Foodborne Diseases Due to Underestimated Hazard of Joint Mycotoxin Exposure at Low Levels and Possible Risk Assessment

The subject of this review paper is to evaluate the underestimated hazard of multiple mycotoxin exposure of animals/humans for the appearance of foodborne ailments and diseases. The significance of joint mycotoxin interaction in the development of foodborne diseases is discussed, and appropriate conclusions are made. The importance of low feed/food levels of some target mycotoxins co-contaminations in food and feedstuffs for induction of target foodborne mycotoxicoses is also studied in the available literature. The appropriate hygiene control and the necessary risk assessment in regard to possible hazards for animals and humans are also discussed, and appropriate suggestions are made. Some internationally recognized prophylactic measures, management of the risk, and the necessity of elaboration of new international regulations in regard to the maximum permitted levels are also carefully discussed and analysed in the cases of multiple mycotoxin contaminations. The necessity of harmonization of mycotoxin regulations and control measures at international levels is also discussed in order to facilitate food trade between the countries and to ensure global food safety.

Mycotoxin and Gut Microbiota Interactions

The interactions between mycotoxins and gut microbiota were discovered early in animals and explained part of the differences in susceptibility to mycotoxins among species. Isolation of microbes present in the gut responsible for biotransformation of mycotoxins into less toxic metabolites and for binding mycotoxins led to the development of probiotics, enzymes, and cell extracts that are used to prevent mycotoxin toxicity in animals. More recently, bioactivation of mycotoxins into toxic compounds, notably through the hydrolysis of masked mycotoxins, revealed that the health benefits of the effect of the gut microbiota on mycotoxins can vary strongly depending on the mycotoxin and the microbe concerned. Interactions between mycotoxins and gut microbiota can also be observed through the effect of mycotoxins on the gut microbiota. Changes of gut microbiota secondary to mycotoxin exposure may be the consequence of the antimicrobial properties of mycotoxins or the toxic effect of mycotoxins on epithelial and immune cells in the gut, and liberation of antimicrobial peptides by these cells. Whatever the mechanism involved, exposure to mycotoxins leads to changes in the gut microbiota composition at the phylum, genus, and species level. These changes can lead to disruption of the gut barrier function and bacterial translocation. Changes in the gut microbiota composition can also modulate the toxicity of toxic compounds, such as bacterial toxins and of mycotoxins themselves. A last consequence for health of the change in the gut microbiota secondary to exposure to mycotoxins is suspected through variations observed in the amount and composition of the volatile fatty acids and sphingolipids that are normally present in the digesta, and that can contribute to the occurrence of chronic diseases in human. The purpose of this work is to review what is known about mycotoxin and gut microbiota interactions, the mechanisms involved in these interactions, and their practical application, and to identify knowledge gaps and future research needs.

The effect of Ochratoxin A on antimicrobial polypeptide expression and resistance to water mold infection in channel catfish (Ictalurus punctatus)

Mycotoxin contamination of agricultural commodities poses a serious risk to animal health, including aquaculture species. Ochratoxin A (OA) is the most immunotoxic ochratoxin, yet little is known about its effect on immune function in fish. Antimicrobial polypeptides (AMPPs) are one of the most potent, innate, host defense factors, yet very little is known about what types of chronic stressors affect their expression. Among the most prevalent and potent AMPPs in fish are histone-like proteins (HLPs). In this study, fish were fed 2, 4, or 8 mg OA/kg diet. Skin antibacterial activity and HLP-1 levels were measured on Days 0, 28 and 56. Feeding 2, 4 or 8 mg OA/kg diet resulted in significant growth depression, but higher levels (4 or 8 mg OA/kg diet) resulted in lowering feed intake (FI) and impaired feed conversion ratio. In addition, feeding 8 mg OA/kg diet increased susceptibility to experimental water mold (Saprolegnia) challenge, suggesting that OA toxicity might contribute to some saprolegnosis outbreaks. However, there were no changes in AMPP expression in any treatment group. Our data suggests that the increased disease susceptibility of channel catfish due to OA is probably due to mechanisms other than a direct effect on antimicrobial polypeptide expression.

