Journal of Clinical Toxicology
Open Access
ISSN: 2161-0495
+44 1478 350008
ISSN: 2161-0495
+44 1478 350008
Paul C Turner
University of Maryland, USA
Posters & Accepted Abstracts: J Clinic Toxicol
Stunting is a significant public health burden in many global regions, yet remains poorly explained by either dietary insufficiency or poor hygiene; and some are suggesting another major player must be contributing to the burden of disease. Aflatoxins are a family of well establish highly toxic metabolites from Aspergillus species that contaminate dietary staples predominantly in tropical world regions. Despite them being identified as potent liver carcinogens more than 20 years ago, approximately 0.5 billion individuals are still at significant risk of exposure. Animal data clearly indicate that aflatoxin B1 (AFB1), the most frequently occurring and toxic form additionally causes poor early life growth. In this presentation I will critique the epidemiological data that provides compelling evidence for a role of dietary AFB1 exposure and early life stunting. Cross-sectional and longitudinal studies using well established exposure biomarkers for aflatoxin reveal that both in utero and early life exposures are important. Early introduction of complimentary foods increases the risk of high levels of aflatoxin exposure in infants, further pushing educational need in breast feeding practices, while associations between early aflatoxin exposure and stunting seem clear, good mechanistic data of this affect are mostly absent or occasionally poorly developed. The mechanisms are likely complex perhaps involving direct gut toxicity, immune suppression and/or liver toxicity. Other fungal metabolites may contribute, and complex mixtures of exposure are common; but in reality stunting is likely a consequence of combination of diet, hygiene and aflatoxin. I will outline some of the larger initiatives that are being developed to investigate this mixture of contributing factors. It is important to understand their relative contribution because it is unlikely that any of the three contributors will be completely eradicated in the foreseeable future; however useful and sustainable interventions may be successful by partial improvement of each.
Email: pturner3@umd.edu