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Benzaken Z, Silva LL, Silva-Neto A, Sachett J, Fé N, Guerra MDGVB, Monteiro W. Urbanization and scorpion stings in Manaus, the largest metropolis in the Brazilian Amazon. Toxicon 2024; 247:107823. [PMID: 38914231 DOI: 10.1016/j.toxicon.2024.107823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024]
Abstract
This study analyzed a total of 260 confirmed scorpion stings reported in the city of Manaus, in the Brazilian Amazon, from 1990 to 2020. Cases were mapped according to the GPS location of their occurrence and plotted on a satellite image of the city. The stings generally occurred close to green areas, and the hotspots of stings moved north as city grew into that direction over time. Spatial analysis shows that scorpion stings mostly occur in poor, recently urbanized areas. The rapid and unplanned urbanization of originally forested areas, without offering adequate infrastructure and services, creates favorable conditions for infestation by scorpions and increases the risk of scorpion stings.
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Affiliation(s)
- Zehev Benzaken
- School of Health Sciences, Amazonas State University, Manaus, Amazonas, Brazil; Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Lincoln Luís Silva
- School of Health Sciences, Amazonas State University, Manaus, Amazonas, Brazil; Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Alexandre Silva-Neto
- School of Health Sciences, Amazonas State University, Manaus, Amazonas, Brazil; Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Jacqueline Sachett
- School of Health Sciences, Amazonas State University, Manaus, Amazonas, Brazil; Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Nelson Fé
- School of Health Sciences, Amazonas State University, Manaus, Amazonas, Brazil; Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Maria das Graças Vale Barbosa Guerra
- School of Health Sciences, Amazonas State University, Manaus, Amazonas, Brazil; Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Wuelton Monteiro
- School of Health Sciences, Amazonas State University, Manaus, Amazonas, Brazil; Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil.
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Martins JG, Reis MB, Zuanazzi BA, Bordon KDCF, Zoccal KF, de Lima Procópio RE, Arantes EC. Clinical outcomes in a murine model after envenoming by the Amazonian scorpions Tityus strandi and Tityus dinizi. Toxicon 2024; 246:107797. [PMID: 38852745 DOI: 10.1016/j.toxicon.2024.107797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/29/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
The Brazilian Amazon is home to a rich fauna of scorpion species of medical importance, some of them still poorly characterized regarding their biological actions and range of clinical symptoms after envenoming. The Amazonian scorpion species Tityus strandi and Tityus dinizi constitute some of the scorpions in this group, with few studies in the literature regarding their systemic repercussions. In the present study, we characterized the clinical, inflammatory, and histopathological manifestations of T. strandi and T. dinizi envenoming in a murine model using Balb/c mice. The results show a robust clinical response based on clinical score, hyperglycemia, leukocytosis, increased cytokines, and histopathological changes in the kidneys and lungs. Tityus strandi envenomed mice presented more prominent clinical manifestations when compared to Tityus dinizi, pointing to the relevance of this species in the medical scenario, with both species inducing hyperglycemia, leukocytosis, increased cytokine production in the peritoneal lavage, increased inflammatory infiltrate in the lungs, and acute tubular necrosis after T. strandi envenoming. The results presented in this research can help to understand the systemic manifestations of scorpion accidents in humans caused by the target species of the study and point out therapeutic strategies in cases of scorpionism in remote regions of the Amazon.
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Affiliation(s)
- Jonas Gama Martins
- Graduated Program in Genetics, Conservation, and Evolutionary Biology (PPG GCBEv), National Institute for Amazon Research (INPA), Manaus, AM, Brazil
| | - Mouzarllem Barros Reis
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Karla de Castro Figueiredo Bordon
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Karina Furlani Zoccal
- School of Medicine, Centro Universitário Barão de Mauá (CUBM), Ribeirão Preto, SP, Brazil
| | - Rudi Emerson de Lima Procópio
- Graduate Program in Biotechnology and Natural Resources of Amazon, University of the State of Amazonas (UEA), Manaus, AM, Brazil
| | - Eliane Candiani Arantes
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
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Gunas V, Maievskyi O, Raksha N, Vovk T, Savchuk O, Shchypanskyi S, Gunas I. Study of the Acute Toxicity of Scorpion Leiurus macroctenus Venom in Rats. ScientificWorldJournal 2024; 2024:9746092. [PMID: 39050385 PMCID: PMC11268967 DOI: 10.1155/2024/9746092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 06/16/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
Background The expansion of the territory of human habitation leads to inevitable interference in the natural range of distribution of one or another species of animals, some of which may be dangerous for human life. Scorpions-the Arachnida class and order Scorpiones-can be considered as such typical representatives. Scorpions of the Buthidae family pose a particular danger to humans. However, LD50 has not yet been defined for many species of this family, in particular, new representatives of the genus Leiurus. Leiurus macroctenus is a newly described species of scorpion distributed in Oman, and the toxicity of its venom is still unknown. Estimating the LD50 of the venom is the first and most important step in creating the antivenom and understanding the medical significance of the researched animal species. The purpose of this study was to determine the lethal dose (LD100), the maximum tolerated dose (LD0), and the average lethal dose (LD50) in rats when using Leiurus macroctenus scorpion venom. Methods and Results 15 sexually mature scorpions were used in the study, which were kept in the same conditions and milked by a common method (electric milking). For the study, 60 male rats were used, which were injected intramuscularly with 0.5 ml of venom solution with a gradual increase in the dose (5 groups, 10 rats in each), and 10 rats were injected intramuscularly with physiological solution as control group. LD calculations were done using probit analysis method in the modification of the method by V.B. Prozorovsky. The LD0 of Leiurus macroctenus scorpion venom under the conditions of intramuscular injection was 0.02 mg/kg, LD100 was 0.13 mg/kg, and LD50 was 0.08 ± 0.01 mg/kg. Conclusions The analysis of scientific publications and other sources of information gives reason to believe that Leiurus macroctenus has one of the highest values of LD50 not only among scorpions but also among all arthropods in the world. All these point to the significant clinical importance of this species of scorpion and require further research that will concern the toxic effect of its venom on various organ systems. Determining the LD50 of the venom for new scorpion species is crucial for creating effective antivenoms and understanding the medical implications of envenomation by this species.
