Balkan nephropathy exposure

Another important and widespread fungal toxin is ochratoxin, which is also found in cereals and, to a lesser extent, in coffee and cocoa beans. The toxin Ochratoxin A is the most commonly found and is produced by the Aspergillus t5rpe of fungus. Exposure occurs in many countries in Europe and affects farm animals as well as humans. The major toxic effect in both humans and animals is kidney damage and cancer of the kidney. The available epidemiological evidence indicates that the disease called Balkan nephropathy is associated with consumption of food contaminated with ochratoxin, and the toxin has been detected in the blood of people living... 

Effects of non-occupational exposure to cadmium [51], itai-itai disease in particular [52, 53], were occasionally compared with kidney damage seen in Balkan nephropathy patients. In spite of some resembhng features, the idea of a common etiology between cadmium nephropathy (including itai-itai disease) and Balkan nephropathy was refuted [52, 54]. 

Based on chronological data, it is clear that no pesticides, fertilizers or chemicals introduced during the last few decades may be blamed for the occurrence of Balkan nephropathy. Except for exposure to agricultural activities, no occupation, habit (e.g., smoking, alcohol consumption), or hobby (e.g., hunting, fishing) might have been shown to precede the disease onset. 

Currently one research group argues in favor of a crucial role of genetic factors. They identified a specific chromosome marker (3q25) in Balkan nephropathy patients [24-26]. Another research team saw some aberrations of the X chromosome, but they resembled changes occurring after exposure to ocharatoxin A [27]. 

Genetic factors may play a role, given the same exposure, in developing Balkan nephropathy, upper urothelial tumors, both diseases, or none of them [66]. However, epidemiological data indicate that one or more external, environmental factors are crucial for the occurrence of both Balkan nephropathy and excessive frequency of these tumors in endemic areas. 

Bactericide A pesticide used to control or destroy bacteria Basal diet Ration for adults and starter ration for the young, appropriate to the species it should meet the standard nutritional requirement Base pair mutagens Chemicals or agents that produce a base change in the DNA BEA 2-Bromoethalamine BEI Biological exposure index BLL Blood lead level BEN Balkan endemic nephropathy... 

The earlier literature on the association between human exposure to ochratoxin A and the occurrence of Balkan endemic nephropathy and associated urinary tract tumours was summarized in the previous evaluation (Annex 1, reference 153. Contrary to the clear causal evidence of ochratoxin A-induced nephrotoxicity and kidney carcinogenicity in rodents, the significance of ochratoxin A for human health remains unclear from the available epidemiological evidence. Moreover, ochratoxin A exposure is only one of several hypotheses concerning an environmental etiology for Balkan endemic nephropathy. 

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