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Amanita muscaria and Amanita pantherina poisoning: Two syndromes
Abstract
A. muscaria contains more excitatory ibotenic acid and less depressant muscimol compared to A. pantherina. In this study A. muscaria poisoned patients were more often confused (26/32, p=0.01) and agitated (20/32, p=0.03) compared to those poisoned with A. pantherina (8/17 and 5/17). Patients poisoned with A. pantherina were more commonly comatose (5/17) compared to those poisoned with A. muscaria (2/32) (p=0.03). In conclusion, the so-called ibotenic or pantherina-muscaria syndrome might be divided into two subtypes.
... Ibotenic acid and muscimol are major active substances contained in Amanita muscaria and A. pantherine mushrooms [4,5]. The clinical effects of poisoning by these mushrooms in the central nervous system include agitation, hallucinations, tremor, drowsiness, respiratory depression, and coma [15][16][17][18][19][20]. Myoclonus and ocular clonus/nystagmus are not common with ibotenic acid and muscimol toxicity in humans [15]; however, they were reported in almost half of our patients. ...
... Myoclonus and ocular clonus/nystagmus are not common with ibotenic acid and muscimol toxicity in humans [15]; however, they were reported in almost half of our patients. Typically, the clinical effects of A muscaria and A. pantherine poisoning do not last long [15,19,20]. However, in one report, the patient was in a state of coma for 72 h after ingestion of Amanita muscaria and stayed in a hospital for 4 days [21]. ...
... The other one case report described symptoms persisting for 5 days in a patient who consumed A. muscaria; this patient also experienced a seizure-like episode, altered consciousness, and paranoid psychosis [22]. Some of our patients experienced clinical effects that might be longer than those caused by ibotenic-acid-and muscimol-containing mushrooms [15][16][17][18][19][20]. ...
The current data regarding poisoning associated with ingestion of fungus-infected cicada nymphs are limited. We performed a retrospective cohort study of patients who ingested fungus-infected cicada nymphs and were referred to the Ramathibodi Poison Center for consultation from June 2010 to June 2022. Thirty-nine patients were included for analysis. Most were men (53.8%). Mean age was 40.2 ± 15.0 years. All nymphs were ingested as a health/food supplement. Thirty-one patients (79.5%) reported gastrointestinal symptoms. Median time from ingestion to symptom onset was 5 h. Twenty-nine patients (74.4%) reported neurological symptoms, including tremor, myoclonus, muscle rigidity, nystagmus/ocular clonus, drowsiness, dysarthria, seizure, and confusion. Some complained of dizziness, urinary retention, and jaw stiffness. Most patients (94.9%) were admitted to the hospital. Median hospital stay was 3 days. Ibotenic acid was detected in the blood and urine samples of one patient. All received supportive care. Four patients developed infectious complications. No deaths occurred. Consuming fungus-infected cicada nymphs may cause poisoning in humans. Gastrointestinal and neurological symptoms were common. Ibotenic acid might be the underlying cause. The main treatment is supportive care and appropriate management of complications. Education of the general public is advocated to prevent the incidence of this type of poisoning.
... Both ibotenic acid and muscimol are readily soluble in water so it is reported that fly agaric may be safely consumed if the cuticle is peeled off and water in which mushrooms were cooked discarded (Michelot & Melendez-Howell, 2003). A study found that summer forms of these mushrooms have more psychotropic potential than autumn forms, with ten times more ibotenic acid content (Vendramin & Brvar, 2014). There are other related, biologically active compounds found in mushrooms of the section Amanita; muscazone is a dihydrogenated oxazole derivative, formed when ibotenic acid is subjected to UV light. ...
... The symptoms usually resolve within 12-24 hours. Gastrointestinal symptoms are reported, but inconsistently; vomiting is more often seen than diarrhea (Michelot & Melendez-Howell, 2003;Vendramin & Brvar, 2014;Diaz, 2017). One study that investigated cases of A. muscaria and A. pantherina poisoning found slight differences in the presentation of symptoms in these two species, with agitation and confusion more frequently experienced after A. muscaria ingestion and coma after A. pantherina ingestion. ...
... One study that investigated cases of A. muscaria and A. pantherina poisoning found slight differences in the presentation of symptoms in these two species, with agitation and confusion more frequently experienced after A. muscaria ingestion and coma after A. pantherina ingestion. The slight difference in intoxication symptoms between these two mushrooms might be due to different ibotenic acid/muscimol content ratios some authors reported; A. muscaria was found to contain higher levels of ibotenic acid compared to muscimol, while A. pantherina contained more muscimol (Vendramin & Brvar, 2014); A. pantherina may thus act more quickly in respect to sedative effects, as ibotenic acid needs to be converted to muscimol first to activate GABA receptors. Most intoxications are mild and severe cases with death outcomes are very rare (Michelot & Melendez-Howell, 2003). ...
... As muscarine is found only in extremely small quantities in these species, cholinergic syndromes are not present. However, there is some debate on the frequency of gastrointestinal (GI) symptoms, variable effects based on age, and the existence of separate syndromes for AM and AP [9,10]. ...
... Despite being widely recognized as a psychoactive mushroom, clinical reports of toxicity from AM and AP in humans are limited to several case reports, a small US pediatric case series, and a Slovenian case series [9][10][11][12]. Thus our objective was to further describe the clinical effects of ibotenic acid and muscimol containing mushrooms reported to a regional poison control center in the United States. ...
... Vendramin reported 32 cases of AM exposure and 17 cases of AP exposure from a Slovenian poison control center [10]. All but one case were foraging errors. ...
Background: Amanita muscaria (AM) and A. pantherina (AP) contain ibotenic acid and muscimol and may cause both excitatory and sedating symptoms. Gastrointestinal (GI) symptoms are not classically described but have been reported. There are relatively few reported cases of poisoning with these mushrooms in North America.
Methods: This is a retrospective review of ingestions of ibotenic acid and muscimol containing mushrooms reported to a United States regional poison center from 2002–2016. Cases were included if identification was made by a mycologist or if AM was clearly described.
Results: Thirty-four cases met inclusion criteria. There were 23 cases of AM, 10 AP, and 1 A. aprica. Reason for ingestion included foraging (12), recreational (6), accidental (12), therapeutic (1), self-harm (1), and unknown (2). Of the accidental pediatric ingestions 4 (25%) were symptomatic. None of the children with a symptomatic ingestion of AM required admission. A 3-year-old male who ingested AP had vomiting, agitation, and lethargy and received benzodiazepines. He was intubated and had a 3-day ICU stay. There were 25 symptomatic patients. All but one patient developed symptoms within 6 h. Six patients had symptoms for less than 6 h while 15 had symptoms lasting less than 24 h. Ingestions of AP were more symptomatic than AM with regard to the presence of any GI symptoms (80% vs. 35%), central nervous system (CNS) depression (70% vs. 35%), and CNS excitation (70% vs. 35%) respectively. Five patients were intubated. No patients experienced hypotension, seizures, acute kidney injury, or hepatotoxicity. No deaths were reported.
Discussion: Ingestion of ibotenic acid/muscimol containing mushrooms often produces a syndrome with GI upset, CNS excitation, and CNS depression either alone or in combination. Ingestion of AP was associated with a higher rate of symptoms compared to AM.
... Amanita pantherina is a mushroom which is widespread in Asia, on the North American continent, in Europe, and in some areas of the southern hemisphere [7]. It contains ibotenic acid and muscimol [8,9]. We report on a patient with A. pantherina poisoning who developed a comatose state associated with a burst suppression pattern on EEG and recovered to a normal state after treatment. ...
... As the patient developed coma 3 h after ingestion of A. pantherina without any other cause, she was diagnosed as having A. pantherina poisoning, though a chromatographic assay of the poison was not performed. Clinical symptoms of A. pantherina poisoning consist of a dysfunction of the peripheral autonomic nerves, gastrointestinal tract, Epilepsy & Behavior Case Reports 4 (2015) 82-83 and central nervous system and appear from 30 min to 2 h after ingestion [7][8][9]. Amanita pantherina poisoning is less lethal compared with poisoning by some other species of the Amanita genus, and patients suffering from the poisoning usually recover without consequences. The course of illness in our patient fits well with that of A. pantherina poisoning, but the severity of symptoms may vary depending on the amount ingested and individual susceptibility to the toxins [7][8][9]. ...
... Amanita pantherina poisoning is less lethal compared with poisoning by some other species of the Amanita genus, and patients suffering from the poisoning usually recover without consequences. The course of illness in our patient fits well with that of A. pantherina poisoning, but the severity of symptoms may vary depending on the amount ingested and individual susceptibility to the toxins [7][8][9]. ...
