Role of Environmental Toxins in Endemic (Balkan) Nephropathy

Grollman, Arthur P.; Jelaković, Bojan

doi:10.1681/asn.2007050537

Cited by 137 publications

(109 citation statements)

References 32 publications

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“…Public health authorities in the several countries having aristolochic acid nephropathy should take immediate measures for reducing dietary exposure of residents to Aristolochia. [43] But still, the intriguing findings in cases from Brodska Posavina need to be confirmed in other endemic areas, especially as there are suggestions of the other environmental risk factors for BEN.…”

Section: Environmentally Induced Diseasementioning

confidence: 95%

Fifty Years of Balkan Endemic Nephropathy: Challenges of Study Using Epidemiological Method

et al. 2009

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Balkan endemic nephropathy (BEN) is a chronic tubulointerstitial disease associated with urothelial cancer, which affects people living in the alluvial plains along the tributaries of the Danube River. Challenges of studying BEN using the epidemiological method are multiple. The natural history from exposure to occurrence of the disease may take many years. The early stages of BEN are not easily detectable clinically, as the disease is asymptomatic until a significant decline in function occurs, and even then symptoms are usually non-specific. The natural history of BEN is complex, possibly with multiple risk factors operating both at the stage of initiation of renal damage and in its progression. In BEN, genetic susceptibility is due to multiple genes of small effects, gene-gene interactions, and gene-environment interactions of complex nature that are difficult to assess with current study designs. BEN is now kidney disease of the old people, and many risk factors for disease such as smoking, alcohol consumption, obesity, and diabetes could contribute to the kidney damage. Evidence is presented that environmental rather than genetic factors play a decisive role in the etiopathogenesis of BEN. Aristolochic acid, described as a culprit of BEN in 1959, is confirmed in 2007 by the molecular biology methods. Mycotoxins and polycyclic aromatic hydrocarbons, leached from lignites and found in the vicinity of endemic settlements, deserve further investigation. Despite advances in understanding the epidemiology of BEN, more research is needed on the patterns of BEN over time and between places, and on identifying the contributions of modifiable risk factors in initiating and hastening progression of BEN in order to improve the scope for preventing BEN. Primary prevention is still at the beginning. Knowledge accumulated in the fifty years of BEN research and new data about prevention and treatment of chronic kidney disease reveal several effective methods in secondary and tertiary prevention of BEN. Genetic epidemiology could establish the relative size of the genetic effect in relation to other sources of variation in disease risk (i.e., environmental effects such as intrauterine environment, physical and chemical effects, as well as behavioral and social aspects). Public health authorities in the several countries having aristolochic acid nephropathy should take immediate measures for reducing dietary exposure of residents to Aristolochia.

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Section: Environmentally Induced Diseasementioning

confidence: 95%

Fifty Years of Balkan Endemic Nephropathy: Challenges of Study Using Epidemiological Method

et al. 2009

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Section: Introductionmentioning

confidence: 99%

“…There are many hypotheses, but the two most actual ones are focused on food contamination either by aristolochic acid, possibly originating in fl our (10) or by ochratoxin A, a mycotoxin (11). These environmental agents are defi ned as main risk factors for this disease that can end in kidney failure and are associated with urothelial cancer (10)(11)(12)(13). New regulations in the European Union, such as regulation EC 258/97 (14) or ISO 9000/EN 29000 (15) and the subsequent ones, including the Nutrition Labeling and Education Act (16,17) that has been a Federal law in the United States since 1990, as well as similar regulations worldwide, had a crucial infl uence on further development of food analysis.…”

Section: Introductionmentioning

confidence: 99%

Foodomics and Food Safety: Where We Are

Andjelković

Gajdošik

Gašo-Sokač

et al. 2017

Food Technol. Biotechnol.

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SummaryThe power of foodomics as a discipline that is now broadly used for quality assurance of food products and adulteration identifi cation, as well as for determining the safety of food, is presented. Concerning sample preparation and application, maintenance of highly sophisticated instruments for both high-performance and high-throughput techniques, and analysis and data interpretation, special att ention has to be paid to the development of skilled analysts. The obtained data shall be integrated under a strong bioinformatics environment. Modern mass spectrometry is an extremely powerful analytical tool since it can provide direct qualitative and quantitative information about a molecule of interest from only a minute amount of sample. Quality of this information is infl uenced by the sample preparation procedure, the type of mass spectrometer used and the analyst's skills. Technical advances are bringing new instruments of increased sensitivity, resolution and speed to the market. Other methods presented here give additional information and can be used as complementary tools to mass spectrometry or for validation of obtained results. Genomics and transcriptomics, as well as affi nity-based methods, still have a broad use in food analysis. Serious drawbacks of some of them, especially the affi nity-based methods, are the cross-reactivity between similar molecules and the infl uence of complex food matrices. However, these techniques can be used for pre-screening in order to reduce the large number of samples. Great progress has been made in the application of bioinformatics in foodomics. These developments enabled processing of large amounts of generated data for both identifi cation and quantifi cation, and for corresponding modeling.

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“…In humans, exposure to OTA has been linked with Balkan endemic nephropathy (BEN), a chronic tubule-interstitial disease associated with progressive renal fibrosis and tumours of the renal pelvis and urethra [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Ochratoxin A Detection by HPLC-FL in Processed Baby Foods

Bonerba¹,

Ceci²,

Balzaretti³

et al. 2017

J Nephrol Ther

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Abstract270 samples of different types of pasta and cereal products, distributed in a nursery school canteen in Milan (Italy), were analyzed to estimate the occurrence of ochratoxin A.OTA was found in all analyzed samples (100%), 39 samples exceeded the maximum limit established by European Commission Regulation for OTA in the foodstuffs listed in the relevant category.The mean concentration of ochratoxin A in samples of pasta, intended for children (over 5 months) consumption was 0.56 µg/kg; the mean concentration in organic pasta was 0.91 µg/kg and the mean concentration detected in cereal products was 3.12 µg/kg.Considering that in European Countries wheat products are the first solid food eaten by babies from the earliest stages of weaning and in the light of the multiple and repeated international food alert notification on OTA occurrence in cereals and cereals product, surveillance should be continuous for an effective risk assessment, especially in these vulnerable groups of consumers.

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Role of Environmental Toxins in Endemic (Balkan) Nephropathy

Cited by 137 publications

References 32 publications

Fifty Years of Balkan Endemic Nephropathy: Challenges of Study Using Epidemiological Method

Fifty Years of Balkan Endemic Nephropathy: Challenges of Study Using Epidemiological Method

Foodomics and Food Safety: Where We Are

Ochratoxin A Detection by HPLC-FL in Processed Baby Foods

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