[6] Levels of nitrogen, manganese, and pH as well as abundance of necessary enzymes regulate the biosynthetic pathway of patulin.

[5] Patulin was originally used as an antibiotic against Gram-positive and Gram-negative bacteria, but after several toxicity reports, it is no longer used for that purpose.

[2] Kashif Jilani and co-workers reported that patulin stimulates suicidal erythrocyte death under physiological concentrations.

It has also been detected in other fruits including cherries, blueberries, plums, bananas, strawberries, and grapes.

[6][10][full citation needed] Dietary intake of patulin from apple juice has been estimated at between 0.03 and 0.26 μg per kg body weight per day in various age groups and populations.

[11] A number of studies have looked into comparisons of organic vs conventional harvest of apples and levels of patulin contamination.

[12][13][14] For example, one study showed 0.9% of children drinking organic apple juice exceeded the tolerable daily intake (TDI) for patulin.

[15][full citation needed] A recent article described detection of patulin in marine strains of Penicillium, indicating a potential risk in shellfish consumption.

[10] A subacute rodent NOAEL of 43 μg/kg body weight as well as genotoxicity studies were primarily the cause for setting limits for patulin exposure, although a range of other types of toxicity also exist.

[18][full citation needed] Patulin is toxic primarily through affinity to sulfhydryl groups (SH), which results in inhibition of enzymes.

Major acute toxicity findings include gastrointestinal problems, neurotoxicity (i.e. convulsions), pulmonary congestion, and edema.

[3] Studies in rats showed decreased weight, and gastric, intestinal, and renal function changes, while repetitive doses lead to neurotoxicity.

[7] Patulin exposure can be successfully managed by following good agricultural practices such as removing mold, washing, and not using rotten or damaged apples for baking, canning, or juice production.