1
|
Su H, Jiang ZH, Hsu YW, Wang YC, Chen YY, Wu DC, Shiea J, Lee CW. Rapid identification of mushroom toxins by direct electrospray probe mass spectrometry for emergency care. Anal Chim Acta 2024; 1296:342343. [PMID: 38401934 DOI: 10.1016/j.aca.2024.342343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/22/2023] [Accepted: 02/04/2024] [Indexed: 02/26/2024]
Abstract
Mushroom poisoning occurs frequently after the ingestion of toxic wild mushrooms misidentified as edible species. The goal of this study is to develop a mass spectrometric platform to bypass the need for morphological recognition of poisonous mushrooms by experts and rapidly identify the toxins in the mushrooms for emergency care. Trace mushroom toxins were collected by penetrating and removing the mushrooms surface for 3 mm with a direct electrospray probe (DEP). The analytes on the DEP were then dissolved in the solution (70% isopropanol containing 0.1% acetic acid) flowing out of a solvent reservoir on the DEP. Electrospray ionization was induced from the sample solution as a high electric field was generated between the DEP and MS inlet. The obtaining mass spectrometric results were further analyzed with principal component analysis (PCA) to classify mushroom toxins. The mass spectrometric platform for detecting mushroom toxins was assessed for its sensitivity, precision, and efficiency by determining its limit-of-detection (LOD), repeatability, and turnaround time, respectively. As a result, the LODs of the mushroom toxins in pure methanol and spiked in human vomitus by DEP/MS were within 0.001-0.5 ng/μL and 0.01-1 ng/μL, respectively. Linear responses of the mushroom toxins in pure methanol with concentrations between 0.01 and 5 ng/μL (R2 between 0.9922 and 0.998) were obtained. The repeatability of the approach (n = 10) was shown in the low relative standard deviation value (<15%) from ten repeat analysis of mushroom toxins standard solution. The corresponding toxic compounds were identified through matching of the obtained mass spectrometric data with those provided by its companion database library of mushroom toxins. Since no time-consuming pretreatment of the samples is required, identification of mushroom toxins with DEP/MS was complete within 1 min. This will be helpful for the emergency physicians to make correct clinical judgment and prescribe appropriate medical treatment in a timely manner.
Collapse
Affiliation(s)
- Hung Su
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Zong-Han Jiang
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yi-Wen Hsu
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yu-Chi Wang
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yun-Yi Chen
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Deng-Chyang Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan; Rapid Screening Research Center for Toxicology and Biomedicine, National Sun Yat-Sen University, Kaohsiung, Taiwan; Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan; Rapid Screening Research Center for Toxicology and Biomedicine, National Sun Yat-Sen University, Kaohsiung, Taiwan.
| |
Collapse
|
2
|
Benvenuti M, Zotti M, La Maestra S. A guide to mycetisms: A toxicological and preventive overview. Med Mycol 2024; 62:myae033. [PMID: 38569657 DOI: 10.1093/mmy/myae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/05/2024] Open
Abstract
Fungi are often considered a delicacy and are primarily cultivated and harvested, although numerous species are responsible for intoxication due to toxin content. Foodborne diseases are a significant public health concern, causing approximately 420 000 deaths and 600 million morbidities yearly, of which mushroom poisoning is one of the leading causes. Epidemiological data on non-cultivated mushroom poisoning in individual countries are often unrepresentative, as intoxication rarely requires emergency intervention. On the other hand, the lack of specialist knowledge among medical personnel about the toxicological manifestations of mushroom consumption may result in ineffective therapeutic interventions. This work aims to provide an easy-to-consult and wide-ranging tool useful for better understanding the variability of mushroom intoxications, the associated symptoms, and the main treatments for the most severe cases, given the absence of a complete species mapping tool toxic. Moreover, we establish an effective collection network that describes the incidence of mushroom poisonings by reporting the species and associated toxicological manifestations for each case. In conclusion, we highlight the need to establish appropriate primary prevention interventions, such as training the affected population and increasing consultancy relationships between mycological experts and specialised healthcare personnel.
Collapse
Affiliation(s)
- Mirko Benvenuti
- Department of Health Sciences (DISSAL), University of Genoa, Via A. Pastore 1, 16132 Genova, Italy
| | - Mirca Zotti
- Department of Earth, Environmental and Life Sciences (DISTAV), University of Genoa, C.so Europa 26, 16132 Genova, Genova, Italy
| | - Sebastiano La Maestra
- Department of Health Sciences (DISSAL), University of Genoa, Via A. Pastore 1, 16132 Genova, Italy
| |
Collapse
|
3
|
Visser M, Hof WFJ, Broek AM, van Hoek A, de Jong JJ, Touw DJ, Dekkers BGJ. Unexpected Amanita phalloides-Induced Hematotoxicity-Results from a Retrospective Study. Toxins (Basel) 2024; 16:67. [PMID: 38393145 PMCID: PMC10891511 DOI: 10.3390/toxins16020067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Amanita phalloides poisoning is a serious health problem with a mortality rate of 10-40%. Poisonings are characterized by severe liver and kidney toxicity. The effect of Amanita phalloides poisonings on hematological parameters has not been systematically evaluated thus far. METHODS Patients with suspected Amanita phalloides poisonings were retrospectively selected from the hospital database of the University Medical Center Groningen (UMCG). Medical data-including demographics; liver, kidney, and blood parameters; treatment; and outcomes-were collected. The severity of the poisoning was scored using the poison severity score. RESULTS Twenty-eight patients were identified who were admitted to the UMCG with suspected Amanita phalloides poisoning between 1994 and 2022. A time-dependent decrease was observed for hemoglobin and hematocrit concentrations, leukocytes, and platelets. Six out of twenty-eight patients developed acute liver failure (ALF). Patients with ALF showed a higher increase in liver enzymes, international normalized ratios, and PSS compared to patients without ALF. Conversely, hemoglobin and platelet numbers were decreased even further in these patients. Three out of six patients with ALF died and one patient received a liver transplant. CONCLUSION Our study shows that Amanita phalloides poisonings may be associated with hematotoxicity in patients. The quantification of hematological parameters is of relevance in intoxicated patients, especially in those with ALF.
Collapse
Affiliation(s)
- Miranda Visser
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands; (M.V.); (W.F.J.H.); (A.M.B.); (A.v.H.); (J.J.d.J.); (D.J.T.)
| | - Willemien F. J. Hof
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands; (M.V.); (W.F.J.H.); (A.M.B.); (A.v.H.); (J.J.d.J.); (D.J.T.)
| | - Astrid M. Broek
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands; (M.V.); (W.F.J.H.); (A.M.B.); (A.v.H.); (J.J.d.J.); (D.J.T.)
| | - Amanda van Hoek
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands; (M.V.); (W.F.J.H.); (A.M.B.); (A.v.H.); (J.J.d.J.); (D.J.T.)
| | - Joyce J. de Jong
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands; (M.V.); (W.F.J.H.); (A.M.B.); (A.v.H.); (J.J.d.J.); (D.J.T.)
| | - Daan J. Touw
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands; (M.V.); (W.F.J.H.); (A.M.B.); (A.v.H.); (J.J.d.J.); (D.J.T.)
- Department of Pharmaceutical Analysis, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Bart G. J. Dekkers
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands; (M.V.); (W.F.J.H.); (A.M.B.); (A.v.H.); (J.J.d.J.); (D.J.T.)
| |
Collapse
|
4
|
Maillot A, Marteau A, Lecot J, Bruneau C, Le Roux G, De Haro L, Chaumont E. Chlorophyllum molybdites poisoning on Reunion Island. Toxicon 2024; 237:107554. [PMID: 38072316 DOI: 10.1016/j.toxicon.2023.107554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
In France, mushroom picking is part of the culture. The practice is not without risk, as around 1300 people are poisoned each year by eating wild mushrooms on the French mainland. However, this practice is not part of local culture on Reunion Island, a French territory located in the Indian Ocean. Indeed, there are practically no reports of mushroom poisoning on Reunion Island. Here we describe, through a retrospective study, cases of mushroom poisoning recorded in the Indian Ocean toxicosurveillance system database from 2020 to 2021. Overall, 19 people were poisoned following wild mushroom ingestion on Reunion Island: 15 in 2020 and 4 in 2021. Six events were recorded: the majority of poisonings involved clusters (n = 5) during a shared meal (pan-fried), only one case was single mushroom poisoning by ingesting a raw mushroom. Of all patients, 15 cases presented a gastrointestinal irritant syndrome (latency between 30 min and 3 h). Chlorophyllum molybdites was positively identified by mycologists in 4 cases, suspected by emergency doctor in 1 case and in one self-declared case, Volvariella volvacea was consumed. Poisoning following ingestion of wild mushrooms does occur on Reunion Island, and Chlorophyllum molybdites is the main culprit.
Collapse
Affiliation(s)
- Adrien Maillot
- Indian Ocean Toxicovigilance Department, University Hospital, 97400 Saint-Denis, Reunion Island, France.
| | - Adrien Marteau
- Department of Emergency, University Hospital, 97410 Saint Pierre, Reunion Island, France
| | - Jérémy Lecot
- Western Poison Control Center, University Hospital, 4 rue Larrey, 49100 Angers, France
| | - Chloe Bruneau
- Western Poison Control Center, University Hospital, 4 rue Larrey, 49100 Angers, France
| | - Gael Le Roux
- Western Poison Control Center, University Hospital, 4 rue Larrey, 49100 Angers, France
| | - Luc De Haro
- Clinical Pharmacology, Poison Control Center, St Marguerite Hospital, Marseille, France
| | - Elliott Chaumont
- Department of Emergency, University Hospital, 97400 Saint Denis, Reunion Island, France
| |
Collapse
|
5
|
La Rosa L, Corrias S, Pintor I, Cosentino S. Epidemiology and clinical aspect of mushroom poisonings in South Sardinia: A 10-year retrospective analysis (2011-2021). Food Sci Nutr 2024; 12:430-438. [PMID: 38268883 PMCID: PMC10804087 DOI: 10.1002/fsn3.3793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 01/26/2024] Open
Abstract
Mushroom poisoning is a severe problem of public health, however, information about its epidemiology and management is still limited. This is the first study focused on Sardinia that investigates data about mushroom poisoning describing epidemiology, clinical presentation, seasonality, and the most common involved species. In this retrospective study, we analyzed data recovered from the database of Mycological Inspectorates during a 10-year period (2011-2021). Overall, 164 cases of mushroom poisoning have been identified, with significant peaks in autumn. The highest number of episodes of intoxication were recorded in Cagliari (64), followed by Carbonia (55) and Sanluri (45), although the annual distribution of cases among the provinces varied considerably in the study period. Thanks to the expertise of the Mycological Inspectorate service, the implicated species have been identified in 162 cases (98.78%); 81 cases were caused by toxic species, 60 by edible, and 45 by not edible species. Omphalotus olearius and Agaricus xanthodermus were the most represented toxic species (22% and 18%, respectively); Boletus aereus (18%) was the most frequent edible species, while Boletaceae were the prevalent not edible mushrooms. The data collected in South Sardinia over a period of 10-years demonstrate how a correct and rapid recognition of mushroom poisoning is important to improve the prognosis of patients, however, there are still problems of lack of knowledge, on the part of the population, on the existence of the consultancy services. Because most illnesses from poisonous mushroom ingestion are preventable, increased public awareness about the potential dangers of mushroom poisoning is mandatory.
