alfaamanitiini

Alpha-amanitin, sometimes transliterated as alfaamanitiini, is a highly potent toxin produced by several poisonous mushrooms in the genus Amanita, most notably Amanita phalloides (death cap) and Amanita virosa (destroying angel). It is a bicyclic octapeptide that is resistant to heat and not destroyed by ordinary cooking.

The toxin acts by inhibiting RNA polymerase II in eukaryotic cells, which blocks mRNA synthesis and leads to cell death. The liver and kidneys are particularly affected due to the toxin’s distribution and the organs’ roles in metabolism and elimination.

Exposure typically occurs through ingestion of contaminated mushrooms. Ingestion of only a few milligrams can be fatal for humans. After a latent period of about 6 to 24 hours, the clinical course often begins with severe gastrointestinal symptoms—nausea, vomiting, abdominal pain, and profuse diarrhea. A deceptive phase of apparent improvement may be followed by progressive hepatic injury, coagulopathy, hypoglycemia, and renal failure. The outcome depends on the amount ingested and the speed and effectiveness of supportive care; mortality has decreased with intensive medical management but remains a risk, particularly in fulminant cases.

Diagnosis is based on clinical history and laboratory confirmation when available, such as detection of α-amanitin in urine or serum by specialized chromatographic methods. There is no universally approved antidote. Treatment is supportive, including aggressive fluid and electrolyte management, correction of coagulopathy, and monitoring of liver and kidney function. Some regimens use hepatoprotective agents like silibinin or silymarin, and high-dose N-acetylcysteine; penicillin G has been used in the past. In cases of severe liver failure, liver transplantation may be life-saving. Prevention centers on avoiding ingestion of wild mushrooms and educating foragers about amanite species.