Measuring Urinary Mycotoxins: In Search Of Validation Of A Biomarker For Fungal Illness
Abstract
Beginning in 2010, there have been an increasing number of patients with a chronic multisystem illness who have been using measurements of mycotoxins in urine to diagnose a putative illness for which antifungals in various forms (oral, IV, sublingual and intranasal) are being used as therapy. Many of these patients and providers believe that the illness is caused by fungi living in the human body, making toxins, or has been acquired by exposure to the interior of water-damaged buildings (WDB). This practice persists despite the absence of (i) an accepted case definition; (ii) any validated control groups; (iii) any rigorous case/control studies; (iv) any prospective, placebo- controlled studies; (v) any confirmation of active fungal infection; (vi) any confirmation that urinary mycotoxins are not simply derived from diet; and presence of (vii) a sharp repudiation from the CDC of this practice and the use of antifungals in 2015; and presence of a robust literature demonstrating causation of illness acquired from WDB is inflammatory in causation, not infectious.
This review looks at the extensive published materials, including a definition of mycotoxins; a case definition for illness acquired following exposure to WDB from 2008 US GAO, multiple biomarkers, proteomics, transcriptomics, volumetric CNS imaging studies and more supporting the diagnosis of an active chronic inflammatory response syndrome (CIRS), acquired following exposure to the interior environment of WDB as a validated diagnosis that leads to use of published therapies with documented efficacy. The review also looks at (i) published literature of fungal contamination of foods; (ii) multiple world-wide studies showing contamination of urine with mycotoxins and metabolites in healthy controls finding 21 studies of 2756 controls with range of positive urinary mycotoxins from 60 to 100%; (iii) a tutorial on diagnostic testing for mycotoxins, including mass spectrometry and liquid chromatography; (iv) protective mechanisms to prevent…...
Keywords
Full Text:
PDFReferences
Audenart K, Vanheule A, Hofte M, Haesaert G. Deoxynivalenol: A major player in the multifaceted response of Fusarium to its environment. Toxins 2013, 6: 1-19.
Medically sound investigation and remediation of water-damaged buildings in cases of CIRS-WDB. Part 1. Berndtson K, McMahon S, Ackerley M, Rapaport S, Gupta S, Shoemaker R. 10/15. www.survivingmold.com. Accessed 7/23/2019.
Ryan J, Shoemaker R. RNA-Seq on patients with chronic inflammatory response syndrome (CIRS) treated with vasoactive intestinal polypeptide (VIP) shows a shift in metabolic state and innate immune functions that coincide with healing. Med Res Arch 2016; 4(7): 1-11.
Shoemaker R, Ryan J. Ebook. 3/1/2018. A Gene Primer for Health Care Providers: The Genomics of CIRS and Associated Molecular Pathways: Interpreting the Transcriptomics Results
www.mycotoxins.info, accessed 8/21/2019
Shoemaker R. Residential and Recreational Acquisition of Possible Estuarine Associated Syndrome: A New approach to Successful Diagnosis and Therapy, Environmental Health Perspectives, Special CDC Pfiesteria Supplement, 2001; 109S5; 791-796.
Kawamoto M, Page E. Notes from the field: use of unvalidated urine mycotoxin tests for the clinical diagnosis of illness-US 2014. M MWR 2015; 64(6): 157-158.
Hooper D, Bolton V, Guilford F, Straus D. Mycotoxin detection in human samples from patients exposed to environmental molds. Int J Mol Sci. 2009, 10: 1465-1475.
Brewer J, Thrasher J, Straus D, Madison R, Hooper D. Detection of mycotoxins in patients with Chronic Fatigue Syndrome. Toxins 2013, 5: 605-617.
Jarvi K, Hyvarinen A, Taubel M, Karvonen A, Turunen M, Jalkanen K, Patovirta R, Syrjanen T, Pirinen J, Salonen H, Nevalainen A, Pekkanen J. Microbial growth in building material samples and occupants’ health in severely moisture-damaged homes. Indoor Air 2018; 28: 287-297.