Collapse
Affiliation(s)
- Laura La Rosa
- Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
| | - Serafina Corrias
- Department of PreventionFood Hygiene and Nutrition Service, ASL CagliariCagliariItaly
| | - Iginio Pintor
- Department of PreventionFood Hygiene and Nutrition Service, ASL CagliariCagliariItaly
| | - Sofia Cosentino
- Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
| |
Collapse
|
6
|
Chan TYC, Ng SW, Chan CK, Lee HHC, Mak TWL. Cholinergic Mushroom Poisoning With a Detection of Muscarine Toxin in Urine. J Med Cases 2023; 14:222-226. [PMID: 37435104 PMCID: PMC10332868 DOI: 10.14740/jmc4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023] Open
Abstract
We report an uncommon case of cholinergic poisoning following an ingestion of wild mushrooms. Two middle-aged patients presented to the emergency unit with acute gastrointestinal symptoms including epigastric pain, vomiting and diarrhea, followed by miosis, palpitations and diaphoresis which were compatible with a cholinergic toxidrome. The patients volunteered a history of taking two tablespoons of cooked wild mushrooms collected in a country park. Mildly elevated liver transaminase was noted in one female patient. Mushroom specimens were sent to a mycologist for identification using morphological analysis. Muscarine, a cholinergic toxin found in mushrooms such as Inocybe and Clitocybe species, was subsequently extracted from and identified in the urine specimens of both patients, using a liquid-chromatography tandem mass spectrometry method. In this report, the variable clinical presentation of cholinergic mushroom poisoning is discussed. Key issues in the management of these cases were presented. In addition to conventional mushroom identification methods, this report also highlights the use of toxicology tests on different biological and non-biological specimens for diagnosis, prognosis and surveillance purposes.
Collapse
Affiliation(s)
- Tina Yee Ching Chan
- Hospital Authority Toxicology Reference Laboratory, Princess Margaret Hospital, Kowloon, Hong Kong Special Administrative Region, China
| | - Sau Wah Ng
- Hospital Authority Toxicology Reference Laboratory, Princess Margaret Hospital, Kowloon, Hong Kong Special Administrative Region, China
| | - Chi Keung Chan
- Hong Kong Poison Information Centre, United Christian Hospital, Kowloon, Special Administrative Region, China
| | - Hencher Han Chih Lee
- Hospital Authority Toxicology Reference Laboratory, Princess Margaret Hospital, Kowloon, Hong Kong Special Administrative Region, China
| | - Tony Wing Lai Mak
- Hospital Authority Toxicology Reference Laboratory, Princess Margaret Hospital, Kowloon, Hong Kong Special Administrative Region, China
| |
Collapse
|
7
|
Liu Y, Li S, Feng Y, Zhang Y, Ouyang J, Li S, Wang J, Tan L, Zou L. Serum metabolomic analyses reveal the potential metabolic biomarkers for prediction of amatoxin poisoning. Toxicon 2023; 230:107153. [PMID: 37178797 DOI: 10.1016/j.toxicon.2023.107153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
Amatoxin poisoning leads to over 90% of deaths in mushroom poisoning. The objective of present study was to identify the potential metabolic biomarkers for early diagnosis of amatoxin poisoning. Serum samples were collected from 61 patients with amatoxin poisoning and 61 healthy controls. An untargeted metabolomics analysis was performed using the ultra-high-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry (UPLC-QTOF-MS/MS). Multivariate statistical analysis revealed that the patients with amatoxin poisoning could be clearly separated from healthy controls on the basis of their metabolic fingerprints. There were 33 differential metabolites including 15 metabolites up-regulated metabolites and 18 down-regulated metabolites in patients with amatoxin poisoning compared to healthy controls. These metabolites mainly enriched in the lipid metabolism and amino acid metabolism pathways, such as Glycerophospholipid metabolism, Sphingolipid metabolism, Phenylalanine tyrosine and typtophan biosynthesis, Tyrosine metabolism, Arginine and proline metabolism, which may serve important roles in the amatoxin poisoning. Among the differential metabolites, a total of 8 significant metabolic markers were identified for discriminating patients with amatoxin poisoning from healthy controls, including Glycochenodeoxycholate-3-sulfate (GCDCA-S), 11-Oxo-androsterone glucuronide, Neomenthol-glucuronide, Dehydroisoandrosterone 3-glucuronide, Glucose 6-phosphate (G6P), Lanthionine ketimine, Glycerophosphocholine (GPC) and Nicotinamide ribotide, which achieved satisfactory diagnostic accuracy (AUC>0.8) in both discovery and validation cohorts. Strikingly, the Pearson's correlation analysis indicated that 11-Oxo-androsterone glucuronide, G6P and GCDCA-S were positively correlated with the liver injury induced by amatoxin poisoning. The findings of the current study may provide insight into the pathological mechanism of amatoxin poisoning and screened out the reliable metabolic biomarkers to contribute the clinical early diagnosis of amatoxin poisoning.
Collapse
Affiliation(s)
- Yarong Liu
- The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410013, PR China; Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, Hunan Normal University, No. 371 Tongzipo Road, Changsha, Hunan, 410013, PR China
| | - Shumei Li
- The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410013, PR China; Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, Hunan Normal University, No. 371 Tongzipo Road, Changsha, Hunan, 410013, PR China
| | - Yang Feng
- The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410013, PR China; Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, Hunan Normal University, No. 371 Tongzipo Road, Changsha, Hunan, 410013, PR China
| | - Yiyuan Zhang
- Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China
| | - Jielin Ouyang
- The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410013, PR China; Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, Hunan Normal University, No. 371 Tongzipo Road, Changsha, Hunan, 410013, PR China
| | - Shutong Li
- The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410013, PR China; Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, Hunan Normal University, No. 371 Tongzipo Road, Changsha, Hunan, 410013, PR China
| | - Jia Wang
- Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China.
| | - Lihong Tan
- Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China.
| | - Lianhong Zou
- Institute of Clinical Translational Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, 410005, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, Hunan Normal University, No. 371 Tongzipo Road, Changsha, Hunan, 410013, PR China.
| |
Collapse
|
8
|
Lewinsohn D, Lurie Y, Gaon A, Biketova AY, Bentur Y. The epidemiology of wild mushroom poisoning in Israel. Mycologia 2023; 115:317-325. [PMID: 36927530 DOI: 10.1080/00275514.2023.2177471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Wild mushroom (macrofungi) picking has become a popular activity in Israel in recent years. Besides the estimated 135 edible species, the mycobiota of Israel includes also around 65 poisonous and potentially dangerous species. We conducted a long-term retrospective study to monitor the frequency, severity, seasonal character, species composition, and geographic distribution of mushroom exposure and poisoning in Israel. Using data collected by the Israel Poison Information Center in Rambam Health Care Campus, Haifa, during the years 2010-2021, we report that only 4% of cases of exposures due to biological agents were caused by mushrooms. Males were significantly (P < 0.004) more affected than females. Most cases involved either above 18 years of age (41%) or below the age of 6 years (39%). Most of the children under 6 years of age did not develop signs or symptoms of toxicity. During 2017-2021, 128 cases (82.5%) involved the consumption of raw mushrooms, mostly by children under 6 years of age. The most common season of mushroom exposure was rainy winters (P < 0.05). Mushrooms collected from irrigated lawns in the summer also posed a risk. Ingestion of Chlorophyllum molybdites was the leading mushroom ingestion in summer and that of Inocybe species in winter. Our study contributes to improved awareness of mushroom exposure and poisoning patterns among the Israeli population.
Collapse
Affiliation(s)
- Dalia Lewinsohn
- Mycology Unit, Shamir Research Institute, University of Haifa, Katzrin, 1290000, Israel
| | - Yael Lurie
- Israel Poison Information Center, Clinical Pharmacology and Toxicology Section, Rambam Health Care Campus, Haifa, 3109601, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, 3525422, Israel
| | - Aviad Gaon
- Mycology Unit, Shamir Research Institute, University of Haifa, Katzrin, 1290000, Israel
| | - Alona Yu Biketova
- Jodrell Laboratory, Royal Botanic Gardens, Kew, Richmond, Surrey, TW9 3DS, UK.,Institute of Evolution and Department of Evolutionary and Environmental Biology, University of Haifa, Aba Khoushi Ave. 199, Mt. Carmel, Haifa, 3498838, Israel
| | - Yedidia Bentur
- Israel Poison Information Center, Clinical Pharmacology and Toxicology Section, Rambam Health Care Campus, Haifa, 3109601, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, 3525422, Israel
| |
Collapse
|
9
|
Janatolmakan M, Jalilian M, Rezaeian S, Abdi A, Khatony A. Mortality rate and liver transplant in patients with mushroom poisoning: A systematic review & meta-analysis. Heliyon 2022; 9:e12759. [PMID: 36685402 PMCID: PMC9849942 DOI: 10.1016/j.heliyon.2022.e12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/09/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Background Mushroom poisoning is raised as a poor food problem that can cause the death of patients or the need for a liver transplant. Objective This study was conducted with the aim of assessment the mortality rate and liver transplantation in people suffering from mushroom poisoning through a systematic review and meta-analysis. Method The study is designed and conducted based on the PRISMA statement. International databases have been checked for articles up to March 1, 2022. The results of the study are presented with the guidance of Garrard's statement. CMA software was used in meta-analysis. Results Thirty-three articles were selected for this study. The mortality rate reported 0-40% and the results of the meta-analysis showed that the mortality rate was 2.87%. in other hand the mortality rate was 1.4% with studies that reported zero death. Overall, 16 patients had liver transplants, that only 2 died after liver transplants and 14 others survived. Conclusion The death in patients with mushroom poisoning is significant. Patients with liver disorders and patients or kidney disorders are more likely to have a poor prognosis. Liver transplant can be lifesaving. Also, quick referral of patients in the early stages reduces the need for liver transplantation.
