Aflatoxin M1and ochratoxin A in a human milk bank in the city of São Paulo, Brazil

Barcode-style lateral flow immunochromatographic strip for the semi-quantitative detection of ochratoxin A in coffee samples

Ochratoxin A (OTA) is a mycotoxin contaminating agricultural products produced by fungi, associated with important toxic effects. Thus, the development of fast, sensitive, and economical approaches for OTA detection is crucial. In this study, a barcode-style lateral flow assay for the semi-quantitative detection of OTA in coffee samples was developed. To achieve this goal, a BSA-OTA complex was immobilized in three test zones to compete with OTA molecules in the sample for binding with anti-OTA antibodies labeled with gold nanoparticles. Different concentrations of OTA in the sample produced distinct colour patterns, allowing semi-quantification of the analyte. The assay exhibited high sensitivity, with a limit of detection of 2.5 µg.L-1, and high reproducibility, with variation coefficient values between 2% and 13%. Moreover, the colour patterns obtained in the analysis with coffee samples were similar to the results obtained with standard OTA solutions, demonstrating a reliable applicability in real samples.

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.

An assessment of the occurrence and nutritional factors associated with aflatoxin M1, ochratoxin A, and zearalenone in the breast milk of nursing mothers in Hamadan, Iran

This research investigated the occurrence of aflatoxin M1 (AFM1), ochratoxin A (OTA), and zearalenone (ZEN) in human milk samples in the Hamadan city, Iran. The study was carried out using the milk of nursing mothers from ten governmental health care centers. Mycotoxin content of ninety milk samples measured using enzyme-linked immunosorbent assay (ELISA). All samples that tested positive for AFM1 with the ELISA test were subsequently analyzed by high-performance liquid chromatography (HPLC). The mean ± SD concentrations of AFM1, determined by ELISA and HPLC were 5.98 ± 1.47 and 4.36 ± 1.23 ng/L, respectively. OTA and ZEN levels were below the detection limit (<5 ng/L) in all samples. None of the contaminated samples exceeded the regulation limit set by the European Commission (25 ng/L) for AFM1 in infant formula. We found a significant correlation between the AFM1 concentration in breast milk and infant age and milk consumption by the nursing mother (p < 0.05). These findings revealed that infants are susceptible to AFM1 exposure from their mother's milk. The authors recommend that additional research be conducted on the analysis of foodstuff and biological fluids for various mycotoxins.

Aflatoxins in rice: Worldwide occurrence and public health perspectives

Aflatoxins are fungal secondary metabolites that contaminate dietary staples worldwide, including maize, rice and groundnuts. Dietary exposure to aflatoxins is a public health concern due to their carcinogenic, acute and chronic effects. Rice is an important staple food consumed widely and consists of a major part of the diets for half of the world population. Human exposure to these mycotoxins is a serious problem especially in developing countries where hot and humid climates favor the fungal growth and where food storage conditions are poor and lack of regulatory limits enforcement. The recent developments of biomarkers have provided opportunities in assessing aflatoxins exposure and related health effects in the high-risk population groups. This review describes the worldwide occurrence of aflatoxins in rice during the period from 1990 to 2015 and biomarkers-based evidence for human exposure to aflatoxins and their adverse health effects. Aflatoxin is a potent hepatocarcinogen and humans may expose to it at any stage of life. Epidemiological studies reported an association between aflatoxin intake and the incidence of hepatocellular carcinoma in some sub-Saharan and Asian countries. Even daily high intake of rice with a low level of contamination is of health concern. Thus, it is necessary to implement effective strategies to prevent contamination and fungal growth in rice. A good agricultural and manufacturing practice should be applied during handling, storage and distribution of rice to ensure that aflatoxins contamination level is lower in the final product. Moreover, a regular survey for aflatoxins occurrence in rice and biomarkers-based studies is recommended to prevent and reduce the adverse health effects in the world population.

