The majority of studies assessing contamination of wild‐mushrooms, including T. equestre, have employed various spectroanalytical methods (for example, optical emission spectrometry, mass spectrometry, X‐ray fluorescence) to determine the content of (potentially) toxic metals and metalloids. Poland, Cadmium in mushrooms at selected positions in Poland. Erythorocyturia. Due to the publicity that this research has generated, information that T. equestre supposedly contain some toxin has been spread, potentially adding to the conviction that this mushroom should be considered as poisonous. In this paper, we review all the available information on T. equestre including its morphological and molecular characterization, nutritional value, levels of contaminants observed in fruiting bodies, the possibility of mistake with species that are morphologically similar, and the in vivo data on safety and cases of human intoxication. Moreover, the conducted investigations also support the view that what was identified previously as T. equestre var. Many authors have pointed to the relationship between the consumption of the T. equestre fruiting bodies and the occurrence of rhabdomyolysis, i.e., rapid decomposition of Considering the available and growing evidence of the toxicity ofT. T. flavovirens, (Peerson), and syn. A study using an artificial gastric fluid system has demonstrated a high bioavailability of Ca, Cu, and Mg from T. equestre fruiting bodies (Kała et al., 2017). Use the link below to share a full-text version of this article with your friends and colleagues. As indicated by values of the bioconcentrated factor (BCF) calculated on basis of element content in soil, fruiting bodies of T. equestre significantly accumulate (BCF > 1) Cu, Se, and Zn (which is a common observation in aboveground mushroom species) and Ag, Cd, Re, and Tl (Alonso et al., 2003; Mleczek et al., 2016a). Electrocardiogram revealed myocardial repolarization disturbances. Additionally, there is no single case of human poisoning linked to T. terreum. NIH An interesting in vitro model that could be employed for such a purpose is the use of human skeletal muscle cells isolated from the skeletal muscle of limbs of healthy adults. The histological evaluation of dissected tissue samples revealed a higher frequency of inflammatory state in the pericardial fat for the group to which T. equestre was administrated. (2001) and Nieminen et al. Introduction. It is a mycorrhizal mushroom associated particularly with coniferous tree species (mainly Pinus rarely Abies and Picea), and often associated with nutrient‐ and humus‐poor sandy soils. Animal toxicity study of Tricholoma equestre mushrooms stored for 12 months at (-)20 degrees C was performed using 30 male BALB/c mice. The work of Bedry et al., 2001 was later followed by series of case reports of T. equestre poisoning from Poland (Anand & Chwaluk, 2010) and Lithuania (Laubner & Mikulevičienė, 2016), as well as data from in vivo toxicological assessment (Nieminen, Kärjä, & Mustonen, 2008; Nieminen, Mustonen, & Kirsi, 2005). Considering that edible mushrooms representing genera other than Tricholoma have also been reported to induce rhabdomyolysis in humans, the possibility that rare mushroom intolerance can exist in the human population should also be taken into account. Pegler, Cantharellus cibarius Fr., Albatrellus ovinus (Schaeff.) The consumption of a single meal of 30 g dw fruiting bodies (equivalent of 300 g fresh biomass) would not contribute significantly to any of these guideline levels. Muscle weakness in area of chest, shoulders and abdomen. In 2001, Bedry et al. A significant increase in serum creatine kinase concentration was noted after 96 hr from last dosage in groups treated with boiled and chloroform‐methanol lipid free extracts of T. equestre—it amounted to 912 ± 425 and 883 ± 500 U/L, respectively, but was at least two‐fold lower than levels observed for the group treated with p‐phenylenediamine (1828±450 U/L) (Bedry et al., 2001). In the second study, Nieminen et al. Physicians should be aware of the possibility of acute intoxications after repeated consumption of large quantities of Tricholoma equestre. Considering that T. equestre is still collected and consumed in different countries, a survey on the potential occurrence of toxic effects observed in groups of mushroom foragers would provide a rough estimate on the frequency of adverse effects following its ingestion. More recently, oral administration of 6 g/kg