@phdthesis{01JWV526CZ4TMHX8SFB8V199ER,
  abstract     = {{The presence of mycotoxins in food and feed is a critical global concern, impacting both human and animal health. These toxic secondary metabolites, produced by molds as a defense mechanism against harsh environmental conditions, are notoriously difficult to eliminate. Despite their relatively low molecular weight, the diversity and prevalence of mycotoxins represent a significant challenge to food safety. The intricate interplay between drugs and the human body is a critical factor in clinical outcomes. While the primary goal of pharmacotherapy is to achieve therapeutic benefit, the efficacy and safety of drugs can be significantly influenced by various external factors. Drugs can also influence other compounds, such as food contaminants, in the body. A deep understanding of how these interactions can have an influence on the pharmacokinetics of both drugs and food contaminants is essential for optimizing treatment regimens and ensuring patient safety. 
This PhD dissertation delves into the complex interactions between mycotoxins and drugs, particularly focusing on the role of cytochrome P450 (CYP450) enzymes – a family of enzymes crucial in drug metabolism. The interactions that occur when drugs and mycotoxins are metabolized by the same CYP450 enzymes can lead to significant changes in drug efficacy and toxicity. These interactions are of particular concern in clinical practice, as they can result in either diminished therapeutic effects or heightened toxicity. In regions where mycotoxin exposure is prevalent, such as low- and middle-income countries, the potential for mycotoxin-drug interactions poses a significant health concern. Our region of interest was Sub-Saharan Africa (SSA) and a focus was put on aflatoxin B1 (AFB1), an abundant and carcinogenic mycotoxin, and on efavirenz (EFV), a drug used in human immunodeficiency virus (HIV) therapies. Furthermore, physiologically based pharmacokinetic (PBPK) modeling was used to predict the impact of AFB1 on drug pharmacokinetics and vice versa, offering a method to study interactions that would be challenging to investigate in vivo due to ethical constraints. This PhD dissertation has put a magnifying glass on mycotoxin-drug interactions, particularly in regions where exposure to both is common. The ultimate goal is to inform clinical practice by providing guidelines for the concomitant use of drugs and mycotoxin-contaminated foods, thereby enhancing patient safety and therapeutic outcomes.}},
  author       = {{Lootens, Orphélie}},
  language     = {{eng}},
  pages        = {{283}},
  publisher    = {{Ghent University. Faculty of Pharmaceutical Sciences}},
  school       = {{Ghent University}},
  title        = {{Under the magnifying glass : investigating aflatoxin B1 and efavirenz in mycotoxin-drug interactions}},
  year         = {{2025}},
}