The Mechanism and Application of Mushroom Toxicity

Mushroom poisoning remains a substantial global health concern, with thousands of cases reported annually and significant morbidity and mortality, especially in regions where wild mushroom foraging is prevalent. The main toxic agentscyclopeptides, orellanine, and hydrazineseach target different organ systems and present unique diagnostic and therapeutic challenges. Cyclopeptides, particularly amatoxins found in Amanita species, induce acute and often fatal hepatotoxicity by inhibiting RNA polymerase II, leading to disrupted protein synthesis and hepatocellular death. Orellanine, present in Cortinarius mushrooms, is characterized by a delayed onset of nephrotoxicity, complicating early diagnosis and frequently resulting in irreversible renal damage. Hydrazines, most notably from false morels, disrupt central nervous system function by interfering with GABA synthesis and can also cause hemotoxicity and liver necrosis.Epidemiological data reveal that Europe, Asia, and North America are the most affected regions, with China alone reporting over 1,400 cases and 44 deaths in 2022. Clinical management remains difficult due to the variability in symptom onset, overlapping presentations, and the absence of specific antidotes for most toxins. Recent research has advanced our understanding of the molecular mechanisms underlying mushroom toxicity and the pharmacokinetics of key toxins, but effective therapeutic interventions are still limited. This review systematically summarizes the toxicological pathways, clinical manifestations, and management strategies associated with major mushroom toxins. It further underscores the urgent need for rapid, accurate diagnostic methods, the development of targeted antidotes, and enhanced public education campaigns to effectively reduce the incidence and impact of mushroom poisoning worldwide.