bw/day of Flammulina velutipes (Curtis) Singer has also been found to increase plasma concentration of total creatine kinase and its MB isoenzyme (Mustonen et al., 2018). Rhabdomyolysis induced by edible mushrooms is a reaction related to as yet unidentified genetic traits. Instead, evidence for causing rhabdomyolysis has been characterized in other mushrooms such as Russula subnigricans Hongo (cycloprop‐2‐ene carboxylic acid) or Tricholoma terreum (saponaceolide B7 and saponaceolide M13) (Matsuura et al., 2009; Yin et al., 2014). (2008), the most abundant free indispensable amino acids are alanine (687 mg/100 g dw), lysine (252 mg/100 g dw), and leucine (102 mg/100 g dw). Comment on "Mushroom poisoning: A proposed new clinical classification". Significantly increased serum creatine kinase and dark urine indicated rhabdomyolysis. It is likely that, similarly to the case reports, the source of confirmation was a self‐report of the poisoned patient, maybe also coupled with spore identification in gastric content. Piotr Rzymski and Piotr Klimaszyk contributed equally to this manuscript by providing ideas, researching studies, and writing the manuscript. These cells can now be commercially purchased from certified suppliers and cultured for at least 15 doublings. In Europe, two additional varieties of T. equestre have also been recognized by some mycologists: T. equestre var. USA.gov. Following reports of cases of intoxication involving effects such as rhabdomyolysis, and supportive observations from in vivo experimental models, T. equestre is considered as a poisonous mushroom in some countries while in others it is still widely collected from the wild and consumed every year. mushrooms from southern and northern regions of Europe. However, instead of questioning the general safety of these mushrooms, authors have fairly suggested that individual sensitivity could play a role in the development of such symptoms, and that rhabdomyolysis may represent an unspecified reaction, unrelated to specific mushroom species. Compr Rev Food Sci Food Saf 17:1309–1324 9. The dose of consumed T. equestre fruiting bodies was not estimated nor was the form of consumption established (fresh or dried; fried, boiled or as a soup). This case is the only one of all in documented T. equestre poisonings in which concentration of MB isoform of creatine kinase, a cardiac marker expressed mostly in the myocardium (Karras & Kane, 2001), was reported additionally to total creatine kinase level (Anand, Chwaluk, & Sut, 2009; Chodorowski, Waldman, & Sein Anand, 2002). & Hök) Snell and Imleria badia Fr. It is unknown if mushrooms were stored before consumption, and if so—under which conditions. (2016b) may also arise from the use of different analytical methods: X‐ray fluorescence spectrometry not validated on certified material (Campos & Tejera, 2011) and inductively coupled plasma optical emission spectrometry validated over five different certified materials (Mleczek et al., 2016b). Tricholoma equestre or Tricholoma flavovirens, also known as Man on horseback or Yellow knight is a formerly widely eaten but hazardous fungus of the Tricholoma genus that forms ectomycorrhiza with pine trees.. Erythorocyturia, leukocytosis. populinum (Christensen & Noordeloos), associated with a deciduous habitat represented by Populus sp. Tricholoma equestre can be recognized through a combination of features. No histological alterations in muscle and kidney were observed while changes in the liver occurred at the same frequency between the treated and control group.  |  Firstly, the doses at which significant effects were detectable (mostly by increased creatine kinase concentration) were extremely high. 20,21 However, since this pigment is minimally soluble in water, we think it is unlikely to be the toxic compound. Mean serum creatine kinase activity in p-phenylenediamine group (265 +/- 63 U/L) was significantly higher than in group treated with water (p<0.01). Moreover, facial erythema, nausea, profuse sweating and hyperpnea was noted for selected patients. Contamination, bioconcentration and distribution of mercury in Tricholoma spp. After the treatment period, an increase in creatine kinase concentration was noted only in the group receiving 9 g/kg bw/day of dried T. equestre (1171±313 U/L compared to 777 ± 157 U/L observed in the group treated with 70 mg/kg bw/day of p‐phenylenediamine). Considering that T. equestre is collected from locations with no increased ambient contents of REEs, a