12% of stool, and 31% of tested urine specimens. In the non-targeted analysis, 356 features were annotated with confidence Levels 2a, 2b, and 3, while 20 compounds were identified at Level 1 with authentic reference standards. This included key toxicants like per- and polyfluorinated substances (PFAS), bisphenol A, cotinine, and phthalates. Albeit a small cohort, this study demonstrated that extremely premature infants were exposed to a mixture of dietary, environmental, and lifestyle-related exposures. While many of the analyzed mycotoxins, including the carcinogenic aflatoxins, were not detected and indicated low overall mycotoxin exposure, plastics- and industry-related chemicals were detected at comparatively high levels, warranting further investigation into their potential health implications.
