Editing Mycotoxin (section)

==Occurrence==
Although various wild mushrooms contain an assortment of poisons that are definitely fungal metabolites causing noteworthy health problems for humans, they are rather arbitrarily excluded from discussions of mycotoxicology. In such cases the distinction is based on the size of the producing fungus and human intention.<ref name=Bennett03>{{cite journal |vauthors=Bennett JW, Klich M |title=Mycotoxins |journal=Clin. Microbiol. Rev. |volume=16 |issue=3 |pages=497–516 |year=2003 |pmid=12857779 |pmc=164220 |doi=10.1128/CMR.16.3.497-516.2003}}</ref> Mycotoxin exposure is almost always accidental whereas with mushrooms improper identification and ingestion causing [[mushroom poisoning]] is commonly the case. Ingestion of misidentified mushrooms containing mycotoxins may result in hallucinations. The cyclopeptide-producing ''[[Amanita phalloides]]'' is well known for its toxic potential and is responsible for approximately 90% of all mushroom fatalities.<ref>{{cite journal |vauthors=Berger KJ, Guss DA |title=Mycotoxins revisited: Part I |journal=J. Emerg. Med. |volume=28 |issue=1 |pages=53–62 |year=2005 |pmid=15657006 |doi=10.1016/j.jemermed.2004.08.013}}</ref> The other primary mycotoxin groups found in mushrooms include: [[orellanine]], [[monomethylhydrazine]], disulfiram-like, hallucinogenic indoles, muscarinic, isoxazole, and gastrointestinal (GI)-specific irritants.<ref>{{cite journal |vauthors=Berger KJ, Guss DA |title=Mycotoxins revisited: Part II |journal=J. Emerg. Med. |volume=28 |issue=2 |pages=175–83 |year=2005 |pmid=15707814 |doi=10.1016/j.jemermed.2004.08.019}}</ref> The bulk of this article is about mycotoxins that are found in microfungi other than poisons from mushrooms or macroscopic fungi.<ref name=Bennett03/>

===In indoor environments===
Buildings are another source of mycotoxins and people living or working in areas with mold increase their chances of adverse health effects. Molds growing in buildings can be divided into three groups – primary, secondary, and tertiary colonizers. Each group is categorized by the ability to grow at a certain water activity requirement. It has become difficult to identify mycotoxin production by indoor molds for many variables, such as (i) they may be masked as derivatives, (ii) they are poorly documented, and (iii) the fact that they are likely to produce different metabolites on building materials. Some of the mycotoxins in the indoor environment are produced by ''[[Alternaria]]'', ''[[Aspergillus]]'' (multiple forms), ''[[Penicillium]]'', and ''[[Stachybotrys]]''.<ref name= "Mycotoxin production by indoor molds.">{{cite journal|pmid=12781669|year=2003|last1=Fog Nielsen|first1=K|title=Mycotoxin production by indoor molds|volume=39|issue=2|pages=103–17|journal=Fungal Genetics and Biology|doi=10.1016/S1087-1845(03)00026-4}}</ref> ''Stachybotrys chartarum'' contains a higher number of mycotoxins than other molds grown in the indoor environment and has been associated with allergies and respiratory inflammation.<ref name=Pestka08>{{cite journal |vauthors=Pestka JJ, Yike I, Dearborn DG, Ward MD, Harkema JR |title=''Stachybotrys chartarum'', trichothecene mycotoxins, and damp building-related illness: new insights into a public health enigma |journal=Toxicol. Sci. |volume=104 |issue=1 |pages=4–26 |year=2008 |pmid=18007011 |doi=10.1093/toxsci/kfm284|doi-access=free }}</ref> The infestation of ''S. chartarum'' in buildings containing gypsum board, as well as on ceiling tiles, is very common and has recently become a more recognized problem. When gypsum board has been repeatedly introduced to moisture, ''S. chartarum'' grows readily on its cellulose face.<ref name=Godish01>{{cite book |author=Godish, Thad |title=Indoor environmental quality |publisher=Lewis Publishers |location=Chelsea, Mich |year=2001 |pages=183–84 |isbn=978-1-56670-402-1}}</ref> This stresses the importance of moisture controls and ventilation within residential homes and other buildings. The negative health effects of mycotoxins are a function of the [[concentration]], the duration of exposure, and the subject's sensitivities. The concentrations experienced in a normal home, office, or school are often too low to trigger a health response in occupants.