Arakawa K. Manipulation of metabolic pathways controlled by signaling molecules, inducers of antibiotic production, for genome mining in Streptomyces spp. Antonie Van Leeuwenhoek 2018; 111: 743-751.
Wahibah N, Tsutsui T, Tamaoki D, Nishiuchi T. Expression of barley Glutathione S Transferase13 gene reduces accumulation of reactive oxygen species by trichothecenes and paraquat in Arabidopsis plants. Plant Biotech 2018, 35: 71-79.
Shoemaker R, Johnson K, Jim L, Berry Y, Dooley M, Ryan J, McMahon S. Diagnostic process for Chronic Inflammatory response Syndrome (CIRS): A consensus statement report of the Consensus Committee of Surviving Mold. Int. Med Rev. 2018, 4(5): 1-47.
Shoemaker R, Rash J, Simon E. Sick Building Syndrome in water-damaged buildings: Generalization of the chronic biotoxin-associated illness paradigm to indoor toxigenic fungi in Johanning E. Editor, Bioaerosols, Fungi. Bacteria, Mycotoxins and Human Health; 2005; pg 66-77.
Shoemaker, R IAQA, Las Vegas, Nevada. 10/14/07 Sequential activation of innate immune elements: a health index for people re-exposed to water-damaged buildings.
Shoemaker R. AIHA 6/08. When SAIIE meets ERMI: correlation of indices of human health and building indices. Minneapolis, Minnesota.
USGAO 2008 Indoor mold: Better coordination of research on health effects and more consistent guidance would improve Federal efforts.
Shoemaker R, House D. SBS and exposure to water damaged buildings: time series study, clinical trial and mechanisms; Neurotoxicology and Teratology 2006; 28: 573-588.
Shoemaker R, House, D, Ryan J. Neurotoxicology and Teratology doi: 10.1016/j.ntt.2014.06.004. Structural brain abnormalities in patients with inflammatory illness acquired following exposure to water-damaged buildings: A volumetric MRI study using NeuroQuant.
McMahon S, Shoemaker R, Ryan J. Reduction in Forebrain Parenchymal and Cortical Grey Matter Swelling across Treatment Groups in Patients with Inflammatory Illness Acquired Following Exposure to Water-Damaged Buildings. J Neurosci and Clin Res 2016; 1: 1-4
Shoemaker R, Katz D, McMahon S, Ryan J. Intranasal VIP safely restores atrophic grey matter nuclei in patients with CIRS. Internal Medicine Review 2017; 3(4): 1-14.
Shoemaker R, House D, Ryan J. Vasoactive intestinal polypeptide (VIP) corrects chronic inflammatory response syndrome (CIRS) acquired following exposure to water-damaged buildings. Health 2013; 5(3): 396-401.
Ryan J, Wu Q, Shoemaker R. Transcriptomic signatures in whole blood of patients who acquire a chronic inflammatory response syndrome (CIRS) following an exposure to the marine toxin ciguatoxin. BMC Med Genomics 2015; 8, 2015.
Cortes-Cantell M. Paul J, Norris E, Bronstein R, Ahn H, Zamolodchikov D, Bhuvanendran S, Fenz K, Strickland S. Fibrinogen and beta-amyloid association alters thrombosis and fibrinolysis: a possible contributing factor to Alzheimer’s disease. Neuron 2010; 66: 695-709
Zamolodchikov D, Strickland S. A possible new role for AB in vascular and inflammatory dysfunction in Alzheimer’s disease. Thromb Res 2016; Suppl 2: S58-61
Ahn H, Chen Z, Zamolodchikov D, Norris E, Strickland S. Interactions of B-amyloid peptide with fibrinogen and coagulation factor XII may contribute to Alzheimer’s disease. Curr Opin Hematol 2017; 24: 427-431.
Khoury A, Atoui A. Ochratoxin A: A general ooverview and actual molecular status. Toxins 2010, 2:461-48.
