Aflatoxins cardiotoxicity and ways to mitigation in humans

Background and Aims: Mitochondrion-toxic agents are numerous and include pharmaceuticals, illicit drugs, exotoxins, and food ingredients. Among these, mycotoxins from Aspergillus Flavus play an important role. Several aflatoxins have been described, with B1, B2, G1, and G2 aflatoxins being the most significant ones. Cardiotoxicity can be prevented by antioxidant like selenium and lycopene, and by methylprednisolone in vitro, and in animal experiments, but no therapy is available in humans. Clay-based adsorbents like Bentonite have been proposed for use as a new drug for removing mycotoxins from contaminated liquids via adsorption of aflatoxins B1 in the gastrointestinal tract, which is available in U.S.A. by FDA, but not in E.U. The aim of this study is to assess the safety-efficacy of Bentonite clay in cardiotoxicity induced by mycotoxins in animal and humans. Methods: Here, we evaluated the safety-efficacy of Bentonite clay using the FDA-AERS database over 16 months of observations. Results: We found 8 case reports of adverse drug reactions (A.D.R.) as a concomitant drug C; among these, 2 cases of young-adult male patients of black origin, with cardiovascular arrhythmias that did not recover after drug suspension. The low number of case reports found in the 16 months of observation period suggest that Bentonite clay is not extensively used as detoxicant. In addition, the mycotoxin-induced cardiotoxicity cannot be reversed. Conclusions: Novel adsorbent drugs acting as a multi-mycotoxin binder are needed as feed additives to overcome the cardiotoxicity induced by mycotoxins in animal and humans.