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Affiliation(s)
- Valery Gunas
- Department of Forensic Medicine and LawNational Pirogov Memorial Medical University, Pyrohova Street, 56, Vinnytsia 21018, Ukraine
| | - Oleksandr Maievskyi
- Department of Clinical MedicineEducational and Scientific Center “Institute of Biology and Medicine” of Taras Shevchenko National University of Kyiv, Hlushkova Avenue, 2, Kyiv 03127, Ukraine
| | - Nataliia Raksha
- Department of BiochemistryEducational and Scientific Center “Institute of Biology and Medicine” of Taras Shevchenko National University of Kyiv, Hlushkova Avenue, 2, Kyiv 03127, Ukraine
| | - Tetiana Vovk
- Department of BiochemistryEducational and Scientific Center “Institute of Biology and Medicine” of Taras Shevchenko National University of Kyiv, Hlushkova Avenue, 2, Kyiv 03127, Ukraine
| | - Oleksiy Savchuk
- Department of BiochemistryEducational and Scientific Center “Institute of Biology and Medicine” of Taras Shevchenko National University of Kyiv, Hlushkova Avenue, 2, Kyiv 03127, Ukraine
| | - Serhii Shchypanskyi
- Department of BiochemistryEducational and Scientific Center “Institute of Biology and Medicine” of Taras Shevchenko National University of Kyiv, Hlushkova Avenue, 2, Kyiv 03127, Ukraine
| | - Igor Gunas
- Department of Human AnatomyNational Pirogov Memorial Medical University, Pyrohova Street, 56, Vinnytsia 21018, Ukraine
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Bisneto PF, Vilhena da Silva Neto A, Mota Cordeiro JS, Monteiro WM, de Almeida Gonçalves Sachett J. Does Covid-19 influence the dynamics of envenomation by animals in a country strongly affected by both conditions? Epidemiological data from Brazil. Toxicon 2024; 244:107776. [PMID: 38795850 DOI: 10.1016/j.toxicon.2024.107776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 05/28/2024]
Abstract
The impact of Covid-19 on envenomations by venomous animals in countries heavily affected by both conditions has not been quantified yet. Brazil shows high incidence of envenomations by scorpions, spiders and snakes and was heavily affected by waves of Covid-19. To determine how the pandemic impacted the epidemiology of envenomations by those three groups of venomous animals, we used online databases from two surveillance sources on number of cases and mortality. During the years before and during the pandemic, scorpion stings typically occurred in adults of both sexes in urban zones in the Southeast and Northeast regions. Spider bites occurred mainly in the South region, in adults of both sexes in urban zone. Snakebites affected mainly rural adult men in the Amazon. Between 2007 and 2021, overall incidence of cases by scorpions, spiders and snakes decreased after the beginning of the pandemic, snakebites did not show changes after the pandemic started in Brazil, but cases by scorpions and spiders decreased. No changes in the incidence of deaths were observed. On national level, Covid-19 affected some demographic, clinical and epidemiological aspects in cases by scorpions, spiders and snakes.
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Affiliation(s)
- Pedro Ferreira Bisneto
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil; Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil.
| | - Alexandre Vilhena da Silva Neto
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Jady Shayenne Mota Cordeiro
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil
| | - Wuelton Marcelo Monteiro
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil; Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Jacqueline de Almeida Gonçalves Sachett
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil; Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
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Siqueira TS, Dos Santos AJ, Santos JLC, da Silva RRN, Silva JRS, Santos VS. Scorpion envenomation in Brazil and its relationship with the social determinants of health: A population-based ecological study. Acta Trop 2024; 253:107165. [PMID: 38428629 DOI: 10.1016/j.actatropica.2024.107165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/03/2024]
Abstract
This study comprehensively analyzed cases of scorpion envenomation in Brazil, exploring the temporal trends and geographic patterns of such incidents between January 1, 2012, and December 31, 2022. Simultaneously, we assessed the correlation between scorpion envenomation and social determinants of health and social vulnerability. We conducted a population-based ecological study, gathering information on the number of scorpion envenomation cases in Brazil, as well as socioeconomic data and social vulnerability indicators across the 5,570 Brazilian municipalities. The season-trend model, based on the classical additive decomposition method, informed estimations of scorpion envenomation variations over time. The spatial correlation of scorpion envenomation with socioeconomic and vulnerability indicators was assessed using the Bivariate Moran's I. A total of 1,343,224 cases of scorpion envenomation were recorded in Brazil from Jan 2012 to Dec 2022. A single increasing time trend was observed for the entire country for this period (APC 8.94, P < 0.001). The seasonal analysis was significant for Brazil as a whole and all regions (p < 0.001), with peaks evident between October and November. The spatial distribution of cases was heterogeneous, with spatial clusters concentrated in the high-risk Southeast and Northeast regions. There was a high incidence of scorpion envenomation in municipalities facing social vulnerability, and, paradoxically, in those with better sanitation and waste collection. Our study revealed a heterogeneous geographical distribution of scorpion accidents in Brazil. Municipalities with higher social vulnerability exhibited a high incidence of scorpion envenomation.