Ponikau J, Sherris D, Weaver A, Kita H. Treatment of chronic rhinosinusitis with intranasal amphotericin B: a randomized, placebo-controlled, double-blind pilot trial. J Allergy Clin Immunol 2005; 115: 125-31.
Ebbens F, Georgalas C, Rinia A, van Drunen C, Lund V, Fokkens W. The fungal debate: where do we stand today? Rhinolog 2007; 45: 178-89.
Fokkens W, van Drunen C, Georgalas C, Ebbens F. Role of fungi in pathogenesis of chronic rhinosinusitis: the hypothesis rejected. Curr Opin Otolaryngol Head Neck Surg 2012; 20: 19-23.
Braun H, Stammberger H, Buzina W, Freudenschuss K, Lackner A, Beham A. Incidence and detection of fungi and eosinophilic granulocytes in chronic rhinosinusitis. Laryngorhinootologie 2003; 82: 330-40.
Institute of Food Technologists. 2006 Updates on the science of fungal toxins, 71(5) J Food Sci doi:10.1111/j.1750-3841.2006.00052. x.).
Bosco F, Mollea C. 2012 Mycotoxins in Food, Food Industrial Processes-Methods and Equipment. Dr. Benjamin Valdez (ed). ISBN 978-953-307-905-9).
Wallin S, Gambocorta L, Kotova N, Warensjo Lemming E, Nalsen C, Solfrizzo M, Olsen M. Biomonitoring of concurrent mycotoxin exposure among adults in Sweden through urinary multi-biomarker analysis. Food Chem Toxicol 2015; pii: S0278-6915(15)00188.
Shoemaker, RC and Lark, D - 2016, HERTSMI-2 and ERMI: “Correlating Human Health Risk with Mold Specific qPCR in Water-Damaged Buildings”, #658 in Proceedings of the 14th International Conference on Indoor Air Quality and Climate, International Society for Indoor Air Quality and Climate, Ghent, Belgium.
Tu C, Akgul B. Drosophila glutathione S-transferases. Methods Enzymol 2005, 401: 204-26.
Gao Y, Cao Y, Tan A, Liao C, Mo Z, Gao F. Glutathione-S-transferase M1 polymorphism and sporadic colorectal risk: An updating meta-analysis and HuGE review of 36 case control studies.
Wu M, Xiao H, Ren W, Yin J, Tan B, Liu G, Li L, Nyachoti C, Xiong X, Wu G. Thereutic effects of glutamic acid in piglets challenged with deoxynivalenol. PLOS One 2014; 9: e100591.
Duan J, Yin J, Wu M, Liao P, Deng D, Liu G, Wen Q, Wang Y, Qiu W, Liu Y, Wu X, Ren W, Tan B, Chen M, Xiao H, Wu L, Li T, Nyachoti C, Adeloa O, Yin Y. Dietary glutamate supplementation ameliorates mycotoxin-induced abnormalities in the intestinal structure and expression of amino acid transporters in young pigs. PLOS One 2014; 9: e112357.
Wu M, Xiao H, Ren W, Yin J, hu J, Duan J, Liu G, Tan B, Xiong X, Oso A, Adeola O, Yao K, Yin Y, Li T. An NMR-based metabolomic approach to investigate the effects of supplementation with glutamic acid in piglets challenged with deoxynivalenol. PLoS One 2014; 9: e113687. doi: 10.371/journal.pone.0133687
Kerkadi A, Barriault C, Tuchweber B, Froohlich A, Yousef M. Dietary cholestyramine reduces ochratoxin A-induced nephrotoxicity in the rat by decreasing plasma levels and increasing fecal excretion of the toxin. J Toxicol Environ Health. 1998, 53: 231-250.
Underhill K, Totter B, Thompson B, Prelusky D, Trenholm H. Effectiveness of cholestyramine in detoxification of zearalenone as determine in mice. Bull Environ Contam Toxicol 1995; 54” 128-134.