We report on a patient with Amanita pantherina poisoning who showed a burst suppression pattern on electroencephalography during a comatose state. The patient recovered without sequelae a week after ingestion. Burst suppression pattern is defined as alternating bursts and periods of electrical silence, and it is associated with comatose states of various causes. The major toxins contained in A. pantherina are ibotenic acid, an excitatory amino acid at the glutamate receptors, and muscimol, an agonist of the gamma-aminobutyric acid receptors. Alteration of the synaptic transmission in the central nervous system by these toxins may lead to a burst suppression pattern.
... Besides, neurotoxins have been found in Amanita genus such as Amanita muscaria and Amanita pantherina. Ibotenic acid (IBA) and muscimol (MUS) are the major mushroom toxins with neurotoxicity in this kind of Amanitas [6,7]. Their poisoning symptoms include dizziness, nervousness, altered perceptions, muscle twitches and numbness in the limbs [6,7]. ...
... Ibotenic acid (IBA) and muscimol (MUS) are the major mushroom toxins with neurotoxicity in this kind of Amanitas [6,7]. Their poisoning symptoms include dizziness, nervousness, altered perceptions, muscle twitches and numbness in the limbs [6,7]. ...
Ibotenic acid (IBA) is an amino acid and muscimol (MUS) is the decarboxyl derivative of IBA. They are mushroom neurotoxins with high polarity and low molecular weight. Only one transition (159->113 for IBA and 115 -> 98 for MUS) can be found when directly measured by high performance liquid chromatography-triple quadrupole mass spectrometry (LC-MS/MS). Therefore, the identification and quantification of trace amount of the toxins in biomaterial are difficult. A highly sensitive and accurate analytical method for IBA and MUS in plasma was developed by LC-MS/MS with the application of bimolecular dansylation and internal standard calibration. Acetonitrile was used for protein precipitation and for toxin extraction from plasma. The toxins and internal standards (L-tyrosine-¹³C9,¹⁵N for IBA and tyramine-d4 for MUS) were derivatized with dansyl chloride (DNSCl). The reaction conditions of the bimolecular dansylation were optimized and the fragmentation pathways of the derivatives in MS/MS were studied. Method validation was carried out according to the Bioanalytical Method Validation Guidance for Industry (FDA, USA, 2018).The limits of detection for IBA and MUS in plasma were 0.3 ng mL⁻¹ and 0.1 ng mL⁻¹, respectively. The linear ranges in plasma were 1 – 500 ng mL⁻¹ and 1 – 200 ng mL⁻¹ with the correlation coefficients of 0.998 and 0.999 for IBA and MUS, respectively. The recoveries at three spiked levels were 90.7% – 111.4% with relative standard deviations (RSDs) of 6.4% – 10.3% for IBA and the results were 85.1% – 94.2% with RSDs of 5.0% – 8.9% for MUS. The toxin levels in patients’ plasma samples under different poisoning degree were presented.
... Severe poisoning is potentially lethal. A recent study suggested that there were clinical differences between poisoning by A. muscaria (more prominent confusion and agitation) versus A. pantherina (more prominent occurrence of coma) warranting division into two distinct clinical subgroups (Vendramin and Brvar, 2014). In this retrospective study the authors reported that patients poisoned by A. muscaria were more confused and agitated than those poisoned by A. pantherina, while this latter group were more commonly comatose, though numbers were small in each group (32 for A. muscaria, 17 for A. pantherina) (Vendramin and Brvar, 2014). ...
... A recent study suggested that there were clinical differences between poisoning by A. muscaria (more prominent confusion and agitation) versus A. pantherina (more prominent occurrence of coma) warranting division into two distinct clinical subgroups (Vendramin and Brvar, 2014). In this retrospective study the authors reported that patients poisoned by A. muscaria were more confused and agitated than those poisoned by A. pantherina, while this latter group were more commonly comatose, though numbers were small in each group (32 for A. muscaria, 17 for A. pantherina) (Vendramin and Brvar, 2014). We consider such subdivision premature, as we suggest it may make the diagnostic process more complicated and the numbers of cases reported in this study are small, the findings currently unverified by independent studies. ...
Mushroom poisoning is a significant and increasing form of toxin-induced-disease. Existing classifications of mushroom poisoning do not include more recently described new syndromes of mushroom poisoning and this can impede the diagnostic process. We reviewed the literature on mushroom poisoning, concentrating on the period since the current major classification published in 1994, to identify all new syndromes of poisoning and organise them into a new integrated classification, supported by a new diagnostic algorithm. New syndromes were eligible for inclusion if there was sufficient detail about both causation and clinical descriptions. Criteria included: identity of mushrooms, clinical profile, epidemiology, and the distinctive features of poisoning in comparison with previously documented syndromes. We propose 6 major groups based on key clinical features relevant in distinguishing between poisoning syndromes. Some clinical features, notably gastrointestinal symptoms, are common to many mushroom poisoning syndromes. Group 1 - Cytotoxic mushroom poisoning. Syndromes with specific major internal organ pathology: (Subgroup 1.1; Primary hepatotoxicity); 1A, primary hepatotoxicity (amatoxins); (Subgroup 1.2; Primary nephrotoxicity); 1B, early primary nephrotoxicity (amino hexadienoic acid; AHDA); 1C, delayed primary nephrotoxicity (orellanines). Group 2 - Neurotoxic mushroom poisoning. Syndromes with primary neurotoxicity: 2A, hallucinogenic mushrooms (psilocybins and related toxins); 2B, autonomic-toxicity mushrooms (muscarines); 2C, CNS-toxicity mushrooms (ibotenic acid/muscimol); 2D, morel neurologic syndrome (Morchella spp.). Group 3 - Myotoxic mushroom poisoning. Syndromes with rhabdomyolysis as the primary feature: 3A, rapid onset (Russula spp.); 3B, delayed onset (Tricholoma spp.). Group 4 – Metabolic, endocrine and related toxicity mushroom poisoning. Syndromes with a variety of clinical presentations affecting metabolic and/or endocrine processes: 4A, GABA-blocking mushroom poisoning (gyromitrins); 4B, disulfiram-like (coprines); 4C, polyporic mushroom poisoning (polyporic acid); 4D, trichothecene mushroom poisoning (Podostroma spp.); 4E, hypoglycaemic mushroom poisoning (Trogia venenata); 4F, hyperprocalcitoninemia mushroom poisoning (Boletus satanas); 4G, pancytopenic mushroom poisoning (Ganoderma neojaponicum). Group 5 - Gastrointestinal irritant mushroom poisoning. This group includes a wide variety of mushrooms that cause gastrointestinal effects without causing other clinically significant effects. Group 6 - Miscellaneous adverse reactions to mushrooms. Syndromes which do not fit within the previous 5 groups: 6A, Shiitake mushroom dermatitis; 6B, erythromelagic mushrooms (Clitocybe acromelagia); 6C, Paxillus syndrome (Paxillus involutus); 6D, encephalopathy syndrome (Pleurocybella porrigens).
... In more severe cases, symptoms include: psychomotor agitation rising up to madness (the so called panterin madness), elevated muscle tone, seizures, flushing, increased body temperature up to 40°C. The usual duration of clinical manifestation after Amanita muscaria intoxication is 8 –24 hours although it may sometimes continue for 5 days (Vendramin & Brvar, 2014). In extremely severe poisoning coma, circulatory and respiratory failure leading to death can occur (Santora et al., 2005). ...
... In extremely severe poisoning coma, circulatory and respiratory failure leading to death can occur (Santora et al., 2005). Since mushrooms grow freely in wild, they take part in cycling of heavy metals in our lithosphere and this potential intoxication should be kept in mind in case of prolonged clinical manifestation (Łukasik-Głębocka, et al., 2011; Drewnowska et al., 2012; Vendramin & Brvar, 2014). In our patient it was not an accidental poisoning. ...
Red fly agaric poisoning is rare. It can be consumed for suicidal purposes or its psychedelic effect. The paper describes the case of a young men, who fell into a coma after ingestion of the red toadstools. Quick identification of the poison, early use of gastric lavage and symptomatic treatment resulted in regression of symptoms and lead to the patient's discharge from the hospital on the third day after intoxication. Authors discussing the poisonous alkaloids contained in the red toadtools: ibotenic acid, muscimol, muscasone and muscarine and theirs properties, responsible for the symptoms of intoxication.
... and Amanita muscaria (L.) Lam. [55,56]. However, other species closely related to these have been suspected of causing the syndrome, ...
