Citrinin

Citrinin Molecular Structure

Citrinin Tech Sheet for Practitioners is included in CME Course Materials.

Citrinin Facts for Patients

Citrinin is associated with poorly stored grains, but can be present in water-damaged buildings. It’s often found along with Ochratoxin, another kidney toxic mycotoxin.

It has a very broad spectrum of negative impacts on the body, but the kidneys take the biggest hit. Both the kidneys and liver are involved in its detoxification, so treatments are targeted toward supplying Citrinin-specific protection for these organs.

Chief among its other negative impacts is mitochondrial dysfunction, with symptoms showing up most prominently in organ systems under high demand, such as the heart, digestion, and reproduction.

Citrinin can also impede fertility and prevent successful pregnancy.

Mold Sources

Aspergillus ochraseus, Aspergillus niger, Penicillium verrucosum, Penicillium nordicum, and Penicillium chrysogenum
Color – arious species of mold can take on any color, even “black mold” color
Favorite building material – flooring, carpet, ceiling tiles, heating ducts

Aspergillus niger, A. awentil, A. ostianus, A. fumigatus, A. niveus, A.awamori and A. parasiticus, Penicillium citrinum, P. expansum, Monascus
Color – typically lemon-yellow, but can change color depending on substrate
Favorite building material – wallpaper, wood, drywall, linoleum, insulation paper

Signs

LABS ~ reduced or lowering GFR (glomerlular filtration rate)

Symptoms

Fatigue, commonly with muscle pain
Reactive blood sugar
Urinary pain, frequent urination, nephrogenic diabetes insipidus
Edema
Reflux, nausea, vomiting, diarrhea
Ulcers, blood in stool
Food sensitivities
Chemical sensitivities
Short of breath
Heart palpitations, chest pain
Menstrual changes, miscarriage
Infertility in both genders

Things That Help My Patients

Therapeutic Diet ~
  Grain-free
  Radishes, as well as vegetables/fruits in the orange-red color band for pelargonidin
(Citrinin-specific Nrf2-restorative liver protection)*
  Butyrate-rich foods – butter, cabbage, radicchio, white part of spring onion, broccoli, Brussels sprouts
  2 Tbsp ground organic seeds as an insoluble fiber binder and to nourish reproductive organs
  Green tea – particularly if skeletal muscle fatigue (Citrinin-specific effect)*

Glutathione or glutathione inducers if not tolerated – ALA, NAC, Selenium

Alpha-lipoic acid as the R-Lipoic acid isomer

Resveratrol

Grape seed extract

Vitamin E as Tocotrienols

Melatonin

Homeopathic Vasopressin

CoQ10

REFERENCES

Huang YL, Pan WL, Cai WW, Ju JQ, Sun SC. Exposure to citrinin induces DNA damage, autophagy, and mitochondria dysfunction during first cleavage of mouse embryos. Environ Toxicol. 2021 Nov;36(11):2217-2224. doi: 10.1002/tox.23335. Epub 2021 Jul 27. PMID: 34314561.

Zhang H, Ahima J, Yang Q, Zhao L, Zhang X, Zheng X. A review on citrinin: Its occurrence, risk implications, analytical techniques, biosynthesis, physiochemical properties and control. Food Res Int. 2021 Mar;141:110075. doi: 10.1016/j.foodres.2020.110075. Epub 2020 Dec 31. PMID: 33641962.

Maroli N, Jayakrishnan A, Ramalingam Manoharan R, Kolandaivel P, Krishna K. Combined Inhibitory Effects of Citrinin, Ochratoxin-A, and T-2 Toxin on Aquaporin-2. J Phys Chem B. 2019 Jul 11;123(27):5755-5768. doi: 10.1021/acs.jpcb.9b03829. Epub 2019 Jun 27. PMID: 31204482.

de Oliveira Filho JWG, Islam MT, Ali ES, Uddin SJ, Santos JVO, de Alencar MVOB, Júnior ALG, Paz MFCJ, de Brito MDRM, E Sousa JMC, Shaw S, de Medeiros MDGF, Dantas SMMM, Rolim HML, Ferreira PMP, Kamal MA, Pieczynska MD, Das N, Gupta VK, Mocan A, Dos Santos Andrade TJA, Singh BN, Mishra SK, Atanasov AG, Melo-Cavalcante AAC. A comprehensive review on biological properties of citrinin. Food Chem Toxicol. 2017 Dec;110:130-141. doi: 10.1016/j.fct.2017.10.002. Epub 2017 Oct 7. PMID: 28993214.

