Presence of ochratoxin A in human milk in relation to dietary intake

Infant nutrition at risk: a global systematic review of ochratoxin A in human breast milk-human health risk assessment

Human breast milk is the optimal source of nutrition for newborns, but the potential transfer of contaminants like mycotoxins, particularly ochratoxin A (OTA), from maternal blood to milk remains a concern. This systematic review aims to provide a comprehensive analysis of global OTA levels in human breast milk and assess the associated health risks. We conducted a thorough search of scientific databases, including Web of Science, ScienceDirect, Scopus, Google Scholar and PubMed, using keywords related to OTA in human breast milk. A total of 39 studies met the inclusion criteria for this review. OTA levels compared to limits, estimated infant intake at various ages and health risks assessed using Margin of Exposures (MOEs) and Hazard quotient (HQ). Our findings reveal the widespread presence of OTA in breast milk across different regions, with notably higher levels detected in Africa compared to Asia, South America and Europe. The higher concentrations observed in warmer, humid climates suggest that environmental factors significantly influence OTA contamination. Mature breast milk samples generally exhibited greater OTA exposure. The neoplastic and non-neoplastic effects demonstrate generally low risks globally. The regional differences in OTA levels and associated health risk assessments underscore the need for continued research into the health impacts of OTA exposure in infants. This includes further investigation into multiple sources of exposure, such as infant formula, within the broader context of the exposome framework.

Determination of aflatoxin M1 and ochratoxin A in breast milk in rural centers of Yazd, Iran: Exposure assessment and risk characterization

Breast milk (BM) is considered as the best source of nutrition which could have prevention effects on various diseases in the first years of a child. Along with nutritive compounds, presence of contaminants such as mycotoxins in BM could be transmitted into neonate. The aim of this study was to determine the occurrence, levels, and factors associated with the presence of aflatoxin M1 (AFM1) and ocratoxin a (OTA) in BM samples of nursing mothers in rural centers of Yazd, Iran. The presence and average AFM1 and OTA concentration in 72 BM samples was measured by competitive ELISA. The demographic and diet parameters of nursing mothers were collected by a questionnaire and were analyzed using SPSS 18 software. AFM1 and OTA were detected in 63 (87.5%) and 47 (65.2%) samples with the mean concentration levels of 19.46 ± 13.26 ng/L (ranges from 5.1 to 53.9) and 200 ± 160 ng/L (ranges from 100 to 2460), respectively. Of these, 32 samples (50.7%) for AFM1 and 23 samples (48.9%) for OTA had values exceeding the limit set by the European Union regulation for infant foods (25 ng/L for AFM1 and 500 ng/L for OTA). It was also found that the risk of AFM1 and OTA occurrence in BM increased significantly with the consumption of beans, bread, cereals, fruit juice and crackers, and cream, respectively. This study showed that the estimated daily intake for AFM1 and OTA by 1 month of age infants was 2.7 and 28.5 ng/kg bw/day, respectively, while, as the age of the infant increased, the values were lower and close to 0.9 and 9.9 ng/kg bw/day for AFM1 and OTA in 12 months of age infants, respectively. The high occurrence and noticeable levels of AFM1 and OTA detected in this study indicated that some infants receive undesirable exposures to AFM1 and OTA with breast milk. Therefore, it is recommended that mothers are advised to avoid certain foods during pregnancy and breastfeeding that are likely sources of mycotoxins.

Occurrence of ochratoxin A in breast milk and urine samples of nursing mothers in Bangladesh

The mycotoxin ochratoxin A (OTA) is a potent nephrotoxin with carcinogenic properties and, thus, of concern as a food contaminant. Since food contaminant data are scarce in Bangladesh, we applied human biomonitoring to gain more insights into OTA exposure in the country's population. OTA concentrations in human milk and urine samples of nursing mothers were determined with the aim to assess also exposure to this mycotoxin in breastfed infants. Breastfeeding mothers (n = 74) from three districts of Bangladesh (Sylhet, Cumilla, and Mymensingh region) participated in this study. They provided demographic data, along with breast milk and urine samples. OTA levels were measured by a competitive enzyme-linked immunosorbent assay (ELISA) with a detection limit of 60 ng/L for milk and 30 ng/L for urine.OTA was detected in 62.2% of all breast milk samples (mean 74.8 ± 49.0 ng/L, range < LOD-243.3 ng/L) and in 51.4% of all urine samples (mean 44.3 ± 63.5 ng/L, range < LOD-519.3 ng/L). The differences observed between regions for mean breast milk or for urinary OTA levels were relatively small. No significant correlation was observed between OTA levels in breast milk and food consumption patterns among nursing mothers. Regarding infant exposure, the estimated average daily intake of OTA for all was 15.0 ng/kg bw/day (range 4.5-45 ng/kg bw/day). In 34.5% of these infants, their estimated daily OTA intake exceeded a preliminary TDI value set by EFSA (17 ng/kg bw/day). The mean OTA intake was slightly higher (16.2 ± 7.8 ng/kg bw/day) in 1-2 months babies than in older infants (< 2 to 12 months), although the difference was not significant. Presence of OTA in most milk and urine samples of nursing mothers documents their widespread dietary mycotoxin exposure. Although based on a relatively small number of participants, the present analysis indicates non-negligible exposure of some nursed infants in Bangladesh. Therefore, further biomonitoring studies and investigations on major sources of OTA in food commodities are encouraged.