Collapse
Affiliation(s)
- Maryam Janatolmakan
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Milad Jalilian
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran,Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran,Corresponding author. Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| |
Collapse
|
10
|
Lee CW, Su H, Shiea J. Potential applications and challenges of novel ambient ionization mass spectrometric techniques in the emergency care for acute poisoning. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
11
|
Su H, Huang MZ, Shiea J, Lee CW. Thermal desorption ambient ionization mass spectrometry for emergency toxicology. MASS SPECTROMETRY REVIEWS 2022:e21784. [PMID: 35603997 DOI: 10.1002/mas.21784] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 01/21/2022] [Indexed: 06/15/2023]
Abstract
In the emergency department, it is important to rapidly identify the toxic substances that have led to acute poisoning because different toxicants or toxins cause poisoning through different mechanisms, requiring disparate therapeutic strategies and precautions against contraindicating actions, and diverse directions of clinical course monitoring and prediction of prognosis. Ambient ionization mass spectrometry, a state-of-the-art technology, has been proved to be a fast, accurate, and user-friendly tool for rapidly identifying toxicants like residual pesticides on fruits and vegetables. In view of this, developing an analytical platform that explores the application of such a cutting-edge technology in a novel direction has been initiated a research program, namely, the rapid identification of toxic substances which might have caused acute poisoning in patients who visit the emergency department and requires an accurate diagnosis for correct clinical decision-making to bring about corresponding data-guided management. This review includes (i) a narrative account of the breakthrough in emergency toxicology brought about by the advent of ambient ionization mass spectrometry and (ii) a thorough discussion about the clinical implications and technical limitations of such a promising innovation for promoting toxicological tests from tier two-level to tier one level.
Collapse
Affiliation(s)
- Hung Su
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Min-Zong Huang
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| |
Collapse
|
12
|
Schenk-Jäger K, Gessler M, Weiler S. [CME: Mushroom Poisoning in the Family Practice]. PRAXIS 2021; 110:543-553. [PMID: 34344191 DOI: 10.1024/1661-8157/a003715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CME: Mushroom Poisoning in the Family Practice Abstract. In the general medical practice, it is not trivial to distinguish between banal intolerances after consumption of edible mushrooms and the initial symptoms of poisoning with potentially fatal outcome. Nevertheless, there are some criteria that can be used as clinical guidance: A latency of six hours or more between the consumption of gilled mushrooms that have not been checked by experts and the onset of mostly severe vomiting and diarrhea is indicative of poisoning with amatoxins, the toxins i.e. in death caps (Amanita phalloides). Although the therapeutic options are controversial, prompt antidotal treatment with silibinin has proven to be effective.
Collapse
Affiliation(s)
- Katharina Schenk-Jäger
- Tox Info Suisse, Nationale Beratungsstelle für Vergiftungen, Assoziiertes Institut der Universität Zürich, Zürich
- Verband Schweizerischer Vereine für Pilzkunde VSVP, Niederurnen
| | - Mirjam Gessler
- Tox Info Suisse, Nationale Beratungsstelle für Vergiftungen, Assoziiertes Institut der Universität Zürich, Zürich
| | - Stefan Weiler
- Tox Info Suisse, Nationale Beratungsstelle für Vergiftungen, Assoziiertes Institut der Universität Zürich, Zürich
| |
Collapse
|
13
|
Bambauer TP, Wagmann L, Weber AA, Meyer MR. Further development of a liquid chromatography-high-resolution mass spectrometry/mass spectrometry-based strategy for analyzing eight biomarkers in human urine indicating toxic mushroom or Ricinus communis ingestions. Drug Test Anal 2021; 13:1603-1613. [PMID: 34080326 DOI: 10.1002/dta.3106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/10/2022]
Abstract
Recently, we presented a strategy for analysis of eight biomarkers in human urine to verify toxic mushroom or Ricinus communis ingestions. However, screening for the full panel is not always necessary. Thus, we aimed to develop a strategy to reduce analysis time and by focusing on two sets of analytes. One set (A) for biomarkers of late-onset syndromes, such as phalloides syndrome or the syndrome after castor bean intake. Another set (B) for biomarkers of early-onset syndromes, such as pantherine-muscaria syndrome and muscarine syndrome. Both analyses should be based on hydrophilic-interaction liquid chromatography coupled with high-resolution mass spectrometry (MS)/MS (HILIC-HRMS/MS). For A, urine samples were prepared by liquid-liquid extraction using dichloromethane and subsequent solid-phase extraction of the aqueous supernatant. For B urine was precipitated using acetonitrile. Method A was validated for ricinine and α- and β-amanitin and method B for muscarine, muscimol, and ibotenic acid according to the specifications for qualitative analytical methods. In addition, robustness of recovery and normalized matrix factors to matrix variability measured by urinary creatinine was tested. Moreover, applicability was tested using 10 urine samples from patients after suspected mushroom intoxication. The analytes α- and β-amanitin, muscarine, muscimol, and ibotenic acid could be successfully identified. Finally, psilocin-O-glucuronide could be identified in two samples and unambiguously distinguished from bufotenine-O-glucuronide via their MS2 patterns. In summary, the current workflow offers several advantages towards the previous method, particularly being more labor-, time-, and cost-efficient, more robust, and more sensitive.
Collapse
Affiliation(s)
- Thomas P Bambauer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, 66421, Germany
| | - Lea Wagmann
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, 66421, Germany
| | - Armin A Weber
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, 66421, Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, 66421, Germany
| |
Collapse
|
14
|
Giusti A, Ricci E, Gasperetti L, Galgani M, Polidori L, Verdigi F, Narducci R, Armani A. Building of an Internal Transcribed Spacer (ITS) Gene Dataset to Support the Italian Health Service in Mushroom Identification. Foods 2021; 10:foods10061193. [PMID: 34070525 PMCID: PMC8227961 DOI: 10.3390/foods10061193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 01/26/2023] Open
Abstract
This study aims at building an ITS gene dataset to support the Italian Health Service in mushroom identification. The target species were selected among those mostly involved in regional (Tuscany) poisoning cases. For each target species, all the ITS sequences already deposited in GenBank and BOLD databases were retrieved and accurately assessed for quality and reliability by a systematic filtering process. Wild specimens of target species were also collected to produce reference ITS sequences. These were used partly to set up and partly to validate the dataset by BLAST analysis. Overall, 7270 sequences were found in the two databases. After filtering, 1293 sequences (17.8%) were discarded, with a final retrieval of 5977 sequences. Ninety-seven ITS reference sequences were obtained from 76 collected mushroom specimens: 15 of them, obtained from 10 species with no sequences available after the filtering, were used to build the dataset, with a final taxonomic coverage of 96.7%. The other 82 sequences (66 species) were used for the dataset validation. In most of the cases (n = 71; 86.6%) they matched with identity values ≥ 97–100% with the corresponding species. The dataset was able to identify the species involved in regional poisoning incidents. As some of these species are also involved in poisonings at the national level, the dataset may be used for supporting the National Health Service throughout the Italian territory. Moreover, it can support the official control activities aimed at detecting frauds in commercial mushroom-based products and safeguarding consumers.
Collapse
Affiliation(s)
- Alice Giusti
- FishLab, Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy; (M.G.); (A.A.)
- Correspondence: ; Tel.: +39-0502210204
| | - Enrica Ricci
- Experimental Zooprophylactic Institute of Lazio and Tuscany M. Aleandri, UOT Toscana Nord, SS Abetone e Brennero 4, 56124 Pisa, Italy; (E.R.); (L.G.)
| | - Laura Gasperetti
- Experimental Zooprophylactic Institute of Lazio and Tuscany M. Aleandri, UOT Toscana Nord, SS Abetone e Brennero 4, 56124 Pisa, Italy; (E.R.); (L.G.)
| | - Marta Galgani
- FishLab, Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy; (M.G.); (A.A.)
| | - Luca Polidori
- Tuscany Mycological Groups Association, via Turi, 8 Santa Croce sull’Arno, 56124 Pisa, Italy; (L.P.); (R.N.)
| | - Francesco Verdigi
- North West Tuscany LHA (Mycological Inspectorate), via A. Cocchi, 7/9, 56124 Pisa, Italy;
| | - Roberto Narducci
- Tuscany Mycological Groups Association, via Turi, 8 Santa Croce sull’Arno, 56124 Pisa, Italy; (L.P.); (R.N.)
| | - Andrea Armani
- FishLab, Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy; (M.G.); (A.A.)
| |
Collapse
|
15
|
Landi N, Ragucci S, Culurciello R, Russo R, Valletta M, Pedone PV, Pizzo E, Di Maro A. Ribotoxin-like proteins from Boletus edulis: structural properties, cytotoxicity and in vitro digestibility. Food Chem 2021; 359:129931. [PMID: 33940474 DOI: 10.1016/j.foodchem.2021.129931] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 01/17/2023]
Abstract
Porcini are edible mushrooms widely used in cooking due to their extraordinary taste. Despite this, cases of food poisoning have been reported in the recent literature also for ingestion of porcini. Here, we report the isolation from Boletus edulis fruiting bodies of two novel ribotoxin-like proteins (RL-Ps), enzymes already studied in other organisms for their toxicity. These RL-Ps, named Edulitin 1 (16-kDa) and Edulitin 2 (14-kDa), show peculiar structural and enzymatic differences, which probably reflect their different bio-activities and a dose/time dependent toxicity (Edulitin 2) on normal and tumoral human cells. Particularly interesting is the resistance to proteolysis of Edulitin 2, for which it was observed that its toxicity was abolished only after heat treatment (90 °C) followed by proteolysis. As mushroom poisoning is a serious food safety issue, data here presented confirm the existence of toxins also in porcini and the importance of a proper cooking before their consumption.
