Ochratoxin A (OTA) is a para-chlorophenolic mycotoxin produced by strains of Aspergillus and Penicillium that is widely found as a contaminant of improperly stored food products. The toxin is a potent renal carcinogen in rats, especially male, and has an implicated role in the etiology of Balkan endemic nephropathy and its associated urinary tract tumours. Although the mechanism of OTA-mediated tumour formation is not fully understood, and represents a hotly debated topic, bioactivation and subsequent DNA adduction through covalent attachment of electrophilic OTA species remains a viable mechanism for OTA-mediated carcinogenesis. In this paper we outline the established chemistry for the bioactivation of chlorophenol carcinogens and demonstrate how this chemistry relates to the bioactivation of OTA. From this basis it is predicted that OTA will form a benzoquinone electrophile following activation by cytochrome P450 enzymes and radical species following activation by enzymes with peroxidase activities. These electrophiles react preferentially with deoxyguanosine (dG) to form benzetheno adducts and C8- dG adducts, respectively. Analysis of OTA-mediated DNA adduction using the 32P-postlabelling method correlates with OTA chemistry and adduct spots derived from the quinone electrophile are generated following activation by cytochrome P450, while a C8-OTA adduct is formed following activation of OTA by peroxidase enzymes. These same adduct spots are also produced in animal (rat and pig) and human tumoral kidney tissue. This model for OTAmediated carcinogenesis is consistent with established structure-activity relationships for covalent attachment of OTA analogues and OTA toxicity. The model also provides a rationale for the synergistic effect observed for OTA in the presence of the mycotoxin citrinin and for the sexual differences observed in rat carcinogenesis where the male is particularly susceptible to OTA-mediated tumour formation.
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Anonymous, 2006. Italian charged after toxic Canadian wheat seized. CBC News: 6 January 2006. Available at: http://www.cbc.ca/story/ world/national/2006/01/11/italy-wheat060111.html. http://www.cbc.ca/story/ world/national/2006/01/11/italy-wheat060111.html
Atanasova, S.Y., von Ahsen, N., Toncheva, D., Dimitrov, T.G., Oellerich, M. and Armstrong, V.W., 2005. Genetic polymorphisms of cytochrome P450 among patients with Balkan endemic nephropathy (BEN). Clinical Biochemistry 38: 223-228.
'Genetic polymorphisms of cytochrome P450 among patients with Balkan endemic nephropathy (BEN) ' () 38 Clinical Biochemistry : 223 -228 .
Bayman, P. and Baker, J.L., 2006. Ochratoxins: A global perspective. Mycopathologia 162: 215-223.
'Ochratoxins: A global perspective ' () 162 Mycopathologia : 215 -223 .
Boorman, G. (ed.), 1988. NTP Technical Report on the Toxicology and Carcinogenesis Studies of Ochratoxin A. NTP Report 358; NIH Publication 88-2813. Research Triangle Park, NC, National Toxicology Program.
Canadas, D., 2006. Evaluation du procédé Oxygreen pour son potentiel de décontamination du blé: les effets toxique lié à une exposition subchronique à l'OTA sont-ils atténués? PhD thesis, Institut National Polytechnique Toulouse, France.
Castegnaro, M., Mohr, U., Pfohl-Leszkowicz, A., Esteve, J., Steinmann, J., Tillmann, T., Michelon, J. and Bartsch, H., 1998. Sex-and strain-specific induction of renal tumors by ochratoxin A in rats correlates with DNA adduction. The International Journal of Cancer 77: 70-75.
'Sex-and strain-specific induction of renal tumors by ochratoxin A in rats correlates with DNA adduction ' () 77 The International Journal of Cancer : 70 -75 .
Creppy, E.E., Kane, A., Dirheimer, G., Lafarge-Frayssinet, C., Mousset, S. and Frayssinet, C., 1985. Genotoxicity of ochratoxin A in mice: DNA single-strand break evaluation in spleen, liver and kidney. Toxicology Letters 28: 29-35.
'Genotoxicity of ochratoxin A in mice: DNA single-strand break evaluation in spleen, liver and kidney ' () 28 Toxicology Letters : 29 -35 .
