Abstract
The consumption of mushrooms has become increasingly popular, partly due to their nutritional and medicinal properties. This has increased the risk of confusion during picking, and thus of intoxication. In France, about 1300 cases of intoxication are observed each year, with deaths being mostly attributed to Amanita phalloides poisoning. Among amatoxins, α- and β-amanitins are the most widely studied toxins. Hepatotoxicity is the hallmark of these compounds, leading to hepatocellular failure within three days of ingestion. The toxic mechanisms of action mainly include RNA polymerase II inhibition and oxidative stress generation, leading to hepatic cell apoptosis or necrosis depending on the doses ingested. Currently, there is no international consensus concerning Amanita phalloides poisoning management. However, antidotes with antioxidant properties remain the most effective therapeutics to date suggesting the predominant role of oxidative stress in the pathophysiology. The partially elucidated mechanisms of action may reveal a suitable target for the development of an antidote. The aim of this review is to present an overview of the knowledge on amanitins, including the latest advances that could allow the proposal of new innovative and effective therapeutics.
Highlights
In recent years, the consumption of mushrooms has become increasingly common, probably due to their nutritional and medicinal properties
Of the 11 to 44 severe cases observed in our territory each year, an amanitin poisoning is found in 62.1% of cases, a pantherin syndrome in 12.6% of cases, and a sudorian muscarinic syndrome in 10.1% of cases
Up to five deaths per year are observed each year, mostly attributed to amanitin poisoning, and caused by the action of powerful toxins known as amanitins [4]
Summary
The consumption of mushrooms has become increasingly common, probably due to their nutritional and medicinal properties. It is estimated that 10 to 50 of the 14,000 known species of mushrooms are potentially lethal [2,3]. Depending on their geographical distribution, the mushroom poisoning issue varies. It represents a serious public health problem in many countries, including North America, Bulgaria, the Czech Republic, China, Iran, Mexico, Italy, Hungary, Japan, Nepal, Poland, Romania, Russia, South Korea, Thailand, Turkey, and Ukraine [2]. Of the 11 to 44 severe cases observed in our territory each year, an amanitin poisoning is found in 62.1% of cases, a pantherin syndrome in 12.6% of cases, and a sudorian muscarinic syndrome in 10.1% of cases. Studies providing information about mechanistic explanation for amanitin toxicity, amanitin poisoning management, and amanitin-conjugated antibodies were included for review
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