Combined toxicity of food-borne mycotoxins and heavy metals or pesticides

Food can be contaminated by multiple classes of toxic substances, mainly including mycotoxins, heavy metals and pesticides, which leads to a possibility of simultaneous exposure to two or more food contaminants for humans. Thus, it is necessary to examine whether the combined exposure could result in enhanced toxicity. Initially, the studies on the combined toxicity of food contaminants mainly focus on the mixtures of same classes of food contaminants due to their co-occurrence feature in foodstuffs, such as mixtures of mycotoxins or mixtures of heavy metals. Given the possibility that consumers are likely exposed to mixtures of different classes of food contaminants, recently, studies on the combined toxicity of different classes of food contaminants have been receiving increasing attentions. In this review article, we summarize the findings of combined toxicity studies related to co-exposure to food-borne mycotoxins and other classes of food contaminants mainly heavy metals or pesticides, and propose issues that need to be addressed in future studies for more accurately performing risk assessment of co-exposure to mycotoxins and other classes of food contaminants. • ∗Combination of mycotoxins and heavy metals/pesticides induces enhanced toxicity. • ∗The combined toxicity is influenced by dose, ratio, exposure duration and cell type. • ∗Multiple mechanisms are involved in the enhancement of combined toxicity.