Abstract
BackgroundConsumption of moldy food has previously been identified as a risk factor for esophageal squamous cell carcinoma (ESCC) in high-risk countries; however, what contributing roles these dietary carcinogenic mycotoxins play in the etiology of ESCC are largely unknown.MethodsA mycotoxin biomarker-incorporated, population-based case-control study was performed in Huaian area, Jiangsu Province, one of the two high-risk areas in China. Exposure biomarkers of aflatoxins (AF) and fumonisins (FN) were quantitatively analyzed using HPLC-fluorescence techniques.ResultsAmong the cases (n = 190), the median levels of AF biomarker, serum AFB1-lysine adduct, and FN biomarker, urinary FB1, were 1.77 pg/mg albumin and 176.13 pg/mg creatinine, respectively. Among the controls (n = 380), the median levels of AFB1-lysine adduct and urinary FB1 were 1.49 pg/mg albumin and 56.92 pg/mg creatinine, respectively. These mycotoxin exposure biomarker levels were significantly higher in cases as compared to controls (p < 0.05 and 0.01, respectively). An increased risk to ESCC was associated with exposure to both AFB1 and FB1 (p < 0.001 for both).ConclusionsMycotoxin exposure, especially to AFB1 and FB1, was associated with the risk of ESCC, and a greater-than-additive interaction between co-exposures to these two mycotoxins may contribute to the increased risk of ESCC in Huaian area, China.
Highlights
Consumption of moldy food has previously been identified as a risk factor for esophageal squamous cell carcinoma (ESCC) in high-risk countries; what contributing roles these dietary carcinogenic mycotoxins play in the etiology of ESCC are largely unknown
Consumption of moldy and mycotoxin-contaminated food has previously been identified as a risk factor for ESCC in high-risk countries [5, 7, 8]; what contributing roles thesedietary carcinogenic mycotoxins play
In the present study, we assessed the exposure to potent mycotoxins, Aflatoxin B1 (AFB1) and fumonisin B1 (FB1), using corresponding exposure biomarkers and evaluated their associations with the risk for ESCC in Huaian area, China
Summary
Consumption of moldy food has previously been identified as a risk factor for esophageal squamous cell carcinoma (ESCC) in high-risk countries; what contributing roles these dietary carcinogenic mycotoxins play in the etiology of ESCC are largely unknown. FB1, on the other hand, is a Group 2B carcinogen and a representative of fumonisin family, produced primarily by maize pathogens, Fusarium verticillioides and F. proliferatum, which contaminates maize and maize-based products ubiquitously [12, 13] As both Aspergillus and Fusarium can contaminate and often co-exist on maize and some other cereal grains, concerns for human co-exposure to these two mycotoxins, and its consequences, have been raised [14, 15]. Efforts must be made to assess the extent of human co-exposure to these mycotoxins, as well as the adverse health effects they may have, in order to more accurately assess the risk posed by the nature of co-contamination and co-exposure [22]
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