Mycotoxins and bone growth: a review of the literature on associations between xenobiotic exposure and bone growth and development.

This article focuses on the associations between mycotoxins—secondary fungal metabolites including aflatoxins, ochratoxins, trichothecenes (such as deoxynivalenol and T-2 toxin), fumonisins, and zearalenone—and linear growth faltering, particularly through their impacts on long-bone development during critical growth periods. It reviews biological mechanisms from animal and human studies showing that mycotoxins can impair bone growth by damaging intestinal integrity, disrupting nutrient absorption, inducing inflammation, and directly affecting chondrocytes and bone remodeling processes. Epidemiological evidence, primarily from low- and middle-income countries, indicates consistent albeit modest negative associations between mycotoxin exposure and child growth outcomes such as stunting. The article highlights the need for longitudinal studies incorporating bone growth biomarkers alongside anthropometric measures to better understand the cumulative and synergistic effects of mycotoxins on skeletal development and to inform public health interventions.