Dai, J., Sloat, A.L., Wright, M.W. and Manderville, R.A., 2005. Role of phenoxyl radicals in DNA adduction by chlorophenol xenobiotics following peroxidase activation. Chemical Research in Toxicology 18: 771-779.
Dai, J., Wright, M.W. and Manderville, R.A., 2003a. An oxygen-bonded C8-deoxyguanosine nucleoside adduct of pentachlorophenol by peroxidase activation: evidence for ambident C8 reactivity by phenoxyl radicals. Chemical Research in Toxicology 16: 817-821.
Dai, J., Wright, M.W. and Manderville, R.A., 2003b. Ochratoxin A forms a carbon-bonded C8-deoxyguanosine nucleoside adduct: implications for C8 reactivity by a phenolic radical. Journal of the American Chemical Society 125: 3716-3717.
'Ochratoxin A forms a carbon-bonded C8-deoxyguanosine nucleoside adduct: implications for C8 reactivity by a phenolic radical ' () 125 Journal of the American Chemical Society : 3716 -3717 .
Delatour, T., Mally, A. Richoz, J. Özden, S. Dekant, W. Ihmels, H. Otto, D. Gasparutto, D. Marin-Kuan, M. Schilter B. and Cavin, C. 2008. Absence of 2'-deoxyguanosine-carbon 8-bound ochratoxin A adduct in rat kidney DNA monitored by isotope dilution LCMS/ MS. Molecular Nutrition & Food Research 52: 472-482.
European Food Safety Agency (EFSA), 2006. Opinion of the scientific panel on contaminants in the food chain on a request from the commission related to ochratoxin A in food. The EFSA Journal 365: 1-56.
El Adlouni, C., Pinelli, E., Azémar, B., Zaoui, D., Beaune P. and Pfohl-Leszkowicz, A., 2000. Role of CYP 2C and microsomal glutathione-S-transferase in modulating susceptibility to ochratoxin A genotoxicity. Environmental and Molecular Mutagenesis 35: 123-131.
'Role of CYP 2C and microsomal glutathione-S-transferase in modulating susceptibility to ochratoxin A genotoxicity ' () 35 Environmental and Molecular Mutagenesis : 123 -131 .
Faucet, V., Pfohl-Leszkowicz, A., Dai, J., Castegnaro, M. and Manderville, R.A., 2004. Evidence for covalent DNA adduction by ochratoxin A following chronic exposure to rat and subacute exposure to pig. Chemical Research in Toxicology 17: 1289-1296.
Faucet-Marquis, V., Pont, F., Størmer, F., Rizk, T., Castegnaro, M. and Pfohl-Leszkowicz, A., 2006. Evidence of a new dechlorinated OTA derivative formed in opossum kidney cell cultures after pretreatment by modulators of glutathione pathways. Correlation with DNA adducts formation. Molecular Nutrition & Food Research 50: 531-542.
Favaro, A. and Challands, S., 2006. Mycotoxins found in Canadian cereals: study. CTVNews 28 September 2006. Available at: http:// www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060928/ mycotoxins_health_060928/. http:// www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060928/ mycotoxins_health_060928/
Gautier, J.-C., Holzhaeuser, D., Markovic, J., Gremaud, E., Schilter, B. and Turesky, R.J., 2001. Oxidative damage and stress response from ochratoxin A exposure in rats. Free Radical Biology and Medicine 30: 1089-1098.
'Oxidative damage and stress response from ochratoxin A exposure in rats ' () 30 Free Radical Biology and Medicine : 1089 -1098 .
Gillman, I.G., Clark, T.N. and Manderville, R.A., 1999. Oxidation of ochratoxin A by an Fe-porphyrin system: model for enzymatic activation and DNA cleavage. Chemical Research in Toxicology 12: 1066-1076.
Goldman, R., Claycamp, G.H., Sweetland, M.A., Sedlov, A.V., Tyurin, V.A., Kisin, E.R., Tyurina, Y.Y., Ritov, V.B., Wenger, S.L., Grant, S.G. and Kagan, V., 1999. Myeloperoxidase-catalyzed redox-cycling of phenol promotes lipid peroxidation and thiol oxidation in HL-60 cells. Free Radical Biology and Medicine 27: 1050-1063.