Human milk mycotoxin contamination: smoking exposure and breastfeeding problems

Purpose: Mammalian milk may contain pollutants as a result of the maternal exposure. The objective was to determine the presence of selected mycotoxins in human milk and to investigate the effect of maternal characteristics on breastmilk mycotoxin levels and to examine the effect of mycotoxin contamination on lactational problems.Materials and methods: Information about maternal characteristics were taken by a questionnaire and breast milk samples were collected. Levels of aflatoxins M1 (AFM1), ochratoxins A (OTA), zearalenone (ZEN), Deoxynivalenol (DON) were determined by the solid-phase direct competitive enzyme immunoassay.Results: Median levels of breast milk AFM1 and OTA was 3.07 pg/mL and 1.38 ng/mL, respectively. ZEN and DON levels were higher than 0.3 ng/mL in 59% and higher than 10 ng/mL in 37.7%. After controlling for confounding factors, mothers who experienced "delayed onset of lactogenesis" had odds 3.33 times more for the highest quartile of ZEN and mothers with cracked nipples had odds 8.36 times more for the highest quartile of DON. Multiple regression analysis revealed that smoking exposure (environmental, maternal smoking versus never) significantly affected being in the highest quartile of OTA.Conclusion: Mycotoxin can pass to breast milk and smoking exposure of the mother may influence this situation. Mycotoxin exposure may lead to lactation problems. Maternal and infant health can be protected by preventing smoking exposure.

Multiple mycotoxin exposure of infants and young children via breastfeeding and complementary/weaning foods consumption in Ecuadorian highlands

The dietary exposure to mycotoxins in Ecuadorian children aged 0-23 months (320 rural and 603 urban) was evaluated based on the intake of breast milk and staple cereals used as complementary/weaning foods. A probabilistic distribution approach by first order Monte Carlo simulation was adopted to assess the locally occurring mycotoxins (aflatoxins M₁ and B₁ in breast milk, ochratoxin A and deoxynivalenol in wheat noodles and oat flakes, and HT-2 toxin in polished rice). Overall, exposure was modest but higher for rural children due to their monotonous diet. Aflatoxin exposure by breast milk intake were of health concern in both areas (Margin of Exposure and Combined Margin of Exposure Index<10,000). Mycotoxin exposure by staple cereals intake was considered tolerable across feeding stages for individual mycotoxin-cereal combination (Hazard Quotient<1) and combined exposure (Hazard Index<1). The major exposure was to HT-2 toxin by rice intake at complementary feeding (15% rural and 4% urban above TDI) and at weaning stage (26% rural and 6% urban above TDI). Since the usual Ecuadorian diet is based on the same staple cereals, risk management actions could lead to a better protection of young children and also ensure higher safety of the recommended breastfeeding practices by protecting nursing mothers.

Detection of ochratoxin A in human breast milk in Jiroft city, south of Iran

Background and Purpose

Breastfeeding plays an important role in the growth and development of infants. However, breast milk may be contaminated with various mycotoxins. Ochratoxin A is one of the most important mycotoxins with nephrotoxic, carcinogenic, teratogenic, genotoxic, and immunotoxic properties. Thus, we carried out this study to determine the concentration of ochratoxin A in human breast milk in Jiroft, Kerman Province, south of Iran.

Materials and Methods

Eighty-four human breast milk samples were collected from mothers visiting the number one clinic in Jiroft city. Enzyme-linked immunosorbent assay (ELISA) was used to detect ochratoxin A in the samples.

Results

Ochratoxin A was found in all the tested samples at a concentration ranging from 0.11 to 7.34 ng/ml. The mean concentration of ochratoxin A in the samples was 1.99±1.34 ng/ml. Fourteen samples contained ochratoxin A at concentrations exceeding the quantitation limit (3 ng/ml).

Conclusion

The results of this study showed that infants are exposed to ochratoxin A in our region. In cases exceeding the quantitation limit, the infant's body cannot detoxify the toxin. Therefore, the infant can be affected by various illnesses such as nephropathy, immune system deficiency, and different types of cancer.

