Sphingoid base levels in humans consuming fumonisin-contaminated maize in rural areas of the former Transkei, South Africa: a cross-sectional study

Chronic oral exposure to low-concentration fumonisin B2 significantly exacerbates the inflammatory responses of allergies in mice via inhibition of IL-10 release by regulatory T cells in gut-associated lymphoid tissue

Contamination with fumonisins produced by Fusarium spp. is rapidly growing in both developing and developed countries. The purpose of this study was to determine whether oral exposure to fumonisin contributed to the development of allergic diseases. We initially examined the immunotoxic potential of short-term, oral administration of fumonisin B1 (FB1, 1 mg/kg) and fumonisin B2 (FB2, 1 mg/kg), both naturally occurring fumonisins, using a BALB/c mouse model of allergic contact dermatitis and Dermatophagoides farina-induced asthma. Using an NC/nga mouse model of atopic dermatitis (AD), we evaluated the adverse effects of subchronic oral exposure to low concentrations of FB2 (2 or 200 μg/kg). Finally, we explored the influence of FB2 on regulatory T cell proliferation and function in mesenteric lymph nodes after 1-week oral exposure to FB2 in BALB/c mice. Oral exposure to FB2 markedly exacerbated the symptoms of allergy, including skin thickness, histological evaluation, immunocyte proliferation, and proinflammatory cytokine production, although no change was observed following exposure to FB1. Furthermore, oral exposure to low concentrations of FB2 considerably exacerbated the AD scores, skin thickness, transepidermal water loss, histological features, and proinflammatory cytokine production. The aggravated allergic symptoms induced by oral exposure to FB2 could be attributed to the direct inhibition of IL-10 production by regulatory T cells in mesenteric lymph nodes. Our findings indicate that the recommended maximum fumonisin level should be reconsidered based on the potential for allergy development.

Development and Limitations of Exposure Biomarkers to Dietary Contaminants Mycotoxins

Mycotoxins are toxic secondary fungal metabolites that frequently contaminate cereal crops globally, presenting exposure hazards to humans and livestock in many settings. The heterogeneous distribution of mycotoxins in food restricts the usefulness of food sampling and intake estimates for epidemiological studies, making validated exposure biomarkers better tools for informing epidemiological investigations. While biomarkers of exposure have served important roles for understanding the public health impact of mycotoxins such as aflatoxins (AF), the science of biomarkers must continue advancing to allow for better understanding of mycotoxins' roles in the etiology of disease and the effectiveness of mitigation strategies. This review will discuss mycotoxin biomarker development approaches over several decades for four toxins of significant public health concerns, AFs, fumonisins (FB), deoxynivalenol (DON), and ochratoxin A (OTA). This review will also highlight some knowledge gaps, key needs and potential pitfalls in mycotoxin biomarker interpretation.

Fumonisin B1 -induced mitochondrial toxicity and hepatoprotective potential of rooibos: An update

Fumonisins are a family of potentially carcinogenic mycotoxins produced by Fusarium verticillioides. Several fumonisins have been identified with fumonisin B₁ (FB₁ ) being the most toxic. The canonical mechanism of FB₁ toxicity is centered on its structural resemblance with sphinganine and consequent competitive inhibition of ceramide synthase and disruption of lipidomic profiles. Recent and emerging evidence at the molecular level has identified the disruption of mitochondria and excessive generation of toxic reactive oxygen species (ROS) as alternative/additional mechanisms of toxicity. The understanding of how these pathways contribute to FB₁ toxicity can lead to the identification of novel, effective approaches to protecting vulnerable populations. Natural compounds with antioxidant properties seem to protect against the induced toxic effects of FB₁ . Rooibos (Aspalathus linearis), endemic to South Africa, has traditionally been used as a medicinal herbal tea with strong scientific evidence supporting its anecdotal claims. The unique composition of phytochemicals and combination of metabolic activators, adaptogens and antioxidants make rooibos an attractive yet underappreciated intervention for FB₁ toxicoses. In the search for a means to address FB₁ toxicoses as a food safety problem in developing countries, phytomedicine and traditional knowledge systems must play an integral part. This review aims to summarize the growing body of evidence succinctly, which highlights mitochondrial dysfunction as a secondary toxic effect responsible for the FB₁ -induced generation of ROS. We further propose the potential of rooibos to combat this induced toxicity based on its integrated bioactive properties, as a socio-economically viable strategy to prevent and/or repair cellular damage caused by FB₁ .