Determination of aflatoxin M1 in breast milk and related factors

OBJECTIVE:

Breastfeeding in women with aflatoxin M1 exposure may be a risk factor for the newborn. Thus, it is crucial to determine aflatoxin M1 levels in breast milk and raise mothers’ awareness about nutrition in lactation and other periods. This study was carried out to determine aflatoxin M1 contamination in milk samples taken from mothers who gave birth.

METHODS:

The study was carried out in the postpartum department of Training and Research Hospital between December 31, 2018, and June 31, 2019, and 90 breastfeeding mothers were included in the study.

RESULTS:

A total of 75 (83.3%) of the examined samples were found positive. The mean aflatoxin M1 ratio in positive samples was 12.16 pg/mL (5.00–23.18 pg/mL). Mothers’ consumption of processed food was associated with aflatoxin M1 levels (p=0.043). It was determined that the aflatoxin M1 levels of mothers who consumed processed food products 1 or 2 times a month were 3.22 times lower than those who consumed 1–2 times a week.

CONCLUSIONS:

This study emphasized the importance of monitoring aflatoxin M1 levels in breast milk for infant health. It is thought that nutrition education given to mothers during pregnancy will significantly impact aflatoxin M1 results. In addition, the dangers of mycotoxins in mother-infant nutrition should be emphasized regularly in health education.

Influence of season and lactational stage on aflatoxin M1 and ochratoxin A in human milk in a cohort study from southeastern region of Turkey

The aim was to evaluate the changes in aflatoxin M1 (AFM1) and ochratoxin A (OTA) levels in human breast milk (HBM) during the first five postpartum months according to the sampling season in a cohort study from Şanlıurfa. From 78 healthy lactating mothers, HBM was taken at the 5-14 days postpartum (D5-14) and the 6^th and 18^th weeks postpartum (W6 and W18). Mycotoxin levels were analyzed with competitive ELISA. Generalized Estimating Equations with repeated measures (three-correlation matrix dimension) revealed a significantly higher mean AFM1 level at W6 than that on D5-14. AFM1 and OTA levels in winter and spring were considerably higher than that in summer and autumn. Maternal smoke exposure, body mass index, history of moldy food exposure, birth order, and breastfeeding type did not influence the results. Whilst season had a marked effect on the milk levels of both analytes, lactation stage affected AFM1 more notable than OTA.

An Immunoenzymatic Method for the Determination of Ochratoxin A in Biological Liquids (Colostrum and Cow's Milk)

Ochratoxins are mycotoxins that have been extensively studied lately due to the multiple toxic effects such as nephrotoxicity, hepatotoxicity, and carcinogenicity. These toxins contaminate plant and animal foods and after ingestion they reach into body fluids. The method of competitive direct enzyme immunoassay, in the solid phase, was validated through the determination of specific parameters (performance, linearity, recovery percentage, limit of detection, limit of quantification). The validated method was used to determine ochratoxin A in colostrum and cow's milk. The method applied for the determination of ochratoxin A was linear for the concentration range of 0.0-0.5 ng/mL, the value for the regression coefficient (r) was 0.9838. Ochratoxin A was present in 91.67% of the colostrum and in 93.33% of cow's milk samples. The linearity of the method, demonstrated for very low concentrations of analyte, the detection limit as well as the limit of quantification recommend the method for the determinations of micro-pollutants from foods, including biological fluids.

