The fungal nephrotoxin orellanine simultaneously increases oxidative stress and down-regulates cellular defenses

Nilsson, Ulf; Nyström, Jenny; Buvall, Lisa; Ebefors, Kerstin; Björnson-Granqvist, Anna; Holmdahl, Johan; Haraldsson, Börje

doi:10.1016/j.freeradbiomed.2008.01.017

Cited by 24 publications

(47 citation statements)

References 31 publications

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“…To our knowledge, this is the first confirmation in patients of the experimental finding of orellanine's dose-dependent toxic effects. 11,12 Third, we could not demonstrate any beneficial effect of combined NAC and corticosteroid treatment on either AKI or CKD. Besides severe inflammation, the production of reactive oxygen radical and the depletion of free radical scavenger have been demonstrated as toxic mechanisms of orellanine.…”

Section: Discussionmentioning

confidence: 64%

“…Besides severe inflammation, the production of reactive oxygen radical and the depletion of free radical scavenger have been demonstrated as toxic mechanisms of orellanine. [9][10][11] In view of the mechanisms of action of orellanine, the combined administration of NAC and corticosteroids seemed reasonable due to their free radical scavenger and anti-inflammatory characteristics. Previous case reports gave conflicting results on the effect of this treatment.…”

Section: Discussionmentioning

confidence: 99%

“…It has been proposed that the tubulotoxic damage of orellanine is caused by the production of oxygen-free radicals and depletion of the free radical scavenger glutathione and ascorbate. [9][10][11] Toxic effects seem to be dose-dependent in animal experiments. 11,12 Treatment is mainly supportive.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11] Toxic effects seem to be dose-dependent in animal experiments. 11,12 Treatment is mainly supportive. RRT was performed in many reported cases but does not play any role in toxin removal.…”

Section: Introductionmentioning

confidence: 99%

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Antioxidant treatment and outcome ofcortinarius orellanuspoisoning: a case series

Grebe

Langenbeck

Schaper³

et al. 2013

Renal Failure

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Objectives: To study the frequency, severity, and long-term outcome of renal injury in Cortinarius orellanus poisoning, to evaluate the association between the ingested amount of C. orellanus and outcome, and to evaluate the effect of N-acetylcysteine and corticosteroid treatment on outcome. Methods: Case series of eight patients. Diagnosis and severity of acute kidney injury (AKI) and chronic kidney disease (CKD) were classified according to current AKI and CKD definitions. N-acetylcysteine and corticosteroids were administered to six patients, former according to the standard for paracetamol poisoning. Main findings: All patients developed AKI, six in the most severe stage and four required renal replacement therapy (RRT). After 12 months, seven patients presented with CKD, of whom three required chronic RRT and further two were in advanced CKD. AKI and CKD severity highly correlated with the consumed amounts of Cortinarius orellanus (r ¼ 0.98, p50.001 and r ¼ 0.78, p ¼ 0.02, respectively) but not with N-acetylcysteine and corticosteroid treatment. Conclusions: AKI and CKD by current definitions and classifications are frequent and severe after Cortinarius orellanus poisoning. The ingested amount of Cortinarius orellanus correlates with the severity of both AKI and CKD. N-acetylcysteine and corticosteroid treatment do not seem to have a beneficial effect on either AKI or CKD.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Antioxidant treatment and outcome ofcortinarius orellanuspoisoning: a case series

Grebe

Langenbeck

Schaper³

et al. 2013

Renal Failure

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“…Žalsvoji musmirė teinų, RNR ir DNR sintezę inkstų kanalėlių ląstelėse [12]. Taip pat manoma, kad jis gali skatinti oksidacinį ląstelės pažeidimą gamindamas orto-semikvinono radikalą, išei-kvojantį ląstelės glutationą [13,14].…”