Assessment of Aflatoxin M1 and Heavy Metal Levels in Mothers Breast Milk in Famagusta, Cyprus

Breast milk contributes towards optimal nutrition for infants. However, studies showed that it can also contain different toxins and heavy metals, which reduce its health benefits. The aim of this study is to determine the level of contaminants such as aflatoxin M1 (AFM1), Pb, Cd, As, and Hg in breast milk samples from Famagusta, Cyprus. Correlations between moldy food consumption, smoking habits of the mothers, and contaminant levels in breast milk were also investigated. Breast milk samples from 50 lactating mothers in rural and urban areas of Famagusta District were analyzed for AFM1 by ELISA. Eighty percent of them were found to be contaminated with AFM1 with the mean measurement of 7.84 ± 1.72 ng/l. Socio-demographic status, moldy food consumption habits, and smoking status do not have any effect on the AFM1 levels observed in breast milk. Heavy metal levels in breast milk were examined by inductively coupled plasma mass spectrometry, and the mean measurements were1.19 ± 1.53 ppm for Pb, 0.73 ± 0.58 ppm for As, 0 ± 0.20 ppm for Hg, and 0.45 ± 0.23 ppm for Cd. This study indicates that the levels of these contaminants in breast milk samples obtained in Famagusta District are well within the acceptable levels. However, the presence of AFM1 and heavy metals still may pose risks for infant health.

Ochratoxin A levels in plasma from inhabitants of northern Paraná, Brazil

Ochratoxin A (OTA), a mycotoxin produced by some fungi like Aspergillus ochraceus, Aspergillus niger, Aspergillus carbonarius and Penicillium viridicatum, is a natural contaminant of many foods worldwide. The intake of OTA is associated with deleterious effects to humans and animals, such as nephro- and hepatotoxicity. Although there are some data about food contamination, there is lack of data about human exposure to OTA in Brazil. Therefore, current research aimed to determine the level of human exposure to OTA and, additionally, identify possible associations with biomarkers of liver and kidney damage. OTA levels were evaluated in plasma samples from 149 individuals living in the state of Paraná, Brazil, by indirect competitive ELISA using monoclonal antibody anti-OTA (cell line OTA.7). Plasma levels of OTA, alanine aminotransferase, aspartate aminotransferase, urea and creatinine were submitted to Pearson's correlation test. It was possible to measure OTA levels in 54.4% of the samples (mean 734±296 pg/ml; maximum 1,585 pg/ml), with an estimated daily intake of 983-1,445 pg/kg body weight. There was no correlation between OTA plasma levels and biochemical parameters, possibly due to the low level of contamination. This is one of the first studies concerning the contamination of humans by OTA in Brazil and we conclude that the plasma levels of the evaluated population indicate an estimated weekly intake below the tolerable weekly intake derived by the EFSA Panel on Contaminants in the Food Chain. Nevertheless, additional longitudinal studies with greater regional coverage and at different seasonal periods are necessary.

Exposure Assessment of Infants to Aflatoxin M₁ through Consumption of Breast Milk and Infant Powdered Milk in Brazil

Aflatoxin M₁ (AFM₁) is an important biomarker that can be used to evaluate aflatoxin exposure in both humans and animals. The aim of this study was to evaluate the exposure degree of infants to AFM₁ through consumption of breast milk and infant powdered milk in Brazil. For this purpose, the estimated daily intake (EDI) for infants was calculated based on the AFM₁ levels analyzed in 94 breast milk (BM) samples collected in Southern Brazil, and 16 infant powdered milk (IPM) samples commonly commercialized in Brazil. AFM₁ was detected in 5.3% (n = 5) and 43.8% (n = 7) of BM and IPM samples, with mean levels of 0.003 ng/g and 0.011 ng/g, respectively. All the IPM samples showed AFM₁ levels lower than those established by the Brazilian guidelines (5 ng/g), and in most of the samples (81.25%) levels were below the maximum limit tolerated by the European Commission (0.025 ng/g). The EDI of AFM₁ for infants aged zero to 12 months old showed values from 0.018 to 0.069 ng/kg body weight/day for BM, and 0.078 to 0.306 ng/kg body weight/day for IPM. Hazard index (HI) values for BM and IPM were less than one, except for IPM intended for infants up to one month. In conclusion, the exposure of infants to AFM₁ was low, but continuous monitoring of mycotoxin levels is essential to minimize infant health risk.

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.

