Mushrooms, amatoxins and the liver

Fulminant liver failure and renal failure related with malva sylvestris

“…Liver failure due to various mushroom toxicities is more common and more known than the ones caused by local foods, which are extremely rare (2). The toxicity in the present patient may be associated with a special feature of this plant.…”

Metabolic Acidosis during Treatment of Mushroom Poisoning: A Diagnostic Pitfall

“…The normal arterial blood gas and serum potassium levels at the first evaluation are inconsistent with this hypothesis. Moreover, severe normal anion gap metabolic acidosis from amatoxin (a toxin isolated from mushroom Amanita Phalloides) is common and has been attributed to fulminant hepatic failure and tubular necrosis (7,14). Although amatoxin is rapidly cleared by the kidneys, its direct nephrotoxicity to the proximal and distal convoluted tubules may lead to acute tubular necrosis (6,14).…”

“…infusion of 20 mg/kg/day. Both above-mentioned doses for activated charcoal and silibinin are the recommended doses for mushroom poisoning treatment (7).…”

Determination of amatoxins and phallotoxins in Amanita phalloides mushrooms from northeastern Portugal by HPLC-DAD-MS

“…The mechanism of action of amatoxins is not completely understood but it is known that the main target of AA is hepatic RNA polymerase II enzyme. Following uptake by organic anion-transporting octapeptide (OATP) located in the sinusoidal membrane of hepatocytes, AA inhibits RNA polymerase II, reducing the mRNA synthesis and consequently provoking a decrease of protein contents and ultimately liver cell death (Mas 2005). The mechanisms of toxicity of AA has been studied by our group, and we have focused our efforts on understanding the molecular mechanism of RNA polymerase II inhibition (Garcia et al 2014).…”