Ergot Use and Overuse: A Pharmacoepidemiology Retrospective Cohort Study

Donnet, Anne; Braunstein, David; Pradel, Vincent; Sciortino, V.; Allaria-Lapierre, Véronique; Micallef, Joëlle; Lantéri-Minet, Michel

doi:10.1111/head.12776

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Another epidemiological study described the high prevalence of ergot users and overusers in an older population, but in our study we only found a low prevalence of ergot overusers (2.9%). A prospective study showed that triptan overusers outnumbered ergot overusers in the MOH population, hence triptan was the most common drug that caused MOH .…”

Section: Discussioncontrasting

confidence: 87%

Headache Characteristics and Clinical Features of Elderly Migraine Patients

2017

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Section: Discussioncontrasting

confidence: 87%

Headache Characteristics and Clinical Features of Elderly Migraine Patients

2017

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“…Amides and peptides containing lysergic acid have contaminated grain and forage crops resulting in human and animal toxicoses (1)(2)(3)(4). Additionally, derivatives of lysergic acid are used to synthesize a range of pharmaceuticals used to treat dementia, migraines, Parkinson's disease, and hyperprolactinemia (5)(6)(7)(8). Lysergic acidderived ergot alkaloids are produced by representatives of several genera in the fungal family Clavicipitaceae, including Claviceps spp., Epichloë spp., Balansia spp., and Periglandula spp.…”

mentioning

confidence: 99%

Several Metarhizium Species Produce Ergot Alkaloids in a Condition-Specific Manner

Leadmon

Sampson

Maust

et al. 2020

Appl Environ Microbiol

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ABSTRACT Genomic sequence data indicate that certain fungi in the genus Metarhizium have the capacity to produce lysergic acid-derived ergot alkaloids, but accumulation of ergot alkaloids in these fungi has not been demonstrated previously. We assayed several Metarhizium species grown under different conditions for accumulation of ergot alkaloids. Isolates of M. brunneum and M. anisopliae accumulated the lysergic acid amides lysergic acid α-hydroxyethyl amide, ergine, and ergonovine on sucrose-yeast extract agar but not on two other tested media. Isolates of six other Metarhizium species did not accumulate ergot alkaloids on sucrose-yeast extract agar. Conidia of M. brunneum lacked detectable ergot alkaloids, and mycelia of this fungus secreted over 80% of their ergot alkaloid yield into the culture medium. Isolates of M. brunneum, M. flavoviride, M. robertsii, M. acridum, and M. anisopliae produced high concentrations of ergot alkaloids in infected larvae of the model insect Galleria mellonella, but larvae infected with M. pingshaense, M. album, M. majus, and M. guizhouense lacked detectable ergot alkaloids. Alkaloid concentrations were significantly higher when insects were alive (as opposed to killed by freezing or gas) at the time of inoculation with M. brunneum. Roots of corn and beans were inoculated with M. brunneum or M. flavoviride and global metabolomic analyses indicated that the inoculated roots were colonized, though no ergot alkaloids were detected. The data demonstrate that several Metarhizium species produce ergot alkaloids of the lysergic acid amide class and that production of ergot alkaloids is tightly regulated and associated with insect colonization. IMPORTANCE Our discovery of ergot alkaloids in fungi of the genus Metarhizium has agricultural and pharmaceutical implications. Ergot alkaloids produced by other fungi in the family Clavicipitaceae accumulate in forage grasses or grain crops; in this context they are considered toxins, though their presence also may deter or kill insect pests. Our data report ergot alkaloids in Metarhizium species and indicate a close association of ergot alkaloid accumulation with insect colonization. The lack of accumulation of alkaloids in spores of the fungi and in plants colonized by the fungi affirms the safety of using Metarhizium species as biocontrol agents. Ergot alkaloids produced by other fungi have been exploited to produce powerful pharmaceuticals. The class of ergot alkaloids discovered in Metarhizium species (lysergic acid amides) and their secretion into the growth medium make Metarhizium species a potential platform for future studies on ergot alkaloid synthesis and modification.

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“…5Valvular heart disease can also be accompanied by myocardial ischemia, pain, claudication and ischemia in upper or lower limbs or a combination of the previous ones, and sometimes symptoms related to heart failure are the ones that lead the patient to consult. (6,7) This pathophysiological event is mediated by the stimulation of alpha adrenergic receptors in the smooth muscle, leading to an important vasospasm and loss of endothelial integrity; (8) some authors have tried to screen this population, Rasmussen VG, et al evaluated 138 patients who received treatment with ergotamine-derived agonists and described 25% of patients with some degree of valvular involvement, found severe aortic insufficiency (n = 4), moderate aortic insufficiency (n = 12), mitral (n = 3) and tricuspid valve insufficiency (n = 5). Two patients had a coexisting mitral insufficiency and moderate tricuspid valve insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Disease Associated with the Chronic Use of Ergotamine: A Case Report

2018

IJCR

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Ergotamine and its derivatives were used for multiple diseases; in the nineties, its use in association with caffeine was considered a standard treatment for migraines, although it has been in decline, due to the evidenced toxic effects related to its chronic use including vascular, cardiovascular and central nervous system manifestations. In this article is reported a case of a 59-yearold female with chronic use of caffeine plus ergotamine for more than 20 years; afterwards she develops peripheral artery disease, severe mitral and tricuspid valve regurgitation with requirement of valve replacement. In the absence of past cardiovascular history and rheumatic fever, its clinical evolution and pathology results are associated with ergotism.

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Ergot Use and Overuse: A Pharmacoepidemiology Retrospective Cohort Study

Abstract: This work outlines a high prevalence of ergotamine tartrate overuse (11.1%). As ergotamine tartrate users are mostly aged more than 55 years, an evaluation of ergotamine cardiovascular risk profile is necessary in the elderly population.

Cited by 7 publications

References 17 publications

Headache Characteristics and Clinical Features of Elderly Migraine Patients

Headache Characteristics and Clinical Features of Elderly Migraine Patients

Several Metarhizium Species Produce Ergot Alkaloids in a Condition-Specific Manner

Cardiovascular Disease Associated with the Chronic Use of Ergotamine: A Case Report

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