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Carcinogenesis Advance Access published online on October 29, 2009
Carcinogenesis, doi:10.1093/carcin/bgp264
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© The Author 2009. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Mycotoxins and human disease: a largely ignored global health issue

Christopher P. Wild1 and Yun Yun Gong2

1 International Agency for Research on Cancer, Lyon, France
2 Molecular Epidemiology Unit, LIGHT Laboratories, University of Leeds, Leeds, UK

Corresponding Author: Christopher Wild, Fax: (33) (0)4.72.73.85.64, e-mail: director{at}iarc.fr

Aflatoxins and fumonisins are mycotoxins contaminating a large fraction of the world's food, including maize, cereals, groundnuts and tree nuts. The toxins frequently co-occur in maize. Where these commodities are dietary staples, for example in parts of Africa, Asia and Latin America, the contamination translates to high level, chronic exposure. This is particularly true in subsistence farming communities where regulations to control exposure are either non-existent or practically unenforceable. Aflatoxins are hepatocarcinogenic in humans, particularly in conjunction with chronic hepatitis B virus infection, and cause aflatoxicosis in episodic poisoning outbreaks. In animals these toxins also impair growth and are immunosuppressive; the latter effects are of increasing interest in human populations. Fumonisins have been reported to induce liver and kidney tumours in rodents and are classified as Group 2B "possibly carcinogenic to humans", with ecological studies implying a possible link to increased oesophageal cancer. Recent studies also suggest the fumonisins may cause neural tube defects in some maize-consuming populations. There is a plausible mechanism for this effect via a disruption of ceramide synthase and sphingolipid biosynthesis. Notwithstanding the need for a better evidence-base on mycotoxins and human health, supported by better biomarkers of exposure and effect in epidemiological studies, the existing data are sufficient to prioritize exposure reduction in vulnerable populations. For both toxins there are a number of practical primary and secondary prevention strategies which could be beneficial if the political will and financial investment can be applied to what remains a largely and rather shamefully ignored global health issue.

Key Words: aflatoxins • fumonisins • hepatocellular carcinoma • aflatoxicosis • neural tube defects • oesophageal cancer • intervention • biomarkers

Received October 13, 2009; revised October 18, 2009; accepted October 22, 2009.


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