Short-term safety evaluation of processed calcium montmorillonite clay (NovaSil) in humans

Reducing human exposure to aflatoxin through the use of clay: a review

Innovative sorption strategies for the detoxification of aflatoxins have been developed. NovaSil clay (NS) has been shown to prevent aflatoxicosis in a variety of animals when included in their diet. Results have shown that NS clay binds aflatoxins with high affinity and high capacity in the gastrointestinal tract, resulting in a notable reduction in the bioavailability of these toxins without interfering with the utilization of vitamins and other micronutrients. This strategy is being evaluated as a potential remedy for acute aflatoxicosis, and as a sustainable human intervention for aflatoxins via the diet. Phase I and II clinical trials confirmed the apparent safety of NS for further study in humans. A recent study in Ghanaians at high risk for aflatoxicosis has indicated that NS (at a dose level of 0.25%) is effective in decreasing biomarkers of aflatoxin exposure and does not interfere with the levels of serum vitamins A and E, and iron and zinc. In summary, enterosorption strategies/therapies based on NS clay are promising for the management of aflatoxins and as a sustainable public health intervention. The NS clay remedy is novel, inexpensive and easily disseminated. Based on the present research, aflatoxin sequestering clays should be rigorously evaluated in vitro and in vivo, and should meet the following criteria: (1) favourable thermodynamic characteristics of mycotoxin sorption, (2) tolerable levels of priority metals, dioxins/furans and other hazardous contaminants, (3) safety and efficacy in multiple animal species, (4) safety and efficacy in long-term studies, and (5) negligible interactions with vitamins, iron and zinc and other micronutrients.

Protective interventions to prevent aflatoxin-induced carcinogenesis in developing countries

The public health impact of aflatoxin exposure is pervasive in economically developing countries; consequently, we need to design intervention strategies for prevention that are practicable for these high-risk populations. The adverse health consequences of aflatoxins in populations are quite varied, eliciting acute effects, such as rapid death, and chronic outcomes, such as hepatocellular carcinoma. Furthermore, a number of epidemiological studies describe a variety of general adverse health effects associated with aflatoxin, such as impaired growth in children. Thus, the magnitude of the problem is disseminated across the entire spectrum of age, gender, and health status in the population. The aflatoxins multiplicatively increase the risk of liver cancer in people chronically infected with hepatitis B virus (HBV), which illustrates the deleterious impact that even low toxin levels in the diet can pose for human health. Thus other aflatoxin interactions, which likely contribute to the disease burden, still remain to be identified. Therefore, many diverse and appropriate strategies for disease prevention are needed to decrease the incidence of aflatoxin carcinogenesis in developing countries.

Distribution of ochratoxin A in plasma and tissues of rats fed a naturally contaminated diet amended with micronized wheat fibres: effectiveness of mycotoxin sequestering activity

The effectiveness of micronized wheat fibres (MWF) alone or in association with yeast cell walls (YCW) as active adsorbents to decrease, in vivo, the levels of ochratoxin A (OTA) was checked in a total of 48 rats, equitably distributed into four groups: (1) control; (2) OTA naturally contaminated diet (2.2 microg/g); (3) OTA naturally contaminated diet (2.2 microg/g) amended with MWF (2%); (4) OTA naturally contaminated diet (2 microg/g) amended with MWF (1.8%) in association with YCW (0.2%). A 4 week experimental period corresponding to a daily intake in the range of 132.2-146.1 microg OTA/kg bw decreased the rat body weight gains, as compared to the controls. The adsorbents did not significantly alleviate the growth depression caused by the contaminated diet. However, a significant protective effect of MWF was observed in terms of OTA concentration in plasma (40.5% decrease), kidney (28.1% decrease) and liver (38.8% decrease). Mixing this sorbent with the YCW did not significantly improve its protective activity against OTA. The faecal OTA concentrations were higher for the MWF and MWF+YCW treated animals, as compared to the positive control (group II). Taken together, these results suggest that MWF are a promising tool to counteract the toxic effects of OTA naturally contaminated diets.