Collapse
Affiliation(s)
- Nicola Landi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania 'Luigi Vanvitelli', Via Vivaldi 43, 81100 Caserta, Italy
| | - Sara Ragucci
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania 'Luigi Vanvitelli', Via Vivaldi 43, 81100 Caserta, Italy
| | - Rosanna Culurciello
- Department of Biology, University of Naples 'Federico II', Via Cinthia 26, 80126 Naples, Italy
| | - Rosita Russo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania 'Luigi Vanvitelli', Via Vivaldi 43, 81100 Caserta, Italy
| | - Mariangela Valletta
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania 'Luigi Vanvitelli', Via Vivaldi 43, 81100 Caserta, Italy
| | - Paolo V Pedone
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania 'Luigi Vanvitelli', Via Vivaldi 43, 81100 Caserta, Italy
| | - Elio Pizzo
- Department of Biology, University of Naples 'Federico II', Via Cinthia 26, 80126 Naples, Italy
| | - Antimo Di Maro
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania 'Luigi Vanvitelli', Via Vivaldi 43, 81100 Caserta, Italy.
| |
Collapse
|
16
|
Li H, Tian Y, Menolli N, Ye L, Karunarathna SC, Perez-Moreno J, Rahman MM, Rashid MH, Phengsintham P, Rizal L, Kasuya T, Lim YW, Dutta AK, Khalid AN, Huyen LT, Balolong MP, Baruah G, Madawala S, Thongklang N, Hyde KD, Kirk PM, Xu J, Sheng J, Boa E, Mortimer PE. Reviewing the world's edible mushroom species: A new evidence-based classification system. Compr Rev Food Sci Food Saf 2021; 20:1982-2014. [PMID: 33599116 DOI: 10.1111/1541-4337.12708] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/04/2020] [Accepted: 12/21/2020] [Indexed: 12/16/2022]
Abstract
Wild mushrooms are a vital source of income and nutrition for many poor communities and of value to recreational foragers. Literature relating to the edibility of mushroom species continues to expand, driven by an increasing demand for wild mushrooms, a wider interest in foraging, and the study of traditional foods. Although numerous case reports have been published on edible mushrooms, doubt and confusion persist regarding which species are safe and suitable to consume. Case reports often differ, and the evidence supporting the stated properties of mushrooms can be incomplete or ambiguous. The need for greater clarity on edible species is further underlined by increases in mushroom-related poisonings. We propose a system for categorizing mushroom species and assigning a final edibility status. Using this system, we reviewed 2,786 mushroom species from 99 countries, accessing 9,783 case reports, from over 1,100 sources. We identified 2,189 edible species, of which 2,006 can be consumed safely, and a further 183 species which required some form of pretreatment prior to safe consumption or were associated with allergic reactions by some. We identified 471 species of uncertain edibility because of missing or incomplete evidence of consumption, and 76 unconfirmed species because of unresolved, differing opinions on edibility and toxicity. This is the most comprehensive list of edible mushrooms available to date, demonstrating the huge number of mushrooms species consumed. Our review highlights the need for further information on uncertain and clash species, and the need to present evidence in a clear, unambiguous, and consistent manner.
Collapse
Affiliation(s)
- Huili Li
- CAS Key Laboratory for Plant Diversity and Biogeography of East Asia, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan, China.,East and Central Asia Regional Office, World Agroforestry Centre (ICRAF), Kunming, Yunnan, China.,Centre for Mountain Futures, Kunming Institute of Botany, Kunming, Yunnan, China
| | - Yang Tian
- College of Food Science and Technology, Yunnan Agricultural University, Kunming, Yunnan, China
| | - Nelson Menolli
- Núcleo de Pesquisa em Micologia, Instituto de Botânica, São Paulo, Brazil.,Departamento de Ciências da Natureza e Matemática (DCM), Subárea de Biologia (SAB), Instituto Federal de Educação, Ciência e Tecnologia de São Paulo (IFSP), São Paulo, Brazil
| | - Lei Ye
- CAS Key Laboratory for Plant Diversity and Biogeography of East Asia, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan, China.,East and Central Asia Regional Office, World Agroforestry Centre (ICRAF), Kunming, Yunnan, China.,Centre for Mountain Futures, Kunming Institute of Botany, Kunming, Yunnan, China
| | - Samantha C Karunarathna
- CAS Key Laboratory for Plant Diversity and Biogeography of East Asia, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan, China.,East and Central Asia Regional Office, World Agroforestry Centre (ICRAF), Kunming, Yunnan, China.,Centre for Mountain Futures, Kunming Institute of Botany, Kunming, Yunnan, China
| | | | - Mohammad Mahmudur Rahman
- Global Centre for Environmental Remediation (GCER), Faculty of Science, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Md Harunur Rashid
- Global Centre for Environmental Remediation (GCER), Faculty of Science, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | | | - Leela Rizal
- The University of Queensland, School of Biological Sciences, Brisbane, Queensland, Australia
| | - Taiga Kasuya
- Department of Biology, Keio University, Yokohama, Kanagawa, Japan
| | - Young Woon Lim
- School of Biological Sciences and Institute of Microbiology, Seoul National University, Seoul, Korea
| | - Arun Kumar Dutta
- Department of Botany, West Bengal State University, Barasat, West Bengal, India
| | | | - Le Thanh Huyen
- Department of Toxicology and Environmental Monitoring, Faculty of Environment, Hanoi University of Natural Resources and Environment, Tu Liem North District, Hanoi, Vietnam
| | - Marilen Parungao Balolong
- Department of Biology, College of Arts and Sciences, University of the Philippines, Manila, the Philippines
| | - Gautam Baruah
- Balipara Tract and Frontier Foundation, Guwahati, Assam, India
| | - Sumedha Madawala
- Department of Botany, Faculty of Science, University of Peradeniya, Peradeniya, Sri Lanka
| | - Naritsada Thongklang
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, Thailand.,School of Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Kevin D Hyde
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, Thailand.,School of Science, Mae Fah Luang University, Chiang Rai, Thailand.,Mushroom Research Foundation, Chiang Mai, Thailand
| | - Paul M Kirk
- Biodiversity Informatics and Spatial Analysis, Jodrell Laboratory, Royal Botanic Gardens Kew, Surrey, UK
| | - Jianchu Xu
- CAS Key Laboratory for Plant Diversity and Biogeography of East Asia, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan, China.,East and Central Asia Regional Office, World Agroforestry Centre (ICRAF), Kunming, Yunnan, China.,Centre for Mountain Futures, Kunming Institute of Botany, Kunming, Yunnan, China
| | - Jun Sheng
- Key Laboratory for Agro-biodiversity and Pest Control of Ministry of Education, Yunnan Agricultural University, Kunming, China
| | - Eric Boa
- Institute of Biology, University of Aberdeen, Aberdeen, UK
| | - Peter E Mortimer
- CAS Key Laboratory for Plant Diversity and Biogeography of East Asia, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan, China.,Centre for Mountain Futures, Kunming Institute of Botany, Kunming, Yunnan, China
| |
Collapse
|
17
|
Arici MA, Tuncok Y. Mushroom-related toxins, alpha amanitin, and usage of antioxidants: Directions toward antioxidant capacity. Toxicology 2021. [DOI: 10.1016/b978-0-12-819092-0.00044-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Flament E, Guitton J, Gaulier JM, Gaillard Y. Human Poisoning from Poisonous Higher Fungi: Focus on Analytical Toxicology and Case Reports in Forensic Toxicology. Pharmaceuticals (Basel) 2020; 13:ph13120454. [PMID: 33322477 PMCID: PMC7764321 DOI: 10.3390/ph13120454] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022] Open
Abstract
Several families of higher fungi contain mycotoxins that cause serious or even fatal poisoning when consumed by humans. The aim of this review is to inventory, from an analytical point of view, poisoning cases linked with certain significantly toxic mycotoxins: orellanine, α- and β-amanitin, muscarine, ibotenic acid and muscimol, and gyromitrin. Clinicians are calling for the cases to be documented by toxicological analysis. This document is therefore a review of poisoning cases involving these mycotoxins reported in the literature and carries out an inventory of the analytical techniques available for their identification and quantification. It seems indeed that these poisonings are only rarely documented by toxicological analysis, due mainly to a lack of analytical methods in biological matrices. There are many reasons for this issue: the numerous varieties of mushroom involved, mycotoxins with different chemical structures, a lack of knowledge about distribution and metabolism. To sum up, we are faced with (i) obstacles to the documentation and interpretation of fatal (or non-fatal) poisoning cases and (ii) a real need for analytical methods of identifying and quantifying these mycotoxins (and their metabolites) in biological matrices.
Collapse
Affiliation(s)
- Estelle Flament
- Laboratory LAT LUMTOX, 07800 La Voulte sur Rhône, France; (E.F.); (Y.G.)
| | - Jérôme Guitton
- Laboratory of Pharmacology and Toxicology, Lyon-Sud University Hospital–Hospices Civil de Lyon, 69002 Pierre Bénite, France
- Department of Toxicology, Faculty of Pharmacy, University Claude Bernard, 69622 Lyon, France
- Correspondence:
| | - Jean-Michel Gaulier
- Department of Toxicology and Genopathy, Lille University Hospital, 59000 Lille, France;
| | - Yvan Gaillard
- Laboratory LAT LUMTOX, 07800 La Voulte sur Rhône, France; (E.F.); (Y.G.)
| |
Collapse
|
19
|
Bambauer TP, Wagmann L, Weber AA, Meyer MR. Analysis of α- and β-amanitin in Human Plasma at Subnanogram per Milliliter Levels by Reversed Phase Ultra-High Performance Liquid Chromatography Coupled to Orbitrap Mass Spectrometry. Toxins (Basel) 2020; 12:toxins12110671. [PMID: 33113909 PMCID: PMC7690657 DOI: 10.3390/toxins12110671] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 01/05/2023] Open
Abstract
Amatoxins are known to be one of the main causes of serious to fatal mushroom intoxication. Thorough treatment, analytical confirmation, or exclusion of amatoxin intake is crucial in the case of any suspected mushroom poisoning. Urine is often the preferred matrix due to its higher concentrations compared to other body fluids. If urine is not available, analysis of human blood plasma is a valuable alternative for assessing the severity of intoxications. The aim of this study was to develop and validate a liquid chromatography (LC)-high resolution tandem mass spectrometry (HRMS/MS) method for confirmation and quantitation of α- and β-amanitin in human plasma at subnanogram per milliliter levels. Plasma samples of humans after suspected intake of amatoxin-containing mushrooms should be analyzed and amounts of toxins compared with already published data as well as with matched urine samples. Sample preparation consisted of protein precipitation, aqueous liquid-liquid extraction, and solid-phase extraction. Full chromatographical separation of analytes was achieved using reversed-phase chromatography. Orbitrap-based MS allowed for sufficiently sensitive identification and quantification. Validation was successfully carried out, including analytical selectivity, carry-over, matrix effects, accuracy, precision, and dilution integrity. Limits of identification were 20 pg/mL and calibration ranged from 20 pg/mL to 2000 pg/mL. The method was applied to analyze nine human plasma samples that were submitted along with urine samples tested positive for amatoxins. α-Amanitin could be identified in each plasma sample at a range from 37–2890 pg/mL, and β-amanitin was found in seven plasma samples ranging from <20–7520 pg/mL. A LC-HRMS/MS method for the quantitation of amatoxins in human blood plasma at subnanogram per milliliter levels was developed, validated, and used for the analysis of plasma samples. The method provides a valuable alternative to urine analysis, allowing thorough patient treatment but also further study the toxicokinetics of amatoxins.
