Mycotoxicology

Syndrome S and Toxin S

One listed a hundred toxic mushroom species, of which a score persons in charge of death. The intoxications by the mushrooms higher were estimated in France than 2,5% of the causes of accidental intoxications (1500 to 2000 annual cases).

One distinguishes a dozen from Syndrome S mycotoxicologic , divided, for practical reasons, in two groups according to their time of Latence (time “ingestion-symptoms”), and listed below by order of frequency:

Syndromes with short latency

The primary symptoms less appear than 6 hours after ingestion.

Gastro-intestinal syndrome

It is mainly about nausea S, Vomissement S, abdominal pains and Diarrhée S. the principal mechanisms are the following:

edible introduced in excessive quantity: Chitin, thréhalose , Mannitol
deficit in trehalase causing a osmotic Diarrhea or of Fermentation: thréhalose
inconstant reactions to certain species ( Armillaires, Lépistes, Agaric yellowing )
Allergy respiratory and cutaneous of the professionals in contact with the Spore S
edible introduced believed (Amanita S, Boletus S, Lactary S, Morel S, Russule S…): Hemolysin S
edible contaminated by a Micro-organism or a Mycotoxin, on foot or during the edible storage
contaminated by the Environment: xenobiotic (Pesticide S)
mushrooms containing of new or badly known toxins: illudine, bolesatine, fasciculols, crustulinols, triterpenes … contained in about thirty species of which Lampteromyces japonicus (Japan, China, Korea, Siberia). See List of toxic mushrooms .

Syndrome muscarinien

Also called sudorien or cholinergic , this syndrome, owes with the Muscarine (which draws its name from the Fly agaric, Amanita muscaria , although this mushroom contains of it too little to be harmful), is characterized by the contraction of the smooth muscles, the hypersecretion of the endocrine Glands (sweat, saliva, tears…), less than 2 hours after ingestion. To the usual digestive disorders are added cramps abdominal, cardiovascular sweats profuses, whimperings and rhinorrhées, disorders (Bradycardie, Hypotension) and a Myosis. They regress spontaneously in 2-3 hours. Among about sixty accused mushrooms, three kinds are distinguished:

many Inocybes ( Inocybe patouillardii, I. fastigiata, I. geophylla …)
the majority of the “white” Clitocybes ( Clitocybe dealbata and closely connected)
Entoloma rhodopolium (in Japan)
some species without trace of muscarine, like Omphalotus illudens and, more rarely, some Mycènes of the group of Mycena will pura , however very low in muscarine, sometimes caused the same symptoms.

Syndrome panthérinien

Also called myco-atropinien , muscarien , or anticholinergic , this syndrome begins between 30 minutes at 3 a.m. after ingestion from the Amanite panther (Amanita pantherina and some other species closely connected), by a anxious Agitation euphoric then with Délire and Hallucinations. Sometimes also a Ataxia, Mydriase, Paraesthesia S and tremors being able to go until the convulsif Coma, precede the phase by depression with Prostration and somnolence. The disorders regress into 8 to 12 midnight.

The toxins are derivatives Isoxazoles : the ibotenic Acid , Agoniste of the Glutamate, seems responsible for the phase for excitation, and its derivative, the Muscimol , of the depressive phase. Other isolated substances, like the Muscazone , are still being studied.

Syndrome coprinien

The Coprine (contained in some coprins ) associated with alcohol blocks the Acétaldéhyde déshydrogénase and carries out a Effet antabuse. A half an hour after each catch of alcohol (between 0,05 and 1 g/l) and in the 3 to 5 days which follow the consumption of the black Coprin of ink ( Coprinus atramentarius ), occurs a faintness with puffs of heat, cutaneous headaches, érythrose, sweat, Tachycardie, Hypotension, and sometimes of the giddinesses, nauseas and vomiting. The symptoms regress in a few hours without a treatment being generally necessary.

Syndrome narcotinien

The syndrome narcotinien (or psilocybien ) is caused by derivatives Indole S, named Psilocybine and Psilocine, acting on the serotoninergic receivers .

The effects, which evoke those of LSD and vary considerably according to the context, begin half an hour after ingestion, by an euphoria and an exacerbation (Hyperesthésie) of the visual, auditive and tactile feelings, with Hallucination S, disturbance of the concept of time and space, as well as disorders of the mood and course of the thought.

They can be accompanied by Angoisse, panic, and mental Confusion. On the Somatic level, nauseas and vomiting, Cephalgia S, giddinesses and a Mydriase are not rare.

Because of their powerful character hallucinogen, the mushrooms with psilocybine can cause serious and durable psychiatric accidents, sometimes as of the first catch. One speaks then about “persistent post-hallucinatory syndrome”, namely anguishes, phobias, confusional state, depression even puffed out delirious acute.

