Georgios I Papakonstantinou, Christos Eliopoulos, Dimitrios Arapoglou, Nikolaos Tsekouras, Katerina Manolakou, Labrini V Athanasiou, Dimitrios Gougoulis, Soultanidis Aris, Vasileios G Papatsiros
Mycotoxin contamination of cereal-based pig feeds is a persistent threat to swine health and global pork safety. Pigs are uniquely susceptible to mycotoxicosis, and the principal toxins-aflatoxins (AFs), deoxynivalenol (DON), zearalenone (ZEN), fumonisins (FUMs), and ochratoxin A (OTA)-cause impaired growth, reproductive failure, hepato- and nephrotoxicity, immunosuppression, and carry-over residues in edible tissue. Anti-mycotoxin feed additives, including mineral adsorbents, biotransforming agents, and multicomponent mycotoxin-detoxifying agents (MMDAs) combining clays, phytogenic antioxidants (curcumin, silymarin), and postbiotics (yeast cell wall, hydrolyzed yeast), constitute the primary mitigation strategy. Beyond animal health, these agents play underappreciated roles in both the circular economy (CE)-enabling safe valorization of by-product feed ingredients and reducing feed waste-and in the life cycle assessment (LCA) sustainability profile of pork production, where feed conversion ratio (FCR) drives 22-95% of greenhouse gas emissions. Field-based in vivo studies in sows and weaned piglets, integrating plasma oxidative stress biomarkers (TBARS, protein carbonyls, total antioxidant capacity) with performance and reproductive endpoints, provide the most comprehensive real-world evidence for MMDA efficacy to date. This review synthesizes mycotoxin toxicology, anti-mycotoxin agent mechanisms, clinical evidence, and the CE/LCA sustainability framework, proposing integrated mycotoxin management as a One Health imperative in modern swine production.