Collapse
Affiliation(s)
| | | | | | - Markus R. Meyer
- Correspondence: ; Tel.: +49-6841-16-26430; Fax: +49-6841-16-26431
| |
Collapse
|
20
|
Lagrange E, Vernoux JP. Warning on False or True Morels and Button Mushrooms with Potential Toxicity Linked to Hydrazinic Toxins: An Update. Toxins (Basel) 2020; 12:toxins12080482. [PMID: 32751277 PMCID: PMC7472412 DOI: 10.3390/toxins12080482] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/28/2022] Open
Abstract
Recently, consumption of the gyromitrin-containing neurotoxic mushroom Gyromitra sp. (false morel), as gourmet food was hypothesized to play a role in sporadic amyotrophic lateral sclerosis genesis. The present review analyses recent data on edibility and toxicity of false and true morels and Agaricus spp. Controversy about the toxic status of Gyromitra esculenta was due to variable toxin susceptibility within consumers. We suggest that Verpa bohemica, another false morel, is also inedible. We found a temporary neurological syndrome (NS) with cerebellar signs associated with high consumption of fresh or dried true morels Morchella sp. After ingestion of crude or poorly cooked fresh or dried morels, a gastrointestinal “haemolytic” syndrome was also observed. Agaritine, a water soluble hydrazinic toxin closely related to gyromitrin is present along with metabolites including diazonium ions and free radicals, in Agaricus spp. and A. bisporus, the button mushroom, and in mice after ingestion. It is a potential weak carcinogen in mice, but although no data are available for humans, a lifetime low cumulative extra cancer risk in humans can be estimated to be about 10−5. To conclude, a safety measure is to avoid consuming any true morels or button mushrooms when crude or poorly cooked, fresh or dried.
Collapse
Affiliation(s)
- Emmeline Lagrange
- EFSN, Pôle de Neurologie, CHUGA, Grenoble University Hospital, 38000 Grenoble, France;
| | - Jean-Paul Vernoux
- Unité de Recherche Aliments Bioprocédés Toxicologie Environnements (ABTE) EA 4651, Normandie University, UNICAEN, 14000 Caen, France
- Correspondence: ; Tel.: +33-680-144-739
| |
Collapse
|
21
|
Chen X, Shao B, Yu C, Yao Q, Ma P, Li H, Cai W, Fu H, Li B, Sun C. The cyclopeptide <alpha>-amatoxin induced hepatic injury via the mitochondrial apoptotic pathway associated with oxidative stress. Peptides 2020; 129:170314. [PMID: 32387737 DOI: 10.1016/j.peptides.2020.170314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 12/19/2022]
Abstract
In order to explore the role of apoptosis in alpha-amatoxin (α-AMA) induced liver injury and probable upstream activation signals, we established animal and cellular models, respectively, for this pathophysiological condition. To this end, we evaluated the survival rate and serum biochemical parameters in BALB/c mice exposed to α-AMA at different time periods, along with the levels of oxidative and antioxidant enzymes in the liver tissue of these mice and proteins involved in apoptosis-related pathways. Our results reveal that α-AMA-induced apoptosis occurs primarily through the mitochondrial apoptotic pathway and is associated with oxidative damage. Further, in order to verify the key nodes and important upstream activators in this apoptotic pathway, we estimated the levels of p53 protein and downstream mitochondrial apoptotic pathway-related proteins in L-02 cells, all of which were found to change significantly. We also found that the levels of total and mitochondrial reactive oxygen species (ROS) in L-02 cells increased with time. Collectively, our findings suggest that α-AMA affects many cellular processes, including the expression of p53 independent of transcription and the expression of Bax and Bcl-2, thereby activating the subsequent caspase cascade pathways. In addition, we identified ROS to be an upstream signaling molecule involved in the α-AMA-induced apoptosis of mouse liver cells and L-02 cells.
Collapse
Affiliation(s)
- Xiao Chen
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Bing Shao
- Institute of Nutrition and Food Hygiene, Beijing Center for Disease Control and Prevention, Beijing 100013, China
| | - Chengmin Yu
- The People's Hospital of ChuXiong Yi Autonomous Prefecture, ChuXiong 675000, China
| | - Qunmei Yao
- The People's Hospital of ChuXiong Yi Autonomous Prefecture, ChuXiong 675000, China
| | - Peibin Ma
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Haijiao Li
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Wenjian Cai
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hao Fu
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Bin Li
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Chengye Sun
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| |
Collapse
|
22
|
Development and application of a strategy for analyzing eight biomarkers in human urine to verify toxic mushroom or ricinus communis ingestions by means of hydrophilic interaction LC coupled to HRMS/MS. Talanta 2020; 213:120847. [DOI: 10.1016/j.talanta.2020.120847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 11/19/2022]
|
23
|
Govorushko S, Rezaee R, Dumanov J, Tsatsakis A. Poisoning associated with the use of mushrooms: A review of the global pattern and main characteristics. Food Chem Toxicol 2019; 128:267-279. [DOI: 10.1016/j.fct.2019.04.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 04/11/2019] [Accepted: 04/11/2019] [Indexed: 02/07/2023]
|
24
|
Garcia J, Costa VM, Bovolini A, Duarte JA, Rodrigues DF, de Lourdes Bastos M, Carvalho F. An effective antidotal combination of polymyxin B and methylprednisolone for α-amanitin intoxication. Arch Toxicol 2019; 93:1449-1463. [PMID: 30891624 DOI: 10.1007/s00204-019-02426-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/04/2019] [Indexed: 10/27/2022]
Abstract
Amanita phalloides is one of the most toxic mushrooms worldwide, and it is involved in the majority of human fatal cases of mushroom poisoning. α-Amanitin, the most deleterious toxin of A. phalloides to humans, inhibits RNA polymerase II (RNAPII), causing hepatic and renal failure. Previously, we have shown that polymyxin B (polB) reverts α-amanitin inhibition of RNAPII, although it was not able to guarantee the full survival of α-amanitin-intoxicated mice or prevent α-amanitin pro-inflammatory effects. α-Amanitin is also a substrate of the organic-anion-transporting polypeptide 1B3 (OATP1B3) and Na(+)-taurocholate cotransporter polypeptide (NTCP) transporters. Therefore, in the present work, we used a combination of polB [(2.5 mg/kg intraperitoneal (i.p.)] with the anti-inflammatory and NTCP inhibitor drug, methylprednisolone (MP) (10 mg/kg i.p.), as an attempt to fully revert α-amanitin-induced toxicity (0.33 mg/kg i.p.) in CD-1 mice. Results showed that the administration of the polB + MP combination, 4 h after α-amanitin, led to the full survival of the intoxicated animals, with a significant attenuation of α-amanitin-induced renal and hepatic necrosis. Also, the combination polB + MP led to a decrease of aminotransferase plasma levels, of the renal myeloperoxidase activity and of renal inflammatory cell infiltrate promoted by α-amanitin, although not preventing any of the hepatic pro-inflammatory effect of the toxin. The obtained results indicate that this combination may represent an important and valuable therapeutic approach to be used against α-amanitin intoxication.
Collapse
Affiliation(s)
- Juliana Garcia
- Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, UCIBIO, REQUIMTE, University of Porto, Rua José Viterbo Ferreira no 228, 4050-313, Porto, Portugal.
| | - Vera Marisa Costa
- Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, UCIBIO, REQUIMTE, University of Porto, Rua José Viterbo Ferreira no 228, 4050-313, Porto, Portugal
| | | | | | - Daniela Ferreira Rodrigues
- Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, UCIBIO, REQUIMTE, University of Porto, Rua José Viterbo Ferreira no 228, 4050-313, Porto, Portugal
| | - Maria de Lourdes Bastos
- Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, UCIBIO, REQUIMTE, University of Porto, Rua José Viterbo Ferreira no 228, 4050-313, Porto, Portugal
| | - Félix Carvalho
- Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, UCIBIO, REQUIMTE, University of Porto, Rua José Viterbo Ferreira no 228, 4050-313, Porto, Portugal.
| |
Collapse
|
25
|
Tavassoli M, Afshari A, Arsene AL, Mégarbane B, Dumanov J, Paoliello MMB, Tsatsakis A, Carvalho F, Hashemzaei M, Karimi G, Rezaee R. Toxicological profile of Amanita virosa - A narrative review. Toxicol Rep 2019; 6:143-150. [PMID: 30705830 PMCID: PMC6348736 DOI: 10.1016/j.toxrep.2019.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/08/2019] [Indexed: 01/06/2023] Open
Abstract
Globally, mushroom poisoning leads to a considerable number of deaths annually. However, no definite antidote has been introduced yet. A mushroom-poisoning outbreak occurred in 2018 in Iran; this overview presents geographical distribution of Amanita virosa along with studies reporting A. virosa poisonings. Also, main toxins of A. virosa, their toxicity mechanisms and pharmacological management of mushroom-poisoned individuals are presented.
Mushrooms account for a part of human diet due to their exquisite taste and protein content as well as their promising health effects unveiled by scientific research. Toxic and non-toxic mushrooms frequently share considerable morphological similarities, which mislead the collectors/consumers, resulting in mycotoxicity. Numerous mushroom species are considered “poisonous” as they produce dangerous toxins. For instance, members of the genus Amanita, especially A. phalloides, A. virosa and A. verna, are responsible for severe and even life-threatening noxious consequences. Globally, mushroom poisoning is a crucial healthcare issue as it leads to a considerable number of deaths annually. However, no definite antidote has been introduced to treat this poisoning. The present article discusses the characteristics of A. virosa in terms of epidemiology, mechanisms of toxicity, poisoning features and management.