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Affiliation(s)
| | - Adriano José Dos Santos
- Malacology of Vectors Graduate Program, Institute of Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil
| | | | | | - José Rodrigo Santos Silva
- Department of Statistics and Actuarial Science, Federal University of Sergipe, Aracaju 49100-000, Brazil
| | - Victor Santana Santos
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju 49060-676, Brazil; Department of Medicine, Federal University of Sergipe, Lagarto 49400-000, Brazil; Applied Health Sciences Graduate Program, Federal University of Sergipe, Lagarto 49400-000, Brazil.
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Ramanan da Cruz J, Bulet P, Mendonça de Moraes C. Exploring the potential of Brazilian Amazonian scorpion venoms: A comprehensive review of research from 2001 to 2021. Toxicon X 2024; 21:100182. [PMID: 38226138 PMCID: PMC10788795 DOI: 10.1016/j.toxcx.2023.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024] Open
Abstract
The Amazon biome is home to many scorpion species, with around two hundred identified in the region. Of these, forty-eight species have been reported in Brazil so far and six of them are of medical importance: Tityus apiacas, T. metuendus, T. obscurus, T. raquelae, T. silvestris, and T. strandi. Three non-medically important species have also been studied: Opisthanthuscayaporum, Brotheas amazonicus and Rhopalurus laticauda. The venom of the scorpion T. obscurus is the most studied, followed by O. cayaporum. We aim to update the study of these Amazonian scorpion species. We will explore the harmful and beneficial properties of scorpion venom toxins and how they could be applied in drug development. This systematic review will focus on collecting and analyzing venoms from scorpions in Brazil. Only papers on Amazonian scorpion venom studies published between 2001 and 2021 (scientific articles, theses, and dissertations) were selected, based on the lists of scorpions available in the literature. Species found in the Amazon but not confirmed to be Brazilian were omitted from the review. Theses and dissertations were chosen over their derived articles. We found 42 eligible studies (13 theses, 27 articles and 2 patents) out of 17,950 studies and a basic statistical analysis was performed. The literature showed that T. obscurus was the most studied venom with 28 publications, followed by O. cayaporum with seven articles, B. amazonicus with four articles, T. metuendus with two article and R. laticauda with one article. No publication on the characterization of T. silvestris and T. apiacas venoms were found during the reviewed period, only the clinical aspects were covered. There is still much to be explored despite the increasing number of studies conducted in recent years. Amazonian scorpions have promising potential for pharmaceutical and clinical applications.
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Affiliation(s)
- Joel Ramanan da Cruz
- Post-graduation Program in Health and Biodiversity, Federal University of Roraima, Boa Vista, Roraima, Brazil
| | - Philippe Bulet
- Institute pour l’Avancée des Biosciences, CR Université Grenoble Alpes, Inserm U1209, CNRS UMR 5309, 38000, Grenoble, France
- Platform BioPark Archamps, ArchParc, 218 Avenue Marie Curie, 74160, Archamps, France
| | - Cléria Mendonça de Moraes
- Post-graduation Program in Health and Biodiversity, Federal University of Roraima, Boa Vista, Roraima, Brazil
- Health Sciences Center and Post-graduation Program in Health and Biodiversity, Federal University of Roraima, Boa Vista, Roraima, Brazil
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Hernández-Muñoz EA, Zavala-Sánchez EV, Rubio-Atondo A, López-Chávez JA, Arredondo-Rojas V, Reyes-Reyes JS. Scorpion sting envenomation outbreak in Mexico. Strategies for prevention and control. Toxicon 2024; 237:107549. [PMID: 38061672 DOI: 10.1016/j.toxicon.2023.107549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
In Mexico occurs 25% of all worldwide cases of scorpion sting envenomation (SSE). An outbreak of SSE was identified in Villa Unión, Sinaloa, Mexico. The objective of this study is to describe the outbreak, and prevention and control strategies implemented. The design was a cross-sectional study. Eligibility criteria included confirmed cases (n = 425) identified from the date the outbreak was recognized (from November 08, 2023 to July 10, 2023). The cases from Villa Unión (n = 231) were included for the analysis of epidemiological and clinical findings. The research followed the recommendations of the Initiative Reporting of studies Conducted Using Observational Routinely collected Data (RECORD). Of the total cases (n = 425), 398 (93.6%) were from the municipality of Mazatlán, and 231 (58%) were from Villa Unión. The incidence rate was 13.64 per 1000 persons. The average cases per week was 51.5(SD ± 12). The male-to-female ratio was 3:4, the average age was 30.7(SD ± 19) years. Most of cases occurred in the 25-44 age group. The sting occurred mostly inside houses (n = 200, 86.5%). The predominant symptoms were local pain (95.2%), and local paresthesia (75.8%). The Case fatality rate was 0%. Implementation of prevention and control strategies based on field epidemiological research and scientific evidence are necessary to reduce the incidence and prevent fatal complications.
