Evaluating Weight of Evidence in the Mystery of Balkan Endemic Nephropathy
Identifieur interne : 004A10 ( Main/Exploration ); précédent : 004A09; suivant : 004A11Evaluating Weight of Evidence in the Mystery of Balkan Endemic Nephropathy
Auteurs : Travis Bui-Klimke [États-Unis] ; Felicia Wu [États-Unis]Source :
- Risk Analysis [ 0272-4332 ] ; 2014-09.
Descripteurs français
- KwdFr :
- MESH :
- épidémiologie : Néphropathie endémique des Balkans.
- Humains, Médecine factuelle.
English descriptors
- KwdEn :
- MESH :
- epidemiology : Balkan Nephropathy.
- Evidence-Based Medicine, Humans.
Abstract
Balkan endemic nephropathy (BEN) is a chronic, progressive wasting disease of the kidneys, endemic in certain rural regions of the Balkan nations Croatia, Serbia, Bulgaria, and Romania. It is irreversible and ultimately fatal. Though this disease was first described in the 1950s, its causes have been a mystery and a source of much academic and clinical contention. Possible etiologic agents that have been explored include exposure to metals and metalloids, viruses and bacteria, and the dietary toxins aristolochic acid (AA) and ochratoxin A (OTA). AA is a toxin produced by weeds of the genus Aristolochia, common in Balkan wheat fields. Aristolochia seeds may intermingle with harvested grains and thus inadvertently enter human diets. OTA is a mycotoxin (fungal toxin) common in many foods, including cereal grains. In this study, we analyzed the weight of evidence for each of the suspected causes of BEN using the Bradford Hill criteria (BHC): nine conditions that determine weight of evidence for a causal relationship between an agent and a disease. Each agent postulated to cause BEN was evaluated using the nine criteria, and for each criterion was given a rating based on the strength of the association between exposure to the substance and BEN. From the overall available scientific evidence for each of these suspected risk factors, AA is the agent with the greatest weight of evidence in causing BEN. We describe other methods for testing causality from epidemiological studies, which support this conclusion of AA causing BEN.
Url:
DOI: 10.1111/risa.12239
Affiliations:
- États-Unis
- Michigan, Pennsylvanie
- East Lansing, Pittsburgh
- Université d'État du Michigan, Université de Pittsburgh
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xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Food Science and Human Nutrition, Michigan State University, MI, 48824, East Lansing</wicri:regionArea><orgName type="university">Université d'État du Michigan</orgName><placeName><settlement type="city">East Lansing</settlement><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Risk Analysis</title><title level="j" type="alt">RISK ANALYSIS</title><idno type="ISSN">0272-4332</idno><idno type="eISSN">1539-6924</idno><imprint><biblScope unit="vol">34</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1688">1688</biblScope><biblScope unit="page" to="1705">1705</biblScope><biblScope unit="page-count">18</biblScope><date type="published" when="2014-09">2014-09</date></imprint><idno 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(BEN) is a chronic, progressive wasting disease of the kidneys, endemic in certain rural regions of the Balkan nations Croatia, Serbia, Bulgaria, and Romania. It is irreversible and ultimately fatal. Though this disease was first described in the 1950s, its causes have been a mystery and a source of much academic and clinical contention. Possible etiologic agents that have been explored include exposure to metals and metalloids, viruses and bacteria, and the dietary toxins aristolochic acid (AA) and ochratoxin A (OTA). AA is a toxin produced by weeds of the genus Aristolochia, common in Balkan wheat fields. Aristolochia seeds may intermingle with harvested grains and thus inadvertently enter human diets. OTA is a mycotoxin (fungal toxin) common in many foods, including cereal grains. In this study, we analyzed the weight of evidence for each of the suspected causes of BEN using the Bradford Hill criteria (BHC): nine conditions that determine weight of evidence for a causal relationship between an agent and a disease. Each agent postulated to cause BEN was evaluated using the nine criteria, and for each criterion was given a rating based on the strength of the association between exposure to the substance and BEN. From the overall available scientific evidence for each of these suspected risk factors, AA is the agent with the greatest weight of evidence in causing BEN. We describe other methods for testing causality from epidemiological studies, which support this conclusion of AA causing BEN.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li><li>Pennsylvanie</li></region><settlement><li>East Lansing</li><li>Pittsburgh</li></settlement><orgName><li>Université d'État du Michigan</li><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Bui Limke, Travis" sort="Bui Limke, Travis" uniqKey="Bui Limke T" first="Travis" last="Bui-Klimke">Travis Bui-Klimke</name></region><name sortKey="Wu, Felicia" sort="Wu, Felicia" uniqKey="Wu F" first="Felicia" last="Wu">Felicia Wu</name><name sortKey="Wu, Felicia" sort="Wu, Felicia" uniqKey="Wu F" first="Felicia" last="Wu">Felicia Wu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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