Collapse
Affiliation(s)
- Milad Tavassoli
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asma Afshari
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Andree Letiţia Arsene
- Department of General and Pharmaceutical Microbiology, Faculty of Pharmacy, "Carol Davila" University of Medicine and Pharmacy, 6 Traian Vuia Street, 020956, Bucharest, Romania
| | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Paris-Diderot University, INSERM UMRS-1144, Paris, France
| | - Josef Dumanov
- Mycological Institute USA EU, SubClinical Research Group, Sparta, NJ 07871, United States
| | - Monica Maria Bastos Paoliello
- Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná, Brazil.,Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Aristidis Tsatsakis
- Center of Toxicology Science & Research, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Félix Carvalho
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal
| | - Mahmoud Hashemzaei
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
| | - Gholamreza Karimi
- Department of Pharmacodynamics and Toxicology, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Pharmaceutical Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ramin Rezaee
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
26
|
Mushroom Poisoning-A 17 Year Retrospective Study at a Level I University Emergency Department in Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122855. [PMID: 30558129 PMCID: PMC6313731 DOI: 10.3390/ijerph15122855] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/08/2018] [Accepted: 12/10/2018] [Indexed: 11/16/2022]
Abstract
The consequences of mushroom poisoning range from mild, mostly gastrointestinal, disturbances to organ failure or even death. This retrospective study describes presentations related to mushroom poisoning at an emergency department in Bern (Switzerland) from January 2001 to October 2017. Gastrointestinal disturbances were reported in 86% of the 51 cases. The National Poisons Information Centre and mycologists were involved in 69% and 61% of the cases, respectively. Identification of the mushroom type/family was possible in 43% of the cases. The most common mushroom family was Boletaceae (n = 21) and the most common mushrooms Xerocomus chrysenteron (n = 7; four being part of a cluster), Clitocybe nebularis, Lepista nuda and Lactarius semisanguifluus (n = 5 each, four being part of a cluster). Poisonous mushrooms included Amanita phalloides (n = 3, all analytically confirmed), Boletus satanas (n = 3), Amanita muscaria (n = 2) and Amanita pantherina (n = 2). There were no fatalities and 80% of the patients were discharged within 24 h. Mushroom poisoning does not appear to be a common reason for emergency consultation and most presentations were of minor severity and related to edible species (e.g., due to incorrect processing). Nevertheless, poisonous mushrooms and severe complications were also recorded. Collaboration with a poison centre and/or mycologists is of great importance, especially in high risk cases.
Collapse
|
27
|
|
28
|
Schmutz M, Carron PN, Yersin B, Trueb L. Mushroom poisoning: a retrospective study concerning 11-years of admissions in a Swiss Emergency Department. Intern Emerg Med 2018; 13:59-67. [PMID: 27988828 DOI: 10.1007/s11739-016-1585-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 11/30/2016] [Indexed: 01/20/2023]
Abstract
Wild mushroom intoxication is an unusual cause of toxic ingestion in Europe. A great diversity of clinical symptoms may arise depending on the variety of wild mushrooms ingested. These initial symptoms are often non-specific, with frequent gastrointestinal symptoms, and have no direct correlation with the outcome. Therefore, management of mushroom poisoning and risk evaluation are a challenge for emergency clinicians. We retrospectively reviewed all cases of mushroom poisoning identified in the ED database spanning 11 years. Demographic and clinical data, time from consumption to symptoms, type of mushrooms, the number of patients presenting at the same time, treatment(s) provided, length of stay, discharge diagnosis, in-hospital mortality, and serious complications were evaluated. We identify 87 cases of mushroom poisoning. The most common symptoms are nausea and vomiting (71 cases, 82%), followed by diarrhea (68%), syncope (10%), abdominal pain (8%), and hallucinations (7%). Sixty-four patients (74%) exhibited early symptoms (appearance <6 h after ingestion) and 23 (26%) late symptoms (appearance >6 h after ingestion). Eleven patients (13%) required hospitalization over 24 h. Patients with late symptoms tended to have longer in-hospital lengths of stay. Only one patient had Amanita phalloides intoxication, with a favorable outcome. Thirty-eight patients (44%) were involved in cluster presentations. Mushroom poisoning is an unusual but potentially severe form of intoxication. Patients presenting with late-appearing symptoms (>6 h) are associated with a higher risk of A. phalloides intoxication, and therefore require specific investigation and management.
Collapse
Affiliation(s)
- Maxime Schmutz
- Emergency Department, Lausanne University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Pierre-Nicolas Carron
- Emergency Department, Lausanne University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Bertrand Yersin
- Emergency Department, Lausanne University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Lionel Trueb
- Emergency Department, Lausanne University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| |
Collapse
|
29
|
Trakulsrichai S, Sriapha C, Tongpoo A, Udomsubpayakul U, Wongvisavakorn S, Srisuma S, Wananukul W. Clinical characteristics and outcome of toxicity from Amanita mushroom poisoning. Int J Gen Med 2017; 10:395-400. [PMID: 29138589 PMCID: PMC5679676 DOI: 10.2147/ijgm.s141111] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To describe and analyze the clinical characteristics and outcome of amatoxin poisoning cases. Methods We performed a retrospective cohort study of amatoxin poisoning cases from Ramathibodi Poison Center Toxic Exposure Surveillance System, from May 2013 to August 2015. Results There were 30 consultations with a total of 55 poisoning cases. Most cases were male and from the north-east region. Hepatitis, acute kidney injury, jaundice, and coagulopathy accounted for 74%, 46.3%, 44.7%, and 52.8% of the cases, respectively. Almost all of the patients were admitted to the hospital, and the median duration of hospital stay was found to be 4 days. Mortality rate was found to be 27.3%. Most patients (73%) received the treatment including multiple-dose activated charcoal (67.5%), intravenous N-acetylcysteine (87.5%), and benzylpenicillin (45%). In 60% of the cases, the treatment was initiated within 24 h after eating mushrooms. Exchange transfusion and liver transplantation were performed in one severe case. However, this patient died eventually. Because intravenous silybinin is not available in Thailand during the study period, 8 patients received oral silymarin instead. All 8 patients had hepatitis and were treated with high dosage of oral silymarin (5 patients with 4.48 g/day, 2 patients with 1.68 g/day, and 1 patient with 1.4 g/day) for a couple of days. One of these patients died as she received treatment very late; she was treated with silymarin at 1.68 g/day dosage. Thus, the fatality in oral silymarin treatment group was 12.5%. We performed the analysis between the dead and survival groups. We found that in hepatitis, initial and maximum serum aspartate transaminase, initial and maximum serum alanine transaminase, and acute kidney injury were significantly different between the two groups. Conclusion Amanita mushroom poisoning caused high fatalities. Serum transaminase and creatinine were the factors associated with death. Treatment with oral high dose silymarin should be investigated further as one of the principal therapies in amatoxin poisoning.
Collapse
Affiliation(s)
| | | | | | | | | | - Sahaphume Srisuma
- Ramthibodi Poison Center.,Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Winai Wananukul
- Ramthibodi Poison Center.,Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
30
|
Xiang H, Zhou Y, Zhou C, Lei S, Yu H, Wang Y, Zhu S. Investigation and analysis of Galerina sulciceps poisoning in a canteen. Clin Toxicol (Phila) 2017; 56:365-369. [PMID: 29052443 DOI: 10.1080/15563650.2017.1388386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Guizhou Province in China has an abundant resource of wild mushrooms, including numerous poisonous species which contain various toxins. The mortality rate from wild mushroom poisoning has been high in this area in recent years. Galerina sulciceps is a dangerously toxic mushroom which can be fatal if ingested. METHODS we report on an epidemiological investigation of G. sulciceps poisoning which occurred in Duyun City of Guizhou Province. The characteristics of this species, its toxicity, observed clinical features, laboratory data, treatment modality, and prognosis were investigated in order to provide a reference point for the prevention and treatment of this kind of mushroom poisoning. RESULTS Thirteen employees showed toxic symptoms after ingesting wild mushrooms the previous day in a company canteen. Clinical manifestation varied from gastroenteritis to hepatic and renal dysfunction. Most of the 13 patients presented with nausea, vomiting, abdominal pain, diarrhea, and elevated levels of biochemical indices of hepatic and renal function, during which transaminase concentration peaked within 48-72 h. At 48 hours post-ingestion, all patients had hemodialysis, in addition to supportive care for hepatic and renal injury with oral Silibinin and Shenshuaining. All acute renal injury had resolved by day 10, and liver transaminases had trended toward normal in all patients and they were discharged. At follow-up in 30 days, both liver and renal function had completely recovered in all. CONCLUSION This poisoning occurs as a result of unintentional consumption of G. sulciceps, which is relatively rare in mushroom poisonings. All patients recovered fully after timely diagnosis and treatment. To prevent wild mushroom poisoning, the best preventive measure is to educate the public not to gather and eat any unidentified wild mushrooms.
Collapse
Affiliation(s)
- Hong Xiang
- a Guizhou Center of Disease Control and Prevention , Guiyang , China
| | - Yajuan Zhou
- a Guizhou Center of Disease Control and Prevention , Guiyang , China
| | - Changlin Zhou
- b Qiannan Center of Disease Control and Prevention , Duyun , China
| | - Shiguang Lei
- a Guizhou Center of Disease Control and Prevention , Guiyang , China
| | - Hong Yu
- a Guizhou Center of Disease Control and Prevention , Guiyang , China
| | - Yafang Wang
- a Guizhou Center of Disease Control and Prevention , Guiyang , China
| | - Shu Zhu
- a Guizhou Center of Disease Control and Prevention , Guiyang , China
| |
Collapse
|
31
|
Cervellin G, Comelli I, Rastelli G, Sanchis-Gomar F, Negri F, De Luca C, Lippi G. Epidemiology and clinics of mushroom poisoning in Northern Italy: A 21-year retrospective analysis. Hum Exp Toxicol 2017; 37:697-703. [DOI: 10.1177/0960327117730882] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Limited information exists about epidemiology and management of mushroom poisoning. We analyzed and described epidemiology, clinical presentation, and clinical course of mushroom-poisoned patients admitted to emergency departments (EDs) of the Province of Parma, Italy. Methods: Data from the database of mycological service were matched with clinical information retrieved from hospitals’ database, from January 1, 1996 to December 31, 2016. Results: Mycologist consultation was obtained in 379/443 identified mushroom poisonings. A remarkable seasonality was found, with significant peak in autumn. Thanks to the collaboration, the implicated species could be identified in 397 cases (89.6%); 108 cases (24.4%) were due to edible mushrooms, Boletus edulis being the most represented (63 cases). Overall, 408 (92%) cases presented with gastrointestinal toxicity. Twenty cases of amatoxin poisoning were recorded (11 Amanita phalloides and 9 Lepiota brunneoincarnata). One liver transplantation was needed. We observed 13 cases of cholinergic toxicity and 2 cases of hallucinogenic toxicity. Finally, 46 cases were due to “mixed” toxicities, and a total of 69 needed hospitalization. Conclusions: Early identification and management of potentially life-threatening cases is challenging in the ED, so that a mycologist service on call is highly advisable, especially during periods characterized by the highest incidence of poisoning.
