engleski

Ochratoxin A in human kidney disease

In the early seventies of the last century, a hypothesis was put forward that mycotoxin ochratoxin A (OTA) was involved in the etiology of endemic nephropathy (EN). EN is a human interstitial bilateral noninflammatory kidney disease with fatal outcome with the highest prevalence in early seventies. Ten years after this peak, a high incidence of otherwise rare urothelial tumors was first noticed in the endemic area of Bulgaria, and then in other countries. The fact that the appearance of EN and these tumors in farmers is geographically limited suggests there may be a unique, and most probably natural cause of both diseases. Although OTA was found in the dust of grain and coffee in food production facilities, the main source of human exposure is food, because it contaminates food of vegetable and animal origin worldwide. Large follow-up studies were performed in Croatia and Bulgaria whose aim was to see whether the population of the EN regions was exposed to higher OTA concentrations than other populations. In both countries, mean blood OTA concentrations in the endemic populations were higher than in control populations. However, OTA was also found in food, feed and human blood in countries where EN has not been detected. Regional differences in OTA blood concentrations in healthy population have been established in Canada, Croatia, France, Sweden, Switzerland, and Tunisia. In Croatia, blood samples obtained from blood banks showed seasonal variations in OTA concentrations, and the highest number of OTA positive samples, as well as the highest mean OTA concentration were found in samples collected in the summer period. OTA was also found in breast milk (Italy, Norway, and Sweden). In the Czech Republic, Italy, Spain, and Turkey dialysis patients had higher OTA concentrations in blood than patients with other renal diseases or healthy persons. Several attempts have been made to link exposure to OTA in patients suffering from the end-stage kidney disease in North Africa with nephropathy.

ochratoxin A; endemic nephropathy; kidney diseases

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