Versilovskis A, De Saeger S. Sterigmatocystin: occurrence in foodstuffs and analytical methods—an overview. Mol Nutr Food Res 2010; 1: 136-47.
Ates I, Ulker O, Akdemir C, Karakaya A. Correlation of ochratoxin A exposure to urinary levels of 8-hydroxydeoxyguanosine and malondialdehyde in a Turkish population. Bull Environ Toxi 2011; 3: 258-62.
Rychlik M. Rapid degradation of the mycotoxin patulin in man quantified by stable isotope dilution assays. Food Addit Contam 2003; 9: 829-37.
Rychlik M, Kircher F, Schusdziarra V, Lippl F. Absorption of the mycotoxin patulin from the rat stomach. Food Chem Toxicol 2004; 5: 729-35.
Santos R, Vermeulen S, Haritova A, Fink-Gremmels J. Isotherm modeling of organic activated bentonite and humic acid polymer used as mycotoxin adsorbents. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2011; 11: 1578-89.
Galvano F, Piva A, Ritieni A, Galvano G. Dietary strategies to counteract the effects of mycotoxins: a review. J Food Prot 2001; 1: 120-31.
Schatzmayr G, Zehner F, Taubel M, Schatzmayr D, Klimitsch A, Loibner A, Binder E. Microbiologicals for deactivating mycotoxins. Mol Nutr Food Res 2006; 6: 543-51.
Cserhati M, Kriszt B, Krifaton C, Szoboszlay S, Hahn J, Toth S, Nagy I, Kukolya J. Mycotoxin-degradation profile of Rhodococcus strains. Int J Food Microbiol 2013; 1: 176-85.
McCormick S. Microbial detoxification of mycotoxins. J Chem Ecol 2013; 7: 907-18.
Molnar O, Schatzmayr G, Fuchs E, Prillinger H. Trichosporon mycotoxinivorans sp. nov, a new yeast species useful in biological detoxification of various mycotoxins. Syst Appl Microbiol 2004; 6: 661-71.
Karlovsky P. Biological detoxification of fungal toxins and its use in plant breeding, feed and food production. Nat Toxins 1997; 1: 1-23.
Larsson P, Busk L, Tjalve H. Hepatic and extrahepatic bioactivation and GSH conjugation of aflatoxin B1 in sheep. Carcinogenesis 1994; 5: 947-55
Hassan Z, Khan M, Saleemi M, Khan A, Javed I, Noreen M. Immunological responses of male white leghorn chicks kept on ochratoxin A (OTA)-contaminated feed. J Immunotoxicol 2012; 1: 56-63.
Khatoon A, Zargham K, Khan A, Saleemi M, Javed I. Amelioration of ochratoxin A-induced immunotoxic effects by silymarin and Vitamin E in white leghorn cockerels. J Immunotox 2013; 1: 25-31.
Pestka J. Deoxynivalenol-induced proinflammatory gene expression: mechanism and pathological sequelae. Toxins (Basel) 2010; 6: 1300-17.58. Pestka J, Zhou H, Moon Y, Chung Y. Cellular and molecular mechanisms for immune modulation by deoxynivalenol and other trichothecenes: unraveling a paradox. Toxicol Lett 2004; 1: 61-73.
Pestka J. Mechanisms of deoxynivalenol-induced gene expression and apoptosis. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2008; 9: 1128-40.
Zhou H, Jia Q, Pestka J. Ribotoxic stress response to the trichothecenes deoxynivalenol in the macrophage involves the SRC family kinase Hck. Toxicol Sci 2005; 2: 916-26.
Lim J, Lee Y, Kim H, Rhyu I, Oh M, Youdim M, Yue Z, Oh Y. Nigericin-induced impairment of autophagic flux in neuronal cells is inhibited by overexpression of Bak. J Biol Chem 2012; 28: 23271-82.
Mycotoxin Test Kits | Fast & reliable mycotoxin detection. (2019). Retrieved on September 28, 2019, from https://www.romerlabs.com/en/products/test-kits/mycotoxin-test-kits/.