In the 1990s, public concern over mycotoxins increased following multimillion-dollar [[mold health issues|toxic mold]] settlements. The lawsuits took place after a study by the [[Centers for Disease Control and Prevention|Center for Disease Control]] (CDC) in [[Cleveland, Ohio]], reported an association between mycotoxins from ''Stachybotrys'' spores and pulmonary hemorrhage in infants. However, in 2000, based on internal and external reviews of their data, the CDC concluded that because of flaws in their methods, the association was not proven. ''Stachybotrys'' spores in animal studies have been shown to cause lung hemorrhaging, but only at very high concentrations.<ref>{{cite journal |title=Update: Pulmonary hemorrhage/hemosiderosis among infants – Cleveland, Ohio, 1993–1996 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=49 |issue=9 |pages=180–4 |year=2000 |pmid=11795499 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4909a3.htm |author1= Centers for Disease Control and Prevention (CDC)}}</ref>

One study by the Center of Integrative Toxicology at [[Michigan State University]] investigated the causes of Damp Building Related Illness (DBRI). They found that ''Stachybotrys'' is possibly an important contributing factor to DBRI. So far animal models indicate that airway exposure to ''S. chartarum '' can evoke allergic sensitization, inflammation, and cytotoxicity in the upper and lower respiratory tracts. Trichothecene toxicity appears to be an underlying cause of many of these adverse effects. Recent findings indicate that lower doses (studies usually involve high doses) can cause these symptoms.<ref name=Pestka08/>

Some toxicologists have used the Concentration of No Toxicological Concern (CoNTC) measure to represent the airborne concentration of mycotoxins that are expected to cause no hazard to humans (exposed continuously throughout a 70–yr lifetime). The resulting data of several studies have thus far demonstrated that common exposures to airborne mycotoxins in the built indoor environment are below the CoNTC, however agricultural environments have potential to produce levels greater than the CoNTC.<ref>{{cite journal |vauthors=Hardin BD, Robbins CA, Fallah P, Kelman BJ |title=The concentration of no toxicologic concern (CoNTC) and airborne mycotoxins |journal=J. Toxicol. Environ. Health A |volume=72 |issue=9 |pages=585–98 |year=2009 |pmid=19296408 |doi=10.1080/15287390802706389 |bibcode=2009JTEHA..72..585H |s2cid=799085 }}</ref>

===In food===
Mycotoxins can appear in the food chain as a result of [[plant pathology#Fungi|fungal infection]] of [[agriculture|crop]]s, either by being eaten directly by humans or by being used as livestock feed.

In 2004 in Kenya, 125 people died and nearly 200 others required medical treatment after eating [[aflatoxin]]-contaminated maize.<ref>{{cite journal |vauthors=Lewis L, Onsongo M, Njapau H, etal |title=Aflatoxin contamination of commercial maize products during an outbreak of acute aflatoxicosis in eastern and central Kenya |journal=Environ. Health Perspect. |volume=113 |issue=12 |pages=1763–67 |year=2005 |pmid=16330360 |pmc=1314917 |doi=10.1289/ehp.7998 |url=http://ehpnet1.niehs.nih.gov/members/2005/7998/7998.html |url-status=dead |archive-url=https://archive.today/20120629132515/http://ehpnet1.niehs.nih.gov/members/2005/7998/7998.html |archive-date=2012-06-29 }}</ref>
The deaths were mainly associated with homegrown maize that had not been treated with fungicides or properly dried before storage. Due to food shortages at the time, farmers may have been harvesting maize earlier than normal to prevent thefts from their fields, so that the grain had not fully matured and was more susceptible to infection.

