Zusammenfassung
Die endemische Nephropathie (EN) ist eine Nierenerkrankung, die noch immer nicht wissenschaftlich erklärt werden kann. Die EN wird von einer hohen Prävalenz von urothelialen Tumoren bei der ländlichen Bevölkerung der endemischen Region begleitet. Man vermutet daher, dass eine natürlich vorkommende nephrotoxische und karzinogene Substanz in die Ätiologie involviert ist. Am meisten wird das Mykotoxin Ochratoxin A (OTA) als schuldige Substanz verdächtigt, da dieses eine gesicherte nephrotoxische und karzinogene Wirkung hat. Die vorliegende Arbeit bringt eine Übersicht über alle relevanten Studien über OTA in der Nahrung beziehungsweise im Blut und im Harn der Bewohner der betroffenen Endemie-Gebiete. Es werden auch Daten über das gleichzeitige Vorkommen von OTA mit anderen Mykotoxinen, wie Zitronin und Fumonisin B1 (FB1) in der Nahrung vorgestellt. Leider existieren keine Studien über das gemeinsame Vorkommen von OTA und anderen Mykotoxinen beim Menschen, und es gibt nur eine Studie über die Exposition mit FB1 in endemischen Gebieten. Diese Übersicht berichtet auch über experimentelle Daten, die in Zellkulturen und Labortieren erhoben wurden, die mit OTA und anderen nephrotoxischen Mykotoxinen (da die meisten Mykotoxin-Kombinationen synergistische Wirkung zeigten) behandelt worden sind. Es wird auch das Vorkommen von OTA- und Aristolochia-Säure-bedingten DNA-Veränderungen diskutiert.
Summary
Endemic nephropathy is a human kidney disease that still escapes scientific explanation. It is accompanied by a high incidence of urothelial tumors in rural populations in endemic areas, which suggests that a natural nephrotoxic and carcinogenic compound may be involved in the etiology. The most imputed causative agent of endemic nephropathy is the mycotoxin ochratoxin A (OTA), because of its confirmed nephrotoxic and carcinogenic action. This paper presents a review of studies of OTA in food collected in the endemic areas and in blood and urine of their residents. Data on the co-occurrence of OTA and other nephrotoxic and carcinogenic mycotoxins such as citrinin and fumonisin B1 in food are also presented. Unfortunately, there is no study on the co-occurrence of OTA and other mycotoxins in humans and there is only one study on fumonisin B1 exposure in endemic areas. The paper also presents experimental data on cultured cells and laboratory animals treated with combinations of OTA and other nephrotoxic mycotoxins, because most such combinations show a synergistic effect. The occurrence of OTA- and aristolochic acid-DNA adducts is also presented.
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Peraica, M., Domijan, AM., Miletić-Medved, M. et al. The involvement of mycotoxins in the development of endemic nephropathy. Wien Klin Wochenschr 120, 402–407 (2008). https://doi.org/10.1007/s00508-008-0981-x
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DOI: https://doi.org/10.1007/s00508-008-0981-x