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Affiliation(s)
- E A Hernández-Muñoz
- Unit of Epidemiological Surveillance, Family Medicine Unit N 53, Mexican Institute of Social Security, Avenida Juan Pablo II Esq Hidalgo 150 Zapopan, Col. Zapopan Centro, Zapopan 45100, Jalisco, Mexico; Postgraduate Specialty Program in Epidemiology, University Center of Health Sciences (CUCS), University of Guadalajara, Sierra Mojada 950, Puerta 7, Edificio A, Col. Independencia, Guadalajara C.P. 44340, Jal, Mexico; Coordination of Epidemiology and Preventive Medicine, Villa Unión Hospital N°16, Mexican Institute of Social Security, Leandro Valle y Carr. Internacional S/N Centro, Villa Unión, Mazatlán 82210, Sinaloa, Mexico; College of History and Philosophy of Medicine of the State of Guanajuato, León, Guanajuato, Mexico.
| | - E V Zavala-Sánchez
- Unit of Epidemiological Surveillance, Family Medicine Unit N 53, Mexican Institute of Social Security, Avenida Juan Pablo II Esq Hidalgo 150 Zapopan, Col. Zapopan Centro, Zapopan 45100, Jalisco, Mexico; Postgraduate Specialty Program in Epidemiology, University Center of Health Sciences (CUCS), University of Guadalajara, Sierra Mojada 950, Puerta 7, Edificio A, Col. Independencia, Guadalajara C.P. 44340, Jal, Mexico.
| | - A Rubio-Atondo
- Coordination of Epidemiology and Preventive Medicine, Villa Unión Hospital N°16, Mexican Institute of Social Security, Leandro Valle y Carr. Internacional S/N Centro, Villa Unión, Mazatlán 82210, Sinaloa, Mexico.
| | - J A López-Chávez
- Villa Unión Hospital N°16, Mexican Institute of Social Security, Villa Unión, Leandro Valle y Carr, Internacional S/N Centro, Mazatlán 82210, Sinaloa, Mexico.
| | - V Arredondo-Rojas
- Department of Vector-Borne and Zoonotic Diseases, Health Ministry, Río Culiacan 38, Tellería, Mazatlán, 82017, Sinaloa, Mexico.
| | - J S Reyes-Reyes
- Department of Epidemiology, Health Ministry, Río Culiacan 38, Tellería, Mazatlán 82017, Sinaloa, Mexico.
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Díaz C, Serna-Gonzalez M, Chang-Castillo A, Lomonte B, Bonilla F, Alfaro-Chinchilla A, Triana F, Sasa M. Proteomic profile of the venom of three dark-colored Tityus (Scorpiones: Buthidae) from the tropical rainforests of Costa Rica. Acta Trop 2023; 248:107031. [PMID: 37777039 DOI: 10.1016/j.actatropica.2023.107031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE We aimed to elucidate the potential differences in the venom peptide sequences of three Tityus species from Costa Rican rainforests: T. jaimei, T. championi and T. dedoslargos, compared to T. cf. asthenes from Colombia, which could explain the low level of scorpionism in Costa Rica, evidenced by the lack of epidemiological data. METHODOLOGY We applied venom proteomics of peptides purified by RP-HPLC and compared the obtained sequences from venoms of these Tityus species to the sequences previously identified from Tityus inhabiting other Central and South American regions. RESULTS Venom proteome analysis evidences that most of the putative peptide toxins identified in Costa Rican dark-colored Tityus are very similar to those present in other T. (Atreus) from the region. CONCLUSIONS Our study suggests that, in the case of potential envenomation by Tityus in Costa Rica, the same level of toxicity should be observed, compared to other cases caused by members of the subgenus from other geographical localities. On the other hand, compared to countries with more accelerated urban expansion, Costa Rican Tityus still inhabit secondary rainforests and do not commonly share the same spaces with humans, so the lack of epidemiological evidence of medical emergencies caused by envenoming by this scorpion group could be more related to ecological and demographic factors and less attributed to the characteristics of the venom.
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Affiliation(s)
- Cecilia Díaz
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica; Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica.
| | | | - Arturo Chang-Castillo
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Bruno Lomonte
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Fabián Bonilla
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Adriana Alfaro-Chinchilla
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Felipe Triana
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Mahmood Sasa
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica; Museo de Zoología, Centro de Investigación en Biodiversidad y Ecología Tropical, Universidad de Costa Rica, San José, Costa Rica
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9
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Vilarinho AC, Lopez VM, Tizo-Pedroso E, Freire Oliveira CJ, Guillermo Ferreira R. Scorpion envenomation in the neotropical savannah: Environmental predictors and years of lost life. Toxicon 2023; 234:107277. [PMID: 37659666 DOI: 10.1016/j.toxicon.2023.107277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023]
Abstract
Scorpion stings envenomation (SSE) is a growing medical concern in Brazil, particularly in the state of Minas Gerais, which has recorded a significant number of incidents. This study aimed to investigate the potential predictors of scorpion sting incidence and evaluate the cost-effectiveness of interventions in Minas Gerais. Generalized Estimating Equations (GEE) models were constructed using socioeconomic and environmental variables as predictors and scorpion sting incidence as the response variable. The analysis revealed that mean annual temperature and major land use type were significant predictors of scorpion sting incidence, while precipitation and socioeconomic variables showed no relationship with incidence. The total number of cases and annual incidence of scorpion stings overlapped with regions experiencing higher forest conversion and agricultural land use, as well as higher temperatures. The estimated Disability-Adjusted Life Years (DALY) for scorpion sting incidents in Minas Gerais was substantial, indicating the need for effective prevention and treatment measures. The cost per DALY averted varied among municipalities, with some requiring minimal investment while others needing significant funding to address the scorpion risk. Mean annual temperature emerged as the main risk factor for scorpion stings, contributing to increased costs associated with antivenom treatment. These findings highlight the importance of considering environmental factors and implementing targeted interventions to mitigate scorpion sting incidents and reduce associated morbidity and mortality.
