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Food Chem Toxicol. 2015 Dec;86:41-55. doi: 10.1016/j.fct.2015.09.008. Epub 2015 Sep 12.

Amanita phalloides poisoning: Mechanisms of toxicity and treatment.

Author information

1
UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua José Viterbo Ferreira n° 228, 4050-313 Porto, Portugal. Electronic address: jugarcia_18@hotmail.com.
2
UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua José Viterbo Ferreira n° 228, 4050-313 Porto, Portugal.
3
Department of Cell and Molecular Biology, Computational and Systems Biology, Uppsala University, Biomedical Center, Box 596, 751 24 Uppsala, Sweden.
4
CIMO/School of Agriculture, Polytechnique Institute of Bragança, Campus de Santa Apolónia, Apartado 1172, 5301-854 Bragança, Portugal.
5
UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua José Viterbo Ferreira n° 228, 4050-313 Porto, Portugal. Electronic address: felixdc@ff.up.pt.

Abstract

Amanita phalloides, also known as 'death cap', is one of the most poisonous mushrooms, being involved in the majority of human fatal cases of mushroom poisoning worldwide. This species contains three main groups of toxins: amatoxins, phallotoxins, and virotoxins. From these, amatoxins, especially α-amanitin, are the main responsible for the toxic effects in humans. It is recognized that α-amanitin inhibits RNA polymerase II, causing protein deficit and ultimately cell death, although other mechanisms are thought to be involved. The liver is the main target organ of toxicity, but other organs are also affected, especially the kidneys. Intoxication symptoms usually appear after a latent period and may include gastrointestinal disorders followed by jaundice, seizures, and coma, culminating in death. Therapy consists in supportive measures, gastric decontamination, drug therapy and, ultimately, liver transplantation if clinical condition worsens. The discovery of an effective antidote is still a major unsolved issue. The present paper examines the clinical toxicology of A. phalloides, providing the currently available information on the mechanisms of toxicityinvolved and on the current knowledge on the treatment prescribed against this type of mushrooms. Antidotal perspectives will be raised as to set the pace to new and improved therapy against these mushrooms.

KEYWORDS:

Amanita phalloides; Amatoxins; Kidney; Liver; RNA polymerase II; Therapy

PMID:
26375431
DOI:
10.1016/j.fct.2015.09.008
[Indexed for MEDLINE]

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