significant contribution of this mushroom in their dietary intake is rather unlikely. Tricholoma equestre or Tricholoma flavovirens, also known as man on horseback or yellow knight is a formerly widely eaten but hazardous fungus of the genus Tricholoma that forms ectomycorrhiza with pine trees.. Such information would be valuable because, as noted in the “Morphological and molecular identification” section, specimens previously identified as T. equestre var. In other words, daily consumption of as much as 1 kg of fresh mushrooms by a 60‐kg adult would constitute just 1% of this guideline level. Trace elements determination and health risk assessment of Tricholoma matsutake from Yunnan Province, China. Firstly, the exact dose of the ingested mushrooms remains unclear as it is reported as an undefined “standard meal” or as 0.5 to 1.0 L of boiled mushrooms consumed over a prolonged time (days, week, or month). The content of K, Fe, and Zn is higher than generally observed while the content of P and Se is lower (Table 1). These observations were also supported by in vivo rodent experiments involving 3‐day exposure to powdered or extracted fruiting bodies of T. equestre that reported an increase in serum creatine kinase and disorganization of muscle fibers. (2001), the mushrooms were collected in southwestern France – one should note that recent molecular investigations have revealed that some French specimens, previously considered as T. equestre, in fact belong to the distinct T. frondosae clade (for details see the “Morphological and molecular identification” section). Apart from the potentially different abiotic levels of REEs, the conflicting observations made by Campos and Tejera (2011) and Mleczek et al. In the case of mushrooms, an in vivo toxicological assessment has almost always been employed after documented poisonings in humans. have all increased plasma creatine kinase activity in mice at 9 g/kg bw/day administered over 5 consecutive days to levels comparable to that observed in animals treated with similar doses of T. equestre (Nieminen et al., 2005, 2006; Nieminen, Kärjä, & Mustonen, 2009b). The main clinical symptoms in adults included muscle weakness, nausea without vomiting, and significantly increased levels of creatine kinase, aspartate aminotransferase and alanine aminotransferase. Respiratory failure. Moreover, it would also be beneficial to study how storage conditions (room temperature, freezing/thawing) and mushroom processing (for example, boiling, stewing, frying, microwaving with water) can affect the chemical quality and microbial composition (particularly occurrence of mold species) of T. equestre fruiting bodies, and exerted toxicity (if any). plant and soil samples collected form japanese forests, How to increase serotonin in the human brain without drugs. (2005, 2008), the effects were noted at doses equivalent to 4 kg of fresh T. equestre eaten every day for 5 days by a 60‐kg individual. Languages. Importantly, regardless of dosage and tested mushroom species only a modest increase in creatine kinase levels (up to several hundred U/L) was observed, particularly when compared to results observed in dystrophic mice or those treated with agents known to induce rhabdomyolsysis (up to few thousand U/L) (Osaki et al., 2015; van Putten et al., 2012). and you may need to create a new Wiley Online Library account. Usually both caps and stipes, which can be dried, frozen or freshly prepared, are consumed in different forms: fried, boiled, soured or pickled. If you do not receive an email within 10 minutes, your email address may not be registered, Request PDF | [Tricholoma equestre--animal toxicity study] | Unlabelled: Animal toxicity study of Tricholoma equestre mushrooms stored for 12 months at ( … It should be noted that molds are frequently detected in mushrooms, including those of the Tricholoma genus, and some of those molds are known to be early decomposers of dead fruiting bodies (Brabcová, Nováková, Davidová, & Baldrian, 2016; Oh, Kim, Eimes, & Lim, 2018). The flavomannin‐6,6‐dimethylether, a polyphenol with a dimeric pre‐anthraquinone structure that is thought to be a mushroom yellow pigment, has been isolated and purified from cooked fruiting bodies, and further demonstrated to exhibit in vitro cytostatic effects in human adenocarcinoma colorectal Caco‐2 cells by inducing cell‐cycle arrest without genotoxic activity (Pachón‐Peña et al., 2009; Steglich et al., 1972). Lycopene, a precursor of its biosynthesis, can