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Affiliation(s)
- Ana Carolina Vilarinho
- Biological Sciences and Health Centre, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil.
| | - Vinicius Marques Lopez
- Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil; Graduate Program in Entomology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | | | | | - Rhainer Guillermo Ferreira
- Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil; Graduate Program in Entomology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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10
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Lacerda MVG, Monteiro W, Hendy A, Guerra MVDF, Guerra MDGVB. The Obituary of the Brazilian Amazon Entomologist: Nelson Ferreira Fé (★1941 †2023). Rev Soc Bras Med Trop 2023; 56:e02602023. [PMID: 37493753 PMCID: PMC10367211 DOI: 10.1590/0037-8682-0260-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 07/27/2023] Open
Affiliation(s)
- Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brasil
- Instituto Leônidas & Maria Deane, Fiocruz, Manaus, AM, Brasil
- University of Texas Medical Branch, Galveston, TX, USA
| | - Wuelton Monteiro
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brasil
- Universidade do Estado do Amazonas, Manaus, AM, Brasil
| | - Adam Hendy
- University of Texas Medical Branch, Galveston, TX, USA
| | - Marcus Vinitius de Farias Guerra
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brasil
- Universidade do Estado do Amazonas, Manaus, AM, Brasil
| | - Maria das Graças Vale Barbosa Guerra
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brasil
- Universidade do Estado do Amazonas, Manaus, AM, Brasil
- Fundação Hospitalar Alfredo da Matta, Manaus, AM, Brasil
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Reis MB, Martins JG, Bordon KDCF, de Campos Fraga-Silva TF, de Lima Procópio RE, de Almeida BRR, Bonato VLD, Arantes EC. Pioneering in vitro characterization of macrophage response induced by scorpion venoms from the Brazilian Amazon. Toxicon 2023; 230:107171. [PMID: 37211059 DOI: 10.1016/j.toxicon.2023.107171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/07/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
There are several scorpion species of medical relevance around the world. Some of them are well characterized by their toxins and clinical outcomes. Brazilian Amazon has a great amount of these arthropods that have an impact in the scorpionism events specifically in this region of Brazil. Recently, several studies pointed out the immune system activation during scorpion envenouming as an important facet of scorpionism, inducing a sepsis-like state that culminates in clinical severity and death. In this work, we characterized the macrophage response of three species of clinical relevance in Brazilian Amazon: Tityus silvestris, T. metuendus and T. obscurus and one specie with no toxic effects to humans, Brotheas amazonicus. All the four species analyzed were able to induce pro- and anti-inflammatory cytokine production in a J774.1 murine macrophage model. This activation was dependent on TLR2/TLR4/MyD88 activation and abolished by TLRs antagonists. These results suggest that the venoms of the four species analyzed were able to induce macrophage response in agreement to the well-established immune activation by T. serrulatus venom. Our findings provide new insights into the clinical repercussions of scorpionism of uncharacterized species and point to new biotechnological applications of these venoms and possible supportive therapies in scorpionism.
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Affiliation(s)
- Mouzarllem Barros Reis
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil; School of Medicine, Centro Universitário Barão de Mauá (CBM), Ribeirão Preto, SP, Brazil
| | - Jonas Gama Martins
- Graduate Program in Genetics, Conservation and Evolutionary Biology (PPG GCBEv), National Institute for Amazon Research (INPA), Manaus, AM, Brazil
| | - Karla de Castro Figueiredo Bordon
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Thais Fernanda de Campos Fraga-Silva
- Program of Basic and Applied Immunology, And Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Rudi Emerson de Lima Procópio
- Graduate Program in Biotechnology and Natural Resources of Amazon, University of the State of Amazonas (UEA), Manaus, AM, Brazil
| | | | - Vânia Luiza Deperon Bonato
- Program of Basic and Applied Immunology, And Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Eliane Candiani Arantes
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
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Acunha T, Rocha BA, Nardini V, Barbosa F, Faccioli LH. Lipidomic profiling of the Brazilian yellow scorpion venom: new insights into inflammatory responses following Tityus serrulatus envenomation. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:283-295. [PMID: 36895096 DOI: 10.1080/15287394.2023.2188896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Due to the high prevalence and clinical relevance, scorpionism is a critical public health issue in several Brazilian regions. Tityus serrulatus, commonly known as the Brazilian yellow scorpion, is the most venomous genus found in Brazilian fauna and associated with severe clinical manifestations such as localized pain, hypertension, sweating, tachycardia and complex hyperinflammatory responses. In general, T. serrulatus venom contains a complex mixture of active compounds, including proteins, peptides, and amino acids. Although knowledge of the protein fractions of scorpion venom is available, venom lipid components are not yet comprehensively known. The aim of the present study was to determine and characterize the lipid constituents/profile of the T. serratus venom utilizing liquid chromatography coupled with high-resolution mass spectrometry. Lipid species (164 in total) belonging to 3 different lipid categories, glycerophospholipids, sphingolipids, and glycerolipids, were identified. A further search on MetaCore/MetaDrug platform, which is based upon a manually curated database of molecular interactions, molecular pathways, gene-disease associations, chemical metabolism, and toxicity information, exhibited several metabolic pathways for 24 of previously identified lipid species, including activation of nuclear factor kappa B and oxidative stress pathways. Further several bioactive compounds, such as plasmalogens, lyso-platelet-activating factors, and sphingomyelins, associated with systemic responses triggered by T. serrulatus envenomation were detected. Finally, lipidomic data presented provide advanced and valuable information to better comprehend the mechanisms underlying the complex pathophysiology induced by T. serrulatus envenomation.
