EFFECTS OF AFLATOXINS ON MATERNAL AND CHILD HEALTH

Yıl 2021, Cilt: 22 Sayı: 5, 432 - 438, 04.08.2021

Büşra Demirer , Mehmet Özdemir

https://doi.org/10.18229/kocatepetip.751953

Cited By: 2

Öz

Aflatoxins are secondary metabolites produced by Aspergillus derivatives. Human exposure to aflatoxin generally results from the consumption of foods contaminated with aflatoxin.; It has been shown in many studies that taking aflatoxins more than the specified amounts has negative effects on human health. These negative effects may play a role in the development of many different pathological conditions in the body, but the mechanisms of action vary depending on the individual's metabolic state, the species taken and the dose. While there are many studies on the effects of aflatoxin exposure in adult individuals, studies on the effects of maternal aflatoxin exposure on the mother and child are quite limited. As a result of human and animal studies, maternal aflatoxin exposure in general; It is reported that there are maternal complications such as maternal anemia, micronutrient deficiencies, increased proinflammatory cytokines and increased oxidative stress during pregnancy. It has been reported that the increased maternal proinflammatory status is associated with the formation of many chronic diseases in the future. Maternal aflatoxin exposure during pregnancy also has negative effects on the fetus and newborn. It has been reported that aflatoxin exposure above safe levels in the body causes placental insufficiency, adversely affects fetal growth and development, and may cause neonatal jaundice. Among the mechanisms that aflatoxin negatively affecting intrauterine growth and development; Although it has been shown to cause enteropathy, suppress the immune system and reduce the release of insulin-like growth factors, it is has also been reported that maternal aflatoxin exposure may be associated with early childhood stunting. However, the effects of maternal aflatoxin exposure on maternal and child health are not yet fully known due to the fact that most of the studies are animal studies and in vitro studies, and the prospective epidemiological human studies are limited. It is essential to provide stronger evidence for the role of aflatoxin in adverse pregnancy outcomes, especially given the widespread exposure in developing countries. The purpose of this review article is to discuss the effects of maternal aflatoxin exposure on maternal and child health in the light of current information.

Anahtar Kelimeler

Aflatoxin, Fungal, Contamination

AFLATOKSİNLERİN ANNE VE ÇOCUK SAĞLIĞINA ETKİLERİ

Öz

Aflatoksinler Aspergillus türevleri tarafından üretilen sekonder metabolitlerdir. İnsanların aflatoksin maruziyeti genel olarak aflatoksin ile kontamine olmuş besinlerin tüketiminden kaynaklanmaktadır. Aflatoksinlerin; belirlenmiş miktarların üzerinde alınmasının insan sağlığı üzerine olumsuz etkilerinin olduğu birçok çalışma ile gösterilmiştir. Bu olumsuz etkiler vücutta birçok farklı patolojik durumun gelişiminde etkili olabilmektedir ancak etki mekanizmaları bireyin metabolik durumuna, alınan türe ve doza bağlı olarak değişmektedir. Yetişkin bireylerde aflatoksin maruziyetinin etkilerine yönelik yapılmış birçok çalışma bulunurken maternal aflatoksin maruziyetinin anne ve çocuk üzerindeki etkilerine yönelik yapılmış çalışmalar oldukça sınırlıdır. Yapılan insan ve hayvan çalışmaları sonucu genel olarak maternal aflatoksin maruziyetinin; gebelikte maternal anemi, mikro besin ögesi eksiklikleri, proinflamatuar sitokinlerin artması ve oksidatif stresin artması gibi maternal komplikasyonlarının bulunduğu bildirilmektedir. Maternal artmış proinflamatuar durumun ise ileride birçok kronik hastalığın oluşması ile ilişkili olduğu bildirilmektedir. Gebelik dönemindeki maternal aflatoksin maruziyetinin aynı zamanda fetüs ve yenidoğan üzerinde de olumsuz etkileri bulunmaktadır. Vücutta güvenilir seviyelerin üzerindeki aflatoksin maruziyetinin, plasental yetmezliğe sebep olduğu, fetal büyüme ve gelişmeyi olumsuz etkilediği, yenidoğan sarılığına sebep olabileceği bildirilmektedir. Aflatoksinin intrauterin büyüme ve gelişmeyi olumsuz etkileme mekanizmalarının arasında; enteropatiye sebep olması, immün sistemi baskılaması ve insülin benzeri büyüme faktörü salınımını azaltması gösterilmekle birlikte ayrıca annenin aflatoksin maruziyetinin erken çocukluk dönemi bodurluğu ile ilişkili olabileceği bildirilmektedir. Ancak yapılmış çalışmaların büyük kısmının hayvan çalışmaları ve in vitro çalışma olması, ileriye dönük epidemiyolojik insan çalışmaların sınırlı olması sebebi ile maternal aflatoksin maruziyetinin anne ve çocuk sağlığına etkileri henüz tam olarak bilinememektedir. Özellikle gelişmekte olan ülkelerdeki yaygın maruziyet göz önüne alındığında, olumsuz gebelik sonuçlarında aflatoksinin rolü için daha güçlü kanıtlar sağlamak oldukça önemlidir. Bu derleme yazının amacı maternal aflatoksin maruziyetinin anne ve çocuk sağlığına etkilerinin güncel bilgiler eşliğinde tartışılmasıdır.

Anahtar Kelimeler

aflatoksin, mantar, kontaminasyon, maternal sağlık, fetal sağlık

Kaynakça

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