Ochratoxin a in breast milk in Morocco: the affecting dietary habits of the lactating mothers and the degree of exposure of newborns "CONTAMILK study"

The aim of the present study is to evaluate the level of contamination of breast milk (BM) by ochratoxin A, among Moroccan lactating mothers in the city of Rabat, and to identify the associated factors of exposure, also to estimate the degree of exposure of the breastfeed infant. The analysis of ochratoxin A (OTA) was accomplished by ELISA method on 82 colostrum samples. OTA was detectable (>0.08 ng/mL) in 55% of samples with a maximum concentration of 10.04 ng/mL, and the levels exceeded 0.5 ng /mL in 50 % of the samples. In addition, several factors and dietary habits affect significantly the level of OTA in the analyzed samples of breast milk including, the consumption of industrial dairy products, the frequency of consumption of canned foods, dried fruits and legumes, also the period of breast milk collection. Besides, OTA was higher than the tolerable daily intake for 49% newborns. However, these results need to be confirmed by multicenter studies to more broadly estimate the levels of exposition of Moroccan population to OTA. Furthermore, awareness campaigns are recommended to inform the public, especially pregnant women and lactating women about appropriate preventive measures to limit exposure to this mycotoxin.

Risk assessment of ochratoxin A in food

The European Commission asked EFSA to update their 2006 opinion on ochratoxin A (OTA) in food. OTA is produced by fungi of the genus Aspergillus and Penicillium and found as a contaminant in various foods. OTA causes kidney toxicity in different animal species and kidney tumours in rodents. OTA is genotoxic both in vitro and in vivo; however, the mechanisms of genotoxicity are unclear. Direct and indirect genotoxic and non-genotoxic modes of action might each contribute to tumour formation. Since recent studies have raised uncertainty regarding the mode of action for kidney carcinogenicity, it is inappropriate to establish a health-based guidance value (HBGV) and a margin of exposure (MOE) approach was applied. For the characterisation of non-neoplastic effects, a BMDL 10 of 4.73 μg/kg body weight (bw) per day was calculated from kidney lesions observed in pigs. For characterisation of neoplastic effects, a BMDL 10 of 14.5 μg/kg bw per day was calculated from kidney tumours seen in rats. The estimation of chronic dietary exposure resulted in mean and 95th percentile levels ranging from 0.6 to 17.8 and from 2.4 to 51.7 ng/kg bw per day, respectively. Median OTA exposures in breastfed infants ranged from 1.7 to 2.6 ng/kg bw per day, 95th percentile exposures from 5.6 to 8.5 ng/kg bw per day in average/high breast milk consuming infants, respectively. Comparison of exposures with the BMDL 10 based on the non-neoplastic endpoint resulted in MOEs of more than 200 in most consumer groups, indicating a low health concern with the exception of MOEs for high consumers in the younger age groups, indicating a possible health concern. When compared with the BMDL 10 based on the neoplastic endpoint, MOEs were lower than 10,000 for almost all exposure scenarios, including breastfed infants. This would indicate a possible health concern if genotoxicity is direct. Uncertainty in this assessment is high and risk may be overestimated.

Influence of Saccharomyces cerevisiae to ameliorate adverse effects of ochratoxin on biochemical profile and immune response in broiler chickens

To establish the ochratoxicosis ameliorating efficacy of dietary Saccharomyces cerevisiae (SC), day-old broiler chicks (240) were divided into 6 treatment groups (T1, control (basal diet); T2, T1 + 200 ppb OTA; T3, T1 + 0.05% SC; T4, T1 + 0.1% SC; T5, T2 + 0.05% SC and T6, T2 + 0.1% SC). Each diet was fed to 5 replicated groups of 8 birds each from 1 to 42 days of age. The total serum protein and haemoglobin (Hb) in T2 and T5 were lower than that of control (T1). The serum protein and Hb content in group T6 was higher than that of T2 and statistically similar to that of control. The serum uric acid, creatinine, ALP, SGOT, SGPT and H/L ratio in ochratoxin fed group (T2) was higher than that of T1. The serum uric acid, creatinine, ALP, SGOT, SGPT and H/L ratio in T6 was lower than that of T2 and statistically similar to that of T1. The CMI and HA titre value in ochratoxin fed group (T2) was lower than that of T1. The CMI and HA titre value in T5 and T6 was lower than T1 but higher than T2. It was concluded that ochratoxin contamination at 200 ppb level in broiler diet altered the biochemical parameters and immune response. Inclusion of Saccharomyces cerevisiae at 0.1% level to the ochratoxin contaminated diet ameliorated the adverse effects of ochratoxicosis on biochemical parameters and immune response of broiler chickens.