'Myeloperoxidase-catalyzed redox-cycling of phenol promotes lipid peroxidation and thiol oxidation in HL-60 cells ' () 27 Free Radical Biology and Medicine : 1050 -1063 .
Gustafsson, J.A., A. Mode, G. Norstedt and P. Skett, 1983. Sex steroid induced changes in hepatic enzymes. Annual Review of Physiology 45: 51-60.
'Sex steroid induced changes in hepatic enzymes ' () 45 Annual Review of Physiology : 51 -60 .
Hoehler, D., Marquardt, R.R., McIntosh, A.R. and Hatch, G., 1997. Induction of free radicals in hepatocytes, mitochondria and microsomes of rats by ochratoxin A and its analogues. Biochimica et Biophysica Acta 1357: 225-233.
'Induction of free radicals in hepatocytes, mitochondria and microsomes of rats by ochratoxin A and its analogues ' () 1357 Biochimica et Biophysica Acta : 225 -233 .
Hult, K., Plestina, R., Habazin-Novak, V., Radic, B. and Ceovic, S., 1982. Ochratoxin A in human blood and Balkan Endemic Nephropathy. Archives of Toxicology 51: 313-321.
'Ochratoxin A in human blood and Balkan Endemic Nephropathy ' () 51 Archives of Toxicology : 313 -321 .
International Agency for Research on Cancer (IARC), 1993. Monographs on the evaluation of carcinogenic risks to humans. Some naturally occurring substances: food items and constituents, heterocyclic aromatic amines and mycotoxins. Vol. 56, Ochratoxin A. International Agency for Research on Cancer, Lyon, France, pp. 489-521.
Kamataki T., Maeda, K., Yamazoe, Y., Nagai, T. and Kato, R., 1983. Sex difference of cytochrome P-450 in the rat: purification, characterization, and quantitation of constitutive forms of cytochrome-P450 from liver microsomes of male and female rats. Archives of Biochemistry and Biophysics 225: 758-777.
'Sex difference of cytochrome P-450 in the rat: purification, characterization, and quantitation of constitutive forms of cytochrome-P450 from liver microsomes of male and female rats ' () 225 Archives of Biochemistry and Biophysics : 758 -777 .
Kamp, H.G., Eisenbrand, G., Schlatter, J., Würth, K. and Janzowski, C., 2005a. Ochratoxin A: Induction of (oxidative) DNA damage, cytotoxicity and apoptosis in mammalian cell lines and primary cells. Toxicology 206: 413-425.
'Ochratoxin A: Induction of (oxidative) DNA damage, cytotoxicity and apoptosis in mammalian cell lines and primary cells ' () 206 Toxicology : 413 -425 .
Kamp, H.G., Eisenbrand, G., Janzowski, C., Kiossev, J., Latendresse, J.R., Schlatter, J. and Turesky, R.J., 2005b. Ochratoxin A induces oxidative DNA damage in liver and kidney after oral dosing to rats. Molecular Nutrition & Food Research 49: 1160-1167.
Krogh, P., 1976. Epidemiology of mycotoxin porcine nephropathy. Nordisk Veterinaermedicin 28: 452-458.
'Epidemiology of mycotoxin porcine nephropathy ' () 28 Nordisk Veterinaermedicin : 452 -458 .
Kuiper-Goodman, T. and Scott, P.M., 1989. Risk assessment of the mycotoxin ochratoxin A. Biomedical and Environmental Sciences 2: 179-248.
'Risk assessment of the mycotoxin ochratoxin A ' () 2 Biomedical and Environmental Sciences : 179 -248 .
Kumar, R., Vodicka, P., Peltonen, K. and Hemminki, K., 1997. 32PPostlabelling analysis of isomeric 7-alkylguanine adducts of styrene oxide. Carcinogenesis 18: 407-414.
'32PPostlabelling analysis of isomeric 7-alkylguanine adducts of styrene oxide ' () 18 Carcinogenesis : 407 -414 .
Mally, A., Zepnik, H., Wanek, P., Eder, E., Dingley, K., Ihmels, H., Völkel, W. and Dekant, W., 2004. Ochratoxin A: lack of formation of covalent DNA adducts. Chemical Research in Toxicology 17: 234-242.
