Effect of groundnut meal containing aflatoxin on Cynomolgus monkeys

Association of aflatoxin with gallbladder cancer in a case-control study nested within a Chinese cohort

We evaluated whether aflatoxin B1 (AFB1 ) exposure was associated with later risk of developing gallbladder cancer (GBC). We measured AFB1 -lysine albumin adducts in baseline samples from the Shanghai Cohort Study of 18 244 men aged 45 to 64 years (recruited 1986-1989). We included 84 GBC cases with sufficient serum and 168 controls matched on age at sample collection, date of blood draw and residence. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for detectable vs non-detectable AFB1 -lysine albumin adducts and gallbladder cancer. AFB1 -lysine albumin adducts were detected in 50.0% of GBC cases, and risk of GBC was twice as high in those with detectable vs undetectable levels (OR = 2.0, 95% CI = 1.0-3.9). ORs ranged from 1.8 (95% CI = 0.75-4.3) for 0.5 to <1.75 pg/mg vs undetectable adduct levels to 2.2 (95% CI = 0.91-5.6) for >3.36 pg/mg vs undetectable, suggesting a dose-response (Ptrend  = .05). When restricted to cases diagnosed before the median time to diagnosis after blood draw (18.4 years), results were similar (OR = 2.2, 95% CI = 0.80-5.8) to those for the entire follow-up duration. The OR was 9.4 (95% CI = 1.7-51.1) for individuals with detectable AFB1 -lysine albumin adducts and self-reported gallstones compared to individuals with neither. Participants with detectable AFB1 -lysine albumin adducts at baseline had increased risk of developing GBC, replicating the previously observed association between AFB1 exposure and providing the first evidence of temporality.

Association of Aflatoxin and Gallbladder Cancer

BACKGROUND & AIMS

Aflatoxin, which causes hepatocellular carcinoma, may also cause gallbladder cancer. We investigated whether patients with gallbladder cancer have higher exposure to aflatoxin than patients with gallstones.

METHODS

We measured aflatoxin B1 (AFB1)-lysine adducts in plasma samples from the Shanghai Biliary Tract Cancer case-control study, conducted from 1997 through 2001. We calculated age- and sex-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) and the population-attributable fraction for 209 patients with gallbladder cancer and gallstones vs 250 patients with gallstones without cancer (controls). In 54 patients with gallbladder cancer, tumor tissue was examined for the R249S mutation in TP53, associated with aflatoxin exposure, through targeted sequencing.

RESULTS

The AFB1-lysine adduct was detected in 67 (32%) of 209 patients with gallbladder cancer and 37 (15%) of the 250 controls (χ2 P < .0001), almost threefold more patients with gallbladder cancer than controls (OR, 2.71; 95% CI, 1.70-4.33). Among participants with detectable levels of AFB1-lysine, the median level of AFB1-lysine was 5.4 pg/mg in those with gallbladder cancer, compared with 1.2 pg/mg in controls. For patients in the fourth quartile of AFB1-lysine level vs the first quartile, the OR for gallbladder cancer was 7.61 (95% CI, 2.01-28.84). None of the 54 gallbladder tumors sequenced were found to have the R249S mutation in TP53. The population-attributable fraction for cancer related to aflatoxin was 20% (95% CI, 15%-25%).

CONCLUSIONS

In a case-control study of patients with gallbladder cancer and gallstones vs patients with gallstones without cancer, we associated exposure to aflatoxin (based on plasma level of AFB1-lysine) with gallbladder cancer. Gallbladder cancer does not appear associate with the R249S mutation in TP53. If aflatoxin is a cause of gallbladder cancer, it may have accounted for up to 20% of the gallbladder cancers in Shanghai, China, during the study period, and could account for an even higher proportion in high-risk areas. If our findings are verified, reducing aflatoxin exposure might reduce the incidence of gallbladder cancer.

Biological significance of trace levels of mutagenic heterocyclic aromatic amines in human diet: a critical review

Cooking of protein-rich foods may induce the formation of a series of heterocyclic aromatic amines (HAAs) that have been found to be mutagens and carcinogens. Despite very potent mutagenic activity found in the Salmonella/microsomal assay, this test cannot predict carcinogenic potency of HAAs in rodents and monkeys. Doses used in the feeding studies with animals exceeded by several orders of magnitude the levels of HAAs found in human diet, being approximately 500,000-3,000,000-fold higher than the human dietary levels. A comparison of these levels and their relevance for humans is presented. Differences in metabolic fate of different HAAs due to species and sex of the animals are discussed. These differences could account for the variable cancer-producing potential in different species. A number of still unresolved variables (such as the levels of HAAs in foods, bioavailability, possible synergistic effect from mixtures of HAAs, and metabolic fate and detoxification) preclude reliable assessment of the potential health hazard from HAAs in foods. The difference in the ability of human and animal liver microsomes to bioactivate HAAs and to form DNA adducts causes further uncertainty. The differences due to the hepatic cytochrome P-450-mediated activation of HAA among rats, monkeys and humans may influence susceptibility to cancer from these agents. HAAs occur only in traces in the human diet; however, they are present in many foods consumed daily. The levels of 2-amino-1-methyl-6-phenylimidazo[4,5-b]-pyridine (PhIP) are approximately 100-fold higher than the levels of 2-amino-3-methylimidazo[4,5-f]-quinoline (IQ) and 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx). However, their mutagenic potential in the Ames Salmonella assay is reversed. Other in vitro tests, however, indicate similar genotoxicity between IQ, MeIQx and PhIP. Although most feeding studies with HAAs have been conducted with IQ and MeIQ, evidence obtained from a variety of studies indicates the possibility that PhIP may have an active role in the aetiology of human cancer and, therefore, its role as such should be evaluated. The influence of trace levels of HAAs on human health remains to be confirmed.

Aflatoxins--experimental studies

The susceptibility of animals to both chronic and acute aflatoxicosis is variable between species and depends upon not only the dose of the toxin and the duration of exposure but also upon the age, sex, and nutritional status of the animal. In general, acute toxicity is manifested by necrosis and cirrhosis, and chronic toxicity by carcinoma of the liver. Current research using both in vivo and in vitro studies has shown that the differences in response to aflatoxin in different animals can be attributed to their differential metabolism. The rates of metabolism and intermediate products formed are important factors in determining the type of toxic action of aflatoxin B1. According to these criteria, monkey and man are more susceptible to acute aflatoxicosis and relatively resistant to carcinogenic effects. On the other hand, animals, such as sheep and rat, are more susceptible to carcinogenic effects.

Aflatoxicol: major aflatoxin B1 metabolite in rat plasma

Aflatoxicol, a carcinogenic metabolite of the foodborne carcinogen aflatoxin B1 previously known only as a bioreduction product in vitro, was identified as the major aflatoxin metabolite in the plasma of Sprague-Dawley rats, a susceptible species, that had been doses orally or intravenously with aflatoxin B1 labeled with carbon-14. Alfatoxicol, however, was not detected in the plasma of similarly dosed mice and monkeys, which are both resistant to aflatoxin B1-induced cardinogenesis. The formation of aflatoxicol both in vitro and in vivo may be an indicatory of species sensitivity to aflatoxin-induced carcinogenesis and may be useful in the prediction of human susceptibility.