Abstract
Alternaria mycotoxins are emerging contaminants frequently detected in food products and threaten human health. This systematic review aims to provide an up-to-date overview of scientific data and knowledge and gaps therein of natural occurrence, toxicological effects, dietary exposure, and prevention and control management of Alternaria mycotoxins in food and feed. A systematic review has been performed, using the databases Scopus and PubMed, retrieving relevant scientific papers published in English from 2011 to 2024. Alternaria mycotoxins are widely present in various food and feed products, with tomatoes and cereals being the most contaminated products. From the Alternaria mycotoxins, tenuazonic acid (TeA) and alternariol were reported with the highest detection rate and concentrations. Identified toxicological effects vary between the different Alternaria mycotoxins and include carcinogenicity, immune toxicity, cytotoxicity, and genotoxicity. Dietary exposure assessments for Alternaria mycotoxins have been conducted in several countries but vary in their scope. The calculations and risk values suggest that exposure of children to TeA via their diet is close to their tolerable daily intake. A similar finding has been reported for exposure of adults to alternariol and alternariol monomethyl ether via food consumption. Most Alternaria mycotoxins are heat-stable and cannot easily be removed during food processing; therefore, prevention and control measures for Alternaria mycotoxin contamination in food and feed are crucial. Fungicide and biocontrol applications have been shown effective in reducing Alternaria fungal growth and toxin production, and the development of predictive models may be promising. Collectively, they can contribute to mitigating the impact of Alternaria mycotoxins on human health.