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Preventive strategies aimed at reducing the health risks of Aflatoxin B1

An Erratum to this article was published on 01 September 2012


The human health impact of AFB1 exposure is widespread in developing countries, is known to cause teratogenicity, immunotoxicity, hepatotoxicity and even death in farm animals and humans. As information has accumulated on toxicological effects of AFB1, preventive strategies whose objective is to reduce the risks to human health have been implemented. Chemical, physical and biological strategies for the control and prevention of aflatoxicosis and AFB1-associated diseases are described. In a primary prevention trial, the purpose is to reduce exposure to AFB1 in the diet. In secondary prevention trials, one goal is to modulate the metabolism of ingested AFB1 to enhance detoxification processes, thereby reducing internal doses and subsequent risk. This information suggested the probable application of different strategies as an alternative method to avoid the effects produced by the AFB1. The extent to which these interventions may ultimately modify the hazard in high-risk populations is an area that needs further investigation.

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  1. 1.

    Blount, W. P. Turkey, “X” disease. J. Br. Turkey Fed. 9, 55–58 (1961).

    Google Scholar 

  2. 2.

    Kensler, T. W., Roebuck, B. D., Wogan, G. N. & Groopman, J. D. Aflatoxin: A 50-year odyssey of mechanistic and translational toxicology. Tox. Sci. 120, S28–S48 (2011).

    Article  CAS  Google Scholar 

  3. 3.

    Hendricks, J. D. Carcinogenicity of aflatoxins in nonmammalian organisms. in The Toxicology of Aflatoxins: Human Health, Veterinary, and Agricultural Significance (eds Eaton, D. L. & Groopman, J. D.) 103–136 (Academic Press, New York, 1994).

    Google Scholar 

  4. 4.

    Turkez, H. & Geyikoglu, F. Boric acid: a potent chemoprotective agent against aflatoxin B1 toxicity in human blood. Cytotechnology 62, 157–165 (2010).

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Groopman, J. D., Kensler, T. W. & Wild, C. P. Protective interventions to prevent aflatoxin-induced carcinogenesis in developing countries. Annu. Rev. Public. Health 29, 187–203 (2008).

    PubMed  Article  Google Scholar 

  6. 6.

    Phillips, T. D. Dietary clay in the chemoprevention of aflatoxin-induced disease. Tox. Sci. 52, 118–126 (1999).

    CAS  Google Scholar 

  7. 7.

    Bennett, J. W. & Klich, M. Mycotoxins. Clin. Microbiol. Rev. 16, 497–516 (2003).

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Brahmi, D. et al. Chemopreventive effect of cactus Opuntia ficus indica on oxidative stress and genotoxicity of aflatoxin B1. Nutrition & Metabolism 8, 1–16 (2011).

    Article  Google Scholar 

  9. 9.

    Sudakin, D. L. Dietary aflatoxin exposure and chemoprevention of cancer: a critical review. Clin. Tox. 41, 195–204 (2003).

    Article  CAS  Google Scholar 

  10. 10.

    Park, D. L. Effect of processing on aflatoxin. Adv. Exp. Med. Biol. 504, 173–179 (2002).

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Simonich, M. T. et al. Natural chlorophyll inhibits aflatoxin B1 induced multi-organ carcinogenesis in the rat. Carcinogenesis 28, 1294–1302 (2007).

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Egner, P. et al. Chlorophyllin intervention reduces aflatoxin-DNA adducts in individuals at high risk for liver cancer. Proc. Nat. Acad. Sci. 98, 14601–14606 (2001).

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Jubert, C. et al. Effects of chlorophyll and chlorophyllin on low-dose aflatoxin B1 pharmacokinetics in human volunteers. Cancer Prev. Res. 2, 1015–1022 (2009).

    Article  CAS  Google Scholar 

  14. 14.

    Fahey, J. W. et al. Chlorophyll, chlorophyllin and related tetrapyrroles are significant inducers of mammalian phase 2 cytoprotective genes. Carcinogenesis 26, 1247–1255 (2005).

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    Hayes J. D. et al. Ethoxyquin-induced resistance to aflatoxin B1 in the rat is associated with the expression of a novel Alpha-class glutathione S-transferase subunit, Yc2, which possesses high catalytic activity for aflatoxin B1-8,9-epoxide. Biochem. J. 279, 385–398 (1991).

    PubMed  CAS  Google Scholar 

  16. 16.

    Guyonned, D., Belloir, C., Suscheted, M., Siess, M. H. & Le Bon, A.-M. Mechanisms of protection against aflatoxin B1 genotoxicity in rats treated by organ sulfur compounds from garlic. Carcinogenesis 23, 1335–1341 (2002).

    Article  Google Scholar 

  17. 17.

    Moyers, S. B. & Kumar, N. B. Green tea polyphenols and cancer chemoprevention: multiple mechanisms and endpoints for phase II trials. Nut. Rev. 62, 204–211 (2004).