Ochratoxin A, citrinin and deoxynivalenol decrease claudin-2 expression in mouse rectum CMT93-II cells

Intestinal epithelial cells are the first targets of ingested mycotoxins, such as ochratoxin A, citrinin and deoxynivalenol. It has been reported that paracellular permeability regulated by tight junctions is modulated by several mycotoxins by reducing the expression of specific claudins and integral membrane proteins in cell-cell contacts, accompanied by increase in phosphorylation of mitogen-activated protein kinases, including extracellular signal-related kinase (ERK) 1/2, p38 and c-Jun NH2-terminal protein kinase. Claudin-2 is expressed in the deep crypt cells, but not in the villus/surface cells in vivo. While Caco-2, T84 and IPEC-J2 cells, which are widely used intestinal epithelial cell lines to assess the influence of mycotoxins, do not express claudin-2, CMT93-II cells express claudin-2. We previously reported that inhibition of the ERK pathway reduced claudin-2 levels in cell-cell contacts in CMT93-II cells. In this study, we examined whether ochratoxin A, citrinin and deoxynivalenol affect claudin-2 expression and ERK1/2 phosphorylation in CMT93-II cells. We found that all mycotoxins reduced claudin-2 expression in cell-cell contacts, with reduction (by citrinin and deoxynivalenol) or no change (by ochratoxin A) in phosphorylated ERK1/2. All mycotoxins increased transepithelial electrical resistance, but did not affect flux of fluorescein. While ochratoxin A and citrinin are known to be nephrotoxic, only deoxynivalenol reduced claudin-2 expression in MDCK II cells derived from the renal tubule. These results suggest that claudin-2 expression is regulated not only by the ERK pathway, but also by other pathways in an organ-specific manner.

Protective effects of compound ammonium glycyrrhizin, L‑arginine, silymarin and glucurolactone against liver damage induced by ochratoxin A in primary chicken hepatocytes

Ochratoxin A (OTA) is a mycotoxin that is produced by fungi in improperly stored food and animal feed. It exhibits nephrotoxic, hepatotoxic, embryotoxic, teratogenic, neurotoxic, immunotoxic and carcinogenic effects in laboratory and farm animals. In the present study, the hepatotoxicity of OPA was investigated in chicken primary hepatocytes. On this basis, the cytoprotective effects of compound ammonium glycyrrhizin (CAG), L‑arginine (L‑Arg), silymarin (Sil) and glucurolactone (GA) were investigated in vitro. Hepatocytes were treated with OTA, which resulted in a significant decrease in cell viability and increases in serum aspartate transaminase and alanine transaminase activities, as determined by an MTT assay and commercial kits, respectively. Furthermore, following OTA treatment, the levels of hepatic antioxidants, such as superoxide dismutase and glutathione, were decreased, and the lipid peroxidation product malondialdehyde was increased, compared with the control group. However, pretreatment with CAG, L‑Arg, Sil and GA significantly ameliorated these alterations and Sil exerted the optimum hepatoprotective effect. The apoptotic rates were measured by flow cytometry and the results revealed that OTA increased cell apoptosis. The four types of hepatoprotective compounds employed in the present study decreased the apoptosis rate and significantly reversed OTA‑induced increases in the mRNA expression levels of caspase‑3, which was determined by reverse transcription‑quantitative polymerase chain reaction. Furthermore, B‑cell lymphoma‑2 (Bcl‑2) mRNA expression was increased in OTA‑treated cells when pretreated with CAG, L‑Arg, Sil and GA. However, no alterations in the mRNA expression of Bcl‑2‑associated X were observed in the L‑Arg and GA groups, compared with the OTA‑only group. These results indicate that OTA may exhibit hepatotoxicity in chickens and that CAG, L‑Arg, Sil and GA may protect the liver against this via anti‑oxidative and antiapoptosis mechanisms. In addition, CAG and GA are likely to mediate their effects through the mitochondrion‑dependent apoptosis pathway; however, the exact hepatoprotective mechanism of L‑Arg and GA require further investigation. Therefore, CAG, L‑Arg, Sil and GA are potential candidates for the prevention and treatment of chicken liver injury.

Estimation of ochratoxin A in poultry feed and its ingredients with special reference to temperature conditions

1. The present study was designed to analyse ochratoxin A (OTA) in poultry feed samples (mixed types) along with different poultry feed ingredients collected from different farms and market of Lahore, Pakistan. 2. The whole year (2012-2013) was divided into three sub-periods depending upon environmental conditions, that is, July-October (hot and humid), November-February (winter) and March-June (moderate). During each sub-period 120 samples were collected for each feed and each ingredient constituting a total of 840 samples (120x7 of feed and feed ingredients in each sub-period). 3. The results of this study indicated that the incidence of OTA-positive samples was highest in July-October followed by that during March-June while the incidence was minimum during November-February. Similarly, the largest number of samples was below the maximum tolerable level (MTL) during November-February followed by March-June while the least number of samples was below MTL during hot weather (July-October). 4. This is the first elaborative study regarding the levels of OTA in poultry feed and its ingredients collected from Lahore, Pakistan.

