ABSTRACT
Mushroom poisoning has always been a threat to human health. There are a large number of reports about ingestion of poisonous mushrooms every year around the world. It attracts the attention of researchers, especially in the aspects of toxin composition, toxic mechanism and toxin application in poisonous mushroom. Inocybe is a large genus of mushrooms and contains toxic substances including muscarine, psilocybin, psilocin, aeruginascin, lectins and baeocystin. In order to prevent and remedy mushroom poisoning, it is significant to clarify the toxic effects and mechanisms of these bioactive substances. In this review article, we summarize the chemistry, most known toxic effects and mechanisms of major toxic substances in Inocybe mushrooms, especially muscarine, psilocybin and psilocin. Their available toxicity data (different species, different administration routes) published formerly are also summarized. In addition, the treatment and medical application of these toxic substances in Inocybe mushrooms are also discussed. We hope that this review will help understanding of the chemistry and toxicology of Inocybe mushrooms as well as the potential clinical application of its bioactive substances to benefit human beings.
Subject(s)
Agaricales/chemistry , Mushroom Poisoning/etiology , Mushroom Poisoning/therapy , Agaricales/metabolism , Agaricales/physiology , Animals , Humans , Lectins/chemistry , Lectins/pharmacology , Muscarine/chemistry , Muscarine/poisoning , Muscarine/toxicity , Organophosphorus Compounds/chemistry , Organophosphorus Compounds/toxicity , Psilocybin/analogs & derivatives , Psilocybin/chemistry , Psilocybin/poisoning , Psilocybin/toxicity , Tryptamines/chemistry , Tryptamines/toxicityABSTRACT
Mushrooms are ubiquitous in nature. They are an important source of nutrition, however, certain varieties contain chemicals that can be highly toxic to humans. Industrially cultivated mushrooms are historically very safe, whereas foraging for mushrooms or accidental ingestion of mushrooms in the environment can result in serious illness and death. The emergency department is the most common site of presentation for patients suffering from acute mushroom poisoning. Although recognition can be facilitated by identification of a characteristic toxidrome, the presenting manifestations can be variable and have considerable overlap with more common and generally benign clinical syndromes. The goal of this two-part article is to review the knowledge base on this subject and provide information that will assist the clinician in the early consideration, diagnosis and treatment of mushroom poisoning. Part I reviewed the epidemiology and demographics of mushroom poisoning, the physical characteristics of the most toxic varieties, the classification of the toxic species, and presented an overview of the cyclopeptide-containing mushroom class. Part II is focused on the presentation of the other classes of toxic mushrooms along with an up-to-date review of the most recently identified poisonous varieties.
Subject(s)
2,2'-Dipyridyl/analogs & derivatives , Emergency Medicine/methods , Mushroom Poisoning/diagnosis , Mushroom Poisoning/therapy , Mycotoxins/poisoning , 2,2'-Dipyridyl/poisoning , Adult , Child , Disulfiram/poisoning , Enzyme Inhibitors/poisoning , Gastroenteritis/chemically induced , Hallucinogens/poisoning , Humans , Indoles/poisoning , Irritants/poisoning , Isoxazoles/poisoning , Monomethylhydrazine/poisoning , Muscarine/poisoningABSTRACT
Since the 1950s, reports of severe and fatal mushroom poisonings have increased worldwide. Clinicians must consider mushroom poisoning in the evaluation of all patients who may be intoxicated by natural substances. Because information on natural exposures is often incorrect or insufficient, a new syndromic classification of mushroom poisoning is proposed to guide clinicians in making earlier diagnoses, especially in cases where only advanced critical care, including kidney or liver transplantation, may be life saving.