Spices are susceptible substrate for growth of mycotoxigenic fungi and mycotoxin production.<ref name="pmid26229535">{{cite journal |vauthors= Jeswal P, Kumar D |title= Mycobiota and Natural Incidence of Aflatoxins, Ochratoxin A, and Citrinin in Indian Spices Confirmed by LC-MS/MS |journal= International Journal of Microbiology |volume= 2015 |pages= 1–8 |year= 2015 |pmid= 26229535 |pmc= 4503550 |doi= 10.1155/2015/242486 |quote= <small>• The results of this study suggest that the spices are susceptible substrate for growth of mycotoxigenic fungi and further mycotoxin production.<br />• Red chilli, black pepper, and dry ginger are the most contaminated spices in which AFs, OTA, and CTN were present in high concentration.</small>|doi-access= free }}</ref> Red chilli, black pepper, and dry ginger were found to be the most contaminated spices.<ref name="pmid26229535"/>

Physical methods to prevent growth of mycotoxin‐producing fungi or remove toxins from contaminated food include temperature and humidity control, [[Food irradiation|irradiation]] and photodynamic treatment.<ref name=":0">{{Cite journal|last1=Liu|first1=Yue|last2=Yamdeu|first2=Joseph Hubert Galani|last3=Gong|first3=Yun Yun|last4=Orfila|first4=Caroline|title=A review of postharvest approaches to reduce fungal and mycotoxin contamination of foods|journal=Comprehensive Reviews in Food Science and Food Safety|year=2020|language=en|volume=19|issue=4|pages=1521–1560|doi=10.1111/1541-4337.12562|pmid=33337083|issn=1541-4337|doi-access=free}}</ref> Mycotoxins can also be removed chemically and biologically using antifungal/anti‐mycotoxins agents and antifungal plant [[metabolite]]s.<ref name=":0" />

===In animal food===
{{main|Mycotoxins in animal feed}}
[[Dimorphic fungi]], which include [[Blastomyces dermatitidis]] and [[Paracoccidioides brasiliensis]], are known causative agents of endemic systemic [[mycoses]].<ref>{{cite journal |last1=Kuria |first1=Joseph N. |last2=Gathogo |first2=Stephen M. |title=Concomitant fungal and Mycobacterium bovis infections in beef cattle in Kenya |journal=Onderstepoort J Vet Res |date=4 March 2013 |volume=80 |issue=1 |pages=4 pages |doi=10.4102/ojvr.v80i1.585 |pmid=23902371 |doi-access=free }}</ref>

There were outbreaks of dog food containing [[aflatoxin]] in North America in late 2005 and early 2006,<ref>{{cite web|url=http://www.news.cornell.edu/stories/Jan06/dogs.dying.ssl.html|title=Dogs keep dying: Too many owners remain unaware of toxic dog food|publisher=Cornell University Chronicle|author=Susan S. Lang|date=2006-01-06}}</ref> and again in late 2011.<ref>{{cite web |title=More Aflatoxin-Related Dog Food Recalls Revealed |url=http://www.foodsafetynews.com/2011/12/more-aflatoxin-related-dog-food-recalls-revealed/ |work=[[Food Safety News]] |date=2011-12-29 |access-date=2012-05-12}}</ref>

Mycotoxins in animal fodder, particularly [[silage]], can decrease the performance of farm animals and potentially kill them.<ref name=MiS>{{cite web |title=Mycotoxins in Silage |url=http://en.engormix.com/MA-mycotoxins/articles/mycotoxins-silage-t2796/p0.htm |date=4 November 2013 |first1=Oscar |last1=Queiroz |first2=Maria |last2=Rabaglino |first3=Adegbola |last3=Adesogan}}</ref><ref name="auto"/> Several mycotoxins reduce milk yield when ingested by [[dairy cattle]].<ref name=MiS/>

