amatoxin

Amatoxins are a group of naturally occurring toxic compounds found in several species of mushrooms, most notably in the death cap (Amanita phalloides) and the destroying angels (Amanita virosa and A. bisporigera). They are cyclic peptides, with alpha-amanitin being the most potent and well-studied. These toxins are extremely stable and resist degradation by heat, so cooking contaminated mushrooms does not eliminate the danger.

The primary mechanism of amatoxin poisoning involves the inhibition of RNA polymerase II, a crucial enzyme in human cells. This inhibition halts the transcription of DNA into messenger RNA, effectively stopping protein synthesis. Cells with high rates of protein production, such as those in the liver and kidneys, are the most severely affected.

Following ingestion, symptoms typically appear after a latency period of 6 to 24 hours. The initial phase involves severe gastrointestinal distress, including vomiting, diarrhea, and abdominal pain. After a deceptive period of apparent improvement, the liver begins to fail, leading to jaundice, hypoglycemia, and potentially coma. This hepatotoxicity is the main cause of death in amatoxin poisoning.

There is no specific antidote. Treatment is primarily supportive and focuses on aggressive hydration, managing electrolytes, and, in severe cases, interventions like liver transplantation. Early administration of certain drugs, such as silibinin, may help block the toxin's uptake by liver cells and improve survival rates. Due to the high fatality rate of untreated poisoning, rapid medical attention is critical after suspected ingestion. Public education on proper mushroom identification is the most effective prevention.