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Affiliation(s)
| | | | | | - Fernando Barbosa
- Departamento de Análise Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Lúcia Helena Faccioli
- Departamento de Análise Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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13
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Martins JG, de Castro Figueiredo Bordon K, Moreno-González JA, Almeida B, Pardal P, Lira A, Candido D, Arantes EC, Procópio R. On the noxious black Amazonian scorpion, Tityus obscurus (Scorpiones, Buthidae): Taxonomic notes, biology, medical importance and envenoming treatment. Toxicon 2023; 228:107125. [PMID: 37054995 DOI: 10.1016/j.toxicon.2023.107125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023]
Abstract
Tityus obscurus has caused mild, moderate and severe accidents of medical relevance in the eastern Brazilian Amazon and French Guiana. Tityus obscurus has sexual dimorphism although males and females have uniform black coloration. In the Amazon, one of the habitats of this scorpion is seasonally flooded forests (igapós and várzeas). However, most stings occur in terra firme forest areas (non-flooded region), where most rural communities are located. Adults and children stung by T. obscurus may experience an "electric shock" sensation for more than 30 h after the sting. Our data shows that people inhabiting remote forest areas, including rubber tappers, fishermen and indigenous people, with no access to anti-scorpion serum, use parts of native plants, such as seeds and leaves, against pain and vomiting caused by scorpion stings. Although there is a technical effort to produce and distribute antivenoms in the Amazon, many cases of scorpion stings are geographically unpredictable in this region, due to the lack of detailed knowledge of the natural distribution of these animals. In this manuscript, we compile information on the natural history of T. obscurus and the impact of its envenoming on human health. We identify the natural sites that host this scorpion in the Amazon, in order to warn about the risk of human envenoming. The use of specific antivenom serum is the recommended treatment for accidents involving venomous animals. However, atypical symptoms not neutralized by the available commercial antivenom are reported in the Amazon region. Facing this scenario, we present some challenges to the study of venomous animals in the Amazon rainforest and possible experimental bottlenecks and perspectives for establishing a method aimed at producing an efficient antivenom.
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Affiliation(s)
- Jonas Gama Martins
- Pós-Graduação em Genética, Conservação e Biologia Evolutiva, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, AM, Brazil.
| | - Karla de Castro Figueiredo Bordon
- Departamento de Ciências BioMoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Jairo A Moreno-González
- Division of Invertebrate Zoology, American Museum of Natural History New York, Central Park West at 79th Street, 10024-5192, New York City, NY, USA
| | - Bruno Almeida
- Instituto Federal de Educação, Ciência e Tecnologia do Pará, Campus Itaituba, PA, Brazil
| | - Pedro Pardal
- Laboratório de Entomologia Médica e Animais Peçonhentos, Núcleo de Medicina Tropical, Universidade Federal do Pará (UFPA), Belém, PA, Brazil
| | - André Lira
- Universidade Federal de Campina Grande, Centro de Educação e Saúde, Cuité, PB, Brazil
| | - Denise Candido
- Laboratório de Artrópodes, Instituto Butantan, São Paulo, Brazil
| | - Eliane Candiani Arantes
- Departamento de Ciências BioMoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Rudi Procópio
- Pós-Graduação em Biotecnologia e Recursos Naturais da Amazônia, Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil
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14
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Scorpion envenomation in Brazil: Current scenario and perspectives for containing an increasing health problem. PLoS Negl Trop Dis 2023; 17:e0011069. [PMID: 36757916 PMCID: PMC9910716 DOI: 10.1371/journal.pntd.0011069] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Opportunistic scorpion species can colonize urban environments, establishing high-density communities that enhance the chances of human accidents. This scenario has been taking place in Brazil, in which some Tityus species have taken city centers, causing an explosion in the number of scorpion envenoming cases. The characteristics of this scorpionism epidemic in Brazil is discussed in the present work. The number of Brazilian scorpion stings has surpassed 120,000 cases in 2017, and has been maintained above this number ever since, representing a more than 3-fold increase in 10 years, which was higher than the number of cases for most of the neglected tropical diseases in the country. The escalation in scorpionism cases is even higher in some regions of Brazil. Fortunately, the proportion of mild cases has also increased in the analyzed period, as well as the number of victims seeking for medical attention within the first hour after the accident. The species Tityus serrulatus, Tityus stigmurus, Tityus bahiensis, and Tityus obscurus are traditionally accountable for most of the scorpion accidents in different regions of Brazil, but other species deserve to be closely watched. Despite scorpionism being a notable health problem in Brazil, accident prevention and pest control regarding this venomous animal have not been properly addressed by the scientific community nor by policy makers. Therefore, this review also aims to point possible fields of research that could help to contain the aggravation of the current scorpionism landscape in Brazil.
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15
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Venomics of the Scorpion Tityus ocelote (Scorpiones, Buthidae): Understanding Venom Evolution in the Subgenus Archaeotityus. Int J Pept Res Ther 2022. [DOI: 10.1007/s10989-022-10476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Lacerda AB, Lorenz C, De Azevedo TS, Cândido DM, Wen FH, Eloy LJ, Bersusa AAS, Chiaravalloti Neto F. Scorpion envenomation in the state of São Paulo, Brazil: Spatiotemporal analysis of a growing public health concern. PLoS One 2022; 17:e0266138. [PMID: 35395017 PMCID: PMC8992990 DOI: 10.1371/journal.pone.0266138] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 11/19/2022] Open
Abstract
Scorpion envenomation is a significant public health concern in São Paulo, Brazil, and its incidence and mortality have increased in recent decades. The present study analyzed documented scorpion envenomation notifications from 2008 to 2018 throughout the 645 municipalities of São Paulo. Annual incidence and mortality rates were calculated and stratified according to sex and age. The local empirical Bayesian method and Getis-Ord Gi* statistic were used to represent standardized incidence rates in the municipalities and to identify high- and low-risk agglomerates. The incidence rate of scorpion envenomation quintupled between 2008 and 2018. Overall, the risk was higher for man, and increased with age. Deaths due to envenomation, however, were concentrated almost entirely in children 0–9 years of age. Incidence maps showed that the risk of envenomation increased in almost all regions and municipalities of São Paulo throughout the study period. The highest incidence rates were found in the western, northwestern and northern regions of the state, in contrast to the São Paulo metropolitan area and southern and coastal regions. Hot spots were identified in the Presidente Prudente, Barretos, São José do Rio Preto, and Araçatuba regional health districts, which over time formed a single high-risk cluster. In spatial terms, however, deaths were randomly distributed. In this study, we identified areas and populations at risk of scorpion envenomation and associated–fatalities, which can be used to support decision-making by health services to reduce human contact with these arachnids and avoid fatalities, especially in children.
