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"Mushroom madness" in the Papua New Guinea Highlands: a case of nicotine poisoning?

"Mushroom madness" is a condition that was first reported in the Western Highlands Province of Papua New Guinea. This condition was originally blamed on the ingestion of hallucinogenic mushrooms. This was later proven to be incorrect and this condition was explained instead as a form of collective hysteria. There is, however, ethnographic, phytochemical and pharmacological evidence to suggest that "mushroom madness" was actually a state of acute nicotine poisoning produced by the ingestion of toxic quantities of tobacco.

Diagnosis, Differential↗

Liver transplantation in mushroom poisoning.

Liver transplantation plays an important role in the treatment of patients with fulminant hepatic failure (FHF). Early determination of prognosis in cases of FHF is important to allow prompt decision-making regarding the need for liver transplantation. Mushroom poisoning is a rare cause of FHF, and as a result, prognostic criteria are not well recognized. It appears that the severity of coagulopathy and encephalopathy predicts a poor outcome, whereas the degree of bilirubin elevation may not. We present a case of FHF related to mushroom poisoning that required liver transplantation. The clinical presentation, medical management, and prognostic criteria in mushroom poisoning are discussed.

Fatal Outcome↗

Learning and memory deficits upon TAU accumulation in Drosophila mushroom body neurons.

Mutations in the neuronal-specific microtubule-binding protein TAU are associated with several dementias and neurodegenerative diseases. However, the effects of elevated TAU accumulation on behavioral plasticity are unknown. We report that directed expression of wild-type vertebrate and Drosophila TAU in adult mushroom body neurons, centers for olfactory learning and memory in Drosophila, strongly compromised associative olfactory learning and memory, but olfactory conditioning-relevant osmotactic and mechanosensory responses remained intact. In addition, TAU accumulation in mushroom body neurons did not result in detectable neurodegeneration or premature death. Therefore, TAU-mediated structural or functional perturbation of the microtubular cytoskeleton in mushroom body neurons is likely causal of the behavioral deficit. These results indicate that behavioral plasticity decrements may be the earliest detectable manifestations of tauopathies.

Animals↗

A novel type of encephalopathy associated with mushroom Sugihiratake ingestion in patients with chronic kidney diseases.

BACKGROUND: The etiology of encephalopathy in uremic patients is multiple. We recently encountered a novel type of encephalopathy which occurred exclusively in patients with chronic kidney diseases after ingestion of a mushroom called Sugihiratake. While the exact etiology of this encephalopathy remained mysterious, we aimed to describe its clinical features. METHODS: A total of 32 patients with chronic kidney diseases who had presented with encephalopathy following ingestion of Sugihiratake were enrolled from seven prefectures in Japan., with 24 of the 32 patients undergoing regular hemodialysis. The patient's clinical data were from surveillance by The Japanese Society of Nephrology. RESULTS: There was a significant association between Sugihiratake ingestion and the occurrence of encephalopathy in 524 hemodialysis patients questioned for a recent ingestion of this mushroom (P= 0.0006). The latent asymptomatic period before the onset of symptoms varied from 1 to 31 days (mean 9.1 +/- 7.3) days. The patient's symptoms consisted of disturbed consciousness in 30 patients (93.8%), convulsions in 25 (78.1%), myoclonus in 15 (46.9%), dysarthria in ten (31.3%), ataxia in eight (25.0%), paresis or paralysis in seven (21.9%), and skin parasthesia in two patients (6.3%). Nine (27.2%) patients died, mostly due to respiratory failure. The other patients were either discharged or still in hospitals with various degrees of clinical improvement. CONCLUSION: Patients with chronic kidney diseases are at risk of having serious encephalopathy following Sugihiratake ingestion and must refrain from eating it. Physicians, in those parts of the world, where this mushroom harvesting is common, should be aware of this complication.

Agaricales↗

Localization of long-term memory within the Drosophila mushroom body.

The mushroom bodies, substructures of the Drosophila brain, are involved in olfactory learning and short-term memory, but their role in long-term memory is unknown. Here we show that the alpha-lobes-absent (ala) mutant lacks either the two vertical lobes of the mushroom body or two of the three median lobes which contain branches of vertical lobe neurons. This unique phenotype allows analysis of mushroom body function. Long-term memory required the presence of the vertical lobes but not the median lobes. Short-term memory was normal in flies without either vertical lobes or the two median lobes studied.

Animals↗

GARBAGE COMPOSTING FOR MUSHROOM PRODUCTION.

Laboratory and pilot-plant composting of garbage mixtures of newspaper and vegetable waste has demonstrated that garbage can be converted to a medium that produces mushrooms (Agaricus campestris) in good yield. Sewage sludge was less satisfactory than newspaper, gumwood sawdust, or vegetable waste as a compost material for growing mushrooms. A sample of commercially produced compost was found to yield mushrooms in the same quantity as was produced in the laboratory experiments.

Agaricales↗

5-Year analysis of mushroom exposures in California.