Mycotoxin exposure is associated with increased risk of esophageal squamous cell carcinoma in Huaian area, China

BACKGROUND

Consumption of moldy food has previously been identified as a risk factor for esophageal squamous cell carcinoma (ESCC) in high-risk countries; however, what contributing roles these dietary carcinogenic mycotoxins play in the etiology of ESCC are largely unknown.

METHODS

A mycotoxin biomarker-incorporated, population-based case-control study was performed in Huaian area, Jiangsu Province, one of the two high-risk areas in China. Exposure biomarkers of aflatoxins (AF) and fumonisins (FN) were quantitatively analyzed using HPLC-fluorescence techniques.

RESULTS

Among the cases (n = 190), the median levels of AF biomarker, serum AFB1-lysine adduct, and FN biomarker, urinary FB1, were 1.77 pg/mg albumin and 176.13 pg/mg creatinine, respectively. Among the controls (n = 380), the median levels of AFB1-lysine adduct and urinary FB1 were 1.49 pg/mg albumin and 56.92 pg/mg creatinine, respectively. These mycotoxin exposure biomarker levels were significantly higher in cases as compared to controls (p <  0.05 and 0.01, respectively). An increased risk to ESCC was associated with exposure to both AFB1 and FB1 (p <  0.001 for both).

CONCLUSIONS

Mycotoxin exposure, especially to AFB1 and FB1, was associated with the risk of ESCC, and a greater-than-additive interaction between co-exposures to these two mycotoxins may contribute to the increased risk of ESCC in Huaian area, China.

Mycotoxin exposure and adverse reproductive health outcomes in Africa: a review

It is well established that mycotoxin exposure can have adverse effects on reproductive health resulting to poor reproductive potential. The most studied mycotoxin in relation to poor reproductive health in humans is aflatoxin, although fumonisins, trichothecenes and zearalenone have also been reported to impair reproductive function and cause abnormal foetal development. These potent fungal toxins contaminate many food products making them a prominent agricultural, food safety and public health challenge, especially in Africa due to little or lack of mycotoxin regulation in agricultural products. Neonates can be exposed to aflatoxins in utero, as the toxins pass from mother to the foetus through the placenta. This exposure may continue during breast feeding, to the introduction of weaning foods, and then foods taken by adults. The consequences of aflatoxin exposure in mothers, foetus and children are many, including anaemia in pregnancy, low birth weight, interference with nutrient absorption, suppression of immune function, child growth retardation and abnormal liver function. In males, reports have indicated a possible relationship between aflatoxin exposure and poor sperm quality culminating in infertility. Maternal exposure to fumonisin during early pregnancy has been associated with increased risk of neural tube defects among newborns in regions where maize is the common dietary staple with the possibility of chronic fumonisin exposure. Furthermore, zearalenone has been linked to precocious puberty and premature thelarche in girls, correlating with extremely high serum oestrogen levels. This review presents an overview of the several reports linking aflatoxins, fumonisins, trichothecenes, and zearalenone exposure to poor reproductive health outcomes in Africa, with emphasis on birth outcomes, foetal health and infertility.

Mitigation of Fumonisin Biomarkers by Green Tea Polyphenols in a High-Risk Population of Hepatocellular Carcinoma