Ochratoxin A: 50 Years of Research

Since ochratoxin A (OTA) was discovered, it has been ubiquitous as a natural contaminant of moldy food and feed. The multiple toxic effects of OTA are a real threat for human beings and animal health. For example, OTA can cause porcine nephropathy but can also damage poultries. Humans exposed to OTA can develop (notably by inhalation in the development of acute renal failure within 24 h) a range of chronic disorders such as upper urothelial carcinoma. OTA plays the main role in the pathogenesis of some renal diseases including Balkan endemic nephropathy, kidney tumors occurring in certain endemic regions of the Balkan Peninsula, and chronic interstitial nephropathy occurring in Northern African countries and likely in other parts of the world. OTA leads to DNA adduct formation, which is known for its genotoxicity and carcinogenicity. The present article discusses how renal carcinogenicity and nephrotoxicity cause both oxidative stress and direct genotoxicity. Careful analyses of the data show that OTA carcinogenic effects are due to combined direct and indirect mechanisms (e.g., genotoxicity, oxidative stress, epigenetic factors). Altogether this provides strong evidence that OTA carcinogenicity can also occur in humans.

Mycotoxins in milk for human nutrition: cow, sheep and human breast milk

Mycotoxins are produced pre harvest by some molds and secreted into various food items of plant origin, such cereals, vegetables, spices, coffee and nuts. If the food items are not stored under adequate conditions, a post harvest contamination may also occur. Animals and humans take them up by food items and some of them are stored and accumulated in different tissues and organs, so that food of animal origin may be contaminated, too. Especially aflatoxin and ochratoxin are secreted into milk by consumers of contaminated food. Since milk represents the major food source of newborns and infants, they are notably exposed to these mycotoxins. This health risk for these individuals may be of particular importance, because their ability to metabolize these fungal toxic agents is not yet fully developed at this stage.

Ochratoxin A: Molecular Interactions, Mechanisms of Toxicity and Prevention at the Molecular Level

Ochratoxin A (OTA) is a widely-spread mycotoxin all over the world causing major health risks. The focus of the present review is on the molecular and cellular interactions of OTA. In order to get better insight into the mechanism of its toxicity and on the several attempts made for prevention or attenuation of its toxic action, a detailed description is given on chemistry and toxicokinetics of this mycotoxin. The mode of action of OTA is not clearly understood yet, and seems to be very complex. Inhibition of protein synthesis and energy production, induction of oxidative stress, DNA adduct formation, as well as apoptosis/necrosis and cell cycle arrest are possibly involved in its toxic action. Since OTA binds very strongly to human and animal albumin, a major emphasis is done regarding OTA-albumin interaction. Displacement of OTA from albumin by drugs and by natural flavonoids are discussed in detail, hypothesizing their potentially beneficial effect in order to prevent or attenuate the OTA-induced toxic consequences.

Do airborne biogenic chemicals interact with the PI3K/Akt/mTOR cell signalling pathway to benefit human health and wellbeing in rural and coastal environments?

Living and taking recreation in rural and coastal environments promote health and wellbeing, although the causal factors involved are unclear. It has been proposed that such environments provide a counter to the stresses of everyday living, leading to enhanced mental and physical health. Living in natural environments will result in airborne exposure to a wide range of biogenic chemicals through inhalation and ingestion of airborne microbiota and particles. The "biogenics" hypothesis formulated here is that regular exposure to low concentrations of mixtures of natural compounds and toxins in natural environments confers pleiotropic health benefits by inhibiting the activities of interconnected cell signalling systems, particularly PI3K/Akt/mTORC1. When overactive, Akt and mTOR (mTORC1) can lead to many pathological processes including cancers, diabetes, inflammation, immunosuppression, and neurodegenerative diseases. There is a substantial body of evidence that many natural products (i.e., from bacteria, algae, fungi and higher plants) inhibit the activities of these protein kinases. Other mTOR-related interconnected metabolic control "switches" (e.g., PTEN & NF-κB), autophagy and other cytoprotective processes are also affected by natural products. The "biogenics" hypothesis formulated here is that regular intermittent exposure to a mixture of airborne biogenic compounds in natural environments confers pleiotropic health benefits by inhibiting activities of the highly interconnected PI3K/Akt/mTORC1 system. It is proposed that future experimental exposures to biogenic aerosols in animal models coupled with epidemiology, should target the activities of the various kinases in the PI3K/Akt/mTORC1 systems and related physiological processes for selected urban, rural and coastal populations in order to test this hypothesis.

