Modified Mycotoxins in Food: Current Evidence, Key Uncertainties, and Priorities for Risk Assessment.

Modified mycotoxins represent a significant yet underappreciated challenge in food safety assessment. Unlike their parent compounds, modified mycotoxins arise from plant, fungal, animal, microbial, or processing-induced transformations. Their toxicological relevance depends on factors such as bioavailability, reconversion to parent toxins, and intrinsic biological activity. To critically assess the current evidence and establish priorities for risk assessment, we systematically reviewed original research articles published from 2015 to 2025 using the four core steps of risk assessment: hazard identification, hazard characterization, exposure assessment, and risk characterization. In total, 151 studies were analyzed through evidence mapping, keyword network analysis, and topic modeling. The literature is dominated by research on deoxynivalenol and zearalenone derivatives, while other toxin classes-especially those related to diacetoxyscirpenol and nivalenol-remain underexplored. Occurrence and analytical detection are generally better characterized than internal exposure, compound-specific potency, or quantitative risk characterization. The evidence suggests that excluding modified forms may underestimate mycotoxin risks in certain foods, but significant uncertainties remain regarding bioavailability, reconversion, relative potency, and the application of parent-equivalent approaches. Although research has advanced toward more mechanistic and exposure-driven methodologies, evidence integration remains insufficient for routine risk assessment. This review identifies critical data gaps and proposes a practical framework to prioritize modified mycotoxins in future food safety management and regulatory decision-making.