OBJECTIVE: To evaluate outcomes following toxic mushroom ingestions. DESIGN: Retrospective data analysis. METHODS: We analyzed American Association of Poison Control Center data for California from 1993 through 1997. RESULTS: A total of 6,317 exposures occurred during the study period. Most (n = 6,229 [99.7%]) were acute exposures, and the rest (0.3%) were chronic; 87.6% (n = 5,536) were unintentional. Most (n = 4,235 [67.0%]) were in children younger than 6 years, and of these, only 6.0% experienced any clinical effects. The most common symptoms in patients aged 6 years and older were vomiting in 588 patients (28.2%), nausea in 307 patients (14.7%), diarrhea in 263 patients (12.6%), and abdominal pain in 221 patients (10.6%). No effects were seen in 3,131 (49.6% of all patients). Major effects were seen in only 17 patients (0.3%). Only 61 patients (1.0%) were admitted to a critical care unit. Death occurred in a 32-year-old adult who ate foraged mushrooms. Of all patients, 1,375 (21.8%) received no therapy or were observed only. CONCLUSIONS: Most mushroom exposures were acute and unintentional and occurred in children younger than 6 years. Major toxic reactions or death was uncommon.

Adolescent↗

Structure of the mushroom bodies of the insect brain.

The past decade has produced an explosion of new information on the development, neuroanatomy, and possible functions of the mushroom bodies. This review provides a concise, contemporary overview of the structure of the mushroom bodies. Two topics are highlighted: the volume plasticity of mushroom body neuropils evident in the brains of some adult insects and a possible essential role for the gamma lobe in olfactory memory.

Adenylyl Cyclases↗

Drosophila mushroom body Kenyon cells generate spontaneous calcium transients mediated by PLTX-sensitive calcium channels.

Spontaneous calcium oscillations in mushroom bodies of late stage pupal and adult Drosophila brains have been implicated in memory consolidation during olfactory associative learning. This study explores the cellular mechanisms regulating calcium dynamics in Kenyon cells, principal neurons in mushroom bodies. Fura-2 imaging shows that Kenyon cells cultured from late stage Drosophila pupae generate spontaneous calcium transients in a cell autonomous fashion, at a frequency similar to calcium oscillations in vivo (10-20/h). The expression of calcium transients is up regulated during pupal development. Although the ability to generate transients is a property intrinsic to Kenyon cells, transients can be modulated by bath application of nicotine and GABA. Calcium transients are blocked, and baseline calcium levels reduced, by removal of external calcium, addition of cobalt, or addition of Plectreurys toxin (PLTX), an insect-specific calcium channel antagonist. Transients do not require calcium release from intracellular stores. Whole cell recordings reveal that the majority of voltage-gated calcium channels in Kenyon cells are PLTX-sensitive. Together these data show that influx of calcium through PLTX-sensitive voltage-gated calcium channels mediates spontaneous calcium transients and regulates basal calcium levels in cultured Kenyon cells. The data also suggest that these calcium transients represent cellular events underlying calcium oscillations in the intact mushroom bodies. However, spontaneous calcium transients are not unique to Kenyon cells as they are present in approximately 60% of all cultured central brain neurons. This suggests the calcium transients play a more general role in maturation or function of adult brain neurons.

6-Cyano-7-nitroquinoxaline-2,3-dione↗

The danger of hallucinogenic mushrooms.

There has been a revival of interest amongst young people in the raw consumption of "wild" Psilocybin mushrooms, because of their hallucinogenic properties. Seven cases of mushroom overdosage are described. Whilst the hallucinogenic mushrooms are relatively harmless, the dangers from inadvertent ingestion of commonly occurring poisonous varieties are emphasised.

Adolescent↗

Drosophila Eph receptor guides specific axon branches of mushroom body neurons.

The conserved Eph receptors and their Ephrin ligands regulate a number of developmental processes, including axon guidance. In contrast to the large vertebrate Eph/Ephrin family, Drosophila has a single Eph receptor and a single Ephrin ligand, both of which are expressed within the developing nervous system. Here, we show that Eph and Ephrin can act as a functional receptor-ligand pair in vivo. Surprisingly, and in contrast to previous results using RNA-interference techniques, embryos completely lacking Eph function show no obvious axon guidance defects. However, Eph/Ephrin signaling is required for proper development of the mushroom body. In wild type, mushroom body neurons bifurcate and extend distinct branches to different target areas. In Eph mutants, these neurons bifurcate normally, but in many cases the dorsal branch fails to project to its appropriate target area. Thus, Eph/Ephrin signaling acts to guide a subset of mushroom body branches to their correct synaptic targets.

Animals↗

Neural plasticity of mushroom body-extrinsic neurons in the honeybee brain.

