Dietary exposure to mycotoxins and their pharmacological and toxicological consequences: a systematic review

Abstract

Mycotoxins are toxic compounds that some filamentous fungi produce and that can contaminate foods such as cereals, nuts, oilseeds, dried fruits, and processed plant products. People can ingest these toxins regularly without realizing it because contaminated food may look, smell, and taste normal. This systematic review and meta-analysis evaluated how dietary mycotoxin exposure affects human health, focusing on aflatoxins, ochratoxin A, fumonisins, trichothecenes, zearalenone, and patulin. It examined their main dietary sources, how the body absorbs and processes them, their biological targets, and their toxic effects. The evidence shows that mycotoxins can damage several body systems. The severity of the effects depends on the specific toxin, dose, duration of exposure, and individual susceptibility. Aflatoxins showed the strongest links to liver injury, DNA damage, and hepatocellular carcinoma. Ochratoxin A mainly affected the kidneys, while fumonisins were associated with liver damage and developmental toxicity. Trichothecenes primarily caused gastrointestinal, immune, and blood-related problems. Zearalenone acted like estrogen and affected reproductive health. Patulin mainly caused gastrointestinal and systemic toxicity. For example, a person who regularly eats food contaminated with aflatoxin may develop liver damage over time and face a higher risk of liver cancer, even if the food shows no visible mold. Similarly, repeated exposure to ochratoxin A may gradually impair kidney function. Eating foods contaminated with several mycotoxins at the same time makes the risk harder to predict because the toxins may interact and increase or alter each other's effects. Overall, dietary exposure to mycotoxins remains a significant food-safety and public-health problem.