Collapse
Affiliation(s)
- G Cervellin
- Emergency Department, University Hospital of Parma, Parma, Italy
| | - I Comelli
- Emergency Department, University Hospital of Parma, Parma, Italy
| | - G Rastelli
- Emergency Department, Hospital of Fidenza, Fidenza, Parma, Italy
| | - F Sanchis-Gomar
- Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA
| | - F Negri
- Mycological Consultation Service, Local Health Agency of Parma, Parma, Italy
| | - C De Luca
- Mycological Consultation Service, Local Health Agency of Parma, Parma, Italy
| | - G Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| |
Collapse
|
32
|
Wild Mushrooms: An Exclusive Delicacy or Last Meal. Am J Gastroenterol 2017; 112:971-972. [PMID: 28572647 DOI: 10.1038/ajg.2017.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
33
|
Dündar ZD, Ergin M, Kilinç İ, Çolak T, Oltulu P, Cander B. The role of oxidative stress in α-amanitin-induced hepatotoxicityin an experimental mouse model. Turk J Med Sci 2017; 47:318-325. [PMID: 28263509 DOI: 10.3906/sag-1503-163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 01/11/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM This study aimed to evaluate oxidative stress markers of liver tissue in a mouse α-amanitin poisoning model with three different toxin levels. MATERIALS AND METHODS The mice were randomly divided into Group 1 (control), Group 2 (0.2 mg/kg), Group 3 (0.6 mg/kg), and Group 4 (1.0 mg/kg). The toxin was injected intraperitoneally and 48 h of follow-up was performed before sacrifice. RESULTS Median superoxide dismutase activities of liver tissue in Groups 3 and 4 were significantly higher than in Group 1 (for both, P = 0.001). The catalase activity in Group 2 was significantly higher, but in Groups 3 and 4 it was significantly lower than in Group 1 (for all, P = 0.001). The glutathione peroxidase activities in Groups 2, 3, and 4 were significantly higher than in Group 1 (P = 0.006, P = 0.001, and P = 0.001, respectively). The malondialdehyde levels of Groups 3 and 4 were significantly higher than Group 1 (P = 0.015 and P = 0.003, respectively). The catalase activity had significant correlations with total antioxidant status and total oxidant status levels (r = 0.935 and r = -0.789, respectively; for both, P < 0.001). CONCLUSION Our findings support a significant role for increased oxidative stress in α-amanitin-induced hepatotoxicity.
Collapse
Affiliation(s)
- Zerrin Defne Dündar
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Ergin
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - İbrahim Kilinç
- Department of Biochemistry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Tamer Çolak
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Pembe Oltulu
- Department of Medical Pathology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Başar Cander
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| |
Collapse
|
34
|
Schenk-Jaeger KM, Hofer-Lentner KE, Plenert B, Eckart D, Haberl B, Schulze G, Borchert-Avalone J, Stedtler U, Pfab R. No clinically relevant effects in children after accidental ingestion of Panaeolina foenisecii (lawn mower's mushroom). Clin Toxicol (Phila) 2017; 55:217-220. [PMID: 28073319 DOI: 10.1080/15563650.2016.1271129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Panaeolina foenisecii is one of the most common and widely distributed lawn mushrooms in Europe and North America, and frequently involved in accidental mushroom ingestion, mainly in children. Nevertheless, there is contradictory information regarding the toxicity profile of P. foenisecii in the literature. Objective of the study was to assess clinical effects with particular attention on psychoactive properties of P. foenisecii in case of accidental oral exposure. METHODS This observational case series is based on prospectively collected data on mushroom poisoning using a structured data collection form, and it was performed in seven poisons centres in Germany and Switzerland. Inclusion criteria were accidental ingestion of at least one cap of P. foenisecii identified by a mycologist, and a follow up of at least 4 hours. RESULTS Nineteen cases met all inclusion criteria, and only children were involved with a mean age of 3 years. They ingested 1-2 mushrooms in 14 cases and 3-5 mushrooms in five cases. Three patients received a single dose of activated charcoal. Sixteen out of 19 cases did not develop any symptoms, 2/19 complained of minor abdominal discomfort. One child was temporarily mildly hyperactive, and this was the only patient observed in a hospital for 12 hours. None of the children showed signs of hallucinations. CONCLUSIONS This multicentre study demonstrates that the typically small amounts of P. foenisecii ingested by children probably do not lead to clinically significant symptoms.
Collapse
Affiliation(s)
- Katharina M Schenk-Jaeger
- a National Poisons Information Centre Tox Info Suisse, Associated Institute of the University of Zurich , Zurich , Switzerland.,b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany
| | - Katharina E Hofer-Lentner
- a National Poisons Information Centre Tox Info Suisse, Associated Institute of the University of Zurich , Zurich , Switzerland.,b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany
| | - Bettina Plenert
- b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany.,c Poisons Information Centre Erfurt , Erfurt , Germany
| | - Dagmar Eckart
- b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany.,d Poisons Center and Clinical Toxicology , Mainz , Germany
| | - Bettina Haberl
- b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany.,e Toxikologische Abteilung, Klinikum rechts der Isar , Technical University Munich , Munich , Germany
| | - Gabriele Schulze
- b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany.,f GIZ - Nord Poisons Center, University Medical Center Goettingen , Goettingen , Germany
| | - Janine Borchert-Avalone
- b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany.,g Poisons Information Centre Berlin , Berlin , Germany
| | - Uwe Stedtler
- b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany.,h Poisons Information Centre, University Medical Centre Freiburg , Freiburg , Germany
| | - Rudolph Pfab
- b Society for Clinical Toxicology (Gesellschaft für Klinische Toxikologie) GfKT , Mainz , Germany.,e Toxikologische Abteilung, Klinikum rechts der Isar , Technical University Munich , Munich , Germany
| |
Collapse
|
35
|
Rapid and reliable species identification of wild mushrooms by matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS). Anal Chim Acta 2016; 934:163-9. [DOI: 10.1016/j.aca.2016.05.056] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 05/24/2016] [Accepted: 05/31/2016] [Indexed: 01/29/2023]
|
36
|
Cho JT, Han JH. A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death. J Korean Med Sci 2016; 31:1164-7. [PMID: 27366018 PMCID: PMC4901012 DOI: 10.3346/jkms.2016.31.7.1164] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/06/2015] [Indexed: 01/06/2023] Open
Abstract
Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis.
Collapse
Affiliation(s)
- Jong Tae Cho
- Department of Internal Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Jin Hyung Han
- Department of Internal Medicine, College of Medicine, Dankook University, Cheonan, Korea
| |
Collapse
|
37
|
Morel S, Fons F, Rapior S, Dubois V, Vitou M, Portet K, Dore JC, Poucheret P. Decision-Making for the Detection of Amatoxin Poisoning: A Comparative Study of Standard Analytical Methods. CRYPTOGAMIE MYCOL 2016. [DOI: 10.7872/crym/v37.iss2.2016.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
38
|
Erenler AK, Doğan T, Koçak C, Ece Y. Investigation of Toxic Effects of Mushroom Poisoning on the Cardiovascular System. Basic Clin Pharmacol Toxicol 2016; 119:317-21. [PMID: 26879235 DOI: 10.1111/bcpt.12569] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 02/08/2016] [Indexed: 12/14/2022]
Abstract
Mushroom poisoning (MP) is a public health problem in many countries. It is well known that consumption of wild mushrooms may cause serious toxicity on renal, hepatic and brain functions. In the literature, however, studies investigating cardiotoxic effects of MP are rare. In this study, we evaluated laboratory and ECG findings of patients and sought for possible toxic effects of MP on the cardiovascular system. During a 2-year period, 175 patients with MP were included in the study. The majority of the poisonings occurred in early summertime. The most common complaint was found to be nausea and vomiting followed by mental status alterations. Methods of treatment were mainly based on gastric lavage, activated charcoal and supportive therapy. The most common ECG abnormalities in the patients with MP were sinus tachycardia, sinus arrhythmia, ST/T inversion, 1st degree AV block and QT prolongation, respectively. Cardiac markers of the patients were found to be normal. Then, patients were divided into two subgroups according to symptom onset after consumption (less than 6 hr and more than 6 hr). When the two groups were compared, prevalence of tachycardia was significantly higher in Group II. Additionally, the interval between mushroom consumption and onset of symptoms was strongly correlated with blood pressure (BP). As this interval prolonged, BP of the patients tended to increase. In conclusion, according to our results, although mechanisms need to be clarified, MP causes hypertension and ECG alterations, particularly tachycardia in patients with late-onset symptoms.
Collapse
Affiliation(s)
- Ali Kemal Erenler
- Department of Emergency Medicine, Çorum Education and Research Hospital, Hitit University, Çorum, Turkey
| | - Tolga Doğan
- Department of Cardiology, Çorum Education and Research Hospital, Hitit University, Çorum, Turkey
| | - Cem Koçak
- Department of Statistics, Çorum Education and Research Hospital, Hitit University, Çorum, Turkey
| | - Yasemin Ece
- Department of Emergency Medicine, Çorum Education and Research Hospital, Hitit University, Çorum, Turkey
| |
Collapse
|
39
|
Cevik AA, Unluoglu I. Factors Affecting Mortality and Complications in Mushroom Poisonings Over a 20 Year Period: A Report from Central Anatolia. Turk J Emerg Med 2016; 14:104-10. [PMID: 27331181 PMCID: PMC4909943 DOI: 10.5505/1304.7361.2014.36024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 04/22/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Mushroom poisoning (MP) is one of the world's leading seasonal and regional health problems. The aim of this study was to analyze the relationship between clinical factors and outcomes of mushroom poisoning. METHODS The study was conducted in the emergency department. The patients who presented between January 1st, 1991 and December 31, 2010 were retrospectively reviewed. RESULTS 599 MP cases were enrolled into the statistical analysis. The elderly group had a higher rate of mortality (8.8%) and complications (12.3%) (p=0.005) (OR 3.98, 95% CI: 1.9291 to 8.2290; p=0.0002). The patients who presented in summer had a higher rate of mortality (9.5%) and complications (11.9%) (p≤0.001). (OR: 3.83, 95% CI 1.7068 to 8.6074, p=0.0011). The rate of mortality and complications in patients who had eaten self-harvested wild mushrooms (WM) was 6.8%, while those who purchased WM had a mortality and complication rate of 15.2% (p=0.016), (Purchased WM OR 2.46, 95% CI 1.1609 to 5.2353, p=0.0189). The rate of mortality and complications in the patients who presented with gastrointestinal symptoms was 9.9% (OR: 3.98, 95% CI 1.5503 to 10.2679; p=0.0041). CONCLUSIONS Factors such as being elderly, summer season, purchased WM, and gastrointestinal symptoms were significantly associated with mortality and complications in our study.
