Combined toxic effects of mycotoxins

It is known for many years that several food items, derived from plants infected by fungi in the field during growing of the plant or during harvest and storage of the food item, can contain concomitantly different mycotoxins. As these combined mycotoxins occur simultaneously in the food item, consumption of the food will lead to a combined intake depending on the absorption rates of the different mycotoxins. Therefore, the question is justified whether such a combined intake of mycotoxins would lead to a possible higher risk for adverse health effects than the intake of one of these mycotoxins alone. It will be dealt with on the basis of some practical cases of such combined intake of mycotoxins of which research data are available. This is the case for citrinin and ochratoxin A, but as the workshop focuses on trichotecenes and so this paper concentrates on these. When the mycotoxins are of similar structure and of the same species, or of the same families, it is likely to expect that the mode of action of the mycotoxins and or the toxicity profiles will be quite similar. This indicates that such related mycotoxins are likely to exert only additive effects, which is important to know. In terms of risk assessment, these mycotoxins could be dealt with by establishing a group daily tolerable intake (TDI) or a provisional tolerable weekly intake (PTWI). In terms of risk assessment those mycotoxins which interact in synergistic manner are of more concern. It is concluded that, at present tools are not fully developed to establish the type of interaction or whether there is any interaction at all.