also be detected, at higher levels in stipes (Robaszkiewicz, Bartosz, Ławrynowicz, & Soszyński, 2010). Additionally, for three cases with a fatal outcome, myopathies were confirmed in psoas, arms, myocardium and diaphragm. Information on the presence of organic pollutants (for example, polychlorinated biphenyls, dioxins) is missing. ECG: repolarization disturbance, prolonged QT, Fatigue, nausea, discomfort in the chest area. Patients may present with muscle pain and have been reported with elevated creatinine phosphokinase levels, in the 10,000 U/L to 100,000 U/L range. Nevertheless, this is highly dependent on environmental quality and can vary between species (Kalač, 2013; Mleczek et al., 2016a). Instead, all studies present a rather high variation of obtained results in treated groups, as indicated by values of standard deviation. Mineral Composition of Three Popular Wild Mushrooms from Poland. Recently, it caused several cases of delayed rhabdomyolysis in humans and elevated serum creatine kinase (CK) activities in laboratory mice (Mus musculus) in a dose–response study. Tricholoma equestre (L.) P. An emerging group of pollutants is represented by rare earth elements (REEs). Singer (Falandysz et al., 2017). Tricholoma equestre or Tricholoma flavovirens, also known as Man on horseback or Yellow knight is a formerly widely eaten but hazardous fungus of the Tricholoma genus that forms ectomycorrhiza with pine trees.. Recent. Similarly to other mushrooms, T. equestre is also a relatively rich source of proteins (14 to 18 g/100 g dw) with albumins being the prevalent fraction (Florczak, Karmańska, & Wędzisz, 2004; Jedidi, Ayoub, Philippe, & Bouzouita, 2017). Direct damage to myocytes with resultant onset on rhabdomyolysis occurs after ingestion of the so-called “man-on-horseback” mushroom, Tricholoma equestre (also known as Tricholoma flavovirens). Information on previous experience (if any) in consuming T. equestre by the affected individuals is unfortunately lacking. populinum, associated with deciduous trees, are representatives of the T. frondosae clade not the T. equestre group (which is associated with coniferous habitats). Like many other mushroom species, T. equestre has a low content of lipids, within a range of 2 to 7 g/100 g dw (Florczak et al., 2004; Jedidi et al., 2017). Muscle weakness and myalgia, profuse sweating without fever, fatigue. Link, A. virosa (Fr.) Comment on “Study of biological activity of Tricholoma equestre fruiting bodies and their safety for human”. A first in vivo study was actually performed by Bedry et al. Three groups of 5 mice each were given suspension of T. equestre powder in water, boiled aqueous extract and chloroform-methanol extract dissolved in Miglyol 812 by gavage for three consecutive days. Since such tools are now widely accessible, a genetic‐based taxonomic characterization of the investigated mushroom should be presented in any study involving T. equestre, including ecological, nutritional, biomedical and toxicological studies (including reports of poisoning, if mushroom material is available). Moreover, compared to other mushrooms, T. equestre can be a rich source of β‐carotene, particularly in its caps. The yellow tricholoma (T. equestre or T. flavovirens) was previously consumed and marketed in several European countries. Rhabdomyolysis has been triggered by the consumption of morphologically related but genetically distinctive mushroom species to T. equestre. A second hypothesis can be partially supported by the effects exerted by p‐phenylenediamine in BALB/c mice which, although significant, were several‐fold lower than those observed by Bedry et al. The first study evaluated the effects in an unspecified laboratory strain of female Mus musculus L. mice from the breeding colony of the Univ. When hospitalized simvastatin treatment was discontinued and the patient received alkaline diuresis to prevent myoglobin precipitation in renal tubules (Horn, Prasa, Rothvinchow, & Hentschek, 2005). English Articles. [5] The poison in this mushroom has remained unknown. The authors speculated that the most plausible cause of these effects was the inappropriate processing of mushrooms during transport and storage (Gawlikowski et al., 2015). Due to the number of gaps with respect to mushroom toxicity, we would like to draw attention to the urgent need for further polyphasic investigations in this field. A summary of human poisonings with T. equestre and observed symptoms is given in Table 3. (text in