{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:30:38Z","timestamp":1787585438281,"version":"build-2736575974"},"reference-count":145,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Aflatoxin B1 (AFB1) is a potent foodborne mycotoxin classified as a Group 1 human carcinogen by the International Agency for Research on Cancer (IARC) and is widely recognized for its causal role in hepatocellular carcinoma (HCC). Beyond its well-established hepatotoxicity, increasing evidence indicates that AFB1 also disrupts intestinal homeostasis by impairing epithelial barrier integrity, reducing mucus production, altering gut microbial composition, and disturbing microbial metabolism. These changes promote increased intestinal permeability, facilitating the translocation of bacteria and microbial products and contributing to chronic inflammation through the gut\u2013liver axis. Recent experimental studies further suggest that alterations in short-chain fatty acid (SCFA) production and microbiota-dependent signaling pathways may actively mediate AFB1-induced intestinal and hepatic injury. Although direct evidence linking AFB1-induced dysbiosis to extrahepatic carcinogenesis remains limited, growing evidence indicates that persistent barrier dysfunction, microbial imbalance, and chronic inflammation may create a microenvironment favorable for tumor initiation and progression in tissues beyond the liver. This review critically summarizes current evidence regarding the effects of AFB1 on intestinal barrier function, gut microbiota dysbiosis, bacterial translocation, microbial metabolites, and the gut\u2013liver axis while evaluating the mechanistic evidence supporting these interactions and highlighting the major knowledge gaps that should be addressed in future research.<\/jats:p>","DOI":"10.3390\/toxins18090361","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:49:34Z","timestamp":1787582974000},"page":"361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aflatoxin B1, Gut Microbiota Dysbiosis, and the Intestinal Barrier: Implications for the Gut\u2013Liver Axis and Extrahepatic Cancer Risk"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0976-5127","authenticated-orcid":false,"given":"Charbel","family":"Sleilaty","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn","family":"Hnein","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5360-5691","authenticated-orcid":false,"given":"Teddy","family":"Lattouf","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9451-3390","authenticated-orcid":false,"given":"Thea","family":"Gemayel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fouad","family":"Attieh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tia","family":"Kreidy","sequence":"additional","affiliation":[{"name":"Laboratory of Cancerology and Carcinogenic Agents, Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6227-1074","authenticated-orcid":false,"given":"Kevin","family":"Sarkis","sequence":"additional","affiliation":[{"name":"Laboratory of Cancerology and Carcinogenic Agents, Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May","family":"Bark","sequence":"additional","affiliation":[{"name":"Laboratory of Cancerology and Carcinogenic Agents, Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7392-4835","authenticated-orcid":false,"given":"Maha","family":"Hoteit","sequence":"additional","affiliation":[{"name":"PHENOL Research Program, Faculty of Public Health, Section 1, Lebanese University, Beirut P.O. Box 6573, Lebanon"},{"name":"Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia 2417, Cyprus"},{"name":"Institut National de Sant\u00e9 Publique, d\u2019\u00c9pid\u00e9miologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5582-2923","authenticated-orcid":false,"given":"Alain","family":"Chebly","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"},{"name":"Center Jacques Loiselet for Medical Genetics and Genomics (CGGM), Faculty of Medicine, Saint Joseph University, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan","family":"Ghosn","sequence":"additional","affiliation":[{"name":"Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut 166830, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1687-1989","authenticated-orcid":false,"given":"Andr\u00e9","family":"El Khoury","sequence":"additional","affiliation":[{"name":"Center for Analysis and Research, Research Unit on Agro-Food Technologies and Valorization, Faculty of Sciences, Saint Joseph University of Beirut, Mar Roukos, Dekwaneh, Beirut P.O. Box 1514, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad","family":"Ch\u00e9mali","sequence":"additional","affiliation":[{"name":"Laboratory of Cancerology and Carcinogenic Agents, Faculty of Medicine, Saint Joseph University of Beirut, Beirut P.O. Box 17-5208, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"ref_1","first-page":"104","article-title":"Metabolic Changes of Aflatoxin B1 to Become an Active Carcinogen and the Control of This Toxin","volume":"11","year":"2015","journal-title":"Immunome Res."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cha\u0142a\u015bkiewicz, K., K\u0119pka-Borkowska, K., Starzy\u0144ski, R.R., Og\u0142uszka, M., Borkowski, M., Po\u0142awska, E., Lepczy\u0144ski, A., Lichwiarska, E., Sultana, S., and Kalra, G. (2025). Impact of Aflatoxins on the Digestive, Immune, and Nervous Systems: The Role of Microbiota and Probiotics in Toxicity Protection. Int. J. Mol. 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