Collapse
Affiliation(s)
- Arif Alper Cevik
- Department of Emergency Medicine, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir; United Arab Emirates University, College of Medicine and Health Sciences, Al Ain, UAE
| | - Ilhami Unluoglu
- Department of Family Medicine, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir
| |
Collapse
|
40
|
Amanita phalloides poisoning: Mechanisms of toxicity and treatment. Food Chem Toxicol 2015; 86:41-55. [PMID: 26375431 DOI: 10.1016/j.fct.2015.09.008] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 02/07/2023]
|
41
|
XXXV International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) 26–29 May 2015, St Julian's, Malta. Clin Toxicol (Phila) 2015. [DOI: 10.3109/15563650.2015.1024953] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
42
|
Abstract
Approximately 100 of the known species of mushrooms are poisonous to humans. New toxic mushroom species continue to be identified. Some species initially classified as edible are later reclassified as toxic. This results in a continually expanding list of toxic mushrooms. As new toxic species are identified, some classic teachings about mycetism no longer hold true. As more toxic mushrooms are identified and more toxic syndromes are reported, older classification systems fail to effectively accommodate mycetism. This review provides an update of myscetism and classifies mushroom poisonings by the primary organ system affected, permitting expansion, as new, toxic mushroom species are discovered.
Collapse
|
43
|
Abstract
Background: The American Association of Poison Control Center (AAPCC) shows that in 2012 there were 0.3% of human exposures involving mushrooms. Only 17% of 6600 cases were then identified by the species. The present retrospective study was designed to identify the epidemiology of mushroom poisoning in adults admitted to Krakow’s Department of Clinical Toxicology (DCT) from 2002 to 2009. Materials and Methods: This study was conducted retrospectively after examining the files of 457 adult patients with wild mushroom poisoning. Mycological analysis was made and the species of the poisoning-inducing mushroom was determined. Furthermore, the circumstances related to the mushroom gathering, transport, storage, preparation, and consumption have been analyzed. Results: The analysis revealed that in 400 (87.53%) out of 457 cases, the clinical symptoms were caused by ingestion of identified edible mushroom species. The main reason for edible mushroom poisoning is associated with their incorrect processing after harvest. The analysis of the circumstances of mushroom collection, transport, and storage shows that the largest percentage of poisoning was connected with long-term storage of mushroom dishes, collecting, and storing them in plastic bags, and long storage of mushrooms. Conclusion: Based on spore analysis of the gastric content, edible mushrooms were responsible for the great majority of mushroom poisoning cases admitted to the DCT. The toxicity of edible mushroom is associated with proceeding with them during collection, transport, and storage. The medical history should be supplemented by questions concerning these circumstances. The identification of the mushroom by a mycologist is highly desirable.
Collapse
Affiliation(s)
- T Gawlikowski
- Department of Clinical Toxicology, Jagiellonian University Medical College, Krakow, Poland
| | - M Romek
- Department of Cytology and Histology, Institute of Zoology Jagiellonian University, Krakow, Poland
| | - L Satora
- Department of Physiology and Reproduction of Animals, University of Rzeszow, Rzeszow, Poland
| |
Collapse
|
44
|
Feeney MJ, Dwyer J, Hasler-Lewis CM, Milner JA, Noakes M, Rowe S, Wach M, Beelman RB, Caldwell J, Cantorna MT, Castlebury LA, Chang ST, Cheskin LJ, Clemens R, Drescher G, Fulgoni VL, Haytowitz DB, Hubbard VS, Law D, Myrdal Miller A, Minor B, Percival SS, Riscuta G, Schneeman B, Thornsbury S, Toner CD, Woteki CE, Wu D. Mushrooms and Health Summit proceedings. J Nutr 2014; 144:1128S-36S. [PMID: 24812070 PMCID: PMC4056650 DOI: 10.3945/jn.114.190728] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The Mushroom Council convened the Mushrooms and Health Summit in Washington, DC, on 9-10 September 2013. The proceedings are synthesized in this article. Although mushrooms have long been regarded as health-promoting foods, research specific to their role in a healthful diet and in health promotion has advanced in the past decade. The earliest mushroom cultivation was documented in China, which remains among the top global mushroom producers, along with the United States, Italy, The Netherlands, and Poland. Although considered a vegetable in dietary advice, mushrooms are fungi, set apart by vitamin B-12 in very low quantity but in the same form found in meat, ergosterol converted with UV light to vitamin D2, and conjugated linoleic acid. Mushrooms are a rare source of ergothioneine as well as selenium, fiber, and several other vitamins and minerals. Some preclinical and clinical studies suggest impacts of mushrooms on cognition, weight management, oral health, and cancer risk. Preliminary evidence suggests that mushrooms may support healthy immune and inflammatory responses through interaction with the gut microbiota, enhancing development of adaptive immunity, and improved immune cell functionality. In addition to imparting direct nutritional and health benefits, analysis of U.S. food intake survey data reveals that mushrooms are associated with higher dietary quality. Also, early sensory research suggests that mushrooms blended with meats and lower sodium dishes are well liked and may help to reduce intakes of red meat and salt without compromising taste. As research progresses on the specific health effects of mushrooms, there is a need for effective communication efforts to leverage mushrooms to improve overall dietary quality.
Collapse
Affiliation(s)
- Mary Jo Feeney
- Consultant to the Food and Agriculture Industries, Los Altos, CA
| | - Johanna Dwyer
- Tufts Medical School and USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Clare M. Hasler-Lewis
- Robert Mondavi Institute for Wine and Food Science, University of California, Davis, Davis, CA
| | - John A. Milner
- Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Manny Noakes
- Commonwealth Scientific and Industrial Research Organization, Adelaide, Australia
| | | | | | - Robert B. Beelman
- Center for Plant and Mushroom Products for Health, Department of Food Science, The Pennsylvania State University, University Park, PA
| | | | - Margherita T. Cantorna
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA
| | - Lisa A. Castlebury
- Systematic Mycology and Microbiology Laboratory, Agricultural Research Service, USDA, Beltsville, MD
| | - Shu-Ting Chang
- The Chinese University of Hong Kong, McKellar, Australian Capital Territory, Australia
| | - Lawrence J. Cheskin
- Johns Hopkins Weight Management Center and Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Roger Clemens
- International Center for Regulatory Science, School of Pharmacy, University of Southern California, Los Angeles, CA
| | | | | | - David B. Haytowitz
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Van S. Hubbard
- NIH Division of Nutrition Research Coordination and the National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Department of Health and Human Services, Bethesda, MD
| | - David Law
- Gourmet Mushrooms, Inc, Sebastopol, CA
| | | | | | - Susan S. Percival
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL
| | - Gabriela Riscuta
- Nutritional Science Research Group, Division of Cancer Prevention, National Cancer Institute, NIH, Rockville, MD
| | | | - Suzanne Thornsbury
- Market and Trade Economics Division, Economic Research Service, USDA, Washington, DC
| | | | | | - Dayong Wu
- Nutritional Immunology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| |
Collapse
|
45
|
Fujioka K, Shimizu N, Manome Y, Ikeda K, Yamamoto K, Tomizawa Y. Discrimination method of the volatiles from fresh mushrooms by an electronic nose using a trapping system and statistical standardization to reduce sensor value variation. SENSORS 2013; 13:15532-48. [PMID: 24233028 PMCID: PMC3871107 DOI: 10.3390/s131115532] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 11/03/2013] [Accepted: 11/06/2013] [Indexed: 12/27/2022]
Abstract
Electronic noses have the benefit of obtaining smell information in a simple and objective manner, therefore, many applications have been developed for broad analysis areas such as food, drinks, cosmetics, medicine, and agriculture. However, measurement values from electronic noses have a tendency to vary under humidity or alcohol exposure conditions, since several types of sensors in the devices are affected by such variables. Consequently, we show three techniques for reducing the variation of sensor values: (1) using a trapping system to reduce the infering components; (2) performing statistical standardization (calculation of z-score); and (3) selecting suitable sensors. With these techniques, we discriminated the volatiles of four types of fresh mushrooms: golden needle (Flammulina velutipes), white mushroom (Agaricus bisporus), shiitake (Lentinus edodes), and eryngii (Pleurotus eryngii) among six fresh mushrooms (hen of the woods (Grifola frondosa), shimeji (Hypsizygus marmoreus) plus the above mushrooms). Additionally, we succeeded in discrimination of white mushroom, only comparing with artificial mushroom flavors, such as champignon flavor and truffle flavor. In conclusion, our techniques will expand the options to reduce variations in sensor values.
Collapse
Affiliation(s)
- Kouki Fujioka
- Department of Molecular Cell Biology, Institute of DNA Medicine, the Jikei University School of Medicine, Tokyo 105-8461, Japan; E-Mails: (K.F.); (K.I.)
| | - Nobuo Shimizu
- Metric Science Group, Department of Data Science, the Institute of Statistical Mathematics, Tokyo 190-8562, Japan; E-Mail:
| | - Yoshinobu Manome
- Department of Molecular Cell Biology, Institute of DNA Medicine, the Jikei University School of Medicine, Tokyo 105-8461, Japan; E-Mails: (K.F.); (K.I.)
- Core Research Facilities, the Jikei University School of Medicine, Tokyo 105-8461, Japan; E-Mail:
| | - Keiichi Ikeda
- Department of Molecular Cell Biology, Institute of DNA Medicine, the Jikei University School of Medicine, Tokyo 105-8461, Japan; E-Mails: (K.F.); (K.I.)
| | - Kenji Yamamoto
- National Center for Global Health and Medicine, Tokyo 162-8655, Japan; E-Mail:
| | - Yasuko Tomizawa
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo 162-8666, Japan
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +81-3-3353-8111
| |
Collapse
|
46
|
Han JJ, Bao L, He LW, Zhang XQ, Yang XL, Li SJ, Yao YJ, Liu HW. Phaeolschidins A-E, five hispidin derivatives with antioxidant activity from the fruiting body of Phaeolus schweinitzii collected in the Tibetan Plateau. JOURNAL OF NATURAL PRODUCTS 2013; 76:1448-1453. [PMID: 23869482 DOI: 10.1021/np400234u] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Five new hispidin derivatives, phaeolschidins A-E (1-5), as well as two known natural products, pinillidine (6) and hispidin (7), were isolated from the fruiting bodies of Phaeolus schweinitzii collected in the Tibetan Plateau. The structures of the new compounds were elucidated by spectroscopic methods. Phaeolschidins A-D (1-4) are new bishispidins. Phaeolschidin E (5) is a new class of hispidin derivative in which one pyrrolidin-2-one moiety was linked to C-3 of hispidin. The antioxidant activity of 1-7 was evaluated using three methods: the DPPH scavenging assay, the total antioxidant capacity assay, and the lipid peroxidation assay. Hispidin showed the strongest antioxidant activity of all tested compounds. This is the first report of secondary metabolites from the fungus P. schweinitzii.
Collapse
Affiliation(s)
- Jun-Jie Han
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences , No. 9 Beiertiao, Zhongguancun, Haidian District, Beijing 100190, People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|