NovaSil clay intervention in Ghanaians at high risk for aflatoxicosis. I. Study design and clinical outcomes

A 3-month double-blind and placebo-controlled, phase IIa clinical trial was conducted in Ghana to investigate the safety, tolerance and aflatoxin-sorption efficacy of dietary NovaSil (NS). Volunteers (507 subjects) were clinically screened to evaluate their general health, pregnancy status and blood AFB(1)-albumin adduct levels. Of these subjects, 177 were randomly assigned to three groups: high-dose (HD), low-dose (LD) and placebo-control (PL) groups receiving 3.0, 1.5 and 0 g NS day(-1) in capsules. Trained study-monitors supervised NS capsule administration to participants and recorded side-effects daily. Physical examinations were performed monthly. Blood and urine samples were collected for laboratory analysis. Approximately 92% of the participants (162 of 177) completed the study and compliance rate was over 97%. Overall, 99.5% of person x time reported no side-effects throughout the study. Mild to moderate health events ( approximately 0.5% of person x time) were recorded in some participants. Symptoms included nausea, diarrhea, heartburn and dizziness. These side-effects were statistically similar among all three groups. No significant differences were shown in hematology, liver and kidney function or electrolytes in the three groups. These findings demonstrate that NS clay is apparently safe and practical for the protection of humans against aflatoxins in populations at high risk for aflatoxicosis.

Inactivation of cadmium induced immunotoxicological alterations in rats by Tunisian montmorillonite clay

Cadmium (Cd(2+)) is a heavy metal that is dispersed throughout the modern environment mainly as a result of pollution from a variety of sources. The aims of the current study were to investigate the efficacy of purified Tunisian montmorillonite clay (TMC) to adsorb Cd, to test the stability of the resulting complex under different conditions in vitro, and to utilize the rat bioassay as an in vivo model to evaluate the protective role of TMC against Cd-induced toxicity and immunodysfunction. In the in vitro study, three concentrations of TMC (0.5, 1.0 and 1.5 g/l aqueous solution) and three concentrations of CdCl(2) (25, 50 and 100 ppm) were tested. The results of the in vitro study showed that TMC had a high capacity of adsorbing Cd at different concentrations tested. The adsorption ranged from 95.7-100% of the available CdCl(2) in aqueous solutions. The complex TMC-Cd was stable at different pHs at 37 degrees C. The in vivo results indicated that treatment with CdCl(2) (2.5 mg/kg BW) for 2 weeks resulted in a significant decrease in triglycerides, total protein, creatinine, creatine kinase, immunoglobulin profile (Ig A and Ig G) and T-cell sub-types (CD3(+), CD4(+), CD8(+) and CD56(+)). Whereas, it significantly increase serum level of AST, ALT, LDH and induced degenerative changes in pro-inflammatory cytokines (TNF-alpha and IL-1). Rats treated with TMC alone (400, 600 and 800 mg/kg BW) were comparable to the control regarding all the tested parameters. The combined treatment of CdCl(2) and TMC at the lowest dose (400 mg/kg BW) showed a significant improvement of all tested parameters. It could be concluded that TMC was effective to protect against Cd hazards at a dose as low as 400 mg/kg BW. These results supported our hypothesis that TMC tightly-bind and immobilized Cd resulted in reduction of metal bioavailability in the gastrointestinal tract.

Workgroup report: public health strategies for reducing aflatoxin exposure in developing countries

Consecutive outbreaks of acute aflatoxicosis in Kenya in 2004 and 2005 caused > 150 deaths. In response, the Centers for Disease Control and Prevention and the World Health Organization convened a workgroup of international experts and health officials in Geneva, Switzerland, in July 2005. After discussions concerning what is known about aflatoxins, the workgroup identified gaps in current knowledge about acute and chronic human health effects of aflatoxins, surveillance and food monitoring, analytic methods, and the efficacy of intervention strategies. The workgroup also identified public health strategies that could be integrated with current agricultural approaches to resolve gaps in current knowledge and ultimately reduce morbidity and mortality associated with the consumption of aflatoxin-contaminated food in the developing world. Four issues that warrant immediate attention were identified: a) quantify the human health impacts and the burden of disease due to aflatoxin exposure; b) compile an inventory, evaluate the efficacy, and disseminate results of ongoing intervention strategies; c) develop and augment the disease surveillance, food monitoring, laboratory, and public health response capacity of affected regions; and d) develop a response protocol that can be used in the event of an outbreak of acute aflatoxicosis. This report expands on the workgroup's discussions concerning aflatoxin in developing countries and summarizes the findings.