Worldwide poisoning potential of Brugmansia and Datura

Abstract

Purpose: The toxicological significance of human exposures to angel's trumpet plants (Brugmansia and Datura species) in their native American and non-native regions (Asia, Africa, and Europe) was highlighted, and the poisoning potential of various plant parts was discussed. Methods: Nearly 2500 cases of human plant exposures, reported to the Hungarian Toxicological Information Service between 2005 and 2017, were analyzed and compared to data of other toxicology centers in America, Asia and Europe, focusing on exposures to tropane alkaloid-containing plants. Results: In America, Brugmansia and Datura were not among the 15 most common plant ingestions, but were responsible for 20% of the fatal outcomes in a 26-year period. In Asia, the anticholinergic toxidrome, related to Brugmansia and Datura, was among the most frequent plant-related intoxications, which included accidental ingestion, improper use of herbal medicines and plant abuse. In Europe, Brugmansia and Datura were among the top four plant taxa causing intoxications with major outcomes, being the leading plants ingested for their hallucinogenic properties, and accounted for 60% of abuse cases in Hungary in a 13-year period. Use of Brugmansia and Datura for criminal purposes has been reported from America, Asia and Europe. The concentrations of tropane alkaloids vary with the species, seasons and plant parts. Ingestion of the seeds and flowers has the highest toxicological significance, but exposure to the leaves and floral nectar can also cause intoxication. Conclusions: Angel’s trumpets have high toxicological significance both in their native and non-native regions, mainly due to their hallucinogenic property and accidental ingestion.