Manderville, R.A., 2005a. Ambident reactivity of phenoxyl radicals in DNA adduction. Canadian Journal of Chemistry 83: 1261-1267.
'Ambident reactivity of phenoxyl radicals in DNA adduction ' () 83 Canadian Journal of Chemistry : 1261 -1267 .
Manderville, R.A., 2005b. A case for the genotoxicity of ochratoxin A by bioactivation and covalent DNA adduction. Chemical Research in Toxicology 18: 1091-1097.
Molinié, A., Faucet, V., Castegnaro, M. and Pfohl-Leszkowicz, A., 2005. Analysis of some breakfast cereals collected on the French market for their content in ochratoxin A, citrinin and fumonisin B1. Development of a new method for simultaneous extractions of ochratoxin A and citrinin. Food Chemistry 92: 391-400.
'Analysis of some breakfast cereals collected on the French market for their content in ochratoxin A, citrinin and fumonisin B1 ' () 92 Development of a new method for simultaneous extractions of ochratoxin A and citrinin. Food Chemistry : 391 -400 .
National Cancer Institute of Canada, 2004. Canadian Cancer Statistics 2004. Toronto, Canada.
Nguyen, T.N., Bertagnolli, A.B., Villalta, P.W., Bühlmann, P. and Sturla, S.J., 2005. Characterization of a deoxyguanosine adduct of tetrachlorobenzoquinone: dichlorobenzoquinone-1,N2-etheno-2'-deoxyguanosine. Chemical Research in Toxicology 18: 1770-1776.
Nikolov, I.G., Petkova-Bocharova, D., Castegnaro, M., Pfohl-Leskowicz, A., Gill, C., Day, N. and Chernozemsky, I.N., 1996. Molecular and epidemiological approaches to the etiology of urinary tract tumors in an area with Balkan endemic nephropathy. Journal of Environmental Pathology, Toxicology and Oncology 15: 201-207.
'Molecular and epidemiological approaches to the etiology of urinary tract tumors in an area with Balkan endemic nephropathy ' () 15 Journal of Environmental Pathology, Toxicology and Oncology : 201 -207 .
O'Brien, E. and Dietrich, D.R., 2005. Ochratoxin A: The continuing enigma. Critical Reviews in Toxicology 35: 33-60.
'Ochratoxin A: The continuing enigma ' () 35 Critical Reviews in Toxicology : 33 -60 .
Odell, E.W., Brown, A. and Mantle, P.G., 2007. DNA ploidy distribution in renal tumours induced in male rats by dietary ochratoxin A. Experimental and Toxicologic Pathology 59: 85-95.
'DNA ploidy distribution in renal tumours induced in male rats by dietary ochratoxin A ' () 59 Experimental and Toxicologic Pathology : 85 -95 .
Omar, R.F., Rahimtula, A.D. and Bartsch, H., 1991. Role of cytochrome P450 in ochratoxin A-stimulated lipid peroxidation. Journal of Biochemical and Molecular Toxicology 3: 203-209.
'Role of cytochrome P450 in ochratoxin A-stimulated lipid peroxidation ' () 3 Journal of Biochemical and Molecular Toxicology : 203 -209 .
Palma, N., Serena, C., Sapora, O., Wilson, S.H. and Dogliotti, E., 2007. Ochratoxin A-induced mutagenesis in mammalian cells is consistent with the production of oxidative stress. Chemical Research in Toxicology 20: 1031-1037.
Pfohl-Leszkowicz, A., Tozlovanu, M., Manderville, R.A., Peraica, M., Castegnaro, M. and Stefanovic, V., 2007. New molecular and field evidences for the implication of mycotoxins but not aristolochic acid in human nephropathy and urinary tract tumor. Molecular Nutrition & Food Research 51: 1131-1146.
Pfohl-Leszkowicz, A. and Manderville, R.A., 2007. Ochratoxin A: An overview on toxicity and carcinogenicity in animals and humans. Molecular Nutrition & Food Research 51: 61-99.
Pfohl-Leszkowicz, A. and Castegnaro, M., 2005. Further arguments in favour of direct covalent binding of ochratoxin A (OTA) after metabolic biotransformation. Food Additives and Contaminants, Suppl. 1: 75-87.
