Pelengkap bahan ajar MK Biologi Jamur Makroskopis Fak.

Biolog Unsoed
Topik : Mushroom Toxicity
Membahas :
1. Syarat terjadinya keracunan oleh karena jamur pada manusia
2. Jenis-jenis racun jamur
3. Jenis-jenis jamur yang mengasilkan racun
4. Gejala akibat terjadinya keracunan karena jamur

Hasil riset Inventarisasi makrofungi koprofil pada kotoran hewan ternak herbivora di wilayah eks-
karesidenan banyumas provinsi jawa tengah menjadi tambahan materi khususnya mengenai jenis-
jenis jamur koprofil yang diperoleh, beberapa diantaranya (Panaelous, Stropharia, Conocybe)
merupakan jamur-jamur beracun penghasil senyawa halusinogenik.
 Mushroom Toxicity
• Mushroom poisoning (mushroom toxicity) occurs
after the ingestion of mushrooms that contain
toxins, often in the context of foraging for nontoxic,
similarly appearing mushrooms.
• Mushrooms are the fruiting bodies of a group of
higher fungi that have evolved contemporaneously
with plants for millions of years. They are widely
distributed throughout the world.
• There are thousands of species of mushrooms, but
only about 100 species of mushrooms cause
symptoms when eaten by humans, and only 15-20
mushroom species are potentially lethal when
ingested.
• No simple rule exists for distinguishing edible mushrooms from
poisonous mushrooms.
• In more than 95% of mushroom toxicity cases, poisoning occurs as a
result of misidentification of the mushroom by an amateur
mushroom hunter.
• In less than 5% of the cases, poisoning occurs after the mushroom is
consumed for its mind-altering properties.
The severity of mushroom
poisoning may vary, depending on
• the geographic location where
the mushroom is grown,
• growth conditions,
• the amount of toxin delivered,
• and the genetic characteristics of
the mushroom.
Boiling, cooking, freezing, or
processing may not alter the
toxicity of some mushrooms.
 Mushroom Toxicity - Pathophysiology
Each poisonous mushroom species contains 1 or more toxins, which
may be classified on the basis of the mushroom’s physiologic and
clinical effects in humans, the target organ toxicity, and the time to
symptom onset. The clinical spectrum and toxicity vary with the
following factors:
• Species consumed
• Amount consumed
• Season
• Geographic location where the mushroom was grown
• Preparation method
• Individual response to the toxins
Diaz, in a review of mushroom poisoning cases reported in the
literature over 50 years, classified mushroom poisoning into the
following 3 major categories on the basis of the time from ingestion to
the development of symptoms :
• Early symptom category – Symptoms generally appear within the first
6 hours of mushroom ingestion and include gastrointestinal (GI),
allergic, and neurologic syndromes
• Late symptom category – Signs and symptoms begin to appear
between 6 and 24 hours after ingestion and may include hepatotoxic,
nephrotoxic, and erythromelalgic syndromes
• Delayed symptom category – Symptoms appear more than 24 hours
after ingestion and include mostly nephrotoxic syndromes