===In dietary supplements===
Contamination of medicinal plants with mycotoxins can contribute to adverse human health problems and therefore represents a special hazard.<ref name="pmid24594211">{{cite journal |vauthors= Ashiq S, Hussain M, Ahmad B |title= Natural occurrence of mycotoxins in medicinal plants: a review |journal= Fungal Genetics and Biology |volume= 66 |pages= 1–10 |year= 2014 |pmid= 24594211 |doi= 10.1016/j.fgb.2014.02.005 |quote= <small>The increase in use of medicinal plants may lead to an increase in the intake of mycotoxins therefore contamination of medicinal plants with mycotoxins can contribute to adverse human health problems and therefore represents a special hazard. Numerous natural occurrences of mycotoxins in medicinal plants and traditional herbal medicines have been reported from various countries including Spain, China, Germany, India, Turkey and from Middle East as well.</small>}}<!--This is a review article--></ref><ref name="pmid26473926">{{cite journal |vauthors= Do KH, An TJ, Oh SK, Moon Y |title= Nation-Based Occurrence and Endogenous Biological Reduction of Mycotoxins in Medicinal Herbs and Spices |journal= Toxins |volume= 7 |issue= 10 |pages= 4111–30 |year= 2015 |pmid= 26473926 |pmc= 4626724 |doi= 10.3390/toxins7104111 |quote= <small>However, inevitable contaminants, including mycotoxins, in medicinal herbs and spices can cause serious problems for humans in spite of their health benefits.</small>|doi-access= free }}<!--This is a review article--></ref> Numerous natural occurrences of mycotoxins in medicinal plants and herbal medicines have been reported<ref>{{Cite journal |last1=Song |first1=Xinjie |last2=Wang |first2=Danhua |last3=Kim |first3=Myunghee |date=2021-04-16 |title=Development of an immuno-electrochemical glass carbon electrode sensor based on graphene oxide/gold nanocomposite and antibody for the detection of patulin |journal=Food Chemistry |language=en |volume=342 |pages=128257 |doi=10.1016/j.foodchem.2020.128257 |pmid=33051098 |s2cid=222352001 |issn=0308-8146|doi-access=free }}</ref><ref>{{Cite journal |last1=Regal |first1=Patricia |last2=Díaz-Bao |first2=Mónica |last3=Barreiro |first3=Rocío |last4=Fente |first4=Cristina |last5=Cepeda |first5=Alberto |date=2017-03-24 |title=Design of a Molecularly Imprinted Stir-Bar for Isolation of Patulin in Apple and LC-MS/MS Detection |journal=Separations |language=en |volume=4 |issue=2 |pages=11 |doi=10.3390/separations4020011 |issn=2297-8739|doi-access=free |hdl=10347/22495 |hdl-access=free }}</ref> from various countries including Spain, China, Germany, India, Turkey and from the Middle East.<ref name="pmid24594211"/> In a 2015 analysis of plant-based dietary supplements, the highest mycotoxin concentrations were found in [[milk thistle]]-based supplements, at up to 37&nbsp;mg/kg.<ref name="pmid26168136">{{cite journal |vauthors= Veprikova Z, Zachariasova M, Dzuman Z, Zachariasova A, Fenclova M, Slavikova P, Vaclavikova M, Mastovska K, Hengst D, Hajslova J |title= Mycotoxins in Plant-Based Dietary Supplements: Hidden Health Risk for Consumers |journal= Journal of Agricultural and Food Chemistry |volume= 63 |issue= 29 |pages= 6633–43 |year= 2015 |pmid= 26168136 |doi= 10.1021/acs.jafc.5b02105 |bibcode= 2015JAFC...63.6633V |quote= <small>The highest mycotoxin concentrations were found in milk thistle-based supplements (up to 37 mg/kg in the sum).</small>}}</ref>