Green tea polyphenols (GTP) are highly effective in inhibiting a variety of tumorigenic effects induced by carcinogens. In this study we assessed GTP mitigation on biomarkers of fumonisin B₁ (FB₁), a class 2B carcinogen, in blood and urine samples collected from an intervention trial. A total of 124 exposed people were recruited and randomly assigned to low-dose (GTP 500 mg, n = 42), high-dose (GTP 1,000 mg, n = 41) or placebo (n = 41) for 3 months. After one-month of intervention, urinary FB₁ was significantly decreased in high-dose group compared to that of placebo group (p = 0.045), with reduction rates of 18.95% in the low-dose group and 33.62% in the high-dose group. After three-month intervention, urinary FB₁ showed significant decrease in both low-dose (p = 0.016) and the high-dose (p = 0.0005) groups compared to that of both placebo group and baseline levels, with reduction rates of 40.18% in the low-dose group and 52.6% in the high-dose group. GTP treatment also significantly reduced urinary excretion of sphinganine (Sa), sphingosine (So), and Sa/So ratio, but had no effect on serum Sa, So, and Sa/So ratio. Analysis with mixed-effect model revealed significant interactions between time and treatment effects of GTP on both urinary free FB₁ levels and Sa/So ratios.

Assessing Risk of Fumonisin Contamination in Maize Using Near-Infrared Spectroscopy

Fumonisins are major mycotoxins found worldwide in maize and maize products. Because of their toxicity for both human and animals, European Union regulations were created to fix the maximal fumonisin B1 and B2 content allowed in foods and feeds. Unfortunately, directly measuring these mycotoxins by current analytical techniques is tedious and expensive and most measurement methods do not lend themselves to online control. Alternative approaches to chemical analysis have been developed and involve models that allow the mycotoxin contamination to be predicted based on environmental conditions and analysis by near-infrared (NIR) spectroscopy. In the present work, we use NIR spectroscopy to determine the fumonisin and fungal contents of 117 samples of maize. The determination coefficient between fumonisin and fungal-biomass content was 0.44. We establish herein a threshold for the number of CFUs for fungal biomass beyond which the fumonisin content is likely to exceed the European regulatory level of 4000 μg/kg. In addition, we determine the fungal content by using a NIR-spectroscopy model that allows us to sort samples of maize. Upon calibration, the percentage of well-classified samples was 96%, which compares favorably to the 82% obtained by independent verification.

Assessment of multi-mycotoxin exposure in southern Italy by urinary multi-biomarker determination

Human exposure assessment to deoxynivalenol (DON), aflatoxin B1 (AFB1), fumonisin B1 (FB1), zearalenone (ZEA) and ochratoxin A (OTA) can be performed by measuring their urinary biomarkers. Suitable biomarkers of exposure for these mycotoxins are DON + de-epoxydeoxynivalenol (DOM-1), aflatoxin M1 (AFM1), FB₁, ZEA + α-zearalenol (α-ZOL) + β-zearalenol (β-ZOL) and OTA, respectively. An UPLC-MS/MS multi-biomarker method was used to detect and measure incidence and levels of these biomarkers in urine samples of 52 volunteers resident in Apulia region in Southern Italy. The presence of ZEA + ZOLs, OTA, DON, FB1 and AFM1 were detected in 100%, 100%, 96%, 56% and 6%, of samples, respectively. All samples contained biomarkers of two or more mycotoxins. The mean concentrations of biomarkers ranged from 0.055 ng/mL (FB1) to 11.89 ng/mL (DON). Urinary biomarker concentrations were used to estimate human exposure to multiple mycotoxin. For OTA and DON, 94% and 40% of volunteers, respectively exceeded the tolerable daily intake (TDI) for these mycotoxins. The estimated human exposure to FB1 and ZEA was largely below the TDI for these mycotoxins for all volunteers.

Strategies for mining fungal natural products

Fungi are well known for their ability to produce a multitude of natural products. On the one hand their potential to provide beneficial antibiotics and immunosuppressants has been maximized by the pharmaceutical industry to service the market with cost-efficient drugs. On the other hand identification of trace amounts of known mycotoxins in food and feed samples is of major importance to ensure consumer health and safety. Although several fungal natural products, their biosynthesis and regulation are known today, recent genome sequences of hundreds of fungal species illustrate that the secondary metabolite potential of fungi has been substantially underestimated. Since expression of genes and subsequent production of the encoded metabolites are frequently cryptic or silent under standard laboratory conditions, strategies for activating these hidden new compounds are essential. This review will cover the latest advances in fungal genome mining undertaken to unlock novel products.