Occurrence, Toxicity, and Analysis of Major Mycotoxins in Food. (2019). Retrieved on September 28, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486318/.
A Brand-New Urine Test for Mycotoxin Exposure” The Great Plains .... (2019). Retrieved on September 28, 2019, from https://www.greatplainslaboratory.com/gpl-blog-source/2017/8/10/a-brand-new-urine-test-for-mycotoxin-exposure.
Concentration Levels of Zearalenone and Its Metabolites in Urine .... (2019). Retrieved on September 28, 2019, from https://pubs.acs.org/doi/10.1021/jf0113631.
Confirmatory analysis method for zeranol, its metabolites and .... (2019). Retrieved on September 28, 2019, from https://library.wur.nl/WebQuery/wurpubs/316862.
LC. (2019). Retrieved on September 28, 2019, from https://link.springer.com/article/10.1007/s00216-013-7011-1.
Mycotoxin Analysis in Human Urine by LC. (2019). Retrieved on September 28, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666377/.
Mycotoxin Biomarkers of Exposure: A Comprehensive Review .... (2019). Retrieved on September 28, 2019, from https://onlinelibrary.wiley.com/doi/full/10.1111/1541-4337.12367.feed-testing/contaminants-and-residues/mycotoxins/.
Notes from the Field: Use of Unvalidated Urine Mycotoxin tests …. (2019). Retrieved on September 28, 2019 https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a7.htm.
Urine as a biomarker of exposure to Fusarium mycotoxins | Food .... (2019). Retrieved on September 28, 2019, from https://www.food.gov.uk/research/research-projects/urine-as-a-biomarkers-of-exposure-to-fusarium-mycotoxins.
Ahn J, et al. (2019). Quantitative determination of mycotoxins in urine by LC. Retrieved on September 28, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/20818517.
Wallin S, et al. (2019). Biomonitoring of concurrent mycotoxin exposure among adults in .... Retrieved on September 28, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/26070503
Capriotti A, Caruso G, Cavaliere C, Foglia P, Samperi R, Lagana A. Multiclass mycotoxin analysis in food, environmental and biological matrices with chromatography/mass spectrometry. Mass Spectrom Rev 2012; 31: 466-503.
Li P, Zhang Z, Hu X, Zhang Q. Advanced hyphenated chromatographic-mass spectrometry in mycotoxin determination: current status and prospects. Mass Spectrom Rev 2013; 32: 450-52.
Capriotti A, Caruso G, Cavaliere C, Foglia P, Samperi R, Lagana A. Multiclass mycotoxin analysis in food, environmental and biological matrices with chromatography/mass spectrometry. Mass Spectrom Rev 2012; 31: 466-503.
Koppen R, Koch M, Siegel D, Merkel S, Maul R, Nehls I. Determination of mycotoxins in foods: current state of analytical methods and limitations. Appl Microbiol Biotechnol 2012; 86: 1595-12.
Gerding J, Cramer B, Humpf H. Determination of mycotoxin exposure in Germany using an LC-MS/MS multibiomarker approach. Mol Nutr Food Res 2014; 58: 2358-68.
Jager A, Tonin F, Souto P, Privatti R, Oliveira C. Determination of urinary biomarkers for assessment of short-term human exposure to aflatoxins in Sao Paulo, Brazil. Toxins 2014; 6: 1996-2007.
Rodriquez-Carrasco Y, Molto J, Manes J, Berrada H. Exposure assessment approach through mycotoxin/creatinine ratio evaluation in urine by GC-MS/MS. Food Chem Toxicol 2014; 72: 69-75.
Follmann W, Ali N, Blaszkewicz M. Biomonitoring of Mycotoxins in Urine: Pilot study in Mill Workers. J Toxicol Environ Health 2016; 79: 1015-1025.