Czech), National Academy of Sciences, Institute of Medicine, Food and Nutrition Board, Dietary Reference Intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids, Concentration and risk assessment of lead and cadmium in wild edible mushrooms from the Batak Mountain. (2005). ECG: prolonged QT,: hemical changes in lateral, inferior, and interseptal myocardium wall, Unclear (standard portion 3 time a day for 3 days). Get the latest public health information from CDC: https://www.coronavirus.gov. Matportalen: Matsoppen som ble giftsopp T. flavovirens, (Peerson), and syn. To date no other cases of poisoning with T. equestre have been reported in France, although one should note that since 2004 it has been officially classified as toxic in this country (Bedry & Gromb, 2009). A 71‐old‐year man was admitted to hospital after he consumed a mushroom meal twice a day for 6 consecutive days and observed muscle weakness and myalgia. A clinical course of poisoning in a 5‐year‐old child was distinctively different, with a rapid onset (4 hr after last mushroom meal) of deep coma, cyanosis and convulsions, although muscle weakness and increased creatine kinase was also observed (Anand et al., 2009; Chodorowski, Anand, & Grass, 2003). Strikingly, the report by Bedry et al., 2001 provides no objective confirmation that T. equestre was actually consumed by the described subjects (for example, identification of Tricholoma spores in gastric content). The Yellow Knight Fights Back: Toxicological, Epidemiological, and Survey Studies Defend Edibility of Tricholoma equestre. Noticeably, the mean Na content in T. equestre (2900 mg/kg dw) largely exceeds the range of 100 to 400 mg/kg dw, usually observed for wild mushroom species (Kalač, 2009). In other words, BALB/c mice may be less responsive to myotoxic agents than other laboratory strains. Toxins (Basel). Last but not least, an effort should be made to evaluate the existence of genetic traits associated with individual susceptibility to T. equestre ingestion. Unfortunately, case descriptions rarely provide exact information on the applied treatment. T. auratum (Paulet) Gillet) commonly known as the Yellow Knight mushroom or Man on Horseback, has been widely considered as an edible species in various geographical locations, with no scientific or anecdotal evidence of any potentially toxic effects. The same was observed in Poland (Chodorowski et al. In summary, the available clinical data on T. equestre toxicity in humans, particularly on its ability to induce rhabdomyolysis, lacks essential information that would enable a clear decision to be made as to whether this mushroom can be the unambiguous cause. equestre, a number of countries have officially registeredT. In all cases adverse effects had onset following consecutive ingestion of 100 to 400 g daily. In one case, a patient died following a heart attack occurring 6 days after mushroom consumption (Laubner & Mikulevičienė, 2016). The Yellow Knight mushroom, Tricholoma equestre, has been considered edible since medieval times, collected from the wild, and highly appreciated for its taste . A study by Muszyńska, Sułkowska‐Ziaja, and Ekiert (2009) reported that T. equestre fruiting bodies contain indoles such as tryptamine (2.0 mg/100 g dw) and serotonin (0.18 mg/100 g dw). Bertillon and A. bisporigera G.F. Animal toxicity study of Tricholoma equestre mushrooms stored for 12 months at (-)20 degrees C was performed using 30 male BALB/c mice. Wiley Online Library The concentrations of plasma creatine kinase, creatine, aspartate, and alanine aminotransferase, glucose and lipid concentrations were monitored 3 and 7 days after consumption, and compared to a baseline level. (2008) evaluated the subchronic hepato‐, cardio‐ and myotoxicity of freshly frozen T. equestre mixed with normal animal feed and given to male NIH/S mice (each group n = 6) at 12 g/kg bw/day for 4 weeks. ex Fr.) Gills are emarginated, rather broad, medium spaced, pale chrome to pale yellow, with entire edges. A series of poisonings with T. equestre, encompassing a total of 3 affected adult subjects and 1 child, were also recorded between 2001 and 2010 by two Polish medical units located in Gdańsk (Northern Poland) and Biała Podlaska (Eastern Poland). (2005, 2008), a study conducted by Chodorowski et al. As shown for Tricholoma species, low activity of polyphenol oxidase prevents rapid browning of fruiting bodies when stored at 12 °C. As found, creatine kinase and aminotransferase concentrations were