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Modification of immune function through exposure to dietary aflatoxin in Gambian children.

By Paul C Turner, Sophie E Moore, Andrew J Hall, Andrew M Prentice and Christopher P Wild


Aflatoxins are immunotoxins that frequently contaminate staple foods in The Gambia and other parts of sub-Saharan Africa, resulting in high exposure throughout life. Impaired infant immune system development may be a key predictor of mortality from infectious disease. In this study we aimed to determine the effect of dietary aflatoxin exposure on a number of immune parameters in Gambian children. A cohort of 472 Gambian children 6-9 years of age was recruited. Serum aflatoxin-albumin (AF-alb) adducts were analyzed to provide a measure of exposure. Immune parameters included secretory IgA (sIgA) in saliva, cell-mediated immunity (CMI), determined using the CMI multitest where test antigens are applied to the skin, and antibody responses to both rabies and pneumococcal polysaccharide vaccines. Birth weight, current anthropometry, and micronutrient status were also recorded. AF-alb adducts were detected in 93% of the children (geometric mean level 22.3 pg/mg; range 5-456 pg/mg). AF-alb level was strongly influenced by month of sampling. In a multivariable analysis, sIgA was markedly lower in children with detectable AF-alb compared with those with nondetectable levels [50.4 micro g/mg protein (95% confidence interval [CI] 48.0-52.8) and 70.2 micro g/mg protein (95% CI 61.1-79.2), respectively; p < 0.0001]. Antibody response to one of four pneumococcal serotypes, but not rabies vaccine, was weakly associated with higher levels of AF-alb. There was no association between CMI responses to test antigens and AF-alb. These data confirm that children in rural Gambia are frequently exposed to high levels of aflatoxin. The study provides evidence that sIgA in saliva may be reduced because of dietary levels of aflatoxin exposure. Given the high burden of infection-related mortality in West Africa, further investigation of the immune effects of aflatoxin exposure in children is merited

Topics: Research Article
Year: 2003
OAI identifier:
Provided by: PubMed Central

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  1. (1987). Aflatoxin and human disease. Adverse Drug React Acute Poisoning Rev 6:175–209.
  2. (1992). Aflatoxin exposure, malaria and hepatitis B infection in rural Gambian children. Trans R Soc Trop Med Hyg 86:426–430.
  3. (1993). Aflatoxin, liver enzymes, and hepatitis B virus infection in Gambian children. Cancer Epidemiol Biomark Prev 2:555–561.
  4. (1984). Breast milk antimicrobial factors of rural Gambian mothers. II. Influence of season and prevalence of infection. Acta Paediatr Scand.
  5. (1996). Cell-mediated immunity after measles in Guinea-Bissau: historical cohort study.
  6. (2002). Cross-sectional study of dietary aflatoxin exposure and impaired growth in young children from Benin and Togo, West Africa.
  7. (1992). Dietary intake of aflatoxins and the level of albumin-bound aflatoxin in peripheral blood in The Gambia, West Africa. Cancer Epidemiol Biomark Prev 1:229–234.
  8. (2000). Effect of aflatoxin on performance, hematology, and clinical immunology in lambs.
  9. (1977). Effects of aflatoxin on the cellular immune system. Ann Nutr Aliment 31:781–787.
  10. (1997). Effects on birth weight and perinatal mortality of maternal dietary supplements in rural Gambia: 5 year randomised controlled trial.
  11. (1991). ELISA for quantification of aflatoxinalbumin adducts and their application to human exposure assessment. In:
  12. (2000). Environmental and genetic determinants of aflatoxinalbumin adducts in the Gambia. Int J Cancer 86:1–7. Children’s Health | Turner et al.
  13. (1994). Epidemiology of aflatoxin-related disease. In: The Toxicology of Aflatoxins: Human Health, Veterinary and Agricultural Significance
  14. (1986). Group, World Health Organization.
  15. (2000). Hepatitis B infection and aflatoxin biomarker levels in Gambian children. Trop Med Int Health 5:837–841.
  16. (1997). Hepatocellular carcinoma: from gene to public health.
  17. (1998). Humoral immunosuppressant activity of aflatoxin ingestion in rabbits measured by response to Mycobacterium bovis antigens using enzyme-linked immunosorbent assay and serum protein electrophoresis.
  18. (2001). Immune function in rural Gambian children is not related to season of birth, birth size, or maternal supplementation status.
  19. (1996). Immunobiological activities of mould products: functional impairment of human monocytes exposed to aflatoxin B1. Rev Microbiol 147:385–391.
  20. (2000). Immunomodulation by fungal toxins.
  21. (1996). Immunosuppressant activity of aflatoxin ingestion in rabbits measured by response to Mycobacterium bovis antigen. I. Cell mediated immune response measured by skin test reaction. Vet Hum Toxicol 38:333–336.
  22. (1991). In-utero exposure to aflatoxin in West Africa [Letter]. Lancet 337:1602.
  23. (1999). Influence of early postoperative enteral nutrition versus placebo on cell mediated immunity, as measured with the Multitest (R) CMI.
  24. (1997). Interaction of aflatoxin in the feed and immunisation against selected infectious disease. 1. Infectious bursal disease. Avian Pathol 26:317–325.
  25. (1988). Measurement of aflatoxin in Nigerian sera by enzymelinked immunosorbent assay. Trans R Soc Trop Med Hyg 82:169–171.
  26. (1992). Molecular dosimetry of aflatoxinN7-guanine in human urine obtained in The Gambia, West Africa. Cancer Epidemiol Biomarkers Prev 1:221–227.
  27. (1985). Mycotoxic suppression of immunity. In:
  28. (1998). Mycotoxins, toxicity and metabolism in animals: a systems approach overview. In: Mycotoxins and Phytotoxins—Developments
  29. (1994). Non-hepatic disposition and effects of aflatoxin B1. In: The Toxicology of Aflatoxins: Human Health, Veterinary and Agricultural Significance
  30. (1999). Prenatal or early postnatal events predict infectious deaths in young adulthood in rural Africa.
  31. (1991). Raised urinary secretory IgA in chronic diarrhoea.
  32. (1997). Season of birth predicts mortality in rural Gambia [Letter].
  33. (1993). Seasonal effects on physical growth and development. In:
  34. (1999). Secondary metabolites of Aspergillus exert immunobiological effects on human monocytes.
  35. (1993). Some Naturally Occurring Substances: Food Items and Constituents, Heterocyclic Aromatic Amines and Mycotoxins. IARC Monogr Eval Carcinog Risks Hum 56:245–395.

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