Aflatoxin M1 in milk and milk products: a short review

Aflatoxin M1 (AFM1) is associated with carcinogenicity, genotoxicity, mutagenicity, and teratogenicity and as a result, represents a human health problem worldwide. This review will detail the toxicity, analytical methodology, occurrence, and prevention and control of AFM1 in milk and milk products. The probable daily intakes (PDI) per bodyweight (bw) worldwide ranged from 0.002 to 0.26 ng/kg bw/day for AFM1. Nevertheless, the high occurrence of AFM1 demonstrated in this review establishes the need for monitoring to reduce the risk of toxicity to humans. The recommended extraction method of AFM1 from milk is liquid-liquid with acetonitrile because of the acceptable recoveries (85-97%), compatibility with the environment, and cleanest extracts. The recommended analytical technique for the determination of AFM1 in milk is the high performance-liquid chromatography-fluorescence detector (HPLC-FLD), achieving a 0.001 µg/kg detection limit. The HPLC-FLD is the most common internationally recognised official method for the analysis of AFM1 in milk. The suggested extraction and analytical method for cheese is dichloromethane (81-108% recoveries) and ELISA, respectively. This review reports the projected worldwide occurrence of AFM1 in milk of 2010-2015. Of the 7,841 samples, 5,873 (75%) were positive for AFM1, 26% (2,042) exceeded the maximum residue levels (MRL) of 0.05 µg/kg defined by the European Union and 1.53% (120) exceeded the MRL of 0.5 µg/kg defined by the US Food and Drug Administration. The most effective way of preventing AFM1 occurrences is to reduce contamination of AFB1 in animal feed using biological control with atoxigenic strains of Aspergillus flavus, proper storage of crops, and the addition of binders to AFB1-contaminated feed. Controllable measures include the addition of binders and use of biological transforming agents such as lactic acid bacteria applied directly to milk. Though the one accepted method for the control of AFM1 in milk and milk products is the enforcement of governmental MRL.

Aflatoxin M1 in Spanish infant formulae: occurrence and dietary intake regarding type, protein-base and physical state

The incidence of aflatoxin M1 (AFM1) in 69 different infant formulae marketed in Spain between 2007 and 2008 was studied and dietary intake estimated. Samples were analysed using an HPLC method coupled with fluorescence detection after immunoaffinity column clean-up. The toxin was detected in 26 formulae (37.7%) at levels below the permissible limit set by EC legislation, giving a range of 0.6-11.6 ng kg(-1) with a mean value of 3.1 ng kg(-1). Increasing occurrence was found in those formulae produced by the less complex manufacturing processes affecting casein/whey protein ratio: pre-term, 14.3%; starter, 35.3%; follow-up, 42.1%; toddler 87.6%; while hypoallergenic and lactose-free were totally exempt. Additionally, the influence of main protein source and physical state (powdered and ready-to-use formula) on AFM1 occurrence was evaluated leading to similar conclusions. Dietary AFM1 weekly intake was observed to be stable around 1 ng kg(-1) bw for standard formula and 0.1 ng kg(-1) bw for pre-term feeding.

The concentration of aflatoxin M1 in the mothers' milk in Khorrambid City, Fars, Iran

INTRODUCTION

Aflatoxins are secondary toxic metabolites produced by certain group of Aspergillus species in suitable conditions. These toxins are highly toxic, immunosuppressive, mutagenic, teratogenic and carcinogenic metabolites. The purpose of this study was to detection aflatoxin M1 concentration in mother's milk from rural area of Khorrambid town of Fars Province.

MATERIALS AND METHODS

In this study, 87 milk samples of mothers were collected by cluster sampling methods in the period between June and July 2011 and the amount of aflatoxin M1 was measured by a competitive ELISA method.

RESULTS

From 87 mother's milk, 24 (27.6%) samples were contaminated with aflatoxin M1 with mean concentration of 0.56 ± 1.23 pg/ml (range 0.13-4.91 pg/ml).

CONCLUSION

The amount of aflatoxin M1 in mothers' milk was lower than 50 ng/l (Europe Union and Iranian standard). Detection of Aflatoxin M1 in mothers' milk is due to consuming contaminated food. This contamination not only threatens the health of the mothers but also has irreversible effects on the growth and health of their babies.

