Wild Christopher Paul
Molecular Epidemiology Unit, Centre for Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
Food Nutr Bull. 2007 Jun;28(2 Suppl):S372-80. doi: 10.1177/15648265070282S217.
Aflatoxins are common contaminants of staple foods in sub-Saharan Africa. These toxins are human liver carcinogens, especially in combination with chronic infection with hepatitis B virus. However, in an agricultural setting, the effects on growth, immune status, and susceptibility to infectious disease in farm animals are also well recognized. These latter effects have been far less explored in human populations.
To review some of the more recent work on aflatoxins where the health outcomes seen in the agricultural setting, including growth impairment and immune suppression, have been investigated in human populations. The paper draws largely on examples from West Africa. The paper also sets out how knowledge gained about aflatoxins in the agricultural setting can be used to design intervention studies in human populations.
A review of the relevant literature.
Human exposure to aflatoxins begins early in life, and recent studies in West Africa have demonstrated an association between exposure and growth faltering, particularly stunting, in young children. At present the underlying mechanisms for the latter effects are unknown but may include impairment of immunity and increased susceptibility to infections. Simple postharvest intervention strategies were successful in reducing aflatoxin exposure in a subsistence farm setting, providing a rationale for prevention of aflatoxin-related disease.
There are potential benefits to public health from intervention strategies combining expertise in the agricultural and health settings to address the aflatoxin problem.
黄曲霉毒素是撒哈拉以南非洲主食的常见污染物。这些毒素是人类肝脏致癌物，尤其是与乙型肝炎病毒慢性感染共同作用时。然而，在农业环境中，其对农场动物生长、免疫状态和传染病易感性的影响也已得到充分认识。而在人群中，这些影响的研究则少得多。
回顾一些关于黄曲霉毒素的最新研究，这些研究调查了人群中在农业环境中出现的健康后果，包括生长发育受损和免疫抑制。本文主要借鉴西非的例子。本文还阐述了如何利用在农业环境中获得的关于黄曲霉毒素的知识来设计针对人群的干预研究。
对相关文献进行综述。
人类在生命早期就开始接触黄曲霉毒素，西非的最新研究表明，接触黄曲霉毒素与幼儿生长发育迟缓，尤其是发育迟缓之间存在关联。目前，这些影响的潜在机制尚不清楚，但可能包括免疫功能受损和对感染易感性增加。简单的收获后干预策略在自给自足的农场环境中成功减少了黄曲霉毒素暴露，为预防黄曲霉毒素相关疾病提供了理论依据。
将农业和卫生领域的专业知识结合起来的干预策略，对于解决黄曲霉毒素问题具有潜在的公共卫生益处。