Salah A, Bouaziz C, Prola A, Pires Da Silva J, Bacha H, Abid-Essefi S, Lemaire C. Citrinin induces apoptosis in human HCT116 colon cancer cells through endoplasmic reticulum stress. J Toxicol Environ Health A. 2017;80(23-24):1230-1241. doi: 10.1080/15287394.2017.1359127. PMID: 29165056.

Chen CC, Chan WH. Inhibition of citrinin-induced apoptotic biochemical signaling in human hepatoma G2 cells by resveratrol. Int J Mol Sci. 2009 Jul 29;10(8):3338-57. doi: 10.3390/ijms10083338. PMID: 20111678; PMCID: PMC2812821.

Sharath Babu GR, Ilaiyaraja N, Khanum F, Anand T. Cytoprotective propensity of green tea polyphenols against citrinin-induced skeletal-myotube damage in C2C12 cells. Cytotechnology. 2017 Aug;69(4):681-697. doi: 10.1007/s10616-017-0077-4. Epub 2017 May 23. PMID: 28536872; PMCID: PMC5507847.

Wu Y, Zhang N, Li YH, Zhao L, Yang M, Jin Y, Xu YN, Guo H. Citrinin exposure affects oocyte maturation and embryo development by inducing oxidative stress-mediated apoptosis. Oncotarget. 2017 May 23;8(21):34525-34533. doi: 10.18632/oncotarget.15776. PMID: 28404941; PMCID: PMC5470988.

Gayathri L, Dhivya R, Dhanasekaran D, Periasamy VS, Alshatwi AA, Akbarsha MA. Hepatotoxic effect of ochratoxin A and citrinin, alone and in combination, and protective effect of vitamin E: In vitro study in HepG2 cell. Food Chem Toxicol. 2015 Sep;83:151-63. doi: 10.1016/j.fct.2015.06.009. Epub 2015 Jun 23. PMID: 26111808.

Suh SH, Lee KE, Kim IJ, Kim O, Kim CS, Choi JS, Choi HI, Bae EH, Ma SK, Lee JU, Kim SW. Alpha-lipoic acid attenuates lipopolysaccharide-induced kidney injury. Clin Exp Nephrol. 2015 Feb;19(1):82-91. doi: 10.1007/s10157-014-0960-7. Epub 2014 Mar 19. PMID: 24643788.

Devi P, Naik CG, Rodrigues C. Biotransformation of citrinin to decarboxycitrinin using an organic solvent-tolerant marine bacterium, Moraxella sp. MB1. Mar Biotechnol (NY). 2006 Mar-Apr;8(2):129-38. doi: 10.1007/s10126-005-5021-5. Epub 2006 Feb 14. PMID: 16467989.

Tuomi T, Reijula K, Johnsson T, Hemminki K, Hintikka EL, Lindroos O, Kalso S, Koukila-Kähkölä P, Mussalo-Rauhamaa H, Haahtela T. Mycotoxins in crude building materials from water-damaged buildings. Appl Environ Microbiol. 2000 May;66(5):1899-904. doi: 10.1128/AEM.66.5.1899-1904.2000. PMID: 10788357; PMCID: PMC101430.

Bilgrami KS, Jeswal P. Control of citrinin caused nephrotoxicosis through aqueous leaf extract of Vitis vinifera L., mercurious corrossivus and cortisone. Indian J Exp Biol. 1993 May;31(5):482-4. PMID: 8359859.