Mechanisms of star fruit (Averrhoa carambola) toxicity: A mini-review

  • Toxicon. 2020 Nov:187:198-202. doi: 10.1016/j.toxicon.2020.09.010.
Pamodh Yasawardene  1 ,  Umesh Jayarajah  2 ,  Ishan De Zoysa  3 ,  Suranjith L Seneviratne  4
Affiliations
  • 1. Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka. Electronic address: [email protected].
  • 2. Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka. Electronic address: [email protected].
  • 3. Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka. Electronic address: [email protected].
  • 4. Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka. Electronic address: [email protected].
PMID: 32966829 DOI: 10.1016/j.toxicon.2020.09.010
Abstract

The star fruit (Averrhoa carambola) is consumed in high amounts in Asia and Central/South America. It contains oxalic acid and caramboxin. In some individuals, its ingestion may lead to nephrotoxicity and neurotoxicity. The nephrotoxic effect is due to oxalate deposition in renal tubules resulting in acute tubular necrosis and interstitial nephritis. Although uraemic encephalopathy secondary to acute kidney injury may play a role, a shift to an excitatory state of the central nervous system (CNS) by caramboxin through activation of excitatory neuroreceptors and inhibition of GABA receptors leads to mental confusion, seizures and status epilepticus seen with star fruit intoxication. In this mini-review, we discuss the mechanisms of star fruit-related toxicity.

Keywords
Averrhoa carambola; Calcium oxalate; Caramboxin; Review; Star fruit; Toxicity; mechanisms.
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