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.
https://academic.oup.com/mmy/article-abstract/doi/10.1093/mmy/myae033/7640032?utm_source=etoc&utm_campaign=mmy&utm_medium=email
... and Amanita muscaria (L.) Lam. [55,56]. However, other species closely related to these have been suspected of causing the syndrome, ...
https://academic.oup.com/mmy/advance-article-abstract/doi/10.1093/mmy/myae033/7640032?redirectedFrom=fulltext
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 manifestation 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. Lay Summary We propose a review of the literature that describes the main syndromes resulting from the consumption of toxic fungal species, reporting symptoms and clinical manifestations, latency times and, where possible, diagnostic tools for recognising the species involved and interventions to be carried out.
... There is no antidote against fly agaric poisoning. Since the symptoms are cholinergic and anticholinergic, atropine and physostigmine are contraindicated [66][67][68][69][70]. ...
A multidisciplinary pharmacognostic, forensic and pharmaceutical, organizational and legal, clinical and pharmacological, forensic and medical, toxicological, chemical evaluation of the irrational use of spices in smoking mixtures from the group of entheogens was carried out. An expert assessment of spices – plants and mushrooms containing psychoactive substances with hallucinogenic effects. Forensic and pharmaceutical practice was analyzed. A conclusion was made about the irrational use of smoking mixtures from the group of entheogens of the amanita muscaria mushroom, which contain psychoactive substances – psilocybin or psilocin. A forensic medical and toxicological study of amanita poisoning was conducted. Informed about pharmaceutical safety measures in case of amanita poisoning. A pharmacognostic study of "Amanita muscaria" – a fly agaric mushroom was conducted. According to the results of the normative study of the features of the circulation of fly agaric entheogens, normative initiatives are proposed.
... There is no antidote against fly agaric poisoning. Since the symptoms are cholinergic and anticholinergic, atropine and physostigmine are contraindicated [66][67][68][69][70]. ...
A multidisciplinary pharmacognostic, forensic and pharmaceutical, organizational and legal, clinical and pharmacological, forensic and medical, toxicological, chemical evaluation of the irrational use of spices in smoking mixtures from the group of entheogens was carried out. An expert assessment of spices-plants and mushrooms containing psychoactive substances with hallucinogenic effects. Forensic and pharmaceutical practice was analyzed. A conclusion was made about the irrational use of smoking mixtures from the group of entheogens of the amanita muscaria mushroom, which contain psychoactive substances-psilocybin or psilocin. A forensic medical and toxicological study of amanita poisoning was conducted. Informed about pharmaceutical safety measures in case of amanita poisoning. A pharmacognostic study of "Amanita muscaria"-a fly agaric mushroom was conducted. According to the results of the normative study of the features of the circulation of fly agaric entheogens, normative initiatives are proposed.
... 7 The average duration of effects after ingesting A. muscaria is between 8 and 24 hours, with only one known case describing a 5-day paranoid psychosis and coma lasting 72 hours; this is mainly due to the amount ingested (13 mushrooms caps). [17][18][19] Along with the psychoactive compounds, the A. muscaria mushroom also contains a myriad of other compounds that include antioxidants, pigments, and polysaccharides. Although the mushroom has adverse effects which require supervised and cautious design studies, there is great potential and versatility of beneficial effects such as cell/neuroprotection, cardio protection, hepatoprotection, inflammation process, oxidative stress, and even the development of new drugs. ...
Herbal products found in nature can serve as great systems of study for drug design. The Amanita muscaria mushroom is native to many parts of the Northern Hemisphere and has a very distinctive appearance with its red cap and white spotted warts. The mushroom comprises several pharmacologically active alkaloids, including muscazone, muscarine, ibotenic acid, and muscimol, the latter two compounds being potent GABA agonists. Muscimol has served as
a backbone in the design of GABA agonists devoid of effects on the GABA-metabolizing enzyme, GABA transaminase, and GABA uptake systems. In this sense, several analogs of muscimol have been
synthesized and studied including THIP, THPO, iso-THIP, iso-THAZ and 4-PIOL which all interact with the GABA receptors much differently. The growing pharmacological and toxicological interest based on many conflicting opinions on the use of the neuroprotective role of muscimol analogs against some neurodegenerative diseases, its potent role in the treatment of cerebral ischemia and other
socially significant health conditions provided the basis for this review.
... Analysis of stomach contents and urine revealed the presence of ibotenic acid and muscimol [11]. The duration of clinical symptoms averages 5-24 h [12]. These symptoms may also result from the presence of other compounds. ...
In recent months, there has been a new trend involving the consumption of Amanita muscaria. The aim of this article was to investigate the reasons for consumption, the form taken and the adverse symptoms that were indicated by those consuming Amanita muscaria. After analysing 5600 comments, 684 people were included in the study, who, in social media groups such as Facebook, stated the purpose of consuming the mushroom (n = 250), the form of mushroom they were taking (n = 198) or the adverse symptoms they experienced (n = 236). The gender of the subjects differentiated the parameters analysed. In the study group of women, the main purpose of consuming Amanita muscaria was to reduce pain, as well as to reduce skin problems, while in men it was mainly to relieve stress, reduce the severity of depressive symptoms and reduce insomnia (p < 0.001). With regard to the form of mushroom ingested, tincture was predominant in the women’s study group, while dried was predominant in the men (p < 0.001). In terms of side effects, women reported primarily headaches, while men reported nausea, vomiting, abdominal pain and drowsiness (p < 0.001). Advanced research on Amanita muscaria should be carried out to make the community aware of the toxicity of this fungus.
... Beetroot (Beta vulgaris L.) also called garden beet belongs to the Chenopodiaceae family of the order Caryophyllales. The order Caryophyllales comprises beetroot red, certain fungi and their non-edible tissues that contain betalain pigment (Vendramin and Brvar 2014). Since, although several plants species contain betalains, but only two sources, namely Beta vulgaris L. and Opuntia ficus-indica, are permitted by the EU for food colourant uses and labelled as E162 (Delgado-Varges and Lopez 2002). ...
Beetroot is one of the most important industrial crops from Caryophyllales order cultivated for its natural colourant, betalains and exceptionally high antioxidant activity. Like other natural pigments, betalains are also associated with reduced stability problem. The effectiveness of various additives for betalain and antioxidant stability was examined in this study. Beetroot (Beta vulgaris L.) cv. Crimson Globe was harvested at the physiological maturity stage used for this study. Each additive was added as per the prescribed limits given by Food Safety and Standards Authority of India (FSSAI) for food uses. Data on total betalain content, total colour change and total antioxidant activity in terms of CUPRAC were recorded after every 24-h interval till significant degradation was recorded in all incubations. Additives, namely 1% ascorbic acid, 10% glucose/ fructose, sucrose > 45%, EDTA 40 ppm and sodium benzoate 350 ppm, were found best for imparting maximum betalain stability. A lower concentration of salt (< 3.0%) was the best to impart stability of betalain pigments and antioxidant activity in beetroot extract. Almost in all incubations, betalains and colour degradation followed a similar trend; however, antioxidant activity was not the exact replica of betalain content. The stability of the pigment was confirmed by enhanced half-life and lower rate constant under first-order degradation kinetics.
... Diese Ähnlichkeit kann unter Umständen zu Verwechslungen führen (Hahn et al. 2000;Pegler 2002), die angesichts der dann konsumierten Quantität und unerwünschten Wirkungen zu gesundheitlichen Komplikationen führen können (Brvar et al. 2006). Bisweilen werden auch der Perlpilz (Amanita rubescens) und der Königsfliegenpilz (A. regalis) mit dem Fliegenpilz verwechselt, was nicht selten zu ebenso starken oder sogar stärkeren Vergiftungen führen kann (Elonen et al. 1979;Stijve 2004;Vendramin & Brvar 2014). Wenn auch starke Vergiftungsverläufe durch den Konsum größerer Mengen des Fliegenpilzes hervorgerufen werden können (Brvar et al. 2006), bleibt, um mit den nunmehr fünfzig Jahre alten Worten von Wieland (1968: 946) abzuschließen, der Eindruck, dass die Giftigkeit von A. muscaria "generell überbewertet" wird. ...