Shephard G, Burger H, Gambacorta L, Gong Y, Krska R, Rheeder J, Solfrizzo M, Srey C, Sulyok M, Visconti A, Waarth V, van der Westhuizen L. Multiple mycotoxin exposure determined by urinary biomarkers in rural subsistence farmers in the former Transkei, South Africa. Food Chem Toxicol 2013; 62: 217-25.
Rodriquez-Carrasco Y, Molto J, Manes J, Berrada H. Development of microextraction techniques in combination with GC-MS/MS for the determination of mycotoxins and metabolites in human urine. J Sep Sci 2017; 40: 1572-1582.
Escriva L, Manyes L, Font G, Berrada H. Mycotoxin analysis of human urine by LC-MS/MS: A comparative extraction study. Toxins (Basel) 2017; 9:10.3390/toxins9100330
Wells L, Hardie L, Williams C, White K, Liu Y, De Santis B, Debegnach F, Moretti G, Greetham S, Brera C, Papageorgiou M, Thatcher N, Rigby A, Atkin S, Sathyapalan T. Deoxynivalenol biomarkers in the urine of UK vegetarians. Toxins (Basel) 2017; 9: doi: 10.3390/toxins9070196.
Li C, Deng C, Zhou S, Zhao Y, Wang D, Wang X, Gong Y, Wu Y. High-throughput and sensitive determination of urinary zearalenone and metabolites by UPLC-MS/MS and its application to a human exposure study. Anal Bioanal Chem 2018; 410: 5301-5312.
Ezekiel C, Oyeyemi O, Ayeni K, Oyeyemi I, Nabofa W, Nworzichi C, Dada A. Urinary aflatoxin exposure monitoring in rural and semi-urban populations in Ogun state, Nigeria. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2018; 35: 1565-1572.
Viegas S, Assuncao R, Nunes C, Osteresch B, Twaruzek M, Kosicki R, Grajewski J, Martins C, Alvito P, Almeida A, Viegas C. Exposure assessment to mycotoxins in a Portuguese fresh bread dough company by using a multi-biomarker approach. Toxins (Basel) 2018; 10: pii: E342. Doi: 10.3390/toxins10090342
Viegas S, Assuncao R, Nunes C, Osteresch B, Twaruzek M, Kosicki R, Grajewski J, Martins C, Alvito P, Almeida A, Viegas C. Exposure assessment to mycotoxins in a Portuguese fresh bread dough company by using a multi-biomarker approach. Toxins (Basel) 2018; 10: pii: E342. Doi: 10.3390/toxins10090342
Papageorgiou M, Wells L, Williams C, White KLM, De Santis B, Liu Y, Debegnach F, Milano B, Moretti G, Greetham S, Brera C, Atkin S, Hardie L, Sathyapalan T. Occurrence of deoxynivalenol in an elderly cohort in the UK: a biomonitoring approach.
Viegas C, Faria T, de Oliveira A, Caetano L, Carolino E, Quintal-Gomes A, Twaruzek M, Kosicki R, Soszczynska E, Viegas S. A new approach to assess occupational exposure to airborne fungal contamination and mycotoxins of forklift drivers in waste sorting facilities. Mycotoxin Res 2017; 33: 285-295.
de Oca V, Valdes S, Segundo C. Gomez G, Ramirez J, Cervantes R. Aspergillosis, a natural infection in poultry: Mycological and molecular characterization and determination of gliotoxin in Aspergillus fumigatus isolates. Avian Dis 2017; 61: 77-82
Scharf D, Brakhage A, Mukherjee P. Gliotoxin—bane or boon? Environ Microbiol 2016; 18: 1096-1099.
Scharf D, Heinekamp T, Remme N, Hortschansky P, Brakhage A, Hertweck C. Biosynthesis and function of gliotoxin in Aspergillus fumigatus. Appl Microbiol Biotechnol 2012; 93: 467-72.
Kwon-Chung K, Sugui J. What do we know about the role of gliotoxin in the pathobiology of Aspergillus fumigatus? Med Mycol 2009; 47 Suppl 1: S97-103.