Diaz JH. 2005. Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med. Feb;33(2):427-36.
• Erythromelalgia adalah syndrom langka dimana arterioles pada kulit
membesar secara bertahap, menyebabkan rasa terbakar, membuat
kulit terasa panas, dan kadang-kadang membuat kulit kaki dan tangan
jadi merah. belum diketahui penyebab pasti sindrom ini.
• Nephrotic syndrome is a kidney disorder that causes your body to
excrete too much protein in your urine. Nephrotic syndrome is
usually caused by damage to the clusters of small blood vessels in
your kidneys that filter waste and excess water from your blood.
 Mushroom toxins
• Cyclopeptides - Amatoxin
• Gyromitrins (monomethylhydrazine)
• Orellanine
• Muscarine
• Psilocybin
• Muscimol and ibotenic acid
• Coprine
• Nephrotoxins (norleucine)
• Myotoxins
• Immunoactive toxins
• Hemolytic toxins
• GI irritants
• GI poisons are the most frequently encountered mushroom toxins.
• Amatoxins, gyromitrins, and orellanine are the toxins most commonly
implicated in fatal mushroom poisonings worldwide.
• The amatoxins, and to a lesser extent the gyromitrins, are
hepatotoxic.
• Gyromitrins are also epileptogenic.
• Orellanine and norleucine are nephrotoxic.
• Muscarine, psilocybin, muscimol, and ibotenic acid are CNS poisons.
• Coprine causes a disulfiramlike reaction when combined with alcohol.
Figure 1. Genera of
coprophilous fungi found
in ex-Banyumas Regency.
1. Panaeolus
2. Coprinopsis
3. Stropharia
4. Tricholoma
5. Lycoperdon
6. Ascobolus
7. Rhodocybe
8. Conocybe
9. Bolbitius
10. Leucocoprinus
11. Mycena
12. Hypoloma.
Cyclopeptides
• Cyclopeptides include amatoxins
(high toxicity), phallotoxins (medium
toxicity), and virotoxins (no toxicity).