Effects of Mycotoxins on mucosal microbial infection and related pathogenesis

Mycotoxins are fungal secondary metabolites detected in many agricultural commodities and water-damaged indoor environments. Susceptibility to mucosal infectious diseases is closely associated with immune dysfunction caused by mycotoxin exposure in humans and other animals. Many mycotoxins suppress immune function by decreasing the proliferation of activated lymphocytes, impairing phagocytic function of macrophages, and suppressing cytokine production, but some induce hypersensitive responses in different dose regimes. The present review describes various mycotoxin responses to infectious pathogens that trigger mucosa-associated diseases in the gastrointestinal and respiratory tracts of humans and other animals. In particular, it focuses on the effects of mycotoxin exposure on invasion, pathogen clearance, the production of cytokines and immunoglobulins, and the prognostic implications of interactions between infectious pathogens and mycotoxin exposure.

Effect of ochratoxin A on the intestinal mucosa and mucosa-associated lymphoid tissues in broiler chickens

The immunotoxic effect of ochratoxin A (OTA) on the intestinal mucosa-associated lymphoid tissue and its cytotoxic action on the intestinal epithelium were studied in broiler chickens experimentally treated with the toxin. From the 7th day of life, 80 male broiler chickens (Ross 308) were randomly divided into four groups of 20 birds each. The three experimental groups (E1-3) were treated with OTA for 28 days (E1: 50 μg/kg body weight [bw]/day; E2: 20 μg/kg bw/day; E3: 1 μg/kg bw/day) and the fourth group served as control. Histological examination of the intestinal mucosa and immunohistochemical staining for identification of CD4+, CD8+, TCR1 and TCR2 lymphocytes in the duodenum, jejunum and ileocaecal junction were performed, and CD4+/CD8+ and TCR1/TCR2 ratios were calculated. OTA toxicity resulted in decreased body weight gain, poorer feed conversion ratio, lower leukocyte and lymphocyte count, and altered intestinal mucosa architecture. After 14 days of exposure to OTA, immunohistochemistry showed a significant reduction of the lymphocyte population in the intestinal epithelium and the lamina propria. After 28 days of exposure, an increase in the CD4+ and CD8+ values in both the duodenum and jejunum of chickens in Groups E1 and E2 was observed, but the TCR1 and TCR2 lymphocyte counts showed a significant reduction. No significant changes were observed in Group E3. The results indicate that OTA induced a decrease in leukocyte and lymphocyte counts and was cytotoxic to the intestinal epithelium and the mucosa-associated lymphoid tissue, altering the intestinal barrier and increasing susceptibility to various associated diseases.

Foodborne mycotoxicoses, risk assessment and underestimated hazard of masked mycotoxins and joint mycotoxin effects or interaction

The existing hazard of joint mycotoxin exposure of animals/humans and the significance of masked mycotoxins in foods or feeds and their respective contributions to the development of some food born mycotoxicoses is briefly reviewed. The importance of joint mycotoxin interaction in the complex etiology of some foodborn mycotoxicoses is covered in depth. The toxicity of low contamination levels of some combinations of mycotoxins ingested often by farm animals was carefully studied. The appropriate hygiene control and the necessary risk assessment in regard to mycotoxin contamination of foods and feeds are briefly analyzed and some useful prophylactic measures and management of the risk of mycotoxin contamination, in addition to tolerable daily intakes are also described. A reference is also made to the most suitable methods of veterinary hygiene control in some practical situations in order to prevent mycotoxins contaminating commercial food commodities and endangering public health.

Modulation of intestinal functions following mycotoxin ingestion: meta-analysis of published experiments in animals

Mycotoxins are secondary metabolites of fungi that can cause serious health problems in animals, and may result in severe economic losses. Deleterious effects of these feed contaminants in animals are well documented, ranging from growth impairment, decreased resistance to pathogens, hepato- and nephrotoxicity to death. By contrast, data with regard to their impact on intestinal functions are more limited. However, intestinal cells are the first cells to be exposed to mycotoxins, and often at higher concentrations than other tissues. In addition, mycotoxins specifically target high protein turnover- and activated-cells, which are predominant in gut epithelium. Therefore, intestinal investigations have gained significant interest over the last decade, and some publications have demonstrated that mycotoxins are able to compromise several key functions of the gastrointestinal tract, including decreased surface area available for nutrient absorption, modulation of nutrient transporters, or loss of barrier function. In addition some mycotoxins facilitate persistence of intestinal pathogens and potentiate intestinal inflammation. By contrast, the effect of these fungal metabolites on the intestinal microbiota is largely unknown. This review focuses on mycotoxins which are of concern in terms of occurrence and toxicity, namely: aflatoxins, ochratoxin A and Fusarium toxins. Results from nearly 100 published experiments (in vitro, ex vivo and in vivo) were analyzed with a special attention to the doses used.

