Clinical uses and toxicity of Ergot, Claviceps purpurea An evidence-based comprehensive retrospective review (2003-2017)

Abstract

Ergot alkaloids produced by the fungus Claviceps parasitizing on cereals presents a high toxicity risk for animals and humans due to presence of its alkaloid content. Ergot-alkaloid toxicity occurs via their medicinal use however human poisoning from ergot plant is rare. The aim of this review is to determine the toxicity of ergot plant or ergotamine derivatives in humans. Databases such as Google scholar, PubMed, Scopus, Web of Science alongwith related books and theses as well as the library resources from Imam Abdulrahman Bin Faisal University were used whereas the Key words searched included; Ergot, Egotism, Ergotamine poisoning, Ergotamine interaction with HIV therapy, Ergotamine overdose, and report cases of ergotism. The relevant literature search suggests many toxicity cases and side effects associated with the use of ergot-alkaloids. More commonly it develops a condition known as ergotism i.e. a disease or toxic condition produced by eating ergot grains or rye or chronic use of ergot drug. The characteristic ARTICLE INFORMATION:Raghad Al-Omari et al.features of ergotism consist of painful and cold extremities. Furthermore, a notable and severe interaction of ergotalkaloids was found in HIV patients using ergotamine and antiretroviral drugs together. Ergotamine which is one of ergot preparation has poisonous effect when taken in over dose and it interacts with antiretroviral drugs also.

Ergotamina y terapia antiretroviral: una combinación peligrosa. Reporte de caso

“…El metabolismo de los derivados del ergot es realizado en el hígado mediante la vía del citocromo P-450, isoenzima CYP3A4 y son eliminados por la vía biliar, heces y riñones 2 . Por consiguiente, otros fármacos que usen esta vía metabólica tales como antibióticos, anticonceptivos orales y antivirales, particularmente los inhibidores de la proteasa incrementan el riesgo de ergotismo por saturación de la ruta metabólica.…”

“…El término fuego de San Antonio se utilizó en la edad media para referirse a la intoxicación por ergotamina debido al consumo de granos infectados con el hongo Claviceps purpurea, produciendo necrosis de extremidades 1 . El metabolismo está determinado por la vía citocromo P-450 (CYP3A4) la cual emplean otros fármacos, entre ellos los antirretrovirales 2 .…”