Ochratoxin Balkan nephropathy

Ochratoxin, citrinin Contaminant (mycotoxin) Produced by Penicillium strains nephropathy (endemic Balkan nephropathy)... 

Ochratoxin A. ochraceus P niger A. alliaceus A. terreus P viridicatum apoptosis nephrotoxin teratogen Balkan nephropathy, renal tumors... 

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... 

Association of ochratoxin A with chronic interstitial nephropathy in Tunisia [41] and its relation to renal tumors [42] provides additional support for the idea of the etiological role of this mycotoxin. Other fungal toxins, as zerealenone, citrinin [43] and aflatoxin were also isolated in endemic foci. Experimental models suggested that a combination of mycotoxins, rather than a single one, might be involved in the etiology of Balkan nephropathy [44]. 

Balkan nephropathy is non-destructive and noninflammatory tubulointerstitial renal disease [69]. The changes are non-specific and in the chronic, sclerotic phase they may be quite similar to changes observed in other chronic interstitial diseases such as analgesic nephropathy [70], vascular nephrosclerosis [69] cyclosporine-induced nephropathy [71], radiation nephritis [72,73] and aging [72], intoxication with silicate, cadmium, lead, uranium [74], mycotoxin ochratoxin... 

Krogh P, Hald B, Plestina R, Ceovic S. Enviromental Ochratoxin Aand Balkan (endemic) nephropathy Evidence for support of a casual relationship. In Endemic (Balkan) Nephropathy, Proc. 4th Symp., Nis 1979. Eds. S. Strahinjic V. Stefanovic. Inst. Nephr. Haemod., NIs 1981, 35-43. 

Mycotoxins The mycotoxins are secondary products of fungal metabolism. Numerous mycotoxins have been identified as toxicants in humans and/or animal models with several organ systems, including the kidney, being targets for these fungal products. Perhaps the two mycotoxins that have received the most attention as nephrotoxicants are citrinin and ochratoxin A. These two mycotoxins have received particular interest due to their possible role in endemic Balkan nephropathy. 

Vrabcheva, T., Usleber, E., Dietrich, R., and Martlbauer, E. (2000). Co-occurrence of ochratoxin A and citrinin in cereals from Bulgarian villages with a history of Balkan endemic nephropathy. J. Agric. Food Chem. 48, 2483-2488. 

Chemical, physical, and toxicological data of ochratoxins was reviewed by IARC (34). The kidney is the target organ, and OA in association with citrinin has been implicated in endemic nephropathy in the Balkans (57). 

T Petkova-Bocharova, M Castegnaro, J Michelon, V Mara. Ochratoxin A and other mycotoxins in cereals from an area of Balkan endemic nephropathy and urinary tract tumors in Bulgaria. In M Castegnaro, R Plestina, G Dirheimer, IN Chernozemskj, H Bartsch, eds. Mycotoxins, Endemic Nephropathy and Urinary Tract Tumors. Lyon IARC Scientific Publications, 1991, pp 83-87. 

Vrabcheva T, Usleber E, Dietrich R, Martlbauer E (2000) Co-occurrence of Ochratoxin A and Citrinin in Cereals from Bulgarian Villages with a History of Balkan Endemic Nephropathy. J Agric Food Chem 48 2483... 

Although the role of ochratoxins in human pathogenesis is stiU speculative, the lesions of nephropathy in humans were reported to be similar to those observed in porcine nephropathy [104]. Outbreaks of kidney disease (Balkan endemic nephropathy) in rural populations in Bulgaria, Romania, Tunisia and the former Yugoslavia were associated with ochratoxin A [104—106]. These correlations were... 

Petkova-Bocharova T, Castegnaro M Ochratoxin A contamination of cereals in an area of high incidence of Balkan endemic nephropathy in Bulgaria. Food Addit Contam 1985 2 267-270. 

Manolova Y, Manolov G, Parvanova L, Petkova-Bocharova T, Castegnaro M, Chernozemsky IN. Induction of characteristic chromosomal aberrations, particularly X-trisomy, in cultured human lymphocytes treated by ochratoxin A, a mycotoxin implicated in Balkan endemic nephropathy. Mutat. Res. 1990 231 (2) 143-9. 

Bach PH, Gregg NJ, Delacruz L. Relevance of a rat model of papillary necrosis and upper urothelial carcinoma in understanding the role of ochratoxin A in Balkan endemic nephropathy and its associated carcinoma. Food Chem Toxicol. 1992 30(3) 205-11. 

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. 

Ochratoxins (Table 6.2, Figure 6.4) are another important group of mycotoxins mainly produced by Aspergillus ochraceus, or in some instances by Penicillium ver-rucosum. Ochratoxicosis produces the Balkan endemic nephropathy first described in Bulgaria. Chemically, ochratoxins are isocoumarin derivatives bound to phenylalanine. The most common and relevant is ochratoxin A or OTA. Most ochratoxicosis is related to field-contaminated maize dne to excess rainfall before harvesting or... 

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