    Article  Google Scholar 

  18. 18.

    Wu, H. C. et al. Urinary 8-oxodeoxyguanosine, aflatoxin B1 exposure and hepatitis B virus infection and hepatocellular carcinoma in Taiwan. Carcinogenesis 28, 995–999 (2007).

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Yang, C. S. et al. Molecular targets for the cancer preventive activity of tea polyphenols. Mol. Carcinog. 45, 431–435 (2006).

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Luo, H. et al. Phase II a chemoprevention trial of green tea polyphenols in high-risk individuals of liver cancer: modulation of urinary excretion of green tea polyphenols and 8-hydroxydeoxyguanosine. Carcinogenesis 27, 262–268 (2006).

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Tang, L. et al. Modulation of aflatoxin biomarkers in human blood and urine by green tea polyphenols intervention. Carcinogenesis 29, 411–417 (2008).

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    McLellan, L. I., Judah, D. J., Neal, G. E. & Hayes, J. D. Regulation of aflatoxin B1-metabolizing aldehyde reductase and glutathione S-transferase by chemoprotectors. Biochem. J. 300, 117–124 (1994).

    PubMed  CAS  Google Scholar 

  23. 23.

    Roebuck, B. D., Liu Y. L., Rogers, A. E., Groopman J. D. & Kensler T. W. Protection against aflatoxin B1-induced hepatocarcinogenesis in F344 rats by 5-(2-pyrazinyl)-4-methyll-1,2-dithiole-3-thione (oltipraz): predictive role for short-term molecular dosimetry. Cancer Res. 51, 5501–5506 (1991).

    PubMed  CAS  Google Scholar 

  24. 24.

    Bolton M. G. et al. Transient intervention with oltipraz protects against aflatoxin-induced hepatic tumorigenesis. Cancer Res. 53, 3499–3504 (1993).

    PubMed  CAS  Google Scholar 

  25. 25.

    Langouet, S. et al. Inhibition of human cytochrome P450 enzymes by 1,2-dithiole-3-thione, oltipraz and its derivatives, and sulforaphane. Chem. Res. Toxicol. 13, 245–252 (2000).

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Talalay, P., Dinkova-Kostova, A. T. & Holtzclaw, W. D. Importance of phase 2 gene regulation in protection against electrophile and reactive oxygen toxicity and carcinogenesis. Adv. Enzyme Regul. 43, 121–134 (2003).

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Fahey, J. W. & Kensler, T. W. Role of dietary supplements/nutraceuticals in chemoprevention through induction of cytoprotective enzymes. Chem. Res. Toxicol. 20, 572–576 (2007).

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Gross-Steinmeyer, K. et al. Sulforaphane- and phenethyl isothiocyanate-induced inhibition of aflatoxin B1-mediated genotoxicity in human hepatocytes: role of GSTM1 genotype and CYP3A4 gene expression. Tox. Sci. 116, 422–432 (2010).

    Article  CAS  Google Scholar 

  29. 29.

    Fahey, J. W. et al. Sulforaphane inhibits extracellular, intracellular, and antibiotic-resistant strains of Helicobacter pylori and prevents benzo[a]pyrene-induced stomach tumors. Proc. Natl. Acad. Sci. U.S.A. 99, 7610–7615 (2002).

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Dinkova-Kostova, A. T. et al. Induction of the phase 2 response in mouse and human skin by sulforaphane-containing broccoli sprout extracts. Cancer Epidemiol. Biomarkers Prev. 16, 847–851 (2007).

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Kensler, T. W. et al. Effects of glucosinolate-rich broccoli sprouts on urinary levels of aflatoxin-DNA adducts and phenanthrene tetraols in a randomized clinical trial in He Zuo Township, Qidong, People’s Republic of china. Cancer Epidemiol. Biomarkers Prev. 14, 2605–2613 (2005).

    PubMed  Article  CAS  Google Scholar 

  32. 32.

    Heber, D. Vegetables, fruits and phytoestrogens in the prevention of diseases. J. Postgrad. Med. 50, 145–149 (2004).

    PubMed  Google Scholar 

  33. 33.

    Ramadan, M. F. & Morsel, J. T. Oil cactus pear (Opuntia ficus-indica). Food Chem. 82, 339–345 (2003).

    Article  CAS  Google Scholar 

  34. 34.

    Stintzing, F. C. & Carle, R. Cactus stems (Opuntia spp.): a review on their chemistry, technology, and uses. Mol. Nutr. Food Res. 49, 175–194 (2005).

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    Tesoriere, L., Fazzari, M., Allegra, M. & Livrea, M. A. Biothiols, taurine, and lipid soluble antioxidants in the edible pulp of Sicilian cactus pear (Opuntia ficusindica) fruits and changes of bioactive juice components upon industrial processing. J. Agric. Food Chem. 20, 7851–7855 (2005).