Ochratoxin A in feed of food-producing animals: an undesirable mycotoxin with health and performance effects

Mycotoxins are secondary fungal metabolites, whose presence in feed- and foodstuffs is unavoidable. Ochratoxin A (OTA) is one of the known mycotoxins with greatest public health and agro-economic significance. Several toxic effects have been ascribed following exposure, namely nephrotoxicity, as well negative impacts in the performance of farm animals, resulting in major economic implications. Of no less importance for the route of human exposure that can also embody the carry-over of OTA from feed into animal-derived products is also a concern. For all these reasons the present article updates the worldwide occurrence of OTA in different raw ingredients and finished feed destined to food-producing animals. After that a brief characterization of specie susceptibility and the major rationales is made. An historical overview of field outbreaks linked to OTA exposure in farm animals, concerning the implicated feeds, contamination levels and major clinical and productivity effects is presented. Finally a review of the major animal health and performance potential impacts of animals being reared on contaminated feed is made allied to a perspective regarding its co-occurrence with other mycotoxins, and simultaneous parasitic and bacterial infections. Ultimately, this article aims to be instructive and draw attention to a mycotoxin so often neglected and elapsed from the list of differential diagnosis in farm practice. For the unpredictability and unavoidability of occurrence, OTA will definitely be an enduring problem in animal production.

A survey of spontaneous occurrence of ochratoxin A residues in chicken tissues and concurrence with histopathological changes in liver and kidneys

Toxicological and histopathological investigations of tissues of commercially slaughtered chickens were carried out to provide a preliminary evaluation of the incidence of occurrence of ochratoxin A (OTA) in chicken sold in Serbian retail market. In addition, the etiology of nephropathies of these chickens was elucidated. The majority of these tissue samples were not found to contain measurable amounts of OTA. Moreover, the OTA levels found in analyzed tissues were generally low and there was no positive correlation between the presence of OTA and the frequency of histopathological changes. Histopathological changes such as degenerative changes in the kidneys and liver differed from the classical description of the mycotoxic nephropathy, indicating that the chicken nephropathy observed in Serbia may have a multitoxic etiology with possible synergistic effect between microorganisms and natural toxins, usually present in low concentrations. The low OTA results also suggested that chicken meat available in the retail market in Serbia are unlikely to pose any significant adverse health risk to the consumers with respect to OTA toxicity.

Some food-associated mycotoxins as potential risk factors in humans predisposed to chronic intestinal inflammatory diseases

Mycotoxins are fungal metabolites able to affect the functions of numerous tissues and organs in animals and humans, including intestinal and immune systems. However, the potential link between exposure to some mycotoxins and human chronic intestinal inflammatory diseases, such as celiac and Crohn's diseases or ulcerative colitis, has not been investigated. Instead, several theories based on bacterial, immunological or neurological events have been elaborated to explain the etiology of these pathologies. Here we reviewed the literature on mycotoxin-induced intestinal dysfunctions and compared these perturbations to the impairments of intestinal functions typically observed in human chronic intestinal inflammatory diseases. Converging evidence based on various cellular and animal studies show that several mycotoxins induce intestinal alterations that are similar to those observed at the onset and during the progression of inflammatory bowel diseases. Although epidemiologic evidence is still required, existing data are sufficient to suspect a role of some food-associated mycotoxins in the induction and/or persistence of human chronic intestinal inflammatory diseases in genetically predisposed patients.

