Emerging mycotoxins and preventive strategies related to gut microbiota changes: probiotics, prebiotics, and postbiotics - a systematic review

Recent research has focused on the involvement of the gut microbiota in various diseases, where probiotics, prebiotics, synbiotics, and postbiotics (PPSP) exert beneficial effects through modulation of the microbiome. This systematic review aims to provide insight into the interplay among emerging mycotoxins, gut microbiota, and PPSP. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In this review, unregulated yet highly recurrent mycotoxins are classified as emerging mycotoxins. The most frequently observed mycotoxins included those from the Fusarium genus-enniatins (n = 11) and beauvericin (n = 11)-and the Alternaria genus-alternariol monomethyl ether, altertoxin, and tentoxin (n = 10). Among probiotics, the most studied genera were Lactobacillus, Bifidobacterium, and the yeast Saccharomyces cerevisiae. Inulin and cellulose were the most found prebiotics. Data on synbiotics and postbiotics are scarce. Studies have shown that both the gut microbiota and PPSP can detoxify and mitigate the harmful effects of emerging mycotoxins. PPSP not only reduced mycotoxin bioaccessibility, but also counteracted their detrimental effects by activating health-promoting pathways such as short-chain fatty acid production, genoprotection, and reduction of oxidative stress. However, both quantitative and qualitative data remain limited, indicating a need for further in vivo and long-term studies. The formulation of PPSP as functional foods, feeds, or nutraceuticals should be considered a preventive strategy against the toxicity of emerging mycotoxins, for which, there is no established regulatory framework. Recent studies highlight the role of gut microbiota in diseases, showing that probiotics, prebiotics, synbiotics, and postbiotics (PPSP) offer health benefits by modulating the microbiome, potentially contributing to improved disease outcomes and overall well-being.