Prevalence of ochratoxin a in human milk in the khorrambid town, fars province, South of iran

BACKGROUND

Ochratoxins belong to a group of mycotoxins produced as the secondary metabolites by filamentous fungi, such as Aspergillus and Penicillium. These toxins may be teratogenic, mutagenic, hepatotoxic, nephrotoxic, and may have immunosuppressive effects and pose a serious health problems to exposed humans and animals.

OBJECTIVES

The present study aimed to determine the level of ochratoxin A (OTA) in the samples of mothers' milk in the Khorrambid Town, Fars Province, south of Iran.

MATERIALS AND METHODS

Between June and July 2011, samples of human milk were obtained from 87 mothers. The samples were diluted by absolute methanol at 1:4 ratio and after centrifugation, the supernatant was directly used to determine the level of OTA using competitive enzyme-linked immunosorbent assay (ELISA).

RESULTS

Among 87 human milk samples, 84 (96.6%) samples had positive results for OTA at a mean level of 24.57 ± 13.6 ng/L. According to the European Union Standard, 14 (16%) positive samples revealed more than the maximum limit of 40 ng/L for ochratoxin (range, 1.6-60 ng/L).

CONCLUSIONS

Presence of OTA in the milk of mothers denotes a probable consumption of a contaminated foods. Therefore, regular monitoring of foods for presence of mycotoxins for lactating mothers seems necessary.

Association between aflatoxin M1 exposure through breast milk and growth impairment in infants from Northern Tanzania

Infants breastfeeding from mothers consuming aflatoxin contaminated foods may be exposed to aflatoxin M1 (AFM1), a metabolite of aflatoxin B1. This study estimated the association between AFM1 exposure levels and growth indicators, for infants under six months of age in the Rombo district in Northern Tanzania. A total of 143 infants and their mothers were involved. Breast-milk samples, infants' anthropometric data and 24 h dietary recall for mothers were taken at the 1st, 3rd and 5th months of children age. AFM1 contaminations in the samples were determined using HPLC. Aflatoxin M1 exposure by an infant was estimated by multiplying contamination in the breast milk consumed by him/her with the breast milk intake recorded by the United States Environmental Protection Agency for infants of his/her age divided by the infant's body weight. All the breast-milk samples were contaminated by AFM1 at levels ranging from 0.01 to 0.55 ng/ml. Above 90% of samples exceeded the EU limit of 0.025 ng/ml for infants' foods while over 76% exceeded the EU limit of 0.05 ng/ml for dairy milk and milk products. Only 1% of the samples exceeded the limit of 0.5 ng/ml set for dairy milk in the United States and several countries in Asia. AFM1 Exposures ranged from 1.13-66.79 ng/kg body weight per day. A small but significant (P<0.05) inverse association was observed between AFM1 exposure levels and weight for age Z-score or height for age Z-score. Appropriate strategies should be applied to minimise aflatoxin B1 exposure in lactating mothers in order to protect infants from AFM1 exposure.

Aflatoxin M1 contamination of human breast milk in Isfahan, Iran

BACKGROUND

During the last decades there has been great attention paid to aflatoxins. They are highly toxic, immunosuppressive, mutagenic, teratogenic, and carcinogenic compounds. Aflatoxin M1 (AFM1), a hydroxylated metabolite of aflatoxin B1 (AFB1), is formed in the liver and excreted into the breast milk. It is considered to cause certain hygienic risks for infant health. The aim of this study was to evaluate the presence of the AFM1 in the breast milk using AFM1 in milk as a biomarker for exposure to aflatoxin B1 and determine the level of AFM1 contamination in the lactating mothers in Isfahan, Iran.

MATERIALS AND METHODS

This study was carried out on 80 lactating women randomly selected from two urban health centers. Mother's milk samples and information on food intake were collected from the participants using structured food-frequency questionnaire. Breast milk samples were tested for AFM1 by a competitive ELISA technique.

RESULTS

Our findings showed that only one sample was contaminated with AFM1 with concentrations of 6.8 ng/L. However, the AFM1 level in this sample was lower than the maximum tolerable limit (25 ng/L) accepted by the European Communities and Codex Alimentarius.