The fly agaric has long since been associated with such divergent properties as luck and lethality. This antinomy and the seeming incontestability with which some persons aver this, appears to contradict the by now well-known diverse uses this very mushroom is put to elsewhere. To reconcile this issue interdisciplinary, three methodological approaches were chosen, to wit, the completion of a questionnaire (N = 143) as well as the execution of an HPLC analysis and bioassays. The perceived toxicity of A. muscaria is indeed highly variable (ranging from utterly toxic to less so) and has been found to be contingent upon the interviewee's self-rated mycological knowledge, i.e., the more the interviewee reported to know about mushrooms in general, the less A. muscaria was judged toxic. It appears notwithstanding that most interviewees regard A. muscaria as highly toxic, albeit the meagre dataset on which this assumption is predicated allows for criticism. This portrayal of toxicity, however, argues against its traditional use for inebriation, which was during shamanic seances often depicted ethnographically as being marked by agitation and somnolence, whereas contemporary self-experiments highlight the rather unpopular effects elicited upon consumption, whereby glorification is probably prevented from being propagated. The biochemical analysis revealed that the highest concentrations of ibotenic acid and muscimol were detected in the dried mushroom caps that were only a few months old, although muscimol was significantly lower. While dried samples from the years 2019 and 2020 showed almost identical concentrations, no ibotenic acid and muscimol could be detected in samples that were two years old. Finally, it is argued that a more nuanced stance vis-à-vis the fly agaric's toxicity be entertained, due to its controversial yet present qualities as food and medicine.
... Confusion, agitation, and euphoria are the main tendencies in the case of A. muscaria, in which ibotenic acid is present in higher concentrations than muscimol, and somnolence and comatose in the case of A. pantherina, in which muscimol is the major compound. Currently, the symptoms following intoxication with these two mushrooms share the same name: the so-called ibotenic or pantherina-muscaria syndrome; some authors suggest making a distinction to underline the specificity of each mushroom and, therefore, of each compound [47]. However, because a portion of ibotenic acid is decarboxylated into muscimol in the stomach, the complete distinction regarding the effects of each compound is difficult [48]. ...
Amanita muscaria is the most emblematic mushroom in the popular representation. It is an ectomycorrhizal fungus endemic to the cold ecosystems of the northern hemisphere. The basidiocarp contains isoxazoles compounds that have specific actions on the central nervous system, including hallucinations. For this reason, it is considered an important entheogenic mushroom in different cultures whose remnants are still visible in some modern-day European traditions. In Siberian civilizations, it has been consumed for religious and recreational purposes for millennia, as it was the only inebriant in this region.
... A famous case is that of Count Achilles de Vecchi, an Italian diplomat residing in Washington, who died in 1897 after ingesting a large amount of mushrooms. The average duration of clinical manifestation is 8-24 hours [5] ; only 1 case described a 5-day paranoid psychosis [2] . In our report, the state of coma lasted 72 hours, and to our knowledge, it represents the first described case of prolonged coma. ...
Amanita muscaria is considered to be one of the most remarkable and beautiful mushrooms. It has a red or orange cap covered with small white plaques and its distinctive appearance makes accidental and severe intoxication very rare. Its consumption is sometimes used as a means of suicide or it can be consumed for its psychedelic effects, and in some cases, it can be mistaken for edible species. In this paper, we will discuss a patient who fell into a coma after accidental Amanita muscaria poisoning. Rapid identification of the mushroom allowed the regression of symptoms and discharge from the hospital on the fourth day after consumption.
Learning points:
Amanita muscaria is one of the most remarkable mushrooms for its distinctive appearance, but sometimes it can be mistaken for edible species.Amanita muscaria is a highly poisonous mushroom; the primary effects usually involve the central nervous system, and in severe poisoning, symptoms may manifest with coma and in rare cases lead to death.The rapid and correct identification of this mushroom is important for optimal risk assessment and in order to prescribe the best therapy.
... It is also characterized by vivid dreams and deep sleep poisoning. Depending on the amount of consumption, the duration of symptoms may be prolonged [60,61]. In addition to its toxic effects, A. pantherina was reported to have antioxidant potential ( ...
Antioxidants play an important role in suppressing oxidative stress. Natural sources contain many compounds that have antioxidant properties. Mushrooms that produce biologically active compounds can be classified as poisonous, edible, and inedible. In this study, antioxidant potentials of poisonous mushrooms were investigated. In the literature, the general characteristics of poisonous mushrooms, whose antioxidant potentials were determined by different methods, were reported. In addition, the symptoms arising from the consumption of these mushrooms were mentioned. There are also studies on the toxic compounds of poisonous mushrooms with the reported antioxidant activity. As a result, it was determined that poisonous mushrooms have antioxidant potentials besides their toxic effects.
... El ácido iboténico evoca efectos enteógenos en el ser humano; el pico de la intoxicación es alcanzado aproximadamente entre dos y tres horas después de la ingestión. A. muscaria contiene más ácido iboténico excitador y menos muscimol depresivo, en comparación con A. pantherina; por lo tanto, los pacientes presentan cuadros clínicos diferentes, como los descriptos y se considera entonces que el llamado síndrome iboténico o síndrome pantherina/muscaria podría dividirse en dos subtipos (63). ...
... Somemes, bodies are buried at remote locaons to hide Table 3: Chromatographic and spectroscopic methods used to detect various fungal species from the forensic (mushroom) samples. [34] [53][54][55][56][57][58][59][60][61][62][63][64] [65][66][67][68] [21,66] [44] [69] [70][71][72][73][74][75] ...
... Mushroom fruiting bodies consist of approximately 92.5 wt% water, 4.3 wt% carbohydrates, 2.5 wt% proteins, 0.1 wt% fat, 0.6 wt% minerals (K, P, Ca, Mg, Na, Zn, Fe) and 0.006 wt% vitamins (B3, B5, B2, B6, B1) 26 . Besides them, Amanita muscaria contains also ibotenic acid, muscimol, hydroxypyrollidone derivatives (structural formulas on Fig. 2b, right) 16,27,28 . Carbohydrates are mainly represented by glucans -polysaccharide that widely distributed in the fungal cell walls; fungi proteins exist in compounds like proteoglycans or glycoproteins where they are covalently bonded with glucans. ...
Combination therapy remains one of the most promising and intensively developed direction in cancer treatment. This study is aimed to combine and investigate the anticancer properties of silver nanoparticles (NPs) and Amanita muscaria mushroom in gel formulation. For this, hyaluronic acid was used as gel-forming agent, whereas Amanita muscaria extract was used as capping agent during silver and ultrasmall iron oxide (MAg) NPs synthesis. Amanita muscaria compounds formed NP’s surface layer and contributed anticancer properties, whereas silver NPs contributed anticancer, fluorescence and photoactive properties to the gel. Physicochemical characterization included X-ray diffraction (XRD), microscopies (SEM, cryo-SEM, TEM, confocal fluorescence), spectrofluorometric method, thermogravimetric analysis (TGA), dynamic light scattering (DLS) techniques, energy dispersive (EDS), Fourier transform infrared (FTIR) and ultraviolet–visible (UV-Vis) spectroscopies, zeta-potential and rheological measurements. Microstructure analysis of hyaluronic acid/MAg NPs gel was performed by cryo-SEM technique. We showed that hyaluronic acid is a perfect gel-forming agent from both biomedical and technological points of view. It is well-mixed with MAg NPs forming stable gel formulation; high homogeneity of hyaluronic acid/MAg NPs gel was shown by SEM EDS elemental mapping. Microstructure of the gel was found to be highly ordered and consisted of domains from perforated parallel tubular structures. This finding expanded our understanding of gels and broke the stereotype of gel structure as chaotic network of fibers. Cytotoxicity studies performed on 2D and 3D HeLa cell cultures pointed to a high potential of hyaluronic acid/MAg NPs gel for local treatment of cancer. Cell response was found to be significantly different for 2D and 3D cell cultures that was related to their different cytoarhitecture and gene expression. Thus, the results of the cellular spheroids viability showed that they were significantly more resistant to the cytotoxic action of MAg NPs and their gel formulation than 2D cell culture. Hyaluronic acid used as gelling agent in gel formulation was found to increase an effectiveness of active components (MAg NPs, Amanita muscaria extract) probably improving their transport inside HeLa spheroids.
... Somemes, bodies are buried at remote locaons to hide Table 3: Chromatographic and spectroscopic methods used to detect various fungal species from the forensic (mushroom) samples. [34] [53][54][55][56][57][58][59][60][61][62][63][64] [65][66][67][68] [21,66] [44] [69] [70][71][72][73][74][75] ...
... Therefore, the effect of treatment of the fruitbodies before consumption may be important (Feeney 2010). Other aspects of A. muscaria toxicology are discussed by Michelot and Melendez-Howell (2003), Tsujikawa et al. (2006), and by Vendramin and Brvar (2014). ...