Ochratoxin A exposure biomarkers in the Czech Republic and comparison with foreign countries

Among ochratoxins, ochratoxin A (OTA) occupies a dominant place and represents significant risk for human and animal health which also implies economic losses around the world. OTA is nephrotoxic, hepatotoxic, teratogenic and immunotoxic mycotoxin. OTA exposure may lead to formation of DNA adducts resulting to genotoxicity and carcinogenicity (human carcinogen of 2B group). Now it seems that OTA could be "a complete carcinogen" which obliges to monitor its presence in biological materials, especially using the suitable biomarkers. In this article, OTA findings in urine, blood, serum, plasma and human kidneys (target dose) in the Czech Republic and comparison with foreign countries are presented.

Immunochemical methods for ochratoxin A detection: a review

The safety of food and feed depends to a great deal on quality control. Numerous compounds and organisms may contaminate food and feed commodities and thus pose a health risk for consumers. The compound of interest in this review is ochratoxin A (OTA), a secondary metabolite of the fungi Aspergillus and Penicillium. Due to its adverse health effects, detection and quantification are of utmost importance. Quality control of food and feed requires extraction and analysis, including TLC, HPLC, MS, and immunochemical methods. Each of these methods has its advantages and disadvantages. However, with regard to costs and rapidity, immunochemical methods have gained much interest in the last decade. In this review an introduction to immunochemistry and assay design will be given to elucidate the principles. Further, the application of the various formats to the detection and quantification of ochratoxin will be described, including the use of commercially available kits.

A review of the diagnosis and treatment of Ochratoxin A inhalational exposure associated with human illness and kidney disease including focal segmental glomerulosclerosis

Ochratoxin A (OTA) exposure via ingestion and inhalation has been described in the literature to cause kidney disease in both animals and humans. This paper reviews Ochratoxin A and its relationship to human health and kidney disease with a focus on a possible association with focal segmental glomerulosclerosis (FSGS) in humans. Prevention and treatment strategies for OTA-induced illness are also discussed, including cholestyramine, a bile-acid-binding resin used as a sequestrant to reduce the enterohepatic recirculation of OTA.

Human ochratoxin a biomarkers--from exposure to effect

Ochratoxin A (OTA) is a nephrotoxic mycotoxin that has received particular attention because of the toxic effects, widespread occurrence in contaminated food and feed chain, suspected causal effect on nephropathies, and, more recently, possibility of exposure by inhalation in domicile and occupational settings. Biomarkers have been used not only to ascertain the role of OTA in inducing chronic renal failure diseases, but also as a means to portray general populations' risk to the mycotoxin. Biomonitoring can thus be used to assess internal OTA exposure, with no need to recognize the main source of exposure. And so it presents undeniable advantages over the monitoring of external dose. With a just right understanding of biomarkers, it is possible to follow the trail from exposure right to effect, and so contribute both to surveillance plans and etiological studies. In recognition of the long serum half-life and the renal elimination of OTA, most of the studies present serum/plasma and/or urine analyses as markers of exposure. In this review and for each of these main matrices, a comparison over the advantages and disadvantages is offered. Although currently limited, an overview of the current knowledge on OTA biomarkers and the influential role of the individual characteristics, namely gender and age, along with season and geographical location is given. Attention is also given to the ongoing debate over the existence of OTA-DNA adducts, a biomarker of effective dose regarded as an alternative to biomarkers of internal dose. Although unspecific, OTA effect biomarkers are also reviewed.

Mycotoxin food and feed regulation and the specific case of ochratoxin A: a review of the worldwide status

Mycotoxins are naturally occurring contaminants whose presence in food- and feedstuffs cannot be completely avoided. The safety and economic impact arising from the commercialization of mycotoxin-contaminated food and feed supply chain is considerable and acknowledged. To protect consumers from mycotoxin-derived health risks, many countries have adopted regulations or guidelines to limit exposure. Similar to regulation for other mycotoxins, the regulatory status of ochratoxin A (OTA) lacks consensus. Although this was one of the first fungal toxins to be subjected to compliance control due to its toxic properties, the conflict between the prime objective of consumer health safeguard and the economic interests of producers and traders remains. One of the key challenges facing policymakers is to balance these conflicting demands and reach consensual regulatory actions or limits. The noteworthy transboundary implications are recognized, both in the case of absence as the unsubstantiated tightening of regulatory limits. This paper scrutinizes the rationales and implications of mycotoxin regulation, with special attention devoted to OTA. In view of the ongoing debate concerning this complex issue, a review of the arguments and suggested strategies proposed by different parties is also made. The specific case of OTA regulation in food and feed is updated and analysed at a European Union and global level.

The presence of ochratoxin A in cord serum and in human milk and its correspondence with maternal dietary habits

BACKGROUND

Ochratoxin A (OTA) is a mycotoxin present in food that can be found in human blood and milk.

