Glycaemic responses to scorpion venom

Clinical comparison of scorpion envenomation by Androctonus mauritanicus and Buthus occitanus in children

The clinical results of scorpion stings by Androctonus mauritanicus (Am) and Buthus occitanus (Bo) (main sources of scorpionism in Morocco) were evaluated in this work. The objective was to compare the clinical manifestations of envenoming from these species by investigating possible correlations among symptoms/signs and laboratory abnormalities of envenomed patients. 41 children (25 males, 18 months - 11 years) were admitted at the Provincial Hospital of El Jadida-Morocco. Their minor (18 children) or severe (23 children) systemic signs such as pallor (48.8%), pulmonary edema (APE) (36.6%), convulsion (26.8%), coma (7.3%) were more frequent in children envenomed by Am than Bo, but angioedema (Quincke's edema) (4.9%) was particularly developed in the latter group. The laboratory blood abnormalities (hyperglycemia, high levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatinine, bilirubin, leukocytes, neutrophils, monocytes, platelets and low levels of lymphocytes and hemoglobin) were significantly higher (p < 0.05) in patients envenomed by Am than Bo, and in all population in comparison to control group. The correlation among these biological analyzes and clinical status showed that higher levels of LDH and value of leukocytes ≥19 × 10(3)/mm(3) were indices of cardiac dysfunction with APE. Pallor sign was correlated with a state of shock and/or low level of hemoglobin, associated or not to bilirubin increase. Fatalities (7.3%), presenting toxic myocarditis, had lowest count of lymphocytes (≤4.2%) in comparison to survivors. This is the first report on lymphopenia which may be useful for forecast the fatal outcome in scorpion envenomation.

Dose-dependent serum biochemical alterations in Wistar albino rats after Palamneus gravimanus (Indian black scorpion) envenomation

Palamneus gravimanus envenomated rats showed dose-dependent alterations in serum biochemical parameters. Sub lethal doses of 100, 200, and 400 microg/kg of P. gravimanus venom were injected intramuscularly into rats. Blood samples were collected by heart puncture before and 4 h after crude venom administration. Serum was analyzed for glucose, blood urea nitrogen (BUN), uric acid, total protein, cholesterol, sodium, potassium, inorganic phosphorus, alkaline phosphatase, aspartate aminotransferase (AST-SGOT), alanine amino-transferase (ALT-SGPT), lactate dehydrogenase (LDH), and creatinine phosphokinase (CPK). Statistically significant increases in serum levels of glucose, creatinine, AST, ALT, BUN, CPK, and LDH and significant decreases in serum levels of total protein, uric acid, cholesterol, calcium, and potassium 4 h after venom administration could be due to the toxic action of P. gravimanus venom on certain organs in rats.

Biochemical and histopathological alterations induced in rats by Tityus serrulatus scorpion venom and its major neurotoxin tityustoxin-I

Intravenous injection into the rat of sublethal doses of Tityus serrulatus scorpion venom (100 micrograms protein/kg) or its major neurotoxin tityustoxin-I (TsTX-I, 20 micrograms/kg) caused, 30-180 min after injection, statistically significant increases in the serum levels of aspartate aminotransferase, amylase, creatine kinase and lactate dehydrogenase, as well as hyperglycemia, a high level of plasma free fatty acids and a low level of liver glycogen. The in vitro serum levels of the above enzymes did not change. For alanine aminotransferase, gamma-glutamyl transferase and alkaline phosphatase, neither in vitro nor in vivo alterations were observed. The whole venom and TsTX-I caused hepatic congestion with hemolysis and hydropic degeneration. Other histological lesions included edema and congestion with subpleural hemorrhage in the lungs, hypertrophy of fibers with degeneration areas in the heart, and congestion and hemorrhage in the kidneys. In the salivary glands, alterations to the acini and ductules were visible. In the adrenal glands no morphological alterations could be detected at the studied doses. The results suggest that the in vivo enzymatic and histopathological alterations are due to tissue lesions evoked by the whole venom and TsTX-I. An indirect effect, however, induced by stimulation of acetylcholine and catecholamine release in the postganglionic nerve terminals, cannot be excluded.

[Scorpion stings in children. Saudi Arabian experience]

Scorpion stings are a major public health problem in Saudi Arabia. The main victims are children who accidentally tread on a scorpion, about 900 children being admitted to hospitals each summer for such stings. Many cases are fatal. The pathophysiology of scorpion stings is complex and its management is difficult. Almost all body systems are affected but circulatory shock and pulmonary oedema are the usual cause of death. The treatment is based on scorpion antivenom and symptomatic treatment of the envenoming manifestations in an intensive care unit. The currently used antivenom is a polyvalent horse serum preparation given intravenously.

The effect of the viper Cerastes cerastes cerastes venom and venom fractions on carbohydrate metabolism

The effect of the viper Cerastes cerastes cerastes venom and venom fractions on carbohydrate metabolism. Toxicon 31, 791-801, 1993.--I.p. injection of a sublethal dose of Cerastes cerastes cerastes venom into white rats induced a marked hypoglycemia after 15 min. This hypoglycemia continued for at least 24 hr. Hypoglycemia was accompanied by a significant increase of liver and muscle glycogen at 15-30 min and 8 hr. Plasma lactate levels were significantly increased for most of the 24 hr test period, and was accompanied by a marked decrease of liver lactate levels. Levels of skeletal muscle lactate increased significantly. Viper venom significantly increased levels of plasma, liver and skeletal muscle pyruvate for most of the 24 hr test period. Cerastes cerastes cerastes venom was fractionated using gel filtration into six fractions. Each of the first four fractions caused a significant hypoglycemic effect at some point of the 6 hr test period, while fraction I also produced a hyperglycemia 30 min after administration. Fraction III, the only fraction to show a continuous hypoglycemic effect during the 6 hr test period, significantly increased plasma insulin levels 30 min after treatment. It is suggested that the hypoglycemia may be due to a direct effect of venom components on plasma insulin levels.

