The association between exposure to aflatoxin, mutation in TP53, infection with hepatitis B virus, and occurrence of liver disease in a selected population in Hyderabad, India

Anitha, S.; Raghunadharao, D.; Waliyar, F; Sudini, Harikishan; Parveen, Monira; Rao, Ratna; Kumar, P. Lava

doi:10.1016/j.mrgentox.2013.12.011

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…Numerous studies that include a focus on China and other countries have established a strong association between AFB1 dietary exposure and the risk of HCC [ 13 – 16 ]. However, only a small number of studies have included an examination of airway exposure to AFB1 [ 5 , 17 – 19 ], and the role that inhaled AFB1 plays as an occupational risk factor in the development of HCC is largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Association between aflatoxin B1 occupational airway exposure and risk of hepatocellular carcinoma: a case-control study

Lai

Yang

et al. 2014

Tumor Biol.

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The aim of this study was to determine the airway exposure of sugar and papermaking factory workers to aflatoxin B1 (AFB1) and to explore the potential association between AFB1 airway exposure and the risk of hepatocellular carcinoma (HCC) in a case-control study. Dust samples were collected from the sugarcane bagasse warehouse, and presser and paper production workshops. Blood samples were collected from 181 workshop employees and 203 controls who worked outside the workshop. AFB1 albumin adducts were detected using a double antibody sandwich enzyme-linked immunosorbent assay (ELISA). To explore the association between AFB1 airway exposure and the risk of HCC, the medical records of 68 HCC patients who worked in a sugar and papermaking factory between January 1994 and December 2013 were analyzed. A questionnaire was used to collect information from 150 healthy controls who worked for the same company and lived near the factory. AFB1 was detected in the dust samples, but could not be detected in any of the rice samples. An analysis of serum samples revealed serum AFB1 albumin adducts in 102 (56.35 %) of the study participants. However, in the control group, only 12 (5.9 %) individuals had detectable levels of AFB1 albumin adducts. Those with airway exposure to Aspergillus flavuscontaminated dust had an elevated risk of HCC compared to those without exposure (odds ratio, 5.24; 95 % confidence interval, 2.77-9.88; P=0.00). The findings of this study indicate that occupational AFB1 airway exposure might be associated with the risk of AFB1-related HCC among the population that was used in this study. Intervention programs aimed at reducing exposure to inhalational AFB1 are needed urgently. Additional suitably designed, multicenter, prospective studies using large samples are needed to further confirm the results.

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Section: Introductionmentioning

confidence: 99%

Association between aflatoxin B1 occupational airway exposure and risk of hepatocellular carcinoma: a case-control study

Lai

Yang

et al. 2014

Tumor Biol.

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“…Of these, 10 records were further excluded because they did not satisfy the inclusion criteria. The remaining 5 studies [12,[19][20][21][22] were included in this systematic review and meta-analysis.…”

Section: Search Resultsmentioning

confidence: 99%

“…Among the five studies that met the inclusion criteria, four of them were case-control studies and one study was a nested case-control study. They were conducted in Gambia [19,20], Taiwan [12], India [21], and China [22] and involved 941 cases and 2, 281 controls. The included studies were published between 2005 and 2018.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…As shown in Table 1, the included studies employed AF- [12,21,22], 249ser TP53 mutation [19][20][21] and groundnut consumption [19,20] as methods of AF exposure assessment in liver cirrhosis patients. As depicted in Table 1, three of the included studies reported unadjusted and adjusted ORs and two studies [21,22] did not report the adjusted odds ratio. Most studies were adjusted for factors such as age, gender, cigarette smoking, and alcohol drinking; two studies [19,20] were also adjusted for recruitment site and date, socioeconomic status, HBV, and HCV status.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Aflatoxins as a risk factor for liver cirrhosis: a systematic review and meta-analysis