Fruiting bodies of Amanita muscaria and topsoil beneath from six background areas in northern regions of Poland were investigated for the concentration levels of Ag, Al, Ba, Ca, Cd, Co, Cu, Fe, Hg, K, Mg, Mn, Na, Rb, Sr, and Zn. In addition, the bioconcentration factors (BCF values) were studied for each of these metallic elements. Similar to studies from other basidiomycetes, A. muscaria showed species-specific affinities to some elements, resulting in their bioconcentration in mycelium and fruiting bodies. This mushroom growing in soils with different levels of the geogenic metallic elements (Ag, Al, Ba, Ca, Co, Cu, Fe, Hg, K, Mg, Mn, Na, Rb, Sr, and Zn) showed signs of homeostatic accumulation in fruiting bodies of several of these elements, while Cd appeared to be accumulated at a rate dependent of the concentration level in the soil substrate. This species is an efficient bio-concentrator of K, Mg, Cd, Cu, Hg, Rb, and Zn and hence also contributes to the natural cycling of these metallic elements in forest ecosystems.
... The consumption of this unmistakable fungus for the experience of its hallucinogenic effects is also disseminated in certain populations and cultures (Feeney 2010;Viess 2012;Sayin 2014), while (accidental) poisonings with the fly agaric (pantherina-muscaria syndrome based on ibotenic acid as the most potent toxin in the fruiting bodies) are also recorded. However, fatal outcomes are rare (2-5% of cases) by advanced diagnosis and good medical treatment (Michelot and Melendez-Howell 2003;Marciniak et al. 2010;Vendramin and Brvar 2014;Mikaszewska-Sokolewicz et al. 2016). ...
... The consumption of this unmistakable fungus for the experience of its hallucinogenic effects is also disseminated in certain populations and cultures (Feeney 2010;Viess 2012;Sayin 2014), while (accidental) poisonings with the fly agaric (pantherina-muscaria syndrome based on ibotenic acid as the most potent toxin in the fruiting bodies) are also recorded. However, fatal outcomes are rare (2-5% of cases) by advanced diagnosis and good medical treatment (Michelot and Melendez-Howell 2003;Marciniak et al. 2010;Vendramin and Brvar 2014;Mikaszewska-Sokolewicz et al. 2016). ...
Fruiting bodies of fungi are rich in multiple types of bioactive compounds with (potential) pharmaceutical effects. Many kinds of mushrooms are thus highly valued in traditional medicine in different cultures over the world for treatment of diseases and maintenance of good health. Modern science has uncovered functional principles in many medicinal species and assigned beneficial activities (antimicrobial, antiviral, anti-oxidative, immunomodulatory, anti-inflammatory, anti-tumorous, hypotensive, hepatoprotective, antidiabetic/hypoglycemic and hypocholesterolemic, mitogenic/regenerative, etc.) to a wealth of secondary metabolites, peptides, proteins, and sugar-based polymers. Compared to the extensive lists of bioactive compounds and the description of their distinctive effects, the pathways of their biosynthesis and the genes behind are largely understudied. This can now become changed by the many genomes which are provided by large-scale fungal sequencing programs. Among are many assembled genomes for important edible and medicinal mushroom species which can be used in genome mining for genes of interest, both for the synthesis of known products and for the synthesis of novel, so far undetected compounds. Also, genomes of other species offer possibilities to predict genes for the biosynthesis of formerly unnoticed bioactive fungal products of either biochemically already known or novel structure. We present here examples of recent identification of genes and gene clusters for bioactive compounds (different terpenoids, phenolics, polyketides, cyclic peptides, aegerolysins, lectins, protease inhibitors, and ribosome-inactivating proteins) in medicinal and edible fungi. Genome comparisons and gene mining identify related genes for similar products in other species. Usually, genes for medicinally interesting products are found in only a restricted range of species, inconsistently distributed over the fungal taxa. Some of the recognized medicinal species probably have genes for a higher variety of bioactive products than species which are estimated purely for their good edible value or species being commonly neglected for exploitation as food and medicine.
... However, the ratio of isoxazoles is different in both mushrooms, which explains the different clinical symptoms of poisoning by these two species of mushroons (?ukasik-G?ebocka et al., 2011;Vendramin and Brvar, 2014). ...
Amanita muscaria, the red fly agaric, is the most famous of all Amanita. The initial history of this fascinating
mushroom dates back to at least the 13th century. The use of mushrooms began in antiquity and is associated
with mysticism. The collection and consumption of mushrooms and other plants containing psychoactive
substances is now very popular, especially among young people who are experimenting with drugs. Ibotenic
acid and muscimol are the main active ingredients of this mushroom, but other substances are likely
to be involved in the psychotropic effects. A. muscaria also contains some other non-psychotropic substances
that are interesting not only for their chemical structure but also for their biological activity. Current
knowledge about chemistry, pharmacology and toxicology regarding this fungus is reviewed in this article.
... (Slatnar et al., 2015), ripening stage (Castellar, Solano, & Obón, 2012;Cayupána, Ochoa, & Nazareno, 2011; Herrera-Hernández, Guevara-Lara, Reynoso-Camacho, & Guzmán-Maldonado, 2011), salinity (Jain & Gould, 2015;Mulry, Hanson, & Dudle, 2015), oxidative stress (Wang, Chen, & Wang, 2007), light (Cao et al., 2012), concentration of micronutrients (Tyszka-Czochara et al., 2016), insects (Casique-Arroyo, Martínez-Gallardo, de la Vara, & Délano-Frier, 2014), drought (Marchesini, Yin, Colmer, & Veneklaas, 2014), growing temperature (Szopińska & Gawęda, 2013), and farming practice (Nizioł-Łukaszewska & Gawęda, 2014). In comparison to the widespread anthocyanins (Fernandes, Faria, Calhau, Freitas, & Mateus, 2014), betalains are limited to a number of families of the order Caryophylalles (Brockington et al., 2015) and certain fungi (Girod & Zryd, 1991), and their tissues are not often edible (Vendramin & Brvar, 2014). Beetroot red (E 162) and dehydrated beet (or beet powder) are currently the only betalain-based colorants approved for use in food products in Europe (EU, 2012) and the USA (FDA, 2009), respectively, which restricts the spectrum of shades that can be explored by the food industry. ...
The search for natural pigments has been driven by growing evidence indicating that synthetic colorants can cause deleterious health effects. Betalains, in addition to anthocyanins, have been proposed as an alternative to address this need. However, the incorporation of natural pigments poses some challenges to the food industry, such as reduced stability in comparison to their synthetic counterparts. Moreover, betalains are not well studied in comparison to anthocyanins and information about the effects of processing on their physicochemical properties and stability is scattered. Thus, this review will provide an overview of the recent research on the extraction and processing of betalains from natural sources, and comparison of their colorant and physicochemical properties with anthocyanins.
... Przeszukując bazę PubMed, znaleźliśmy tylko nieliczne opisy zatrucia muchomorem czerwonym stosowanym w celu odurzenia się. W ośrodku toksykologicznym uniwersytetu w Lublanie w ciągu 33 lat hospitalizowano 32 osoby zatrute muchomorem czerwonym, z czego tylko jedną w następstwie użycia grzyba jako halucynogenu (Vendramin & Brvar 2014). Sądząc po zawartości forów internetowych, w Polsce, wśród osób odurzających się są dość dobrze znane praktyki stosowania muchomorów przez dawnych mieszkańców Syberii, spopularyzowane między innymi dzięki Wassonom (1957,1968,1986). ...
The genus Amanita sect. Amanita harbors approximately 150 species in the world, and 27 species have been recognized in China. Some of the species in China have continuously caused poisoning. The responsible toxins should be ibotenic acid (IBO) and muscimol (MUS). However, species of the section Amanita containing IBO and MUS and their systematic positions are unclear. In this study, the contents of IBO and MUS in 84 samples of 24 species in section Amanita were detected using UPLC‒MS/MS, and the distribution of toxin-containing species in the molecular phylogeny was analyzed by the combined (ITS, nrLSU, RPB2, TUB2 and TEF1-α) dataset using maximum likelihood (ML) analysis and Bayesian inference (BI). Our results indicated that 10 of the 24 species contained IBO and MUS ranging from 0.6125 to 32.0932 and 0.0056-5.8685 g/kg dry weight, respectively. Among these 10 species, the toxins of eight species, including Amanita altipes, A. concentrica, A. flavopantherina, A. griseopantherina, A. pseudopantherina, A. rubrovolvata, A. subglobosa and A. sychnopyramis, were detected for the first time. In addition, the IBO and MUS contents of A. subglobosa in different growth stages showed that both toxins decreased in the mature stage. The phylogenetic analysis showed that all species of sect. Amanita from China were divided into 5 groups. And IBO- and MUS-containing species were gathered in clades Ⅰ and Ⅳ, but not all of the species in the two clades contain the toxins. No presence of IBO and MUS in the species of clades Ⅱ, Ⅲ and Ⅴ were confirmed.