Dolan S, O’Keeffe G, Jones G, Doyle S. Resistance is not futile: gliotoxin biosynthesis, functionality and utility. Trends Microbiol 2015; 23: 419-28.
Davis C, Carberry S, Schrettl M, Singh I, Stephens J, Barry S, Kavanagh K, challis G, Brougham D, Doyle S. The role of glutathione S-transferase GliG in gliotoxin biosynthesis in Aspergillus fumigatus. Chem Biol 2011; 18: 542-52.
Gardiner D, Howlett B. Bioinformatic and expression analysis of the putative gliotoxin biosynthetic gene cluster of Aspergillus fumigatus. FEMS Microbiol Lett 2015; 248: 241-8.
Kupfahl C, Michalka A, Lass-Florl C, Fischer G, Haase G, Ruppert T, Geginat G, Hof H. Gliotoxin production by clinical and environmental Aspergillus fumigatus strains. Int J Med Microbiol 2008; 298: 319-27.
. Ali N, Hossain K, Degen G. Blood biomarkers of citrinin and ochratoxin A exposure in young adults in Bangladesh. Mycotoxin Res 2018; 34: 59-67.
Ali N, Blaszkewicz M, Degen G. Occurrence of the mycotoxin citrinin and its metabolite dihydrocitrinone in urines of German adults. Arch Toxicol 2015; 89: 573-8.
Ali N, Blaszkewicz M, Manirujjaman M, Degen G. Biomonitoring of concurrent exposure to ochratoxin A and citrinin in pregnant women in Bangladesh. Mycotoxin Res 2016; 32: 163-72.
Brezina U, Rempe I, Kersten S, Valenta H, Humpf H, Danicke S. Diagnosis of intoxications of piglets fed with Fusarium toxin-contaminated maize by the analysis of mycotoxin residues in serum, liquor and urine with LC-MS/MS. Arch Anim Nutr 2014; 68: 425-47.
Danicke S, Keese C, Meyer U, Starke A, Kinoshita A, Rehage J. Zearalenone (ZEN) metabolism and residue concentrations in physiological specimens of dairy cows exposed long-term to ZEN-contaminated diets differing in concentrate feed proportions. Arch Anim Nutr 2014; 68: 492-506.
Cirlini M, Mazzeo T, Roncoroni L, Lombardo V, Elli L, Bardella M, Agostoni C. Doneda L, Brighenti F, Dall’Asta C, Pellegrini N. Are Treated Celiac patients at risk for mycotoxins? An Italian case-study. Toxins (Basel) 2016; 9: pii: E11. doi: 10.3390/toxins9010011.
Karima H, Ridha G, Zied A, Chekib M, Salem M, Abderrazek H. Estimation of Ochratoxin A in human blood of healthy Tunisian population. Exp Toxicol Pathol 2010; 62: 539-42.
Peraica M, Domijan A, Matasin M, Lucic A, Radic B, Delas F, Horvat M, Bosanac I, Balija M, Grgicevic D. Variations of ochratoxin A concentration in the blood of healthy populations in some Croatian cities. Arch Toxicol 2001; 75: 140-4.
Polychronaki N, Wild C, Mykkanen H, Amra H, Abdel-Wahhab M, Sylla A, Diallo M, El-Nezami H, Turner P. Urinary biomarkers of aflatoxin exposure in young children from Egypt and Guinea. Food Chem Toxicol 2008; 46: 519-26.
Hassan A, Sheashaa H, Abdel M, Ibrahim A, Gaber O. Does aflatoxin as an environment mycotoxin adversely affect the renal and hepatic functions of Egyptian lactating mothers and their infants? A preliminary report. Int Urol Nephrol 2006; 38: 339-42.
B. Warth, M. Sulyok, et al: Development and validation of a rapid multi-biomarker liquid chromatography/tandem mass spectrometry method to assess human exposure to mycotoxins. Mass Spectrom. 2012, 26, 1533–1540
DOI: http://dx.doi.org/10.18103/imr.v5i6.832
Refbacks
- There are currently no refbacks.