ABSTRACT
This chapter provides state-of-the-art overviews on foodborne diseases caused by Grayanotoxins (GTXs) in relation to their etiology, biology, epidemiology, clinical presentation, pathogenesis, diagnosis, treatment, and prevention. GTXs are a group of toxic compounds classified as polyhydroxylated cyclic diterpenes. GTXs, also known as andromedotoxin, acetylandromedol, and rhodotoxin, are found in the leaves, flowers, twigs, and nectar of the genera Rhododendron, Pieris, Agarista, and Kalmia of the botanical family Ericaceae. Of these, the genus Rhododendron with more than one thousand species is one of the largest genera of vascular plants native to the northern hemisphere. Grayanotoxins may also be found in a number of products originating from these plants, for example, honey, tea, and extracts used in folk medicine. The numerous cases of grayanotoxin toxicity caused by overconsumption of mad honey are classified as mad honey disease. Grayanotoxins are toxic diterpenes with polyhydroxylated cyclic hydrocarbon structures that do not contain nitrogen.