'Further arguments in favour of direct covalent binding of ochratoxin A (OTA) after metabolic biotransformation ' () 1 Food Additives and Contaminants, Suppl. : 75 -87 .
Pfohl-Leszkowicz, A., Pinelli, E., Bartsch, H., Mohr, U. and Castegnaro, M., 1998. Sex-and strain-specific expression of CYPs involved in ochratoxin A genotoxicity and carcinogenicity in rats. Molecular Carcinogenesis 23: 78-85.
'Sex-and strain-specific expression of CYPs involved in ochratoxin A genotoxicity and carcinogenicity in rats ' () 23 Molecular Carcinogenesis : 78 -85 .
Pfohl-Leszkowicz, A., Grosse, Y., Kane, A., Gharbi, A., Baudrimont, I., Obrecht, S., Creppy, E.E. and Dirheimer, G., 1993. Is the oxidative pathway implicated in the genotoxicity of ochratoxin A? In: Creppy, E.E., Castegnaro, M. and Dirheimer, G. (eds.), Human Ochratoxicosis and its Pathologies. John Libbey Eurotext INSERM 231, pp. 177-187.
'Is the oxidative pathway implicated in the genotoxicity of ochratoxin A? ', in Human Ochratoxicosis and its Pathologies. John Libbey Eurotext INSERM 231 , () 177 -187 .
Pfohl-Leszkowicz, A., Chakor, K., Creppy, E.E. and Dirheimer, G., 1991. DNA adduct formation in mice treated with ochratoxin A. In: Castegnaro M., Plestina, R., Dirheimer, G., Chernozemsky, I.N. and Bartsch, H. (eds.), Mycotoxin, endemic nephropathy and urinary tract tumors. IARC Scientific publications no 115, Lyon International Agency for Research on Cancer, pp 245-253.
Pfohl-Leszkowicz, A., Molinié, A. and Castegnaro, M., 2004. Presence of ochratoxin a, citrinin and fumonisin b1 in breakfast cereals collected in French market. Comparison of OTA analysis using or not immunoaffinity clean-up before HPLC. The Revista Mexicana de Micologia 19: 7-15.
'Presence of ochratoxin a, citrinin and fumonisin b1 in breakfast cereals collected in French market ' () 19 Comparison of OTA analysis using or not immunoaffinity clean-up before HPLC. The Revista Mexicana de Micologia : 7 -15 .
Pfohl-Leszkowicz, A., Petkova-Bocharova, T., Chernozemsky, I.N. and Castegnaro, M., 2002.) Balkan endemic nephropathy and the associated urinary tract tumours: review on etiological causes, potential role of mycotoxins. Food Additives and Contaminants 19: 282-302.
'Balkan endemic nephropathy and the associated urinary tract tumours: review on etiological causes, potential role of mycotoxins ' () 19 Food Additives and Contaminants : 282 -302 .
Schwartz, G.G., 2002. Hypothesis: Does ochratoxin A cause testicular cancer? Cancer Causes and Control 13: 91-100.
'Hypothesis: Does ochratoxin A cause testicular cancer ' () 13 Cancer Causes and Control : 91 -100 .
Schwartz, G.G., Marquis, V.F., Gennings-Gee, J., Miller, M., Manderville, R., Pfohl-Leszkowicz, A., 2007. Prenatal exposure to Ochratoxin A cases DNA adducts in the testes of newborn mice. Scandinavian Journal of Urology and Nephrology, Suppl., 217-220.
'Prenatal exposure to Ochratoxin A cases DNA adducts in the testes of newborn mice ' () Suppl. Scandinavian Journal of Urology and Nephrology : 217 -220 .
Scott, P.M., Kanhere, S.R., Lau, B.P., Lewis, D.A., Hayward, S., Ryan, J.J. and Kuiper-Goodman, T., 1998. Survey of Canadian human blood plasma for ochratoxin A. Food Additives and Contaminants 5: 555-562.
'Survey of Canadian human blood plasma for ochratoxin A ' () 5 Food Additives and Contaminants : 555 -562 .
Stander, M.A., Steyn, P.S., van der Westhuizen, F.H. and Payne, B.E., 2001. A kinetic study into the hydrolysis of the ochratoxins and analogues by carboxypeptidase A. Chemical Research in Toxicology 14: 302-304.