Mekuria

Routledge

Gong

et al. 2020

BMC Pharmacol Toxicol

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Background: Liver cirrhosis is characterized by fibrosis and nodule formation in the liver, due to a chronic injury, and subsequent alteration of the normal architecture of the liver. Even though there is a huge effort to elucidate the possible etiologic factors of liver cirrhosis, a significant number of cases are cryptogenic, especially in Sub Saharan Africa, where there is a high burden of aflatoxin exposure. Aflatoxins are known to cause hepatocellular carcinoma, which share similar etiologic factors with liver cirrhosis. This study aimed to assess the association between aflatoxin exposure and the risk of liver cirrhosis. Methods: Relevant studies were identified through systematic searches conducted in Ovid MEDLINE, PubMed and Google Scholar. Also, by searching the references of retrieved articles. The abstracts and full text were screened for eligibility and the risk of bias was assessed for each study using Joanna Briggs Institute (JBI) critical appraisal checklist for observational studies. The extracted data from included studies using Microsoft Excel were exported to Stata software version 15.0 for analyses. The overall pooled estimation of outcomes was calculated using a randomeffects model of DerSimonian-Laird method at a 95% confidence level. The heterogeneity of studies was determined using I2 statistics. The presence of publication bias between studies was evaluated using the Begg's and Egger's tests and funnel plot. The protocol of this systematic review and meta-analysis was registered in the Prospero database with reference number ID: CRD42019148481. Results: A total of 5 studies published between the years 2005 and 2018 that met the pre-defined inclusion and exclusion criteria were included. The meta-analysis showed that a significant increase in the risk of liver cirrhosis is associated with aflatoxin exposure (unadjusted pooled odds ratio (OR) = 3.35, 95% CI: 2.74-4.10, p = 0.000; I 2 = 88.3%, p = 0.000; adjusted OR = 2.5, 95% CI: 1.84-3.39, p = 0.000; I 2 = 0%, p = 0.429). Conclusions: The present meta-analysis suggests that aflatoxin exposure is associated with a higher risk of liver cirrhosis.

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“…Aflatoxin may induce P53 mutation at codon 249 (R249s) in patients with hepatocellular carcinoma exposed or unexposed to HBV . Many studies have reported that HBV infection increases the likelihood of AFB1-induced P53 249 ser mutation and induces a higher risk of HCC in mice − and humans. − MC-LR can strongly enhance P53 expression in HepG cells, although there are no data indicating the ability of MC-LR to induce the mutation. Third, HBV can activate cytochrome P450s in the toxin-exposed people and can stimulate the specific cytochrome P450s to transform AFB1 into AFB1-8,9-epoxide in hepatocytes .…”

Section: Discussionmentioning

confidence: 99%

Environmental Microcystin Exposure Increases Liver Injury Risk Induced by Hepatitis B Virus Combined with Aflatoxin: A Cross-Sectional Study in Southwest China

Liu¹,

Wang²,

Yang³

et al. 2017

Environ. Sci. Technol.

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Three liver hazards, two confirmed-hepatitis B virus (HBV) and aflatoxin (AFB), and one rarely studied in populations-microcystin (MC), simultaneously exist in tropical and humid areas; however, there are no epidemiological data on their risks in the same population. We conducted a community-based cross-sectional survey among 5493 adults in two rural towns and statistically analyzed the comparative and combinative effects of the three factors after detecting HBsAg and HBV DNA titers, determining estimated daily intakes (EDIs) of AFB1 and MC-LR and testing serum AST and ALT as liver injury markers for each participant. We observed a HBsAg(+) rate of 7.6%, a relatively high AFB1 exposure level (mean EDI = 471.30 ng/d), and a relatively low MC-LR exposure level (mean EDI = 228.25 ng/d). ORs for abnormal AST (2.42, 95%CI = 1.69-3.45) and ALT (2.87, 95%CI = 1.91-4.29) increased in HBV infections compared with HBV-unexposed participants but did not increase in participants with separate or combined exposure to AFB1 and MC-LR (EDIs ≥ mean). Meanwhile, after adjustment for confounding factors, means of AST and ALT and ORs of abnormal AST and ALT were successively elevated after exposure to HBV, HBV&AFB1 (or HBV&MC-LR), and HBV&AFB1&MC-LR, especially in the group with detectable HBV DNA (AST: OR = 11.38, 95%CI = 3.91-33.17; ALT: OR = 17.09, 95%CI = 5.36-54.53). Notably, ORs for abnormal AST and ALT in the HBV exposed group were not significantly different from those in HBV&AFB1 or in the HBV&MC-LR exposed group but were significantly higher in the HBV&AFB1&MC-LR exposed group (P = 0.029 and P = 0.037, respectively). Our study indicated that microcystin may have the potential to increase the risk of liver injury induced by combined exposure to HBV and aflatoxin. However, in consideration of the uncertainties in the detection of the toxins and evaluation of the EDIs, more epidemiological data are expected to determine the increasing toxic effects of microcystins.

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The association between exposure to aflatoxin, mutation in TP53, infection with hepatitis B virus, and occurrence of liver disease in a selected population in Hyderabad, India

Cited by 10 publications

References 21 publications

Association between aflatoxin B1 occupational airway exposure and risk of hepatocellular carcinoma: a case-control study

Association between aflatoxin B1 occupational airway exposure and risk of hepatocellular carcinoma: a case-control study

Aflatoxins as a risk factor for liver cirrhosis: a systematic review and meta-analysis

Environmental Microcystin Exposure Increases Liver Injury Risk Induced by Hepatitis B Virus Combined with Aflatoxin: A Cross-Sectional Study in Southwest China

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