Mycological analysis and multimycotoxins in maize from rural subsistence farmers in the former Transkei, South Africa

Maize harvested in the Centane region of the former Transkei, Eastern Cape Province, South Africa, by subsistence farmers has been shown over many seasons to be contaminated with fumonisin mycotoxins. However, there are limited data on the presence of other mycotoxins. Two multimycotoxin LC-MS/MS methods were applied to good and moldy maize samples, as separated by the farmers themselves from the 2011 harvest. One method involved extract cleanup on multitoxin immunoaffinity columns before LC-MS/MS analysis for aflatoxins, fumonisins, deoxynivalenol (DON), zearalenone (ZEN), and T-2 and HT-2 toxins. The other method was based on a "dilute-and-shoot" approach for the above mycotoxins and a wide range of other fungal secondary metabolites. Both methods showed high incidences of fumonisins B1 and B2 (FB1 and FB2) in good maize (100% for both by the first method, means were 2083 and 927 μg/kg for the two analogues; 93% for both by the second method, positive means of 2764 and 1050 μg/kg, respectively). All samples of moldy maize were contaminated (mean FB1 of 27.64 and 35.98 mg/kg, respectively; mean FB2 of 10.58 and 14.14 mg/kg, respectively). Comparison of the two methods for FB1 and FB2 over the entire range of samples gave R(2) values 0.9144 and 0.8859, respectively. Low levels of DON were found by both methods (positive means of 12 and 4.7 μg/kg in good maize, respectively, and of 14 and 5.8 μg/kg in moldy maize, respectively). ZEN was determined with positive means of 108 and 25 μg/kg in good maize, respectively, and of 111 and 135 μg/kg in moldy maize, respectively. No aflatoxins, OTA, or T-2 or HT-2 toxins were detected. A wide range of other Fusarium , Aspergillus , Alternaria , and Penicillium mycotoxins and secondary metabolites were determined.

Multiple mycotoxin exposure determined by urinary biomarkers in rural subsistence farmers in the former Transkei, South Africa

Subsistence farmers are exposed to a range of mycotoxins. This study applied novel urinary multi-mycotoxin LC-MS/MS methods to determine multiple exposure biomarkers in the high oesophageal cancer region, Transkei, South Africa. Fifty-three female participants donated part of their maize-based evening meal and first void morning urine, which was analysed both with sample clean-up (single and multi-biomarker) and by a 'dilute-and-shoot' multi-biomarker method. Results were corrected for recovery with LOD for not detected. A single biomarker method detected fumonisin B1 (FB1) (87% incidence; mean±standard deviation 0.342±0.466 ng/mg creatinine) and deoxynivalenol (100%; mean 20.4±49.4 ng/mg creatinine) after hydrolysis with β-glucuronidase. The multi-biomarker 'dilute-and-shoot' method indicated deoxynivalenol-15-glucuronide was predominantly present. A multi-biomarker method with β-glucuronidase and immunoaffinity clean-up determined zearalenone (100%; 0.529±1.60 ng/mg creatinine), FB1 (96%; 1.52±2.17 ng/mg creatinine), α-zearalenol (92%; 0.614±1.91 ng/mg creatinine), deoxynivalenol (87%; 11.3±27.1 ng/mg creatinine), β-zearalenol (75%; 0.702±2.95 ng/mg creatinine) and ochratoxin A (98%; 0.041±0.086 ng/mg creatinine). These demonstrate the value of multi-biomarker methods in measuring exposures in populations exposed to multiple mycotoxins. This is the first finding of urinary deoxynivalenol, zearalenone, their conjugates, ochratoxin A and zearalenols in Transkei.