The mycotoxin deoxynivalenol promotes uptake of Salmonella Typhimurium in porcine macrophages, associated with ERK1/2 induced cytoskeleton reorganization

Both the mycotoxin deoxynivalenol (DON) and Salmonella Typhimurium are major issues in swine production. This study aimed at examining the interaction between DON and Salmonella Typhimurium at the level of the porcine innate immune system, represented by macrophages. First, we assessed the direct cytotoxic effect of DON on porcine macrophages. Incubation with 0.25 microg/mL of DON or higher resulted in a significant cytotoxic effect after 24 h of incubation. Secondly, the direct toxic effect of DON on the growth and on the expression of Salmonella pathogenicity island 1 (SPI-1) and SPI-2 virulence genes of Salmonella Typhimurium was determined. At low non-cytotoxic concentrations, as can be found in the serum of pigs, DON did not have any effect on either growth or virulence gene expression of Salmonella Typhimurium. However, when the invasion and intracellular survival of Salmonella Typhimurium in macrophages preexposed to 0.025 microg/mL of DON was examined, DON significantly promoted the uptake of Salmonella Typhimurium into macrophages. The enhanced uptake coincided with marked F-actin reorganization of the cells, which was due to the activation of extracellular signal-regulated protein kinase 1/2 (ERK1/2). These results suggest that low but relevant concentrations of DON modulate the innate immune system and could thus increase the susceptibility of pigs to infections with Salmonella Typhimurium.

Ochratoxin A displaces claudins from detergent resistant membrane microdomains

Ochratoxin A (OchA) is a food-borne mycotoxin with multiple effects in vivo. Previously, we have demonstrated that the toxin can significantly impair the barrier function of the gut epithelial cell line, Caco-2. Barrier disruption involved loss of claudins 3 and 4, but not claudin 1 from the tight junction complex. In this study, we demonstrate for the first time, that OchA is able to remove claudins 3 and 4 from the detergent insoluble membrane microdomains associated with the tight junctions. However, cholesterol distribution within the microdomain was unaffected by the toxin. In addition, the thiol antioxidant, N-acetyl cysteine, preserved the microdomain localisation of claudins and also the barrier function of Caco-2 cells. This work suggests that OchA-mediated barrier toxicity is due to removal of claudins from detergent insoluble membrane microdomains. Moreover, loss of microdomain association may be due to oxidative events.

Immunotoxicological risk of mycotoxins for domestic animals

Mycotoxins are a group of structurally diverse fungal secondary metabolites that elicit a wide spectrum of toxicological effects. Of particular interest is the capacity of some mycotoxins to alter normal immune function when present in food at levels below observable overt toxicity. The sensitivity of the immune system to mycotoxin-induced immunosuppression arises from the vulnerability of the continually proliferating and differentiating cells that participate in immune-mediated activities and regulate the complex communication network between cellular and humoral components. Mycotoxin-induced immunosuppression may be manifested as depressed T- or B-lymphocyte activity, suppressed antibody production and impaired macrophage/neutrophil-effector functions. The immune system is primarily responsible for defence against invading organisms. Suppressed immune function by mycotoxins may eventually decrease resistance to infectious diseases, reactivate chronic infections and/or decrease vaccine and drug efficacy.

Ochratoxin A increases permeability through tight junctions by removal of specific claudin isoforms

On interaction with the intestine, the mycotoxin ochratoxin A is know to cause rapid inflammation, diarrhea, and increased bacterial translocation. All these effects are consistent with a decrease in epithelial barrier function. However, this has not been shown directly. We determined that ochratoxin A is able to reduce the barrier properties of the model intestinal cell line Caco-2. Over 24 h, ochratoxin A reduces the transepithelial electrical resistance of Caco-2 monolayers growing on Transwell filters by ∼40%. At the same time, the permeability of the monolayer is increased with respect to 4- and 10-kDa FITC dextrans, but not to 20- or 40-kDa dextrans. Immunoblotting and immuofluorescence reveal that the decrease in barrier properties is concomitant with disappearance of claudins 3 and 4, but not claudin 1 from Caco-2 cell membranes. These results suggest that ochratoxin A is able to modulate the barrier function of Caco-2 cells by removal of specific claudin isoforms.