Central interneurons exiting the alpha lobe of the mushroom bodies were studied with respect to their plasticity by electrically stimulating their presynaptic inputs, the Kenyon cells. Special attention was given to the analysis of a single, identified neuron, the PE1. Three stimulation protocols were tested: double pulses, tetanus (100 Hz for 1 s), and tetanus paired with intracellular de- or hyper-polarization of the recorded cell. Double-pulse stimulations revealed short-term facilitation and depression, tuning the responses of these interneurons to frequencies in the range of 20-40 Hz. The tetanus may lead to augmentation of responses to test stimuli lasting for several minutes, or to depression followed by augmentation. Associative long-term potentiation (LTP) was induced in the PE1 neuron by pairing a presynaptic tetanus with depolarization. This is the first time that associative LTP has been found in an interneuron of the insect nervous system. These data are discussed in the context of spike tuning in the output of the mushroom body, and the potential role of associative LTP in olfactory learning. It is concluded that the honeybee mushroom body output neurons are likely to contribute to the formation of olfactory memory.

Action Potentials↗

Chlorophyllum molybdites--severe mushroom poisoning in a child.

The case of a 6-year-old female who developed hypovolemic shock from mushroom poisoning is discussed. The mushroom ingested, Chlorophyllum molybdites, is considered to be a benign gastrointestinal irritant. This case emphasizes that the gastrointestinal irritant mushrooms can produce severe toxicity and that pediatric patients have a limited capacity for fluid loss before becoming hypovolemic.

Charcoal↗

Composition of chemical species of selenium contained in selenium-enriched shiitake mushroom and vegetables determined by high performance liquid chromatography with inductively coupled plasma mass spectrometry.

Selenium (Se) species in Se-enriched shiitake mushroom (Lentinula edodes) were identified and quantified by high performance liquid chromatography with inductively coupled plasma mass spectrometry (HPLC-ICPMS). Two types of Se-enriched shiitake obtained from selenite- or selenate-fertilized mushroom beds were used. More than 80% of Se in both shiitake samples could not be extracted with 0.2 M HCl. Protease digestion released a large amount of selenomethionine from the shiitake enriched with selenite. However, most of the Se in the shiitake enriched with selenate was not released by protease but was released by a cell wall digestive enzyme and most of the Se released was identified as selenate. These results indicate that the main Se species in the shiitake enriched with selenite or selenate is selenomethionine bound to protein or selenate bound to polysaccharides in the cell wall, respectively. Several Se-enriched vegetables grown on a soil fertilized with selenate were also analyzed by HPLC-ICPMS. Four Se species, selenate, Se-methylselenocysteine, selenomethionine, gamma-glutamyl-Se-methylselenocysteine, and an unknown Se compound were detected in the vegetables. The composition of Se species varied with the kinds or parts of vegetables. The main Se species in bulbs, leaves or flowers of the Se-enriched garlic, onions, cabbage and ashitaba were selenate, Se-methylselenocysteine or gamma-glutamyl-Se-methylselenocysteine, while those in fruit bodies of the peppers and pumpkin were selenomethionine bound to protein. Bioavailabilities of Se in the shiitake mushroom enriched with selenite and the vegetables enriched with selenate are expected to be high, but that in shiitake enriched with selenate may be low.

Chromatography, High Pressure Liquid↗

A bioactive (1-->3)-, (1--4)-beta-D-glucan from Collybia dryophila and other mushrooms.

Polysaccharides from higher Basidiomycete mushrooms, mainly beta-D-glucans, are considered to be potent bioactive fungal compounds. In this study a beta-glucan (1.237 x 10(6) Da) consisting of (1-->3) and (1-->4) glucosidic linkages, named Collybia dryophila polysaccharide (CDP), was extracted from the wild mushroom C. dryophila. CDP was shown to strongly inhibit nitric oxide production in activated macrophages suggesting that this polysaccharide displays a potential anti-inflammatory activity. In addition it was shown that polysaccharides similar to CDP (CDP-like) are present in Lentinus edodes and different wild mushrooms collected in northeastern North America.

Agaricales↗

Suspected poisoning of puppies by the mushroom Amanita pantherina.

Amanita pantherina poisoning is suspected as the cause of a severe, transient neurological disorder in three 5-week-old German shepherd puppies. There was very strong circumstantial evidence that this mushroom had been eaten, and the signs encountered were similar to those described in confirmed field cases of intoxication in dogs. It was also in many respects consistent with the syndrome seen in humans. A veterinary perspective on the hallucinogenic Amanita spp. is given and the veterinary literature on mushroom intoxication is briefly reviewed as, in contrast to humans, it is not often reported in animals. This is the 1st report of suspected mushroom intoxication of animals in South Africa.

Amanita↗

Poisoning from accidental ingestion of mushrooms.

Poisoning from the accidental ingestion of mushrooms is an uncommon cause of morbidity within Australia and unlike many other countries no deaths have yet been recorded. This review seeks to draw attention to the various syndromes associated with mushroom poisoning and their management, thereby helping to keep our good record intact. Although the number of toxic species is relatively small, the collection and ingestion of field varieties should be left to those absolutely certain of their quest. In cases of poisoning, identification of the offending mushroom is of paramount importance in the management. In suspected or known amatoxin poisoning prompt treatment favourably influences outcome.

Amanita↗