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Affiliation(s)
- Alec Brian Lacerda
- Faculdade de Saúde Pública–Universidade De São Paulo, São Paulo, Brazil
- * E-mail:
| | - Camila Lorenz
- Faculdade de Saúde Pública–Universidade De São Paulo, São Paulo, Brazil
| | - Thiago Salomão De Azevedo
- Faculdade de Saúde Pública–Universidade De São Paulo, São Paulo, Brazil
- Secretaria de Saúde do Município de Santa Bárbara d’Oeste–SP, Santa Bárbara d’Oeste, Brazil
| | | | | | - Luciano José Eloy
- Centro de Vigilância Epidemiológica “Prof. Alexandre Vranjac”, São Paulo, Brazil
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Borges A, Graham MR, Cândido DM, Pardal PPO. Amazonian scorpions and scorpionism: integrating toxinological, clinical, and phylogenetic data to combat a human health crisis in the world's most diverse rainfores. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210028. [PMID: 34887908 PMCID: PMC8629433 DOI: 10.1590/1678-9199-jvatitd-2021-0028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/21/2021] [Indexed: 11/21/2022] Open
Abstract
Venom from Amazonian scorpions of the genus Tityus contains components capable of eliciting a distinct clinical, mostly neurological, syndrome. This contrasts with the mainly autonomic manifestations produced after envenomation by congeneric southern and northern South American species. Herein, we summarize Pan-Amazonian scorpionism by synthesizing available toxinological, clinical, and molecular data gathered from all affected areas in Amazonia, including Brazil, Ecuador, Colombia, Peru, Venezuela, and French Guiana. We searched multiple databases, as well as our own records, for reports of scorpion envenomations in Amazonia by confirmed Tityus spp., and compared the clinical manifestations. To help uncover clinical and venom relationships among problematic species, we explored phylogenetic relationships with a rate-calibrated analysis of mitochondrial COI data from available species. The possible existence of diversity gradients for venom toxic and immunogenic components despite the predicted strong phylogenetic association among species is underscored by discussed clinical and toxinological findings. A multicentric effort, involving all nations affected by this neglected disease, is urgently needed to offer alternatives for treating and understanding this pathology, including the preparation of neutralizing antibodies with a broad range of efficacy.
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Affiliation(s)
- Adolfo Borges
- Center for the Development of Scientific Research (CEDIC), Asunción,
Paraguay
- Laboratory of Molecular Biology of Toxins and Receptors, Institute
of Experimental Medicine, School of Medicine, Central University of Venezuela,
Caracas, Venezuela
| | - Matthew R. Graham
- Department of Biology, Eastern Connecticut State University,
Willimantic, CT, United States
| | | | - Pedro P. O. Pardal
- Laboratory of Medical Entomology and Venomous Animals, Center of
Tropical Medicine, Federal University of Pará (UFPA), Belém, PA, Brazil
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Martins JG, Santos GC, Procópio REDL, Arantes EC, Bordon KDCF. Scorpion species of medical importance in the Brazilian Amazon: a review to identify knowledge gaps. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210012. [PMID: 34589120 PMCID: PMC8452272 DOI: 10.1590/1678-9199-jvatitd-2021-0012] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/09/2021] [Indexed: 12/24/2022] Open
Abstract
Scorpionism is a relevant medical condition in Brazil. It is responsible for most accidents involving venomous animals in the country, which leads to severe symptoms that can evolve to death. In recent years, an increase of almost 50% in the incidence of scorpionism has been observed in the Northern Region, where the highest severity of envenoming has been notified since the beginning of the 21st century. This review aims to provide an in-depth assessment of public data and reports on symptoms and epidemiology of envenoming, ecological aspects of scorpions, and characterization of venoms and toxins to access the gaps that need to be filled in the knowledge of the scorpion species of medical importance from the Brazilian Amazon. A systematic search using the string words "Amazon" and "scorpion" was performed on 11 databases. No restriction on date, language or status of the publication was applied. Reports not related to the Brazilian Amazon were excluded. Therefore, 88 studies remained. It is shown that populations of scorpions of medical importance, even of the same species, may present significant toxic variations peculiar to some regions in the Brazilian Amazon, and commercial scorpion antivenoms were not able to shorten the intensity and duration of neurological manifestations in patients stung by T. silvestris, T. apiacas or T. obscurus. It is also highlighted that the toxins responsible for triggering these alterations have not been elucidated yet and this is a fruitful field for the development of more efficient antivenoms. Furthermore, the geographic distribution of scorpions of the genus Tityus in the Brazilian Amazon was revised and updated. The cumulative and detailed information provided in this review may help physicians and scientists interested in scorpionism in the Brazilian Amazon.