Fumonisin biomarkers in maize eaters and implications for human disease

Maize is the predominant food source contaminated by fumonisins and this has particular health risks for communities consuming maize as a staple diet. The main biochemical effect of fumonisins is the inhibition of ceramide biosynthesis causing an increase in sphingoid bases and sphingoid base 1-phosphates and a depletion of the complex sphingolipids, thereby disrupting lipid metabolism and sphingolipid-mediated processes and signalling systems. Attempts to use the elevation of sphinganine as a human biomarker of fumonisin exposure have to date been unsuccessful. Consequently, recent research has focussed on developing a urinary exposure biomarker based on the measurement of the nonmetabolised toxin. In animals, fumonisins are poorly absorbed in the gut and are mostly excreted unmetabolised in faeces, with only a small percentage (0.25-2.0%) in urine. This appears to also be true in humans were fumonisin B1 (FB1) is detectable in urine soon after exposure, but in very small amounts relative to total intake. However, with modern sensitive and selective analytical methods such as liquid chromatography-tandem mass spectrometry, these low levels can be readily determined. The first study to show a positive correlation between consumption of maize and urinary FB1 was conducted in a Mexican population consuming tortillas as a staple food. Further validation of this relationship was achieved in a South African subsistence farming community with a positive correlation between urinary FB1 and fumonisin exposure, as assessed by food analysis and food intake data. The most recent developments are aimed at measuring multiple mycotoxin biomarkers in urine, including FB1. Current exposure studies in Guatemala are combining the urinary biomarker with measurement of sphinganine-1-phosphate in blood spots as a measure of biochemical effect. Thus, the urinary FB1 biomarker could contribute considerably in assessing the adverse health impact of fumonisin exposure.

Effect of the traditional cooking practice on fumonisin content of maize porridge consumed in the former Transkei region of South Africa

Fumonisin exposure in the rural district of Centane, former Transkei region of South Africa, has largely been determined from surveys of fumonisin levels in home-grown maize kernels collected from household storage cribs, rather than from the traditional cooked dishes. In this current study, five samples of home-grown maize kernels were ground in the conventional manner of the district, i.e. without separation of any kernel components. The contamination levels of total fumonisins (FB1+FB2+FB3) in the resultant meals ranged from 2.130 to 13.27 mg/kg. In each of two separate villages, five volunteer householders each cooked a portion of one of the maize meals into a traditional porridge. The resultant ten porridges were subsequently analysed for fumonisins by HPLC. The mean decrease in total fumonisin levels, based on a dry weight basis and corrected for recovery, was 11.3% (standard deviation 6.9%), confirming that preparation of traditional porridge has only a limited effect on fumonisin exposure in this population.

Mycotoxicological research in South Africa 1910-2011

The British mycologist, I.B. Pole-Evans, was appointed as the first South African government mycologist in 1905 following the Anglo-Boer War (1899-1902). The Onderstepoort Veterinary Research Institute was founded in 1908 with the Swiss veterinarian, Arnold Theiler, as the first director. Thus, the stage was set for the commencement of mycotoxicological research when the Union of South Africa came into being in 1910. The first accounts of this pioneering research appeared in the 'Seventh and eight reports of the Director of Veterinary Research, Union of South Africa. 1918' in which D.T. Mitchell reported on the experimental reproduction of the neurotoxic syndrome, diplodiosis, in cattle with pure cultures of Stenocarpella maydis (= Diplodia zea) isolated by P.A. Van der Bijl and grown on sterile maize kernels. This is the first report of the experimental reproduction of a veterinary mycotoxicosis with a pure culture of a fungus in South Africa and possibly in the world. This seminal research was followed by a great deal of multidisciplinary research on veterinary mycotoxicoses as well as human syndromes in which fungal toxins are suspected to be involved, taxonomy of mycotoxigenic fungi and chemistry of mycotoxins in South Africa. The mycotoxicoses studied in South Africa include the following (more or less in chronological order): diplodiosis, Paspalum staggers, aflatoxicosis, human hepatocellular carcinoma, ochratoxicosis, lupinosis, facial eczema, tremorgenic mycotoxicosis, hyperoestrogenism, stachybotryotoxicosis, ergotism, leukoencephalomalacia and human oesophageal cancer. A major breakthrough in mycotoxicological research was made in South Africa in 1988 with the isolation and chemical characterisation of the carcinogenic fumonisins produced by Fusarium verticillioides in maize. Current research at the PROMEC Unit of the South African Medical Research Council on the risk assessment of fumonisins and intervention methods to reduce fumonisin intake by rural populations on a maize staple diet is highlighted. This paper concludes with a selected list of mycotoxicological publications by South African mycologists/plant pathologists, veterinarians and chemists/biochemists.