• Amatoxins, which are responsible for

more than 95% of mushroom-related
fatalities in the United States, are
cyclic octapeptides that are
synthesized by some Amanita,
Galerina, and Lepiota species (see
the list below).
 Cyclopeptides
• At least 5 subtypes of amatoxins are known, the only significant
human toxin being alpha-amatoxin, which inhibits RNA polymerase II
and protein synthesis. Alpha-amatoxin is rapidly absorbed by the GI
tract, has limited protein binding, and may undergo enterohepatic
recirculation. It is excreted in the urine and may be detected in the
vomitus and feces. Hepatocellular damage is presumably caused by
the formation of free radical intermediates.
• Amanita phalloides (death cap), Amanita virosa (destroying angel),
Amanita verna (fool’s mushroom), Amanita bisporigera, Galerina
autumnalis (autumn skullcap), and Galerina sulcipes are the most
common mushrooms implicated in liver injury and death amongst the
amatoxin-containing mushrooms.
 Cyclopeptides
• The other associated toxin in Amanita ingestions are the phallotoxins,
specifically phalloidin, which produce a choleralike syndrome with
vomiting and watery diarrhea, usually starting 6 hours after ingestion,
although cases with both earlier and later onset have occurred.
• Many Lepiota species lack phallotoxins, so ingestion of these may not
present with the onset of vomiting and diarrhea until after 12 hours
post ingestion, or they may occasionally present only with symptoms
of liver failure at 24 hours post ingestion.
 Cyclopeptides
Amanitin-containing mushroom species
Amanita group, as follows: • Lepiota josserandi
• Amanita phalloides • Lepiota fulvella
• Amanita virosa • Lepiota subincarnata
• Amanita verna • Lepiota brunneoincarnata
• Amanita ocreata • Lepiota brunneolilacea
• Amanita bisporigera
• Amanita suballiacea Galerina group, as follows:
• Galerina autumnalis
Lepiota group, as follows: • Galerina sulcipes
• Lepiota helveola • Galerina marginata
• Lepiota chlorophyllum
 Gyromitrins
• Gyromitrin is a volatile hydrazine
derivative synthesized by certain
species of false morel (Gyromitra
esculenta) and is easily confused
with the early false morel (Verpa
bohemica).
• Gyromitrin poisoning typically
occurs after ingestion of the
toxin-containing mushrooms but
may also result from inhalation
of the cooking vapors during
their preparation.
 Gyromitrins
• In the stomach, gyromitrin is rapidly hydrolyzed into acetaldehyde
and N -methyl-N -formyl hydrazine (MFH), which is then slowly
converted to N -methylhydrazine (MH). Both MFH and MH are toxic
to humans. MFH inhibits a number of hepatic systems, including
cytochrome P-450 and glutathione, and causes hepatic necrosis.
Hepatocellular damage is presumably caused by the formation of free
radical intermediates.
 Gyromitrins
• MH inhibits pyridoxine kinase and interferes with all the pyridoxine-
requiring enzymes in the body, including those involved in the
synthesis of gamma-aminobutyric acid (GABA). The reduction of
GABA concentrations in the brain leads to CNS hyperexcitability and
convulsions. Gyromitrin ingestion may also rarely result in
methemoglobinemia, hemolysis, and renal failure.
 Orellanine
• Orellanine is a nephrotoxic
compound that is synthesized by
several species of Cortinarius
mushrooms. Orellanine-
containing species include
Cortinarius orellanus and
Cortinarius speciosissimus, both
of which are commonly found in
Europe and Japan but not in
North America.
• Cortinarius species that may
contain small amounts of
orellanine include Cortinarius
gentilis, Cortinarius rainierensis,
and Cortinarius splendens
henrici; however, there are very
few confirmed cases of
Cortinarius-induced renal failure
in North America.
 Orellanine
• Orellanine is colorless and crystalline in nature and may be converted
into orelline, which itself may be toxic. Its main effects are on the
renal tubular system, where it causes necrosis with relative sparing of
the glomerular apparatus. Fatty degeneration of the liver and severe
inflammatory changes in the intestine may accompany the renal
damage.
• Cortinarius mushrooms also may elaborate other compounds, such as
cortinarin A, B, and C, which exhibit a nephrotoxic potential in
laboratory animals.
 Norleucine
• Other nephrotoxic mushrooms, such as Amanita smithiana and
Amanita proxima, have also been associated with an acute oliguric
renal failure. Amanita smithiana may be mistaken for the matsutake
mushroom (Tricholoma magnivelare) by foragers.
• These mushrooms cause vomiting and diarrhea 1-12 hours after
ingestion, followed by a transient elevation of transaminases, then
oliguric renal failure in 3-6 days.
• It is important to note that renal failure occurs within days of
ingestion, as opposed to orellanine-induced renal failure that has an
onset over 1-2 weeks. Exposure to norleucine-containing mushrooms
may require temporary hemodialysis.
 Psilocybin
• Psilocybin and psilocin are elaborated by a
number of mushroom genera, including
Psilocybe cubensis, Psilocybe semilanceata
(Liberty cap) , Panaeolus cyanescens
(previously referred to as Copelandia
species), Gymnopilus spectabili (Big
Laughing Jim), Conocybe cyanopus,
Psathyrella foenisecii, and several species of
Pluteus.
• Psilocybin and psilocin are serotonin (5-
HT2) agonists and, when ingested, cause
psychedelic effects similar to those of
lysergic acid diethylamide (LSD).
 Ibotenic acid and muscimol
• Amanita muscaria (fly agaric) and Amanita pantherina (panthercap)
mushrooms synthesize ibotenic acid and muscimol, both of which are
excitatory neurotoxins and may be mildly hallucinogenic.
• Ibotenic acid is structurally similar to glutamic acid and acts as an
agonist at the glutamic acid receptors (NMDA/N-methyl-D-aspartate
receptors) in the CNS.
• Ibotenic acid is decarboxylated in vivo to muscimol. Muscimol is
structurally similar to GABA and acts as a GABA-receptor agonist.
Amanita muscaria (fly agaric) and Amanita pantherina also may
contain some anticholinergic substances and small amounts of
muscarine, a cholinergic agent.
 Muscarine
• Muscarine stimulates M1 and M2 types of postganglionic cholinergic
receptors (muscarinic receptors) in the autonomic nervous system.
This action results in parasympathetic stimulation similar to that
caused by the release of endogenous acetylcholine at postganglionic
receptors of smooth muscle and exocrine glands. The action on
muscarinic receptors produces a cholinergic syndrome that is
characterized by sweating, bronchorrhea with shortness of breath,
salivation, lacrimation, diarrhea, miosis, abdominal cramps, and rarely
bradycardia.

