Evaluation of emerging biomarkers of renal damage and exposure to aflatoxin-B1 in Mexican indigenous women: a pilot study

Abstract

Aflatoxins (AFs) are mycotoxins produced by Aspergillus parasiticus and Aspergillus flavus which frequently contaminate maize. These compounds are considered toxic, especially AFB₁ which has been classified as a human carcinogen, due to its relationship with the generation of hepatocellular carcinoma. Studies in vivo, in animal models, prove that chronic consumption of AFB₁ has an association with renal adverse effects, but evidence in humans is scarce. Therefore, the main objective of this research was to conduct a pilot study to evaluate the correlation between exposure to AFB₁ and early-stage renal damage in indigenous women of San Luis Potosí, Mexico. Exposure to AFB₁ was measured through the biomarker AFB₁-lysine and renal damage through kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin-C (Cys-C). AFB₁-Lys was measured by HPLC-FLD. The method was validated with a correlation coefficient of 0.99 and limit of detection and quantification of 3.5 and 4.7 pg mL^-1, respectively. Levels of NGAL, KIM-1, and Cys-C were determined (median (P25-P75), 5.96 (3.16-15.91), 0.137 (0.137-0.281), and 18.49 (5.76-29.57) ng mL^-1, respectively). Additionally, glomerular filtration rate (GFR) (83.3 (59.8-107.4) mL/min/1.73 m²) and serum creatinine (SCr) (0.88 (0.72-1.22) mg dL^-1) were obtained. The median concentrations for AFB₁-Lys were 2.08 (1.89-5.8) pg mg^-1 of albumin. Statistically significant correlations between AFB₁-Lys/KIM-1 (Rho = 0.498, p = 0.007) and AFB₁/Cys-C (Rho = 0.431, p = 0.014) were found. Our results indicate that women are exposed to AFB₁, due to the fact that the AFB₁-Lys biomarker was found in a high percentage of the study population (83%). In addition, the results of exposure to AFB₁ show a strong significant correlation between KIM-1 and Cys-C that may indicate the toxic renal effect. These results are alarming because of the high toxicity of this compound and require adequate intervention to reduce AFB₁ exposure in these populations.

Keywords: AFB1-Lys; Aflatoxins; Cys-C; Exposure biomarkers; KIM-1; NGAL; Renal biomarkers; Renal damage.