Mycotoxin fumonisin B1 increases intestinal colonization by pathogenic Escherichia coli in pigs

Fumonisin B(1) (FB(1)) is a mycotoxin that commonly occurs in maize. FB(1) causes a variety of toxic effects in different animal species and has been implicated as a contributing factor of esophageal cancers in humans. In the present study, we examined the effect of dietary exposure to FB(1) on intestinal colonization by pathogenic Escherichia coli associated with extraintestinal infection. Three-week-old weaned pigs were given FB(1) by gavage as a crude extract or as a purified toxin at a dose of 0.5 mg/kg of body weight daily for 6 days. On the last day of the toxin treatment, the pigs were orally inoculated with an extraintestinal pathogenic E. coli strain. All animals were euthanized 24 h later, necropsies were performed, and tissues were taken for bacterial counts and light microscopic examination. Ingestion of FB(1) had only a minimal effect on animal weight gain, did not cause any macroscopic or microscopic lesions, and did not change the plasma biochemical profile. However, colonization of the small and large intestines by an extraintestinal pathogenic E. coli strain was significantly increased. Our results show that FB(1) is a predisposing factor to infectious disease and that the pig can be used as a model for the study of the consequences of ingesting mycotoxin-contaminated food.

Incidence of Salmonella infection in healthy dogs in Gifu Prefecture, Japan

A total of 1,013 feces samples and 8 mesenteric lymphonodus samples obtained from apparently healthy dogs were examined for the incidence of salmonella infection. One strain of S. typhimurium (ST) was isolated from feces of one dog, and S. enteritidis (SE) was isolated from the mesenteric lymphonodus of one dog. Sera obtained from 330 apparently healthy dogs were examined for Salmonella antibodies using an ELISA with heated whole cells of SE and ST. Fifty-one of the 330 serum samples were considered to be positive for salmonella antibodies, including 12 which were SE-positive and 39 which were ST-positive. These results indicate that dogs cause possible environmental problems as Salmonella carriers.

The mycotoxin ochratoxin A alters intestinal barrier and absorption functions but has no effect on chloride secretion

Ochratoxin A (OTA) is a mycotoxin that contaminates cereals and animal feed and causes nephropathy to a variety of animal species. OTA is also known as a potent immunotoxic, teratogenic, and carcinogenic mycotoxin. In addition, OTA ingestion induces intestinal injuries, including inflammation and diarrhea. With the aim to study the cellular mechanisms associated with the intestinal toxicity of OTA, two human epithelial intestinal cell lines (HT-29-D4 and Caco-2-14 cells), widely used as in vitro models for the intestinal epithelium, were incubated with OTA. The main effects of the mycotoxin were an inhibition of cellular growth and a dramatic decrease of transepithelial resistance in both cell lines. Since transepithelial resistance reflects the organization of tight junctions over the cell monolayer, these data may suggest that OTA could potentiate its own absorption through paracellular pathways. OTA induced a 60% decrease of sodium-dependent glucose absorption but increased the absorption of fructose and L-serine in HT-29-D4 cells. Moreover, the mycotoxin did not inhibit the cAMP-dependent chloride secretion through the cystic fibrosis transmembrane conductance regulator channel. The inhibitory effect of OTA on active glucose transport was partially antagonized by L-phenylalanine, but not by alpha-tocopherol, suggesting that the toxicity of OTA could result from an inhibition of protein synthesis, rather than an induction of lipid peroxidation. In particular, OTA affected the protein content of plasma membrane microdomains, which are known to regulate tight junction assembly and intestinal transport activity. Taken together, these data showed that OTA alters both barrier and absorption functions of the intestinal epithelium.

Effects of mycotoxins on the immune system - is there a single comprehensive test parameter?

There is no single comprehensive parameter for the identification of immunotoxic effects of mycotoxins, since immunological processes are very complex. Different aspects of the immune response have to be studied to detect the characteristic actions of mycotoxins and to identify the most sensitive immune functions.

Mycotoxicosis in food producing animals

Mycotoxins are toxic secondary metabolites of fungi. Diseases caused by mycotoxins are collectively referred to as mycotoxicosis. Disease is usually initiated after ingestion of feeds containing toxic doses of mycotoxins. Signs and symptoms vary and depend on the animal, the organ system involved, and on the dose and type of mycotoxins ingested. The symptoms can range from acute death, immunosuppression to skin lesions or to signs of hepatotoxicity, nephrotoxicity, neurotoxicity, or genotoxicity. In addition to concerns over adverse effects of mycotoxins on food animals consuming mycotoxin-contaminated feeds, there is also a public health concern over the potential for human beings to consume animal-derived food products such as meat, milk, or eggs, containing residues of those mycotoxins or their metabolites.