• Agonist : a substance that initiates a physiological response when

combined with a receptor.
 Muscarine

• Mushrooms that contain

muscarine are commonly found
in yards, parks, and wooded
areas throughout the United
States, Europe, and Asia. Species
from the genera Clitocybe and
Inocybe are most commonly
responsible for muscarinic
mushroom poisoning in the
United States.
 Muscarine
• Clitocybe dealbata (the
sweating mushroom)
may be confused with
the edible fairy ring
champignon
(Marasmius oreadus)
or sweetbread
mushroom (Clitopilus
prunulus).
 Muscarine

• Omphalotus olearius (the

Jack O’ Lantern mushroom)
may be confused with the
edible chanterelle
(Cantharellus cibarius).
 Muscarine
• Other muscarine-containing
mushrooms include species from
the genera Boletus, Mycena, and
Omphalotus. Although Amanita
muscaria derives its name from
the trace amounts of muscarine
it contains, it does not cause
clinical cholinergic toxicity.
 Muscarine
• Muscarine-containing mushrooms typically produce cholinergic
symptoms such as sweating, facial flushing, salivation, lacrimation,
vomiting, abdominal cramps, diarrhea, urination, and miosis;
occasionally, bradycardia, hypotension, and dizziness develop.
• Symptoms typically occur within 1 hour of ingestion and last for 4-24
hours. In most cases, they resolve without drug therapy or with a
dose of atropine
 Coprine
• A few species of mushrooms, including
Coprinopsis atramentaria (formerly known as
Coprinus atramentarius), commonly referred to as
inky cap or tippler’s bane and mistaken for the
edible Coprinus comatus (shaggy mane), produce
coprine, an amino acid that is metabolized to 1-
aminocyclopropanol in the human body.
• This metabolite blocks acetaldehyde
dehydrogenase, and in the presence of alcohol,
acetaldehyde builds up, resulting in a disulfiram
reaction.
• The effects of 1-aminocyclopropanol may last as
long as 72 hours after ingestion of the mushroom.
 Involutin
• Ingestion of Paxillus involutus
may result in the acute onset of
abdominal pain, nausea,
vomiting, and diarrhea within 30
minutes to 3 hours of ingestion,
followed by an immune
complex-mediated hemolytic
anemia with hemoglobinuria,
oliguria, anuria, and acute renal
failure.
 GI toxins
• Hundreds of mushrooms contain
toxins that can cause GI
symptoms (eg, nausea, vomiting,
diarrhea, and abdominal pain)
similar to those observed with
more dangerous mushrooms.
• They include Chlorophyllum
molybdites (green gill), Boletus
piperatus (pepper bolete), and
Agaricus arvensis (horse
mushroom), among many
others.
Bronchoalveolar
allergic syndrome

• An immune reaction is believed

to be the cause of the
bronchoalveolar allergic
syndrome seen after inhalation
of spores of some puffball
(Lycoperdon) mushroom species.
Erythromelalgia syndrome
• Two species of mushrooms,
Clitocybe acromelaga (in Japan)
and Clitocybe amoenolens (in
Europe), cause a painful burning
sensation with reddening of the
skin several days after eating
them. In Europe, the Clitocybe
amoenolens mushroom has
been mistaken for the edible
mushroom Lepista inversa. The
suspected toxin is acromelic acid
A.
 Etiology
The main causes of mushroom toxicity are as follows:
• Incorrect identification of a mushroom (eg, by a novice mushroom
harvester or by someone who mistakes a poisonous local variety for
an edible variety that is native to where they learned to pick
mushrooms); many species are similar enough in appearance to
confuse an inexperienced or insufficiently informed mushroom
hunter
• Unintentional ingestion by a child who found mushrooms growing in
yards or outdoor play areas
• Intentional ingestion by a person with euphoric intent (substance
abuse)
 Etiology
Rare causes are as follows:
• Intentional ingestion by a suicidal person
• Foul play in which an individual is poisoned by someone else
• Inadvertent poisoning from dried mushrooms purchased on the
Internet or from other sources for which the composition of the
mushroom is unreliable or the mushroom might be contaminated
with unknown toxic compounds
• Accidental poisoning accounts for more than 95% of the cases of
mushroom intoxications; most of the remaining cases are due to
intentional ingestion of the mushrooms for their mind-altering
properties.