Fagbohun Temitope R, Nji Queenta Ngum, Okechukwu Viola O, Adelusi Oluwasola A, Nyathi Lungani A, Awong Patience, Njobeh Patrick B
Department of Biotechnology and Food Technology, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa.
Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Private Bag X680, Pretoria 0001, South Africa.
Toxins (Basel). 2025 Aug 16;17(8):414. doi: 10.3390/toxins17080414.
Aflatoxins (AFs), harmful secondary metabolites produced by the genus , particularly and , are one of the best-known potent mycotoxins, posing a significant risk to public health. The primary type, especially aflatoxin B (AFB), is a potent carcinogen associated with liver cancer, immunosuppression, and other health problems. Environmental factors such as high temperatures, humidity, and inadequate storage conditions promote the formation of aflatoxin in staple foods such as maize, peanuts, and rice. Immunocompromised individuals, including those with HIV/AIDS, hepatitis, cancer, or diabetes, are at increased risk due to their reduced detoxification capacity and weakened immune defenses. Chronic exposure to AF in these populations exacerbates liver damage, infection rates, and disease progression, particularly in developing countries and moderate-income populations where food safety regulations are inadequate and reliance on contaminated staple foods is widespread. Biomarkers such as aflatoxin-albumin complexes, urinary aflatoxin M, and aflatoxin (AF) DNA adducts provide valuable insights but remain underutilized in resource-limited settings. Despite the globally recognized health risk posed by AF, research focused on monitoring human exposure remains limited, particularly among immunocompromised individuals. This dynamic emphasizes the need for targeted studies and interventions to address the particular risks faced by immunocompromised individuals. This review provides an up-to-date overview of AF exposure in immunocompromised populations, including individuals with cancer, hepatitis, diabetes, malnutrition, pregnant women, and the elderly. It also highlights exposure pathways, biomarkers, and biomonitoring strategies, while emphasizing the need for targeted interventions, advanced diagnostics, and policy frameworks to mitigate health risks in these vulnerable groups. Addressing these gaps is crucial to reducing the health burden and developing public health strategies in high-risk regions.
黄曲霉毒素（AFs）是由曲霉属产生的有害次生代谢产物，尤其是黄曲霉和寄生曲霉，是最著名的强效霉菌毒素之一，对公众健康构成重大风险。主要类型，尤其是黄曲霉毒素B（AFB），是一种与肝癌、免疫抑制和其他健康问题相关的强效致癌物。高温、高湿度和储存条件不足等环境因素会促进玉米、花生和大米等主食中黄曲霉毒素的形成。免疫功能低下的个体，包括艾滋病毒/艾滋病、肝炎、癌症或糖尿病患者，由于其解毒能力下降和免疫防御减弱，风险增加。这些人群长期接触AF会加剧肝脏损伤、感染率和疾病进展，特别是在食品安全法规不完善且普遍依赖受污染主食的发展中国家和中等收入人群中。黄曲霉毒素-白蛋白复合物、尿黄曲霉毒素M和黄曲霉毒素（AF）DNA加合物等生物标志物提供了有价值的见解，但在资源有限的环境中仍未得到充分利用。尽管AF对全球健康构成的风险已得到公认，但针对人类接触情况监测的研究仍然有限，尤其是在免疫功能低下的个体中。这种情况凸显了开展针对性研究和干预措施以应对免疫功能低下个体所面临特定风险的必要性。本综述提供了免疫功能低下人群（包括癌症、肝炎、糖尿病、营养不良患者、孕妇和老年人）AF暴露的最新概述。它还强调了暴露途径、生物标志物和生物监测策略，同时强调需要有针对性的干预措施、先进的诊断方法和政策框架，以降低这些弱势群体的健康风险。填补这些空白对于减轻高风险地区的健康负担和制定公共卫生战略至关重要。