CONCLUSION

Although the concentration of AFM1 in none of the samples was higher than the acceptable level, the presence of AFM1 in only one of them confirms the need for developing strategies to reduce exposure to aflatoxin in foods and to carry out biological monitoring of aflatoxins as a food quality control measure routinely.

Impact of pH on the stability and the cross-reactivity of ochratoxin A and citrinin

Mycotoxins are secondary metabolites produced by several fungi contaminating crops. In several countries, the maximum permitted levels of mycotoxins are found in foodstuffs and feedstuffs. The common strategy of mycotoxin analysis involves extraction, clean-up and quantification by chromatography. In this paper, we analyzed the reasons of underestimation of ochratoxin A (OTA) content in wine, and overestimation of OTA in wheat, depending on the pH of the clean-up step and the simultaneous presence of citrinin (CIT). We demonstrated that the increase of pH by adding polyethylene glycol (PEG) to wine led to an underestimation of OTA by conversion of OTA into open ring ochratoxin A OP-OA. In comparing three methods of extraction and clean-up for the determination of OTA and CIT in wheat--(i) an inter-laboratory validated method for OTA in cereals using immunoaffinity column clean-up (IAC) and extraction by acetonitrile/water; (ii) a validated method using IAC and extraction with 1% bicarbonate Na; and (iii) an in-house validated method based on acid liquid/liquid extraction--we observed an overestimation of OTA after immunoaffinity clean-up when CIT is also present in the sample, whereas an underestimation was observed when OTA was alone. Under neutral and alkaline conditions, CIT was partially recognized by OTA antibodies.

Simultaneous analysis of aflatoxins B1, B2, G1, G2, M1 and ochratoxin A in breast milk by high-performance liquid chromatography/fluorescence after liquid-liquid extraction with low temperature purification (LLE-LTP)

The aims of this study were to optimize and validate a methodology for the simultaneous analysis of aflatoxins B1, B2, G1, G2, M1 (AFB1, AFB2, AFG1, AFG2, AFM1) and ochratoxin A (OTA) in breast milk, and to analyze these mycotoxins in samples obtained from human milk banks in the Federal District, Brazil. The optimized analytical method was based on liquid-liquid extraction with low temperature purification (3.25mL of acidified acetonitrile+0.75mL of ethyl acetate), followed by analysis by high-performance liquid chromatography with fluorescence detector (HPLC/FLD) and a photochemical post-column reactor. Limits of quantification (LOQ) ranged from 0.005 to 0.03ng/mL, recoveries from 73 to 99.5%, and relative standard deviations (RSD) from 1.8 to 17.3%. The LLE-LTP extraction method was shown to be simple and cost-effective, since no columns were needed for clean-up. Only 2 of the 224 breast milk samples analyzed were positive for the mycotoxins, both samples containing AFB2 at the LOQ level (0.005ng/mL). The identity of the mycotoxin detected was confirmed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). This result indicates that infants who are fed with breast milk from the milk banks are not at risk from aflatoxin and ochratoxin exposure.

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.

Assessment of exposure of Egyptian infants to aflatoxin M1 through breast milk

BACKGROUND

Mothers are exposed to many toxins that can reach their infants through breast milk. One of these toxins is aflatoxins, produced by Aspergillus fungus. Aspergillus colonizes grains, especially in tropical regions where there is high temperature and humidity. Aflatoxins are highly toxic, mutagenic, teratogenic, and carcinogenic. One of these is aflatoxin B1 that is excreted in breast milk as aflatoxin M1 (AFM1).

MATERIALS AND METHODS

This is a cross-sectional study in which 150 mother-infant dyads were included. All the infants were exclusively breastfed. Infant weights' standard deviation scores were documented at birth and at 6 months. At 6 months, before starting weaning, AFM1 was measured in breast milk by enzyme-linked immunosorbent assay and by liver enzymes; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) for all mothers and infants.

