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Objectives: Gene-environment interaction is an emerging hypothesis to expound not only the autism pathogenesis but also the increased incidence of neurodevelopmental disorders (such as autistic spectrum disorder, attention-deficit, hyperactivity disorder). Among xenobiotics, mycotoxins are worldwide contaminants of food that provoke toxicological effects, crucially resembling several symptoms associated with autism such as oxidative stress, intestinal permeability, and inflammation. Here, we focused on a group of mycotoxins to test their role in the manifestation of autism, try to explain their mechanism of action, and discuss possible preventive and therapeutic interventions. Methods: Autistic children ( n  = 52) and healthy children [ n  = 58 (31 siblings and 27 unrelated subjects)] were recruited and body fluids and clinical data collected. The diagnosis of autism was made according to DSM V criteria, then with GMDS 0-2, WPPSI, and ADOS. Ochratoxin A (OTA), gliotoxin, zearalenone, and sphingosine/sphinganine ratio were determined by LC analysis in sera and urines. Statistical analysis was performed by the Wilcoxon Rank Sum (Mann-Whitney) test and Spearman test. Results: By comparing the results of autistic patients with those of unrelated controls, a significant association was found for OTA levels in urines ( P  = 0.0002) and sera ( P  = 0.0017), and also comparing patients with siblings and unrelated controls together ( P  = 0.0081). Discussion: Our results are the first describing a possible role of OTA in the pathobiology of autism. Recalling the male prevalence of ASD (male/female = 4-5/1), it is noted that, in animal models, OTA exerts its neurotoxicity especially in males. Moreover, in vitro , OTA increases microRNA-132 that is dysregulated in autistic patients and involved in reciprocal regulation of the autism-related genes MeCP2 and PTEN. A personalized diet coupled with probiotic administration, especially OTA adsorbing Lactobacillus , could ameliorate autistic symptoms in OTA-positive patients.

Background: Autism is an increasing neurodevelopmental disease that appears by 3 years of age, has genetic and/or environmental etiology, and often shows comorbid situations, such as gastrointestinal (GI) disorders. Autism has also a striking sex-bias, not fully genetically explainable., Objective: Our goal was to explain how and in which predisposing conditions some compounds can impair neurodevelopment, why this occurs in the first years of age, and, primarily, why more in males than females., Methods: We reviewed articles regarding the genetic and environmental etiology of autism and toxins effects on animal models selected from PubMed and databases about autism and toxicology., Discussion: Our hypothesis proposes that in the first year of life, the decreasing of maternal immune protection and child immune-system immaturity create an immune vulnerability to infection diseases that, especially if treated with antibiotics, could facilitate dysbiosis and GI disorders. This condition triggers a vicious circle between immune system impairment and increasing dysbiosis that leads to leaky gut and neurochemical compounds and/or neurotoxic xenobiotics production and absorption. This alteration affects the 'gut-brain axis' communication that connects gut with central nervous system via immune system. Thus, metabolic pathways impaired in autistic children can be affected by genetic alterations or by environment-xenobiotics interference. In addition, in animal models many xenobiotics exert their neurotoxicity in a sex-dependent manner., Conclusions: We integrate fragmented and multi-disciplinary information in a unique hypothesis and first disclose a possible environmental origin for the imbalance of male:female distribution of autism, reinforcing the idea that exogenous factors are related to the recent rise of this disease.

The need to obtain a representative sample deserves particular consideration since a wrong sampling plan can greatly affect the reliability of the measured levels of mycotoxins. This can even result in legal disputes and barriers to trade. Reported here is an holistic view for an ideal sampling plan, which is based on two consecutive steps: (i) To establish 'why, where and when' sampling has to be performed by assessing the purpose, the appropriate time and the site for collecting the samples; (ii) To establish 'how' to draw samples by assessing practical ad hoc guidelines, considering that, for bulk goods in particular, mycotoxins are not at all homogeneously distributed in a lot. So far, step 1 is not yet covered by specific guidelines while for step 2, European regulations establish the procedures for the sampling of bulk and retail products potentially contaminated by mycotoxins.

In order to estimate the incidence of ochratoxin A (OA) in biological fluids, a study was carried out to determine the concentration of OA in breast milk of donor mothers in Italy. Out of 111 samples, 22 were contaminated in the range 0.1-12 micrograms/kg.

A study was undertaken to evaluate the total aflatoxin content in naturally contaminated eggs. Two pools of eggs from laying hens were collected after 2 and 7 days of treatment with aflatoxin B1 (AFB1). An HPLC method has been developed for the determination of AFB1, aflatoxin M1 (AFM1), aflatoxin B2a (AFB2a) and aflatoxicol (Ro) both in free form and after release from water-soluble conjugates. The bound form was cleaned up after acid hydrolysis of the aqueous phase. Eggs collected after 2 days of treatment revealed residues of AFB1, AFB2a and Ro in the organic phase, but none in the aqueous portion. After 7 days of treatment both AFB1 and its hydroxy derivative were found in the organic phase but the aqueous portion showed only hydroxylated metabolites accounting for 35% of the total aflatoxin content.

36 samples representative of the 1981 Italian durum wheat crop were separated by an industrial Italian milling process and the products obtained analyzed by AAS for their Pb, Cd, Cr, Cu, Zn content. The results obtained were: Pb ranging from 0.04 to 0.80 ppm, Cd from 0.02 to 1.39 ppm, Cr from 0.05 to 1.60 ppm, Cu from 1.8 to 39.7 ppm and Zn from 8.8 to 117.6 ppm. Although Cr content was relatively homogeneous, Pb, Cd, Cu and Zn distribution in the various mill products proved to be rather inhomogeneous. Maximum contamination for Pb, Cd and Cr, was appreciably lower than in previous studies.

A study was performed to determine aflatoxin residues in tissues and organs of male broilers and hens that had been fed a diet contaminated with 50 micrograms/kg aflatoxin B1 (AFB1). Residue levels of AFB1, aflatoxicol (Ro), aflatoxin M1 (AFM1) and aflatoxin B2a (AFB2a) were determined by an HPLC method and, with the exception of AFB2a, were detected in the liver, kidney and thigh of both male broilers and hens. The highest levels found were for Ro in liver (1.10 and 0.60 micrograms/kg for male broilers and hens, respectively). On the other hand no detectable amounts of aflatoxins were found in any tissue after withdrawal periods of 14 and 33 days for male broilers and laying hens respectively.

A study was performed to evaluate the contamination by ochratoxin A in coffee beans. Twenty-nine samples of green coffee were collected from large lots of material by representative sampling. The analyses of green coffee samples showed a significantly high contamination percentage (58%) ranging from 0.2 to 15 micrograms/kg. Naturally and artificially contaminated samples were roasted at different operation times (5-6 min) to verify the percentage of destruction of the mycotoxin. The percentage ranged from 48% to 87% and from 90% to 100% in artificially and naturally contaminated samples respectively. The beverages prepared from artificially contaminated coffee using the most common types of coffee makers showed no residues of ochratoxin A.