The mushrooms in question are mainly species of the kind Psilocybe , Panaeolus , Pholiotina and Stropharia , classified like narcotics and to which the possession and transport are liable to penal sanctions (stopped of February 22nd, 1990).

Syndrome paxillien

Syndromes with long latency

The primary symptoms appear more than 6 hours after ingestion.

Syndrome phalloïdien

It is a syndrome in three phases, outcome with an irreversible hépatocellulaire insufficiency (destruction of the noble cells of the Foie).

In septentrional Europe, this syndrome is responsible for the quasi totality of the ascribable deaths to higher mushrooms. Although there is no Antidote to date, the rate of death which was of 50% before the years 1965 at summer reduced to 15% (10% in the adult and 30% in the child), with progress of the Réanimation, the treatment and the Transplantation.

It must be suspecté each time the time “ingestion-symptoms” exceeds 6 hours, the early diagnosis and the emergency hospitalization in unit of Toxicologie being essential.

The principal responsible species are Amanita phalloid , Amanita verna and Amanita virosa (see also the Liste of toxic mushrooms).

Toxins:

Of the cyclic octapeptides: Amatoxines, in particular the α-amanitine and β-amanitine , persons in charge of the process hepatotoxic (DLL: 0,1 mg/kg in the mouse, is at the man 30-50 G of Death cap, 100 G of Lépiotes, or 150 G of Galères.
of the cyclic heptapetides: 7 Phallotoxines ( phalloïne, prophalloïne, phallisine, phallacine, phallicidine, phallisacine , and especially the phalloïdine , credits in the gastro-intestinal attack, but also in the destruction of the endoplasmic Reticulum and the Mitochondries hépatocytaires. Its connections with the Actine increase the membrane permeability, causes edema and of cellular death). The Phallolysine (ex phallin ), thermolabile (degrading itself with cooking), causes a Hémolyse in the animal. Lastly, 5 Virotoxines: alaviroïdine, viroïsine, déoxoviroïsine, viroïdine, déoxoviroïdine , strongly poisons by Parenteral way , but whose role is still badly known.

At the end of an average latency from 10 to 12 noon, asymptomatic, but during which settle the intestinal and hepatic lesions, 3 phases or syndromes follow one another:

phase of digestive attack (day 1), characterized by nausea S, incoercible Vomiting violent one and, pains abdominal and Diarrhea S Cholériforme S (which can persist until the 10th day). At this stage, a important Dehydration, a Hypovolémie and a functional Impaired renal function can occur and cause an early death with 3rd or 4th day.
clinical phase of remission (day 2) regression of the symptoms between the 36e and the 48e hour, masking the beginning of the insufficiency hépatocellulaire (rise insidious but considerable in the Transaminase S, which will culminate at the 5th day)
hepatic phase of attack (day 3-4): clinical Hepatitis with hepatomegaly and ictère, which join sometimes starting from the 4-5th day, acute impaired renal function, digestive Hémorragie, hepatic Encéphalopathie, and Hypoglycémie.

The serious forms of intoxication evolve either to the cure into 4 to 8 weeks, or towards the death as of the 6th day, more generally in the second week.

Syndrome orellanien

Syndrome gyromitrien

Acute impaired renal function

Acrosyndrome (Erythermalgie)

Two species known to date cause, 3 days approximately after ingestion, a erythermalgie (reddening and rise in temperature) of the ends (fingers, toes, penis) with Paresthésie (feeling of swarming) and oedemas, then acute pains in the form of feelings of intolerable burns, carrying out true a torture with red iron , resistant to analgesics, but temporarily relieved by ice-cold water. Walk, the sleep and little by little all the acts of the normal life being prevented or being disturbed, the hospitalization is necessary. The disorders, generally not mortals, regress slowly at the end of several months (3-6 month for the pain, up to one year for the paraesthesias).

Toxins: A dozen toxins were insulated in Japan, of which Amino-acid close to the acid kainic, agonist of the Glutamate: Acid acromelic has and B, clitidine, etc

(outline in progress, to continue)

List toxic mushrooms

To consult the List of toxic mushrooms ', classified by syndrome and the list of the poisons centres .

See too

External references and bonds

D.Michelot Site, CNRS
CHU of Lille
University of Lyon
H. Lambert. Forecast and treatment of the intoxication phalloïdienne , in F.J. Baud - Reanimations of the acute intoxications , Masson, Paris, 1995,185-195.
P. Saviuc and P. -. Moreau has - Intoxications by higher mushrooms , in V. Danel and P. Barriot - acute Intoxications in reanimation , 2nd edition, Arnette, Paris, 1999,523-548.

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