RESULTS

Ninety-eight mothers (65.3%) had AFM1-positive breast milk samples (AFM1>0.05 μg/l according to the European Community and Codex Alimentarius). AFM1 levels ranged between 0.2 and 19.0 μg/l (mean: 7.1±5.0 μg/l). In cases considered negative, AFM1 levels ranged between 0.01and 0.05 μg/l (mean: 0.04±0.01 μg/l). Infants of AFM1-positive mothers had lower weight standard deviation scores at birth and at 6 months (P=0.04 and 0.0001). ALT and aspartate aminotransferase of mothers and ALT of infants were significantly higher in dyads having AFM1-positive breast milk (P=0.0001, 0.0001, and 0.03, respectively).

CONCLUSION

Aflatoxins represent a real threat in Egypt. The higher liver enzymes in AFM1-positive cases might represent an alarm toward future development of hepatocellular carcinoma.

RECOMMENDATIONS

Cooperation of ministries is recommended to combat this problem. The public should be educated about proper food storage and about the hazards of aflatoxin ingestion.

Exposure of newborns to aflatoxin M1 and B1 from mothers' breast milk in Ankara, Turkey

Aflatoxins (AFs) are important risks for human health due to their widespread presence in foods and environment. However, contamination risk of breast milk with different pollutants including AFs is high in today's life conditions. Since breast milk is a major nutrient for infants, feeding of infants with safe milk is essential. Therefore, the objective of this study was to determine the levels of AF M(1) and B(1) in breast milk samples collected from 75 mothers in Ankara, Turkey. AF M(1) and B(1) levels were investigated by high performance liquid chromatography (HPLC) with a fluorescence detector following an extraction procedure. The limit of detection was found to be 5 ng/l. Both AFs were detected in diverse degrees in all breast milk samples: The level of AF M(1) were in the ranges of 60.90-299.99 ng/l, and AF B(1) were in the ranges of 94.50-4123.80 ng/l. These results pointed out the exposure of mothers and neonates to AF M(1) and B(1), and the necessity of further research on mycotoxin contamination both in foods and biological fluids as well as protection strategies.

Detection of aflatoxin M1 in human breast milk and raw cow's milk in Istanbul, Turkey

This survey was undertaken to determine the extent of aflatoxin M1 (AFM1) contamination in human breast milk and raw cow's milk in Istanbul, Turkey. Samples of human and raw cow's milk were collected randomly and analyzed for AFM1 using an enzyme-linked immunosorbent assay and high-performance liquid chromatography with fluorescence detection in which the samples were cleaned up with immunoaffinity columns. In this study, AFM, was detected in 8 (13.1%) of 61 human breast milk samples examined (mean +/- SD level, 5.68 +/- 0.62 ng/liter; range, 5.10 to 6.90 ng/liter) and 20 (33.3%) of 60 raw cow's milk samples examined (range, 5.40 to 300.20 ng/liter). Five (8.3%) of the positive raw cow's milk samples had AFM1 levels (153.52 +/- 100.60 ng/liter; range, 61.20 to 300.20 ng/liter) that were higher than the maximum tolerance limit (0.05 ppb) stipulated by regulations in Turkey and some other countries.

An overview of conventional and emerging analytical methods for the determination of mycotoxins

Mycotoxins are a group of compounds produced by various fungi and excreted into the matrices on which they grow, often food intended for human consumption or animal feed. The high toxicity and carcinogenicity of these compounds and their ability to cause various pathological conditions has led to widespread screening of foods and feeds potentially polluted with them. Maximum permissible levels in different matrices have also been established for some toxins. As these are quite low, analytical methods for determination of mycotoxins have to be both sensitive and specific. In addition, an appropriate sample preparation and pre-concentration method is needed to isolate analytes from rather complicated samples. In this article, an overview of methods for analysis and sample preparation published in the last ten years is given for the most often encountered mycotoxins in different samples, mainly in food. Special emphasis is on liquid chromatography with fluorescence and mass spectrometric detection, while in the field of sample preparation various solid-phase extraction approaches are discussed. However, an overview of other analytical and sample preparation methods less often used is also given. Finally, different matrices where mycotoxins have to be determined are discussed with the emphasis on their specific characteristics important for the analysis (human food and beverages, animal feed, biological samples, environmental samples). Various issues important for accurate qualitative and quantitative analyses are critically discussed: sampling and choice of representative sample, sample preparation and possible bias associated with it, specificity of the analytical method and critical evaluation of results.