Enniatin Mycotoxins in Food: A Systematic Review of Global Occurrence, Biosynthesis, and Toxicological Impacts on In Vitro Human Cell Models

Enniatins (ENNs) are emerging mycotoxins mainly produced by Fusarium species. They frequently contaminate cereals and cereal-based products. Despite their widespread occurrence, these mycotoxins are not yet regulated, but concerns about their potential health effects due to dietary exposure exist. The most prevalent and well-characterized are ENN A, A1, B, and B1. Their ionophoric nature enables them to disrupt cellular ion homeostasis, leading to potent cytotoxic effects. This review is structured into three major sections. First, we provide a comprehensive meta-analysis based on ENNs occurrence in 6916 food samples collected worldwide, between 2004 and 2024, including cereals, products derived from cereals, other products, and baby food and discuss mycotoxin mitigation. Second, we indicate known ENN-producing Fusarium species and performed a gene sequence analysis suggesting that a dedicated biosynthetic gene cluster exists. Finally, we provide an in-depth overview of ENNs toxicity, ranging from cytotoxicity studies to mechanistic insights into their cellular effects. By consolidating current knowledge, this review highlights critical gaps in ENN research and emphasizes the need for further investigations to better understand their health impacts in a regulatory framework.