Single-kernel analysis of fumonisins and other fungal metabolites in maize from South African subsistence farmers

Fumonisins are important Fusarium mycotoxins mainly found in maize and derived products. This study analysed maize from five subsistence farmers in the former Transkei region of South Africa. Farmers had sorted kernels into good and mouldy quality. A total of 400 kernels from 10 batches were analysed; of these 100 were visually characterised as uninfected and 300 as infected. Of the 400 kernels, 15% were contaminated with 1.84-1428 mg kg(-1) fumonisins, and 4% (n=15) had a fumonisin content above 100 mg kg(-1). None of the visually uninfected maize had detectable amounts of fumonisins. The total fumonisin concentration was 0.28-1.1 mg kg(-1) for good-quality batches and 0.03-6.2 mg kg(-1) for mouldy-quality batches. The high fumonisin content in the batches was apparently caused by a small number (4%) of highly contaminated kernels, and removal of these reduced the average fumonisin content by 71%. Of the 400 kernels, 80 were screened for 186 microbial metabolites by liquid chromatography-tandem mass spectrometry, detecting 17 other fungal metabolites, including fusaric acid, equisetin, fusaproliferin, beauvericin, cyclosporins, agroclavine, chanoclavine, rugulosin and emodin. Fusaric acid in samples without fumonisins indicated the possibility of using non-toxinogenic Fusaria as biocontrol agents to reduce fumonisin exposure, as done for Aspergillus flavus. This is the first report of mycotoxin profiling in single naturally infected maize kernels.

Simple intervention method to reduce fumonisin exposure in a subsistence maize-farming community in South Africa

In the Centane magisterial area of South Africa, high rates of oesophageal cancer have been associated with home-grown maize contaminated with fumonisins. The aim of this study was to implement a simple intervention method to reduce fumonisin exposure in a subsistence-farming community. The hand-sorting and washing procedures, based on traditional maize-based food preparation practices, were previously customised under laboratory-controlled conditions. Home-grown maize and maize-based porridge collected at baseline were analysed for fumonisin B(1), B(2) and B(3). The geometric mean (95% confidence interval) of fumonisin contamination in the home-grown maize at baseline was 1.67 (1.21-2.32) mg kg(-1) and 1.24 (0.75-2.04) mg kg(-1) (dry weight) in the porridge. Fumonisin exposure was based on individual stiff porridge consumption and the specific fumonisin levels in the porridge (dry weight) consumed. Porridge (dry weight) consumption at baseline was 0.34 kg day(-1) and fumonisin exposure was 6.73 (3.90-11.6) µg kg(-1) body weight day(-1). Female participants (n = 22) were trained to recognise and remove visibly infected/damaged kernels and to wash the remaining maize kernels. The discarded kernels represented 3.9% by weight and the fumonisins varied from 17.1 to 76.9 mg kg(-1). The customised hand-sorting and washing procedures reduced fumonisin contamination in the maize and porridge by 84 and 65%, respectively. The intervention reduced fumonisin exposure by 62% to 2.55 (1.94-3.35) µg kg(-1) body weight day(-1). This simple intervention method has the potential to improve food safety and health in subsistence-farming communities consuming fumonisin-contaminated maize as their staple diet.

Biomonitoring of Fusarium spp. Mycotoxins: Perspectives for an Individual Exposure Assessment Tool

Fusarium species are probably the most prevalent toxin-producing fungi of the northern temperate regions and are commonly found on cereals grown in the temperate regions of America, Europe and Asia. Among the toxins formed by Fusarium we find trichothecenes of the A-type or B-type, zearalenone, fumonisins or nivalenol. The current exposure assessment consists of the qualitative and/or quantitative evaluation based on the knowledge of the mycotoxin occurrence in the food and the dietary habits of the population. This process permits quantifying the mycotoxin dietary intake through deterministic or probabilistic methods. Although these methods are suitable to assess the exposure of populations to contaminants and to identify risk groups, they are not recommended to evaluate the individual exposition, due to a low accuracy and sensitivity. On the contrary, the use of biochemical indicators has been proposed as a suitable method to assess individual exposure to contaminants. In this work, several techniques to biomonitor the exposure to fumonisins, deoxynivalenol, zearalenone or T-2 toxin have been reviewed.