    Article  Google Scholar 

  36. 36.

    Shon, M. Y., Choi, S. D., Kahng, G. G., Nam, S. H. & Sung, N. J. Antimutagenic, antioxidant and free radical scavenging activity of ethyl acetate extracts from white, yellow and red onions. Food Chem. Toxicol. 42, 659–666 (2004).

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Abdel-Wahahab, M. A. et al. Zizyphus spina christi extract protects against aflatoxin B1-initiated hepatic carcinogenicity. Afr. J. Trad. CAM 4, 248–256 (2007).

    Google Scholar 

  38. 38.

    Cavin, C., Holzhäuser, D., Constable, A., Huggett, A. C. & Schilter, B. The coffee-specific diterpenes cafestol and kahweol protect against aflatoxin B1-induced genotoxicity through a dual mechanism. Carcinogenesis 19, 1369–1375 (1998).

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Pérez, A. & Hurtado, T. Actividad antimutagénica de extractos vegetales sobre la aflatoxina B1. Rev. Cubana Aliment. Nutr. 11, 10–14 (1997).

    Google Scholar 

  40. 40.

    Verma, R. J. & Nair, A. Vitamin E ameliorate aflatoxin-induced biochemical changes in the testis of mice. Asian J. Androl. 3, 305–309 (2008).

    Google Scholar 

  41. 41.

    Madrigal-Santillán, E. et al. Antigenotoxic studies of different substances to reduce the DNA damage in-duced by aflatoxin B1 and ochratoxin A. Toxins 2, 738–757 (2010).

    PubMed  Article  Google Scholar 

  42. 42.

    DeFlora, S. & Ferguson, I. R. Overview of mechanisms of cancer chemopreventive agents. Mutat. Res. 591, 8–15 (2005).

    Article  CAS  Google Scholar 

  43. 43.

    Yang, C.-F. et al. Inhibition of ebselen on aflatoxin B1-induced hepatocarcinogenesis in Fisher 344 rats. Carcinogenesis 21, 2237–2243 (2000).

    PubMed  Article  CAS  Google Scholar 

  44. 44.

    Mogilnaya, O. A., Puzyr, A. P., Baron, A. V. & Bondar, V. S. Hematological parameters and the state of liver cells of rats after oral administration of aflatoxin B1 alone and together with nanodiamonds. Nanoescale Res. Lett. 5, 908–912 (2010).

    Article  CAS  Google Scholar 

  45. 45.

    Phillips, T. D. et al. Reducing human exposure to aflatoxin through the use of clay: a review. Food Addit. Contam. Part A Chem. Anal. Control Expo. Risk Assess 25, 134–145 (2008)

    PubMed  CAS  Google Scholar 

  46. 46.

    Kannewischer, I., Tenorio, M. G., White, G. N. & Dixon, J. B. Smectite Clays as Adsorbents of Aflatoxin B1: Initial Steps. Clay Science, Japan. 12Suppl 2, 99–204 (2006).

    Google Scholar 

  47. 47.

    Mulder, I., Barrientos, A. L., Tenorio, M. G., White, G. N. & Dixon J. B. Smectite clay sequestration of aflatoxin B1: particle size and morphology. Clays and Clay Minerals 56, 558–570 (2008).

    Article  CAS  Google Scholar 

  48. 48.

    Tenorio, M. G., Mulder, I., Barrientos, A. L. & Dixon, J. B. Smectite clay adsorption of aflatoxin vs. octahedral composition and alteration history indicated by FTIR. Clays and Clay Minerals 56, 571–578 (2008).

    Article  Google Scholar 

  49. 49.

    Strosnider, H. et al. Workgroup report: public health strategies for reducing aflatoxin exposure in developing countries. Environ. Health Perspect. 114, 1898–1903 (2006).

    PubMed  CAS  Google Scholar 

  50. 50.

    Liu, Y. & Wu, F. Global burden of aflatoxin-induced hepatocellular carcinoma: a risk assessment. Environ. Health Perspect. 118, 818–824 (2010).

    PubMed  Article  CAS  Google Scholar 

  51. 51.

    Turner, P. C. et al. Aflatoxin exposure in utero causes growth faltering in Gambian infants. Int. J. Epidemiol. 36, 1119–1125 (2007).

    PubMed  Article  Google Scholar 

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Correspondence to Rafael Valencia-Quintana.

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Valencia-Quintana, R., Sánchez-Alarcón, J., Tenorio, M.G. et al. Preventive strategies aimed at reducing the health risks of Aflatoxin B1 . Toxicol. Environ. Health Sci. 4, 71–79 (2012).

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  • Aflatoxin B1
  • HCC risks
  • Chemoprevention
  • Aspergillus flavus
  • Chlorophyllin
  • Polyphenols
  • Ethoxyquin
  • Isothiocyanates
  • Enterosorbents
  • DNA damage