Editing Kwashiorkor (section)

=== Aflatoxins ===
Recent studies have attempted to pinpoint a relationship between kwashiorkor and high levels of [[aflatoxin]]s. Aflatoxins are naturally occurring toxins produced by the mold ''[[Aspergillus flavus]]'', a fungus found in areas with hot and humid climates.<ref name="Kumar Mahato Kamle et al 2017">{{cite journal |last1=Kumar |first1=Pradeep |last2=Mahato |first2=Dipendra K. |last3=Kamle |first3=Madhu |last4=Mohanta |first4=Tapan K. |last5=Kang |first5=Sang G. |title=Aflatoxins: A Global Concern for Food Safety, Human Health and Their Management |journal=Frontiers in Microbiology |date=17 January 2017 |volume=07 |page=2170 |doi=10.3389/fmicb.2016.02170 |pmid=28144235 |pmc=5240007 |doi-access=free }}</ref> These toxins tend to grow and can be found in agricultural crops such as millet, maize, and rice.<ref name="Kumar Mahato Kamle et al 2017"/> An analysis found that the presence of aflatoxins was found more frequently and in higher concentrations in individuals with kwashiorkor when compared to individuals with marasmus (another form of severe acute malnutrition).<ref name="Soriano Rubini Morales-Suarez-Varela et al 2020">{{cite journal |last1=Soriano |first1=Jose M. |last2=Rubini |first2=Ana |last3=Morales-Suarez-Varela |first3=María |last4=Merino-Torres |first4=Juan F. |last5=Silvestre |first5=Dolores |title=Aflatoxins in organs and biological samples from children affected by kwashiorkor, marasmus and marasmic-kwashiorkor: A scoping review |journal=Toxicon |date=October 2020 |volume=185 |pages=174–183 |doi=10.1016/j.toxicon.2020.07.010 |pmid=32693007 |bibcode=2020Txcn..185..174S |s2cid=220698925 }}</ref><ref>{{cite journal |last1=Watson |first1=Sinead |last2=Gong |first2=Yun Yun |last3=Routledge |first3=Michael |title=Interventions Targeting Child Undernutrition in Developing Countries May Be Undermined by Dietary Exposure to Aflatoxin |journal=Critical Reviews in Food Science and Nutrition |date=15 July 2015 |volume=57 |issue=9 |pages=1963–1975 |doi=10.1080/10408398.2015.1040869 |pmid=26176888 |s2cid=24089209 |url=http://eprints.whiterose.ac.uk/124824/3/Interventions%20targeting%20child%20undernutrition%20in%20developing%20countries%20may%20be%20undermined%20by%20dietary%20exposure%20to%20aflatoxin%207th%20JAN%20SW%20%282%29.pdf }}</ref> In particular, biological samples showed greater levels of aflatoxins in the brain, heart, kidney, liver, lungs, serum, stool, and urine.<ref name="Soriano Rubini Morales-Suarez-Varela et al 2020"/> Aflatoxins were not found in liver samples of individuals with marasmus.<ref name="Soriano Rubini Morales-Suarez-Varela et al 2020"/> It has been known that the liver organ is the main target of aflatoxins and chronic toxicity can result in immunosuppressive and carcinogenic effects.<ref name="Soriano Rubini Morales-Suarez-Varela et al 2020"/> However, there is currently conflicting evidence to pinpoint a connection between kwashiorkor and aflatoxins. Studies have shown that not all children with kwashiorkor present with detectable aflatoxin levels.<ref name="Pham Alou Golden et al 2021"/> It has also been proposed that damage done by aflatoxins may be due to glutathione depletion (another proposed mechanism of the disease) in children with kwashiorkor.<ref name="Pham Alou Golden et al 2021"/>