Pyrrolizidine alkaloids in food could be a cause of chronic disease
Pyrrolizidine alkaloids (PAs) are natural substances with known toxicity that occur in a number of weeds found in agricultural production systems worldwide.1,2 Bread made from PA-contaminated grain is a recurring cause of large regional outbreaks of a food poisoning-like syndrome characterised by rapid liver failure and death or development of hepatic sinusoidal obstruction syndrome (HSOS) and cirrhosis.1,2 Similar liver damage can also result from the consumption of herbal medicines, teas, salads and spices containing PAs.1-4 PAs have been detected worldwide as contaminants in milk, eggs, meat and honey at levels that are too low to cause rapid liver failure or HSOS but perhaps sufficient to initiate chronic diseases, including a range of cancers and pulmonary arterial hypertension (PAH) leading to right-sided heart failure.2,5
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