Stefanovic, V., Toncheva, D., Atanasova, S. and Polenakovic, M., 2006. Etiology of Balkan Endemic Nephropathy and associated urothelial cancer. American Journal of Nephrology 26: 1-11.
'Etiology of Balkan Endemic Nephropathy and associated urothelial cancer ' () 26 American Journal of Nephrology : 1 -11 .
Tozlovanu, M., Faucet-Marquis, V., Pfohl-Leszkowicz, A. and Manderville, R.A., 2006. Genotoxicity of the hydroquinone metabolite of ochratoxin A: Structure-activity relationships for covalent DNA adduction. Chemical Research in Toxicology 19: 1241-1247.
Turesky, R.J., 2005. Perspective: Ochratoxin A is not a genotoxic carcinogen. Chemical Research in Toxicology 18: 1082-1090.
Vaidyanathan, V.G., Villalta, P.W. and Sturla, S.J., 2007. Nucleobasedependent reactivity of a quinone metabolite of pentachlorophenol. Chemical Research in Toxicology 20: 913-919.
Van der Merwe, K.J., Steyn, P.S., Fourie, L., Scott D.B. and Theron, J.J., 1965. Ochratoxin A, a toxic metabolite produced by Aspergillus ochraceus Wilh. Nature 205: 1112-1113.
'Ochratoxin A, a toxic metabolite produced by Aspergillus ochraceus Wilh ' () 205 Nature : 1112 -1113 .
Waidyanatha, S., Lin, P.H. and Rappaport, S.M., 1996. Characterization of chlorinated adducts of hemoglobin and albumin following administration of pentachlorophenol to rats. Chemical Research in Toxicology 9: 647-653.
World Health Organisation (WHO), 2002. JECFA Report from 56th Meeting: Evaluation of Certain Mycotoxins in Food, WFO Technical Report Series 906, WHO, Geneva, Switzerland.
Xiao, H., Marquard, R.R., Frohlich, A.A. and Ling, Y.Z., 1995. Synthesis and structural elucidation of analoues of ochratoxin A. Journal of Agricultural and Food Chemistry 43: 524-530.
'Synthesis and structural elucidation of analoues of ochratoxin A ' () 43 Journal of Agricultural and Food Chemistry : 524 -530 .
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Ochratoxin A (OTA) is a para-chlorophenolic mycotoxin produced by strains of Aspergillus and Penicillium that is widely found as a contaminant of improperly stored food products. The toxin is a potent renal carcinogen in rats, especially male, and has an implicated role in the etiology of Balkan endemic nephropathy and its associated urinary tract tumours. Although the mechanism of OTA-mediated tumour formation is not fully understood, and represents a hotly debated topic, bioactivation and subsequent DNA adduction through covalent attachment of electrophilic OTA species remains a viable mechanism for OTA-mediated carcinogenesis. In this paper we outline the established chemistry for the bioactivation of chlorophenol carcinogens and demonstrate how this chemistry relates to the bioactivation of OTA. From this basis it is predicted that OTA will form a benzoquinone electrophile following activation by cytochrome P450 enzymes and radical species following activation by enzymes with peroxidase activities. These electrophiles react preferentially with deoxyguanosine (dG) to form benzetheno adducts and C8- dG adducts, respectively. Analysis of OTA-mediated DNA adduction using the 32P-postlabelling method correlates with OTA chemistry and adduct spots derived from the quinone electrophile are generated following activation by cytochrome P450, while a C8-OTA adduct is formed following activation of OTA by peroxidase enzymes. These same adduct spots are also produced in animal (rat and pig) and human tumoral kidney tissue. This model for OTAmediated carcinogenesis is consistent with established structure-activity relationships for covalent attachment of OTA analogues and OTA toxicity. The model also provides a rationale for the synergistic effect observed for OTA in the presence of the mycotoxin citrinin and for the sexual differences observed in rat carcinogenesis where the male is particularly susceptible to OTA-mediated tumour formation.
| All Time | Past 365 days | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 305 | 100 | 14 |
| Full Text Views | 68 | 11 | 1 |
| PDF Views & Downloads | 18 | 3 | 0 |