Amatoxin: A Review

Abstract

This paper presents a comprehensive review of amatoxin poisoning. The paper discusses the biochemistry of amatoxin, as well as the clinical manifestations of amatoxin ingestion. In addition, the evaluation of the patient with amatoxin ingestion is discussed, along with the treatment—including newer therapy—and the ultimate prognosis of the syndrome.

Discovery of a novel DNA polymerase inhibitor and characterization of its antiproliferative properties

“…Some of the side effects and toxicities of DNA damaging agents likely originate from inhibition of transcription in normal tissues 49 . The consequences of transcription inhibition are somewhat under-appreciated, even though the toxicity from α-amanitin, the toxin from some poisonous mushrooms, is well known 50,51 . The initial effects of α-amanitin exposure share significant similarities with those from chemotherapy, such as abdominal pain, vomiting, and diarrhea 51,52 .…”

“…The consequences of transcription inhibition are somewhat under-appreciated, even though the toxicity from α-amanitin, the toxin from some poisonous mushrooms, is well known 50,51 . The initial effects of α-amanitin exposure share significant similarities with those from chemotherapy, such as abdominal pain, vomiting, and diarrhea 51,52 . Evidently, for cancer treatment, the challenge is to inhibit DNA replication with minimal impact on other nucleotide metabolism pathways such as transcription.…”

Mycetismus: a review

“…The toxin is excreted into the urine and may be detectable for up to three to four days after ingestion [ 8 ]. The level in urine is usually higher than that found in the serum, but does not correlate to the degree of hepatonecrosis [ 10 , 15 ]. The lethal dose of amatoxin for adults is 0.1 mg/kg [ 11 ].…”

“…Although diarrhea usually occurs during the second phase of the illness, Escudie et al . have shown that an early predictor of a fatal outcome was the onset of diarrhea within eight hours of ingestion [ 12 , 15 ].…”

“…The progression of the disease may also be defined as hyperacute (0–7 days), acute (8–28 days), or sub-acute (9–84 days) [ 20 ]. There are multiple proposed criteria for urgent liver transplantation ( Table 1 ) [ 15 ]. The single set of criteria that has been developed for use in amatoxin poisoning is the Ganzert criteria ( Table 2 ) [ 7 ]; however, the most commonly used criteria for determining whether an urgent liver transplantation is needed are the King’s College criteria ( Table 3 ) [ 7 , 15 ].…”