Section: Orelano Sindromasunclassified

Dažniausi Apsinuodijimo Grybais Sindromai Ir Inkstų Pažeidimai

Rėkutė¹,

Miglinas

Rimševičius

2017

Medicinos Teorija Ir Praktika

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SANTRAUKAReikšminiai žodžiai: grybai, apsinuodijimai, amanitinas, orelaninas, inkstai. Apsinuodijimas grybais yra reta ūminių inkstų ir kepenų pažeidimų priežastis, tačiau gali sukelti rimtų sveikatos sutrikimų ir baigtis mirtimi. Lietuvoje dažniausiai apsinuodijama musmirėmis (Amanita genties grybais) ir nuodingaisiais nuosėdžiais (Cortinarius orellanus), kurie atitinkamai sukelia Amanitino ir Orelano sindromus. Užsienyje nustatyta rabdomiolizės sukeltų mirties atvejų apsinuodijus nuodingąja ūmėde (Russula subnigricans). Apsinuodijus grybais, atsiranda ankstyvųjų simptomų -pykinimas, vėmimas, viduriavimas, arba vėlyvųjų -negrįžtamų inkstų ir kepenų pažeidimų, elektrolitų disbalansas, kvėpa-vimo ir kardiovaskulinės sistemos pokyčių. Intoksikacijos veikimo mechanizmas siejamas su DNR bei RNR sintezės inhibicija, oksidaciniais ląstelės pažeidimais. Lietuvoje diagnozė remiasi klinika ir surinkta anamneze, užsienyje atliekama inkstų biopsija ir ieškoma histologinių pokyčių. Specifinio gydymo nėra. Efektyviausias gydymas -palaikomasis: agresyvus skysčių atstatymas, elektrolitų balanso palaikymas, gyvybiškai svarbių funkcijų stabilizavimas. Sunkiais atvejais atliekama inkstų ar/ ir kepenų transplantacija. Norint apsaugoti save ir aplinkinius nuo apsinuodijimo grybais, svarbu atpažinti valgomus grybus, tinkamai apdoroti prieš valgant bei riboti vartojamų grybų kiekį. ABSTRACTKey words: mushrooms, poisoning, amanitin, orellanine, kidney. Although mushroom poisoning is a rare cause of renal and liver diseases, it can result in serious health problems and even death. In Lithuania, the most common poisonous mushrooms are Amanita phalloides (Amanita family) and Cortinarius orellanus (Cortinarius family), which respectively causes Amanitin and Orellanus syndromes. In foreign countries, Russula subnigricans (Russulaceae family) poisoning it is not unusual, which may cause rhabdomyolysis induced death. Early symptoms of mushroom poisoning are sickness, vomiting, diarrhea, while advanced symptoms include irreversible kidney and liver injury, electrolytes imbalance, respiratory and cardiovascular system disorders. Mushroom caused intoxication is linked with DNA and RNA synthesis inhibition and oxidative cell damage. In Lithuania, mushroom poisoning diagnosis is primarily based on clinical evidence and anamnesis, while in foreign countries kidney biopsy is also a common procedure. However, there is no specific therapy for mushroom poisoning and, hence, treatment is mainly supportive. In severe cases, kidney or/and liver transplantation may be necessary. Serious health disorders, which result from mushroom poisoning, highlight the importance to spread knowledge about the potential nephrotoxicity of mushrooms, proper preparation and even limited consumption. Skirmantė Rėkutė VUL Santariškių klinikos Santariškių g. 2, Vilnius

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Biomarkers of Se Status

Renko

2018

Molecular and Integrative Toxicology

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The fungal nephrotoxin orellanine simultaneously increases oxidative stress and down-regulates cellular defenses

Cited by 24 publications

References 31 publications

Antioxidant treatment and outcome ofcortinarius orellanuspoisoning: a case series

Antioxidant treatment and outcome ofcortinarius orellanuspoisoning: a case series

Dažniausi Apsinuodijimo Grybais Sindromai Ir Inkstų Pažeidimai

Biomarkers of Se Status

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