Effect of scorpion Leiurus quinquestriatus (H&E) venom on the clinical chemistry parameters of the rat

Egyptian scorpion venom was collected by electrical stimulation of the telson. Rats were injected with the lyophilized venom in 3 different doses (100, 200 and 400 micrograms/kg). Blood samples were drawn by heart puncture before and 4 h after venom administration. Serum was separated and collected for determination of glucose, blood urea nitrogen (BUN), creatinine, uric acid (UA), total proteins, cholesterol, sodium, potassium, calcium, inorganic phosphorus, alkaline phosphatase, aspartate aminotransferase (AST, GOT), alanine aminotransferase (ALT, GPT), lactate dehydrogenase and creatine phosphokinase (CPK). Serum glucose, creatinine, GOT, GPT and LDH were increased significantly in all treatments. At the same time serum BUN and CPK were elevated significantly with a dose-response relationship. On the other hand, serum total proteins, uric acid, cholesterol, calcium and potassium were significantly decreased 4 h after administration of the 3 doses. These changes in clinical chemistry parameters are most probably related to the toxic effect of the venom on the target organs.

Are the toxicological effects of scorpion envenomation related to tissue venom concentration?

The pharmacokinetics of 125I-labelled Androctonus amoreuxi venom and its lethal fraction was studied in rabbits. Comparative pharmacokinetic studies of labelled A. amoreuxi, Leisurus quinquestriatus and Buthotus judaicus venoms were carried out in guinea-pigs. The pharmacokinetics of A. amoreuxi venom was also studied in rats. Groups of rats were injected with labelled A. amoreuxi venom and killed at frequent time intervals for the determination of the relative tissue venom concentration as a function of time. Several groups of rabbits were injected with A. amoreuxi venom and serial blood samples withdrawn at time intervals comparable with those used in the pharmacokinetic studies for the determination of serum glucose, insulin, cortisol, total proteins, albumin, globulins, cholesterol, total bilirubin, urea, uric acid, bicarbonate, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase, sodium, potassium, calcium and phosphorus. The packed cell volume, and total and differential leucocyte counts were also determined. In another series of experiments continuous monitoring of the electrocardiograms of rabbits following venom injection was made to correlate any abnormalities with tissue venom concentration. All three venoms and the lethal fraction showed an open two-compartment behaviour with rapid distribution half-lives ranging between 4 and 7 min and overall elimination half-lives of 4.2 to 13.4 hr. The behaviour of A. amoreuxi venom was not markedly different in the three species of animals used. In a given species (guinea-pigs) the behaviour of the three venoms was not markedly different. Correlation of the ECG changes with cardiac venom concentration showed that arrhythmias and infarction occurred at times when cardiac concentration was very low, indicating that the cardiac abnormalities might result from indirect factors. Comparison of the course of the biochemical changes with venom concentration in the central compartment indicated that the site of action of the venom is not located in the central compartment. Correlation of the intensity of the biochemical effects with venom concentration in the peripheral compartment revealed an apparent delay in the onset and peak of action. This was explained by assuming that the tissue compartment could be divided into a rapidly accessible and a slowly accessible compartment with the venom acting through the slowly accessible compartment. There was also the possibility of the venom acting indirectly through the release of other substances or transformation to an intermediate.(ABSTRACT TRUNCATED AT 400 WORDS)

Teratogenicity in the rat of the venom from the scorpion Androctonus amoreuxi (Aud. & Sav.)

A. amoreuxi venom caused a high foetal resorption rate in rats, particularly when injected on days 9-11 of gestation. Vertebral and ossification defects and foetal weight loss were observed in many of the viable foetuses obtained from mothers treated with scorpion venom. Treatment of the rats with phentolamine in addition to the venom significantly reduced the venom-induced hyperglycemia. It also conferred some protection against foetal resorption but had only a slight effect on chondrification or foetal weight loss. This shows that hyperglycemia might be responsible for foetal mortality, but alone is not a decisive factor in the effect of the venom on the chondrification process. Treatment of the rats with triamterene reduced the foetal resorption rate and significantly decreased the effects of the venom on chondrification. However, marked stippling was observed in the long bones and was ascribed to marked mobilization of ionized calcium in the foetus. Foetuses removed from rats treated with phentolamine or triamterene in addition to the venom, however, showed flattened and depressed skulls, possibly from a missing 1st cervical vertebra or failure of the occipital fontanel to close. Treatment of the rats with the scorpion venom over a longer period of time and starting at an earlier time of gestation (days 7-14) caused total foetal resorption, which may be due to inhibition of histamine formation by the venom. The teratogenic effect of the venom appears to be the result of its metabolic effect and action on body electrolytes of the maternal animal, rather than to a direct effect on the foetuses. This was evidenced from experiments with labelled venom, where only a small fraction (0.08-0.33%) was detected in foetuses or placenta.