PURPOSE

The link between the nutritional habits of pregnant women both of Italian and foreign nationality resident in Italy and the presence of ochratoxin A in cord blood and in maternal milk was investigated.

METHODS

The study involved 130 pregnant women. Food consumption during pregnancy was evaluated by means of the EPIC questionnaire; OTA content was determined in cord serum and maternal milk by HPLC.

RESULTS

The mean daily dietary intake of OTA was 1.02 ± 1.20 and 0.87 ± 0.78 ng/kg of bodyweight for Italian and non-Italian women, respectively, but this difference was not statistically significant. The incidence of positive milk samples was 73.0 and 85.0% among the Italian and non-Italian mothers, respectively. Pork meat, soft drinks, sweets and red wine showed a significant relationship with OTA level in serum. As far as milk is concerned, a positive relationship resulted for pork meat, sweets, soft drinks and seed oils. A positive relationship between serum OTA level and the ratio serum/milk OTA was found. The intake of OTA had no effect on the cord blood creatinine level.

CONCLUSIONS

This study confirms that OTA is widely present in human milk and therefore could pose a risk for the newborn.

Effects of ochratoxin a on livestock production

Ochratoxin A (OTA) contamination often causes large economic losses on livestock production. The intake of feed contaminated by OTA also represents a potential risk for animal health and a food safety issue due to the transfer of the toxin through the food chain to humans. The aim of this paper is to review the available literature on: (1) the frequency and degree of occurrence of OTA in different feedstuffs; (2) the toxicological effects of OTA intake on the performance of the main livestock (i.e., poultry, swine, cattle, goats and sheep); and (3) the transfer of OTA, or its metabolites, from animal feed into animal products such as milk, meat and eggs.

Ochratoxin a in Portugal: a review to assess human exposure

In Portugal, the climate, dietary habits, and food contamination levels present the characteristics for higher population susceptibility to ochratoxin A (OTA), one of the known mycotoxins with the greatest public health and agro-economic importance. In this review, following a brief historical insight on OTA research, a summary of the available data on OTA occurrence in food (cereals, bread, wine, meat) and biological fluids (blood, urine) is made. With this data, an estimation of intake is made to ascertain and update the risk exposure estimation of the Portuguese population, in comparison to previous studies and other populations.

Ochratoxins in feed, a risk for animal and human health: control strategies

Ochratoxin A (OTA) has been shown to be a potent nephrotoxic, hepatotoxic, and teratogenic compound. In farm animals, the intake of feed contaminated with OTA affects animal health and productivity, and may result in the presence of OTA in the animal products. Strategies for the control of OTA in food products require early identification and elimination of contaminated commodities from the food chain. However, current analytical protocols may fail to identify contaminated products, especially in animal feed. The present paper discusses the impact of OTA on human and animal health, with special emphasis on the potential risks of OTA residue in animal products, and control strategies applied in the feed industry.

Biodegradation of ochratoxin a for food and feed decontamination

Ochratoxin A (OTA) is one of the most important mycotoxins that is found in food and feed products. It has proven toxic properties, being primarily known for its nephrotoxicity and carcinogenicity to certain animal species. OTA is produced by several species of Aspergillus and Penicillium that can be found in a wide variety of agricultural products, which makes the presence of OTA in these products common. Many countries have statutory limits for OTA, and concentrations need to be reduced to as low as technologically possible in food and feed. The most important measures to be taken to control OTA are preventive in order to avoid fungal growth and OTA production. However, these measures are difficult to implement in all cases with the consequence of OTA remaining in agricultural commodities. Remediation processes are often used to eliminate, reduce or avoid the toxic effects of OTA. Biological methods have been considered increasingly as an alternative to physical and chemical treatments. However, examples of practical applications are infrequent. This review will focus on the (i) known microorganisms and enzymes that are able to biodegrade OTA; (ii) mode of action of biodegradation and (iii) current applications. A critical discussion about the technical applicability of these strategies is presented.

Review. Ochratoxin A: Presence in Human Plasma and Intake Estimation

Ochratoxin A (OTA) is a fungal toxic secondary metabolite that can be found in several foodstuffs and thereby ingested by humans. One way to assess exposure of humans to OTA is the determination of the levels of this mycotoxin in blood plasma from a certain population. Such studies have been done in many countries, both in healthy people and nephropathy patients. Relationships with individual characteristics were investigated in several cases. Thus, most studies found no correlation with age, either with gender. However, the few studies that found correlation between OTA plasma levels and gender showed that men presented the highest values. When sampling was done over more than one season, the highest OTA plasma levels were found mostly in summer. Differences within regions of a country were related to dietary habits of each area. OTA levels of group populations showed variations from year to year, whereas intraindividual repetitions showed no specific trend. Daily intake of the toxin can be estimated from OTA plasma concentrations by the Klaassen equation. OTA toxicokinetics are considered in this review. Calculated daily intake of OTA by different studies did not overpass the proposed tolerable daily intakes of OTA.

