The role of aflatoxins and hepatitis viruses in the etiopathogenesis of hepatocellular carcinoma: A basis for primary prevention in Guinea-Conakry, West Africa
The role of aflatoxins and hepatitis viruses in the etiopathogenesis of hepatocellular carcinoma: A basis for primary prevention in Guinea-Conakry, West Africa
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DOI：
10.1046/j.1440-1746.17.s4.7.x
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发表时间：
2002-12-01
影响因子：
4.1
通讯作者：
Wild, CP
中科院分区：
文献类型：
--
作者：
Turner, PC;Sylla, A;Wild, CP
黄曲霉毒素和B型肝炎病毒（HBV）是东南亚和非洲肝细胞癌（HCC）的主要危险因素，这是世界上这种癌症最流行的地区。接触这两种因素是地方性的，发生在生命的早期。流行病学研究和动物模型都有证据表明，这两种因素可以协同作用，增加HCC的风险，但相互作用的潜在细胞和分子机制尚未确定。在HBV转基因小鼠中的研究表明，慢性肝损伤改变了致癌物代谢酶的表达，从而调节了黄曲霉毒素与DNA的结合水平。在世界肝癌高发地区，肝癌的一级预防应主要集中在提供安全、有效的乙肝疫苗上。然而，在慢性HBV感染流行的地区，降低高水平黄曲霉毒素暴露的措施也将显著有助于降低HCC的发病率。在西非几内亚-科纳克里，对乙型肝炎病毒感染和黄曲霉毒素接触情况的调查为实施社区干预研究建立了基线数据。本研究将评估的有效性，提高收获后的加工和储存的花生作物，黄曲霉毒素的主要来源，使用黄曲霉毒素-白蛋白加合物作为结果的测量。(C)2002 Blackwell Publishing Asia Pty Ltd.
Aflatoxins and hepatitis B virus (HBV) are major risk factors for hepatocellular carcinoma (HCC) in South-east Asia and Africa, parts of the world where this cancer is most prevalent. Exposure to both factors is endemic, occurring from early in life. There is evidence from both epidemiological studies and animal models that the two factors can act synergistically to increase the risk of HCC, but the underlying cellular and molecular mechanisms of interaction are as yet undefined. One possiblity suggested by studies in HBV transgenic mice is that chronic liver injury alters the expression of carcinogen metabolizing enzymes, thus modulating the level of binding of aflatoxin to DNA. Primary prevention of HCC in high incidence areas of the world should primarily be focused on provision of the safe, effective vaccine against HBV. However, measures to reduce the high levels of aflatoxin exposure, where chronic HBV infection is currently epidemic, would also significantly contribute to reducing HCC incidence. In Guinea-Conakry, West Africa, surveys of HBV infection and aflatoxin exposure have established baseline data for the implementation of a community-based intervention study. This study will evaluate the effectiveness of improving the post-harvest processing and storage of the groundnut crop, a major source of aflatoxins, using aflatoxin-albumin adducts as the outcome measurement. (C) 2002 Blackwell Publishing Asia Pty Ltd.