Thursday, July 17, 2014

Sweet poison: Star fruit neurotoxin identified

(Phys.org) —Patients with kidney disease have to watch what they eat: bananas, oranges, tomatoes, nuts, broccoli, and beans are all off-limits. Putting star fruit or carambola on the menu would be downright dangerous. This fruit contains a substance that is a deadly neurotoxin for people with kidney disease. Brazilian researchers have now isolated and identified this neurotoxin. As they report in the journal Angewandte Chemie, it is an amino acid similar to phenylalanine.

People suffering from chronic  have to avoid eating star fruit if they value their lives. Around the world, many cases have been documented in which ingestion of the yellow star-shaped fruit led to poisoning of dialysis patients and people with kidney disease. There are a variety of symptoms: from intractable hiccups, vomiting, weakness, mental confusion, and psychomotor agitation, to unusually long-lasting epileptic seizures, coma, and death. In acute cases, only hemodialysis can save the patient.

It is clear that star fruit contains an unidentified neurotoxin that healthy people clear out through the kidneys without problems. In those with kidney disease, however, the toxin accumulates and can eventually enter the brain. A team at the University of São Paulo (Brazil) has now been able to unmask the culprit.

To do this, scientists led by Norberto Garcia-Cairasco and Norberto P. Lopes modeled star fruit poisoning in animals. They gave either crude extracts of star fruit to animals with experimental kidney disease (to mimic the patient´s ingestion) or injected extracts of star fruit into the brains of healthy rats, inducing the behavioral and electrographical seizures typical of star fruit poisoning. The extracts were fractionated by means of chromatographic procedures and each individual fraction tested for activity. Active fractions were then chromatographically separated and tested again. This process was repeated until a single substance responsible for the seizures was isolated. The researchers named it caramboxin.

By using a variety of spectroscopic techniques, the scientists were able to determine the structure of caramboxin. The main structure of the neurotoxin resembles that of the amino acid phenylalanine. In contrast to the natural amino acid, the phenol ring of the toxin is also bound to extra ether, alcohol, and acid groups.

Further tests revealed that caramboxin acts on AMPA and kainate receptors, two important glutamate-controlled neurotransmitter receptors of the central nervous system. This causes hyperexcitability in the brain, resulting in the typically observed seizures, which showed neurodegenerative effects in the study.

肾病患者吃杨桃会要命

  传言:如果你有肾脏疾病,吃杨桃可能会结束你的生命。据马来西亚大学某神经学家介绍,杨桃中含有一种神经毒素,会影响大脑和神经,这在其他水果中并不存在。杨桃吃多了可能引起中毒,症状是打嗝、四肢麻木和疲乏。肾病患者只要吃了一个杨桃或喝100毫升杨桃汁,杨桃中的毒素在短时间内就会给肾脏病患者带来伤害,而健康人的肾脏可将神经毒素排出。
  杨桃对于肾病患者来说的确可成为杀手,食之不慎可能带来生命危险。但由于这种毒性作用对人群的影响面较小,所以长期以来未引起人们的关注。
  杨桃是产于南亚热带和亚热带地区的一种水果,在我国多产于广东、广西、云南、福建、海南、台湾等地,因其价格低廉、味道鲜美多汁,所以深受广大群众的喜爱。中医认为,夏天吃杨桃可清热解毒、生津止渴、润肺化痰、下气和中、利尿通淋。民间认为,吃杨桃能治身热烦渴、风热咳嗽、口腔糜烂、咽喉肿痛、牙痛、骨节风痛、痈、疽、肿、毒和跌打肿痛等。
  吃杨桃虽然好处颇多,但对于部分肾病患者来说,吃杨桃就有可能使病情加重。杨桃加重肾损害的机制目前尚不清楚,可能与以下因素有关:
  1.杨桃中含有一种天然毒素,这种毒素的成分还不是十分清楚。但动物实验证实,杨桃含有刺激性神经毒素,这种神经毒素可能是草酸盐。草酸盐具有肾脏毒性,会损伤肾小球毛细血管基底膜和上皮细胞,导致血尿,但此说法并没有经过大规模的临床试验证实。
  2.对于有肾脏基础疾病或尿毒症的患者,因神经毒素排出障碍,会进一步加重肾脏损害。
  3.杨桃引起血尿的发生机制与变态反应有关。杨桃作为抗原物质进入体内,由于机体的超敏状态而引起病理反应,导致肾组织损伤而产生血尿。但变态反应发生机制极其复杂,要阐明其引起血尿的详细机制,还需进一步研究。
  有学者观察到,原本肾功能正常的人在饥饿状态下,或者大量出汗后(机体处于缺水状态),于短时间内吃进大量的酸杨桃汁,血肌酐会突然升高,出现急性肾功能衰竭。肾病患者若食用杨桃过多,其所含的神经毒素会使部分肾病患者出现神志不清、四肢无力和手脚麻木等症状,甚至昏迷。而肾功能衰竭患者即使吃一个杨桃,也会出现不同程度的毒性反应,重者会使病情迅速发展成尿毒症,甚至死亡。
  为安全起见,肾功能不好者尽量不要吃杨桃。此外,肾脏病患者最好不要吃含钾高的水果,如葡萄和橙子等。

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