Ochratoxin A and aristolochic acid involvement in nephropathies and associated urothelial tract tumours

This review addresses the unresolved aetiology of several nephropathies and associated upper tract tumours diagnosed all over the world, but especially in the Balkan regions. Studies conducted over the last 35 years point to mycotoxins, mainly ochratoxin A (OTA) as the main culprit. Recent theories however have implicated aristolochic acids (AA). The aim of this review is to put forward arguments in favour of the mycotoxin theory and to show the incoherence of the AA theory. It discusses the differences between the epidemiology of Balkan endemic nephropathy (BEN) and aristolochic acid nephropathy (AAN); OTA and AA carcinogenicity; clinical and pathological effects induced by OTA and AA; sources of OTA contamination (food, air, drinking water); OTA- and AA-DNA adduct formation; the role of genetic polymorphisms; and the risk for young children.

Ochratoxin a contamination in italian wine samples and evaluation of the exposure in the italian population

The scope of this study was to evaluate the exposure of the Italian population to ochratoxin A (OTA) attributable to wine consumption. With this aim 1166 wine samples (773 red wines, 290 white, 75 rose, and 28 dessert wines), collected in 19 different Italian regions and mostly produced between 1988 and 2004, were analyzed for OTA content. The obtained results are reported by year of harvest, geographical area of production, and type of wine. Red wine showed the highest maximum level of contamination (7.50 ng/mL), even though rose wines were characterized by a higher mean value (0.01 ng/mL). A gradually increasing mean concentration was also observed from the north (0.05 ng/mL) to south of Italy (0.54 ng/mL). Exposure calculations, performed using two different consumption databases, indicate a daily intake for consumer only of 0.59 up to 1.24 ng/(kg of b.w.)/day and of 0.33 up to 0.90 ng/(kg of b.w.)/day for the total population. Even in the worst case, corresponding to the calculation of the intake for consumers only in southern Italy and Islands and considering the mean consumption data increased by 1 standard deviation, a quite low exposure (1.68 ng/(kg of b.w.)/day, accounting for 9.8% of TDI) was obtained. Considering the overall OTA dietary exposure, obtained exposure rates indicate that wine did not pose a risk to the Italian population health.

Maternal dietary habits and mycotoxin occurrence in human mature milk

During 2006, 82 samples of human mature milk were collected at Italian hospitals and checked for aflatoxin M1 (AFM1) and ochratoxin A (OTA) by immunoaffinity column extraction and HPLC. AFM1 was detected in four (5%) of milk samples (ranging from < 7 ng/L to 140 ng/L; mean level: 55.35 ng/L); OTA was detected in 61 (74%) of milk samples (ranging from < 5 ng/L to 405 ng/L; mean level: 30.43 ng/L. OTA levels were significantly higher (p less, not double equals 0.05) in milk of habitual consumers of bread, bakery products and cured pork meat. No other statistically significant differences were observed although habitual consumers of pasta (p = 0.059), cookies (p = 0.061) and juices (p = 0.063) had mean contamination values of OTA higher than the moderate consumer. The very few AFB1 positive samples did not allow statistical comparisons. The present study confirms that the occurrence of OTA in human milk is related to maternal dietary habits. The findings support the possibility of dietary recommendations to woman, during pregnancy and lactation, aimed to tentatively reduce the OTA contamination of human milk.

Analysis of ochratoxin A in milk after direct immunoaffinity column clean-up by high-performance liquid chromatography with fluorescence detection

The present work describes a new analytical method for direct immunoaffinity column clean-up of ochratoxin A (OTA) in milk samples followed by determination of the toxin using high-performance liquid chromatography with fluorescence detection (HPLC-FD). Two different immunoaffinity cartridges (IAC) were investigated, and Ochraprep columns were chosen because they showed the best results. An average recovery of 89.8% and a mean RSD of 5.8% for artificially contaminated cow's milk in the range of 5-100 ng/L were attained. The calculated limit of detection (LOD) and limit of quantitation (LOQ) were as low as 0.5 and 5 ng/L, respectively. This new easy and fast method avoids a previous liquid-liquid extraction step and therefore the use of toxic chlorinated solvents. Chromatograms of the final extracts were clean and OTA could be easily detected at a retention time of 8.4 min without interferences. To assess the presence of the toxin in cow's milk eight samples of skimmed and four samples of whole milk were analysed and OTA was not detected over the established detection limit.