Microbiome–mycotoxin interactions and probiotic strategies: implications for gut health and cancer

This structured, hypothesis-driven narrative review examines how mycotoxins, pervasive food contaminants, disrupt intestinal microbial balance, epithelial barrier integrity, xenobiotic metabolism, and carcinogenic signaling. Emerging evidence indicates that bidirectional interactions between the gut microbiome and mycotoxins modulate these effects, with microbial detoxification enzymes influencing toxin metabolism, immune responses, and epithelial resilience. However, the mechanistic understanding of microbiome–mycotoxin interplay remains incomplete, particularly regarding enzymatic pathways, microbial metabolites, and cancer-associated signaling. This review synthesizes recent (2016–2025) mechanistic studies on gut microbiota–mediated mycotoxin biotransformation, enzymatic detoxification, and probiotic interventions as strategies to mitigate mycotoxin-induced gut and cancer-related damage, focusing on key dietary toxins such as aflatoxin B₁, deoxynivalenol, zearalenone, ochratoxin A, fumonisins, and patulin. Evidence indicates that microbial enzymes, including de-epoxidases, lactonases, and reductases, contribute to mycotoxin biotransformation, while probiotics can enhance epithelial barrier function, restore microbial ecosystem balance, and modulate immune responses through toxin binding, competitive exclusion, and anti-inflammatory actions. The review further highlights the strain-specific nature of detoxification, the impact of mycotoxin-induced dysbiosis on short-chain fatty acid production and inflammation, and the modulation of cancer-related pathways including NF-κB, STAT3, and IL-6. Finally, it provides an integrated framework linking microbial mechanisms, bioactive microorganisms, and regulatory considerations, identifies critical knowledge gaps, and outlines mechanistically informed probiotic strategies for mitigating mycotoxin exposure and its associated health risks.