amanitins and Poisoning

Clinical toxicological analysis can significantly contribute toward the confirmation or exclusion of poisoning, especially if clinical signs and symptoms of unknown origin have to be explained. It may be of help when planning specific, but risky, poisoning therapies. Besides frequently used immunoassays for the detection of drugs of abuse, of a small number of medical drugs, and of amatoxins. Chromatographic methods with mass-selective detectors are available in specialized toxicology laboratories. The results of toxicological analyses have to be evaluated and interpreted carefully. Poison control centers can offer support for all medical aspects of poisoning including lab investigations.

Topics: Amanitins; Drug Overdose; Gas Chromatography-Mass Spectrometry; Humans; Illicit Drugs; Immunoassay; Poisoning; Poisons; Prescription Drugs; Toxicology

The amanitins found in several mushroom species are responsible for many deaths every year. Based on its successful application to cardiac glycoside overdose, immunotherapy could be applicable to amanitin toxicity. Therefore, we produced polyclonal amanitin antibodies by immunizing rabbits with a novel conjugate of alpha-amanitin. Purified antibodies had an average association constant for alpha-amanitin of 1.3 x 10(9) M-1. A partially protective effect of the antibodies against amanitin toxicity in vitro in Chang cells was evident at a molar ratio of antibody binding sites to alpha-amanitin of 4:1. Together with reported studies in vivo, these investigations indicate the potential of immunotherapy for amanitin poisoning.

Topics: Amanitins; Animals; Antibodies; Antigen-Antibody Complex; Cell Line; Humans; Poisoning; Rabbits

The sorbent capacity of uncoated charcoal column (Detoxyl 2, Sorin Biomedica) on alpha-amanitin was studied by adding known amounts of alpha-amanitin to fresh human blood, which was recirculated through a clinical hemoperfusion circuit over a period of 30 min. The column was washed with saline to remove loosely bound alpha-amanitin, and eluted with 0.1 N HCl to detach absorbed alpha-amanitin. Alpha-amanitin concentration was measured in the saline washings and in the acid eluates by means of a radioimmunoassay. Only negligible amounts of amanitin were recovered in the saline washings. Suitable amounts of alpha-amanitin were present in the acid eluates, showing an adsorption optimum for blood concentrations ranging from 50 to 200 ng . ml-1. The results were discussed as predictable of the clinical usefulness of charcoal hemoperfusion in A. phalloides poisoning.

Topics: Adsorption; Amanitins; Charcoal; Hemoperfusion; Humans; Poisoning