Currently, there is a scarcity of data on the immunosuppressive effects of mycotoxins in humans. Future research needs to be conducted to: i) establish the association between my-cotoxin exposure in humans and modulation of various aspects of immune function; ii) determine the mode of action of the different mycotoxins and their interaction; and iii) evaluate immunomodulatory interactions between mycotoxins, nutritional factors and infectious agents, especially those that are immunosuppressive, such as HIV/AIDS.
The study by Jiang et al. (2005) was relatively small and exploratory in nature. The results suggest that additional larger investigations are needed on the association between aflatoxin levels and immune status/function. Thus, large randomized follow-up studies to assess the association between aflatoxin levels, immune status, susceptibility to infectious diseases and failure to produce an effective immune response to vaccines need to be conducted. The availability of appropriate biomarkers for aflatoxin makes these studies possible. However, appropriate biomarkers also need to be developed for many other mycotox-ins. Molecular and advanced immunologic methods used in recent mycotoxin research, mostly in animal and in in vitro studies, now need to be applied in human studies.
The proportion of, and secretion of major cytokines by, subsets of lymphocytes, macrophages or other leukocytes can be determined by using immunoassays and more advanced flow cytometric methods such as five color staining. Specific mechanisms of immunomodulation and synergistic effects of commonly occurring mycotoxins also need to be investigated. A major area for investigation is the immunomodulatory interactions between mycotoxins and infectious agents that are immunosuppressive, e.g., HIV, and between mycotoxins and immune modulators, e.g., nutritional factors. The dietary interactions in immunosuppression by aflatoxin are not known, but a less than fully functioning immune system due to mycotox-in suppression certainly could enable many secondary disease conditions.
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