Ingestion of Amanita muscaria mushrooms results in transient central nervous system excitation and depression mediated by its components, ibotenic acid and muscimol. The mushroom is distributed worldwide and ingestions occur with some frequency. Although these ingestions have traditionally been considered benign, serious complications can occur. We present 2 cases of serious toxicity, including a fatality. The first case was a 44-y-old man who presented to the emergency department (ED) after cardiopulmonary arrest approximately 10 h after ingesting 4 to 5 dried A muscaria mushroom caps, which he used for their mind-altering effects. Despite successful resuscitation, he remained unresponsive and hypotensive and died 9 days later. The second case was a 75-y-old man who presented to the ED after accidentally consuming one large A muscaria mushroom cap he foraged in Eastern Turkey. The patient initially presented to the ED with hallucinations followed by lethargy, and he was intubated for airway protection. The patient’s condition gradually improved, and he made a full recovery. A muscaria ingestion should not be considered benign as serious outcomes do occur. An understanding of how the main neuroactive chemicals, ibotenic acid and muscimol, affect the brain can help anticipate outcomes. Several high-risk features that portend a more serious course are identified.
ABSTRACT: The earliest publication related to mushroom poisoning dates back to 1837. To date, bibliometric analysis related to the field of mushroom poisoning has not been published. This study aimed to assess the most significant
publications in this field as well as the associated trends and important drivers in the research related to mushroom
poisoning. The Scopus database was screened to identify relevant publications on mushroom poisoning. A total of
985 publications with a minimum of five citations were identified and analyzed. Pearson’s correlation demonstrated
an insignificant weak negative correlation (Pearson’s correlation of −0.020, P > 0.01) between the number of years
since publication and the number of citation counts of a paper. Bradford’s law of scattering revealed that one-third of
publications were published in 31 core journals, with Clinical Toxicology topping the list (41 papers). VOSviewer was
used to generate a network visualization based on country. The United States was the largest contributor of publications on mushroom poisoning, contributing 19.6% of 985. China is an emerging leader in publications on mushroom
poisoning research since 2011, with the most recent average publication year of 2011.18. A term map was also created
to visualize the co-occurrence of key terms, whereby Amanita phalloides–related research appeared to be the most
frequently published topic in this field. In conclusion, the results of this bibliometric study shed light on the status
of mushroom poisoning research and can guide investigators on current research trends for high-impact knowledge
contribution in the field.
Mushroom poisoning is becoming a serious food safety and public health issue due to its high morbidity and mortality in some parts of the world. Identifying mushroom toxins at an early stage of suspected intoxication is crucial for therapeutic decision making. Ibotenic acid, muscimol, 2-amino-4,5-hexadienoic acid and 2-amino-4-pentynoic acid are a group of amino group-containing mushroom toxins that can lead to hallucination and neurotoxicity on humans. However, there is no method established for simultaneous detection of the four toxins. In this present study, a new derivatization method was developed for the determination of these toxins in mushroom and urine samples by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). After sample extraction the extract was directly derivatized by using 9-fluorenylmethyloxycarbonyl chloride and multiple factors affecting derivatization reaction were systematically optimized to enhance method sensitivity. Furthermore, liquid-liquid extraction with dichloromethane was employed for purification of the derivatized products. The method was fully validated for linearity, sensitivity, recovery and precision. Recoveries of four mushroom toxins were in the range of 85%–101% for urine and 82%–108% for mushroom. The limits of quantification were from 0.05 to 1 μg/L in urine and 1–20 μg/kg in mushroom. In addition, the developed method was successfully applied on mushroom samples treated by cooking and digesting with artificial gastric juice, demonstrating that vomitus as well as cooked mushroom and its soup can be used as the valuable materials for identifying mushroom poisoning caused by these four toxins.
Covering: up to June 2021A wide variety of mushrooms have traditionally been recognized as edible fungi with high nutritional value and low calories, and abundantly produce structurally diverse and bioactive secondary metabolites. However, accidental ingestion of poisonous mushrooms can result in serious illnesses and even death. Chemically, mushroom poisoning is associated with secondary metabolites produced in poisonous mushrooms, causing specific toxicity. However, many poisonous mushrooms have not been fully investigated for their secondary metabolites, and the secondary metabolites of poisonous mushrooms have not been systematically summarized for details such as chemical composition and biosynthetic mechanisms. The isolation and identification of secondary metabolites from poisonous mushrooms have great research value since these compounds could be lethal toxins that contribute to the toxicity of mushrooms or could provide lead compounds with remarkable biological activities that can promote advances in other related disciplines, such as biochemistry and pharmacology. In this review, we summarize the structures and biological activities of secondary metabolites identified from poisonous mushrooms and provide an overview of the current information on these metabolites, focusing on their chemistry, bioactivity, and biosynthesis.
Amanita pantherina is a poisonous mushroom that causes muscle cramps, insanity, and audiovisual disorders. As part of our systematic study on Korean mushrooms, a chemical investigation of A. pantherina fruiting bodies resulted in the isolation and structural identification of three new fatty acid derivatives, pantheric acids A-C (1-3), and a known compound, 1,10-dimethyl ester-2-decenedioic acid (4). Although 1,10-dimethyl ester-2-decenedioic acid (4) was previously reported as a synthetic product, it was structurally identified from a natural source for the first time. The structures of the new compounds were established by detailed analysis of 1D and 2D (1H-1H COSY, HSQC, and HMBC) NMR, HRMS, and LC/MS/MS data. The absolute configurations of compounds 1 and 2 were unambiguously determined by a recently developed method using competing enantioselective acylation coupled with LC/MS analysis. The isolated compounds (1-4) were evaluated for their effects on lipid accumulation during adipocyte maturation. Pantheric acids A-C (1-3) promoted the enlargement of lipid droplets in 3T3-L1 adipocytes and altered lipid metabolism by inducing lipogenesis and inhibiting lipolysis. Our findings provide experimental evidence suggesting the potential adverse effects of pantheric acids A-C from a poisonous mushroom on lipid metabolism.
Worldwide, special attention has been paid to wild mushrooms-induced poisoning. This review article provides a report on the global pattern and characteristics of mushroom poisoning and identifies the magnitude of mortality induced by mushroom poisoning. In this work, reasons underlying mushrooms-induced poisoning, and contamination of edible mushrooms by heavy metals and radionuclides, are provided. Moreover, a perspective of factors affecting the clinical signs of such toxicities (e.g. consumed species, the amount of eaten mushroom, season, geographical location, method of preparation, and individual response to toxins) as well as mushroom toxins and approaches suggested to protect humans against mushroom poisoning, are presented.
Ingestion of wild and potentially toxic mushrooms is common in the United States and many other parts of the world. US poison centers have been logging cases of mushroom exposure in The National Poison Data System (NPDS) annual publications for over 30 years. This study compiles and analyzes US mushroom exposures as reported by the NPDS from 1999 to 2016. Over the last 18 years, 133 700 cases (7428/year) of mushroom exposure, mostly by ingestion, have been reported. Cases are most frequently unintentional (83%, P < 0.001); cause no or only minor harm (86%, P < 0.001); and in children <6 years old (62%, P < 0.001). Approximately 704 (39/year) exposures have resulted in major harm. Fifty-two (2.9/year) fatalities have been reported, mostly from cyclopeptide (68–89%)-producing mushrooms ingested by older adults unintentionally. The vast majority of reported ingestions resulted in no or minor harm, although some groups of mushroom toxins or irritants, such as cyclopepides, ibotenic acid, and monomethylhydrazine, have been deadly. Misidentification of edible mushroom species appears to be the most common cause and may be preventable through education.
The article presents an integration and analysis of data collected by ethnographers, toxicologists, pharmacologists, travellers, psychiatrists, and chemisists on the psychological effects of Amanita muscaria and its constituent psychoactive substances - iboteic acid and muscimol. The article shows the changes brought about in psyche by Amanita muscaria and its psychoactive components in terms of activation, sleep, motility, perception, memory, speech, attention, thinking, self-consciousness, body sense, orientation in space and time, situation assessment, control over and regulation of behaviour as well as emotional, volitional, and motivation and semantic aspects. The presence or absence of an idea of deliberate Fly Agaric intoxication in a particular culture is discussed as one of possible causes of differing psychological effects of Amanita muscaria identified in different data sets.