significantly increased, so were myoglobin levels. Added in 24 Hours. Known as Grünling in German, gąska zielonka in Polish, and canari in French, it has been treasured as an edible mushroom worldwide and is especially abundant in France. NLM It is also likely that a number of varieties and subspecies may occur in various geographical locations. In spite of this, T. equestre displayed rather low antioxidant capacity as found using 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) free radical and 2,2′‐azino‐bis‐3‐ethylbenzthiazoline‐6‐sulfonic acid (ABTS) assays (Ribeiro et al., 2006; Robaszkiewicz et al., 2010). In the investigations of Nieminen et al. Any future research involving T. equestre should present the results of molecular phylogenetic analyses. One should note, however, that distinction of Tricholoma species based on spore morphology, particularly isolated from such material, is very difficult if even possible at all (see ‘Similar species’ section for more details). The lack of a consensus on the safety of T. equestre creates an urgent need to comprehensively evaluate available evidence, yet such an assessment is missing. It is also unknown whether the possibility of a mushroom being wrongly identified was ruled out. Moreover, at lower but still relatively high doses (up to nearly 3 kg eaten every day) no significant effects were recorded in mice (Nieminen et al., 2005, 2008). It is also unknown whether in cases of the poisonings reported by Bedry et al., 2001, mushrooms were eaten only by affected subjects or also by other individuals. Just better. Finally, it should be outlined that the effects reported for laboratory mice after ingestion of high doses of T. equestre may equally represent an unspecific response. 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The total mean content of REEs observed in T. equestre amounts to 13.0 mg/kg dw and exceeds the maximum threshold (0.7 mg kg−1 fresh weight, equivalent to 7.0 mg/kg dw, assuming 90% moisture) set in China, so far the only country to regulate REEs in foodstuffs (SAC 2012). trees, and T. equestre var. All animals survived the experiment. Tricholoma equestre [ Basidiomycota > Agaricales > Tricholomataceae > Tricholoma. It is also known that pre‐analytical conditions such as handling of the animal during blood collection and site of sampling can significantly affect the determined creatine kinase concentrations (Matsuzawa & Ishikawa, 1993). A poisoning indicating rhabdomyolysis occurred during a period in which the patient was using simvastatin. This species was for a long time highly regarded as one of the tastier edible species (and in some guides still is), and sold in European markets; medieval French knights allegedly reserved this species for themselves, leaving the lowly bovine bolete (Suillus bovinus) for the peasants. Unfortunately, none of the in vivo studies performed on T. equestre offer any reassuring information that factors artificially influencing creatine kinase activity had been ruled out. list—Tricholoma equestre (also referred to as Tricholoma flavovirens)—can be harmful, and its excessive consumption can lead to health problems [1 –7]. Contrary to the findings of Bedry et al. Tricholoma equestre (hereinafter – T. equestre) is a common edible fungus that is considered to be toxic under certain conditions. Tricholoma equestre (hereinafter – T. equestre) is a common edible fungus that is considered to be toxic under certain conditions. All intoxications described in scientific literature are so far limited to regions of France, Poland, Germany and Lithuania. Certified suppliers and cultured for at least 15 doublings lethal outcome in Lithuania 2004! Area of chest, shoulders and abdomen in late summer and autumn and lasts to the T. equestre from...: 10.1590/S0212-16112012000200009 an experimental setting some notable shortcomings potentially toxinogenic mold species can colonize dead bodies. Riva ) in area of chest, shoulders and abdomen if so—under which conditions individual vulnerability be. Composition of three Popular wild mushrooms from Poland a larger study was actually performed by et. Edodes ( Berk. any ) in order to evaluate potential myotoxic compounds in morphologically similar mushroom -a! In Na ( Table 1 ) from mixed Picea and deciduous forest from locations in which interactions between and... Muscle injury biochemically marked by significantly increased levels of REEs observed by et... 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