Prix Interfimo régional 2016 Montpellier
Avec un potentiel de 16000 espèces sur le sol français, chaque année des centaines de cas
d’intoxications dues aux champignons macroscopiques sont déclarées, allant du simple trouble gastrointestinal
pour la plupart, jusqu’aux atteintes graves de certains organes pouvant laisser des séquelles
à vie, ou même quelques fois entraîner la mort. Le pharmacien est le seul professionnel de santé à
bénéficier d’un apprentissage en mycologie durant son cursus universitaire. Il est aussi un acteur
majeur de la prévention en Santé Publique, rôle qu’il exerce pleinement lorsque des cueilleurs de
champignons le sollicitent pour vérifier le contenu de leur panier et savoir « si ça se mange ».
Les pharmaciens sont reconnus historiquement pour leurs compétences mycologiques. Mais qu’en
est-il aujourd’hui ?
Après avoir relaté les différentes causes d’intoxications et cité les espèces responsables des principaux
syndromes, l’auteure aborde comment intervenir en prévention, et propose une fiche de
renseignements à transmettre lors d’un appel au Centre antipoison en cas d’urgence. Les missions des
CAPTV, ainsi que les réseaux mycotoxicologiques auxquels ils appartiennent, sont évoqués. Pour faire
suite au contexte toxicologique, sera rappelée brièvement la place de la mycologie au coeur des
nouvelles missions du pharmacien, issues de la loi « Hôpital Patient Santé Territoire », et vue à travers
le référentiel de bonnes pratiques de la Société Française de Pharmacie Clinique. Le paysage
pédagogique sera lui aussi dépeint, avec communication sur la place de la mycologie dans la formation
initiale (heures de mycologie sur les macromycètes, attribuées par chaque faculté de pharmacie) et
dans la formation continue universitaire (Diplômes Universitaires, DPC et autres enseignements
pratiques proposés).
C’est dans ce contexte qu’a été également réalisée une enquête nationale auprès de plus de 680
pharmaciens entre février et avril 2015. Celle-ci a permis de dresser un état des lieux permettant de
connaître la motivation et le ressenti des professionnels de santé vis-à-vis de leurs compétences, et a
mis également en évidence leurs besoins, en termes d’outils pour enrichir leur équipement de
déterminateur. Enfin, quelques suggestions d’outils variés viennent compléter cette enquête, puisque
celle-ci a démontré un manque de communication concernant les ressources existantes. L’auteure
espère que sa modeste contribution vous encouragera à mieux remplir votre rôle de prévention en
santé publique face aux demandes d’identification de champignons.
MOTS-CLES : Mycologie, Macromycètes, Macrofungi, champignons, détermination, identification,
reconnaissance, pharmacie, officine, intoxications, nouveaux syndromes, prévention, conseils,
urgence, formation initiale, formation continue, enquête, questionnaire, outils, ouvrages, livres,
études pharmaceutiques, cursus pharmaceutique, facultés de pharmacie, centre antipoison, CAPTV,
(réseau mycotoxicologique, MYCOLISTE, MYCOTOX), compétences, besoins, associations
mycologiques, mycologues, Cd-Rom, Internet, application mobile, Diplôme Universitaire, DPC.
Mushroom poisonings in Poland are quite common, especially in summer and autumn, but fly agaric (Amanita muscaria) and panther cap (Amanita pantherina) are rather rare cause of these intoxications. Fly agaric is a cause of deliberate poisoning, whereas panther cap poisoning also happens accidentally. The main toxins of these two mushrooms are ibotenic acid (pantherine, agarine), muscimol, muscazone and muscaridine. The other bioactive substances are stizolobic and stizolobinic acids and aminodicarboxyethylthiopropanoic acids. All these compounds are responsible for diverse picture of intoxication. An analysis of patients with Amanita muscaria and Amanita pantherina poisoning hospitalized in the Poznan Departament of Toxicology revealed that symptoms occurred after 30 minutes to 2 hours with vomiting, hallucinations, restlessness, increased psychomotor drive and central nervous system depression. Other antycholinergic symptoms like tachycardia and increased blood pressure, mydriasis, dry and red skin were seen only in a few cases. Acute respiratory failure was the most dangerous symptom observed in the course of poisoning.
Gathering and eating mushrooms and other plants containing psychoactive substances has become increasingly popular among young people experimenting with drugs. Dried fly agaric Amanita muscaria fruiting bodies were eaten by five young persons (18-21 years of age) at a party in order to evoke hallucinations. Visual and auditory hallucinations occurred in four of them, whereas a 18-year-old girl lost consciousness. The following morning, she went to the Clinic of Toxicology. Due to the fact that not all the active substances present in the fly agaric have been identified, and some of them have an effect after a period of latency, the patient was admitted for several days of observation during which check-up examinations were performed. After four days without any problems, she was discharged. The poisoning regressed with no organ complications. The remaining persons who had eaten the fly agaric were free from any complaints.
An analysis of patients with mushroom poisoning hospitalized in the Clinic of Toxicology in Cracow revealed that only a small percentage of cases had been caused by the death cap Amanita phalloides (Vaill. ex Fr.) Secr. The most important factors contributing to intoxication are confusion of toxic mushrooms with edible species, and non-specific mushroom poisoning. The genus Amanita has a global distribution and is one of the most well-known genera of macrofungi. Active toxins present in the panther cap (A. pantherina) (DC ex Fr.) Secr are ibotenic acid and muscimol, which are rapidly absorbed from the gastrointestinal tract. It is likely that other substances also participate in the psychotropic effects. Five frayed panther cap fruiting bodies were eaten by mistake by two persons (27 and 47 years of age). Symptoms onset occurred after 120 min with central nervous system (CNS) depression, ataxia, waxing and waning obtundation, religious hallucinations and hyperkinetic behaviour. In the present case, successful general symptomatic treatment was administered, which consisted of controlling the nervous symptoms and stabilizing the electrolyte balance. The poisoning regressed with no organ complications.
History and admission findings: A 41-year-old patient was found in his flat in a state of coma. After emergency treatment his vital signs were stable and he was transferred to an acute hospital with possible cannabis intoxication. The patient, a hobby gardener, was previously well and had an adversion to the use of any chemical substances. The main symptom showed a cholinergic syndrome with deep coma. We assumed plant ingestion because of the clinical picture and history. Investigations: The laboratory results were within normal limits apart from a slight rise of the serum creatinine kinase level. The electrocardiogram showed a bradycardia. A drug-screening could not be performed. Treatment and course: The differential diagnosis of plant alkaloids or mushroom toxins were considered due to possible plant ingestion and a cholinergic syndrome. Later the toadstool (Amanita muscaria) was found. After treatment oft the cholinergic syndrome with high doses of atropine primary poison elimination was performed. 24 hours later the patient awoke from his coma. Visual hallucinations persisted for a few days. No organic damage due to the intOXication was found. Conclusion: Toxic mushroom ingestion can produce a variety of clinical pictures. Most commonly an anticholinergic syndrome is found, but this was not the case in this patient. The effect of the poison depends on the amount and the preparation, so that no reliable outcome predicition can be made. The drug 'poisonous mushroom' is legal and hallucinogenic substances are trendy. As a result clinical signs like those described here wilt have to be expected in the future.
It is believed by people in mountainous areas that toxins in A. muscaria are reduced by drying, storing or cooking. The main physiologically active substances, ibotenic acid (IBO) and muscimol (MUS), in A. muscaria were therefore investigated. IBO is readily transformed to into MUS through decarboxylation, and MUS is a hallucinogen. Drying A. muscaria in the sun or with a heater caused an increase of MUS in the mushroom, though a lot of precursor IBO was lost. It was suggested that the toxicity of the mushroom would be intensified by processing. IBO and MUS in the mushroom were stable on storage under dry or salt conditions. MUS increased in concentration while IBO decreased during heat-cooking, and the changes were more marked under acidic than alkaline conditions. However, general cooking (within 10 minutes) hardly reduced the toxic substances. Boiling or soaking A. muscaria in water caused most of the IBO and MUS in the mushroom to be released rapidly into the water.
Summary Muscimol and GABA applied microintophoretically onto nigral neurones reduce the discharge rate of most of these cells. Bicuculline reversibly antagonizes the action of muscimol. I.p. applied muscimol reduces the firing rate of about half of the nigral cells tested.
The central excitatory neurotransmitter (S)-glutamic acid (Glu) activates at least three types of receptors the NMDA, AMPA, and kainic acid (KAIN) receptors. These receptors mediate the neurotoxicity of a number of naturally-occurring Glu analogues. Thus, domoic acid, a KAIN receptor agonist, has probably been the cause of severe neurologic illness in people who consumed domoic acid poisoned food. beta-N-oxalylaminoalanine (beta-ODAP), an AMPA receptor agonist, has been associated with lathyrism, a spastic paraparesis caused by dietary intake of Lathyrus sativus. The neurotoxic Amanita muscaria constituent ibotenic acid, a nonselective NMDA receptor agonist, has been used as a lead structure for the development of the specific NMDA receptor agonist AMAA, AMPA, and a number of therapeutically interesting AMPA and KAIN receptor agonists.
The clinical features and management of nine cases of mushroom poisoning due to Amanita pantherina (eight cases) and Amanita muscaria (one case) admitted to a children's hospital are described. Most ingestions were in the toddler age group with males being more frequently involved. Symptoms occurred between 30-180 min with the onset of central nervous system depression, ataxia, waxing and waning obtundation, hallucinations, intermittent hysteria or hyperkinetic behavior. Vomiting was rare. Seizures or myoclonic twitching occurred in 4/9 patients, but was controlled with standard anticonvulsant therapy. No other anticholinergic or cholinergic signs were prominent. Recovery was rapid and complete in all patients.
The complex pharmacological profile (excitation/inhibition) of ibotenic acid on single neurons in the mammalian CNS prompted studies on the stability of ibotenic acid and a number of structurally related excitatory amino acids under different in vitro conditions in the presence or absence of enzymes. Ibotenic acid, (RS)-3-hydroxy-4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridine-7-carboxylic acid (7-HPCA), (RS)-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), and (RS)-alpha-amino-3-hydroxy-4-bromo-5-isoxazolepropionic acid (4-Br-homoibotenic acid) were all inhibitors of (S)-glutamic acid decarboxylase (GAD) in mouse brain homogenates, but only ibotenic acid was shown to undergo decarboxylation during incubation with brain homogenates. The formation of the decarboxylated product, muscimol, which primarily occurred in a synaptosomal fraction, was dependent on the presence of pyridoxal-5-phosphate (PALP) and was inhibited by (S)-glutamic acid, 3-mercaptopropionic acid (3MPA), aminooxyacetic acid (AOAA), and allyglycine, suggesting that ibotenic acid is a substrate for GAD. The overall decomposition rate for ibotenic acid (8.7 nmol min-1 mg-1 of protein), which apparently embraces other reactions in addition to decarboxylation to muscimol, was higher than the rate of decarboxylation of (S)-glutamic acid (3.2 nmol min-1 mg-1 of protein). At pH 7.4 and 37 degrees C, but in the absence of enzymes, none of the excitatory amino acids under study underwent any detectable decomposition, whereas ibotenic acid and 7-HPCA, but not AMPA and 4-Br-homoibotenic acid, decomposed, partially by decarboxylation, at 100 degrees C in a pH-dependent manner. In the presence of liver homogenates, ibotenic acid was also shown to decompose.(ABSTRACT TRUNCATED AT 250 WORDS)
A 41-year-old patient was found in his flat in a state of coma. After emergency treatment his vital signs were stable and he was transferred to an acute hospital with possible cannabis intoxication. The patient, a hobby gardener, was previously well and had an adversion to the use of any chemical substances. The main symptom showed a cholinergic syndrome with deep coma. We assumed plant ingestion because of the clinical picture and history.
The laboratory results were within normal limits apart from a slight rise of the serum creatinine kinase level. The electrocardiogram showed a bradycardia. A drug-screening could not be performed.
The differential diagnosis of plant alkaloids or mushroom toxins were considered due to possible plant ingestion and a cholinergic syndrome. Later the toadstool (Amanita muscaria) was found. After treatment oft the cholinergic syndrome with high doses of atropine primary poison elimination was performed. 24 hours later the patient awoke from his coma. Visual hallucinations persisted for a few days. No organic damage due to the intoxication was found.
Toxic mushroom ingestion can produce a variety of clinical pictures. Most commonly an anticholinergic syndrome is found, but this was not the case in this patient. The effect of the poison depends on the amount and the preparation, so that no reliable outcome prediction can be made. The drug "poisonous mushroom" is legal and hallucinogenic substances are trendy. As a result clinical signs like those described here will have to be expected in the future.
The fly agaric is a remarkable mushroom in many respects; these are its bearing, history, chemical components and the poisoning that it provokes when consumed. The 'pantherina' poisoning syndrome is characterized by central nervous system dysfunction. The main species responsible are Amanita muscaria and A. pantherina (Amanitaceae); however, some other species of the genus have been suspected for similar actions. Ibotenic acid and muscimol are the active components, and probably, some other substances detected in the latter species participate in the psychotropic effects. The use of the mushroom started in ancient times and is connected with mysticism. Current knowledge on the chemistry, toxicology, and biology relating to this mushroom is reviewed, together with distinctive features concerning this unique species.
Many review papers have been published on mushrooms of the genus Amanita, as these are well known to both scientific and lay audiences, probably due to the toxic and/or hallucinogenic properties of some species. This article aims to supplement the content of previous reviews by categorizing all of the natural products isolated from any species in the genus Amanita. These compounds are subdivided into six major structural types, and references are provided for all species that have been examined chemically.
The constituents of seven mushrooms sold as Amanita muscaria or Amanita pantherina (five A. muscaria and two A. pantherina) and four "extracts purported to contain A. muscaria" products that are currently circulated in Japan were determined. All mushroom samples were identified as A. muscaria or A. pantherina by macroscopic and microscopic observation. The dissociative constituents, ibotenic acid (IBO) and muscimol (MUS), were extracted with 70% methanol twice and determined by gas chromatography/mass spectrometry. The IBO (as the hydrate)/MUS contents were in the range of <10-2845ppm/46-1052ppm in the cap of A. muscaria and 188-269ppm/1554-1880ppm in the cap of A. pantherina. In the caps, these compounds had a tendency to be more concentrated in the flesh than in the cuticle. On the other hand, the IBO/MUS contents in the stem were far lower than in the caps. In the "extracts purported to contain A. muscaria" products, IBO/MUS were detected below the lower limit of calibration curve (<10ppm/<25ppm) or not detected. However, these samples contained other psychoactive compounds, such as psychoactive tryptamines (5-methoxy-N,N-diisopropyltryptamine and 5-methoxy-N,N-dimethyltryptamine), reversible monoamine oxidase inhibitors (harmine and harmaline) and tropane alkaloids (atropine and scopolamine), which were not quantified. This is the first report of the chemical analysis of Amanita mushrooms that are circulated in the drug market.
Amanita muscaria has a bright red or orange cap covered with small white plaques. It contains the isoxazole derivatives ibotenic acid, muscimol and muscazone and other toxins such as muscarine. The duration of clinical manifestations after A. muscaria ingestion does not usually exceed 24 hours; we report on a 5-day paranoid psychosis after A. muscaria ingestion. A 48-year-old man, with no previous medical history, gathered and ate mushrooms he presumed to be A. caesarea. Half an hour later he started to vomit and fell asleep. He was found comatose having a seizure-like episode. On admission four hours after ingestion he was comatose, but the remaining physical and neurological examinations were unremarkable. Creatine kinase was 8.33 microkat/l. Other laboratory results and brain CT scan were normal. Toxicology analysis did not find any drugs in his blood or urine. The mycologist identified A. muscaria among the remaining mushrooms. The patient was given activated charcoal. Ten hours after ingestion, he awoke and was completely orientated; 18 hours after ingestion his condition deteriorated again and he became confused and uncooperative. Afterwards paranoid psychosis with visual and auditory hallucinations appeared and persisted for five days. On the sixth day all symptoms of psychosis gradually disappeared. One year later he is not undergoing any therapy and has no symptoms of psychiatric disease. We conclude that paranoid psychosis with visual and auditory hallucinations can appear 18 hours after ingestion of A. muscaria and can last for up to five days.
A case of a 72-year-old female who ingested panther cap (Amanita pantherina) was presented. During the ingestion of mushrooms she developed short-time diarrhea and severe transient neurological disorders; short-term hallucination followed by deep coma, skeletal muscle flaccidity with hyporeflexia. Also significant facial asymmetry was noted. A head CT showed a small ischaemic focus in capsula interna. After a neurological consult it was concluded that this small malformation was not the cause of severe patient's condition. The sporological test revealed numerous spores of panther cap in patient's vomit. After the next 6 hours complete resolution of neurological symptoms was observed. Finally it was assumed that patient's symptoms and signs were most probably a result of panther cap poisoning complicated with transient ischaemia of the brain.
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- A Antonczyk
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Naturally-occurring excitatory amino acids as neurotoxins and leads in drug design The most widely recognized mushroom: chemistry of the genus Amanita Clinical symptoms and circumstances of acute poisonings with fly agaric (Amanita muscaria)
- P Krogsgaard-Larsen
- J J Hansen
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