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Affiliation(s)
- Jonas Gama Martins
- Graduate Program in Genetics, Conservation and Evolutionary Biology
(PPG GCBEv), National Institute for Amazon Research (INPA), Manaus, AM,
Brazil
| | - Gabrielle Cristina Santos
- Department of BioMolecular Sciences, School of Pharmaceutical
Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP,
Brazil
| | - Rudi Emerson de Lima Procópio
- Graduate Program in Biotechnology and Natural Resources of Amazon,
University of the State of Amazonas (UEA), Manaus, AM, Brazil
| | - Eliane Candiani Arantes
- Department of BioMolecular Sciences, School of Pharmaceutical
Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP,
Brazil
| | - Karla de Castro Figueiredo Bordon
- Department of BioMolecular Sciences, School of Pharmaceutical
Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP,
Brazil
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Amado TF, Moura TA, Riul P, Lira AFDA, Badillo-Montaño R, Martinez PA. Vulnerable areas to accidents with scorpions in Brazil. Trop Med Int Health 2021; 26:591-601. [PMID: 33560566 DOI: 10.1111/tmi.13561] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify areas that present a higher risk of exposure to accidents with scorpions in Brazil. METHODS We used techniques of spatial prioritisation to determine the most vulnerable localities to envenomation by four scorpion species. Our prioritisation integrated ecological niche models with health investment, antivenin availability, access to health care facilities and metrics of human impact data. RESULTS The ecological niche models indicated that three scorpion species (Tityus bahiensis, Tityus serrulatus, and Tityus stigmurus) are more associated with human population density, while T. obscurus demonstrated a strong association with temperature variations during the year. Spatial prioritisation indicated that the areas with higher risk exposure to accidents with scorpions are in northern and northeastern Brazil. Alternatively, more isolated but densely populated areas in the southeastern and central regions also emerged as a priority. CONCLUSION Mapping areas where humans are more likely to interact with scorpions can assist in the design of efficient public health policies.
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Affiliation(s)
- Talita Ferreira Amado
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil.,Biodiversity and Macroecology Lab, Universidad Rey Juan Carlos, Madrid, Spain
| | - Thais Andrade Moura
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Pablo Riul
- Departamento de Sistemática e Ecologia, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - André Felipe de Araujo Lira
- Programa de Pós-Graduação em Ciência Animal Tropical, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Raúl Badillo-Montaño
- Red de Estudios Moleculares Avanzados, Instituto de Ecologia A, C, Xalapa-Enríquez, Mexico
| | - Pablo Ariel Martinez
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil
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Gomes JV, Fé NF, Santos HLR, Jung B, Bisneto PF, Sachett A, de Moura VM, Mendonça da Silva I, Cardoso de Melo G, Pereira de Oliveira Pardal P, Lacerda M, Sampaio V, Wen FH, de Almeida Gonçalves Sachett J, Monteiro WM. Clinical profile of confirmed scorpion stings in a referral center in Manaus, Western Brazilian Amazon. Toxicon 2020; 187:245-254. [PMID: 32991937 DOI: 10.1016/j.toxicon.2020.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 11/19/2022]
Abstract
Scorpion envenomations are a major public health problem in Brazil, and most medically important cases are attributable to the Tityus genus. The objective of this study is to describe the clinical and epidemiological aspects of a series of 151 cases of confirmed scorpion stings, which were treated at the hospitals of two cities in the Western Brazilian Amazon, between June 2014 and December 2019. This study shows that the genus Tityus was the most prevalent. Tityus (Atreus) metuendus (Pocock, 1897) was responsible for the greatest number of cases (68.2%), followed by Tityus (Archaeotityus) silvestris (Pocock, 1897) (14.6%). Most of the envenomations involved males (53.6%), and analysis showed a slight predominance in the group from 40 to 49 years (22.5%). The most affected body regions were feet (49.0%) and hands (31.8%). The time elapsed between the accident and medical care was ≤6 h in 92.1% of cases. Regarding clinical severity, classes I (80.8%) and II (15.9%) predominated. However, there were five (3.3%) class III cases; four for T. metuendus and one for T. silvestris. The most frequent local and systemic manifestations were, respectively, pain (84.1%), paresthesia (34.4%) and mild edema (25.8%), and nausea (9.3%) and myoclonia (8.6%). The clinical manifestations were similar among the patients stung by the different species of scorpions. There were no differences between the manifestations of envenomation caused by T. metuendus, T. silvestris and T. raquelae. For victims of T. apiacas, a higher frequency of piloerection and myoclonia was observed, and was described by the affected patients as a 'sensation of receiving an electric shock' throughout the body. No deaths were registered. The species of greatest epidemiological importance in Manaus is T. metuendus, a species that leads to clinical pictures that do not differ substantially from those observed in other Brazilian regions. T. apiacas causes neurological manifestations that differed from other Tityus species. Our findings suggest that the available antivenoms have little effectiveness when used in the treatment of envenomations by some Amazonian scorpions.
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Affiliation(s)
- Jacimara Vasques Gomes
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Nelson Ferreira Fé
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Hildegard Loren Rebouças Santos
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Bruna Jung
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Pedro Ferreira Bisneto
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Programa de Pós-Graduação em Zoologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - André Sachett
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Valéria Mourão de Moura
- Programa de Pós-graduação em Recursos Naturais da Amazônia, Universidade Federal do Oeste do Pará, Santarém, Pará, Brazil
| | - Iran Mendonça da Silva
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Gisely Cardoso de Melo
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | - Marcus Lacerda
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Instituto Leônidas & Maria Deane, Manaus, Brazil
| | - Vanderson Sampaio
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | - Jacqueline de Almeida Gonçalves Sachett
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus, Brazil
| | - Wuelton M Monteiro
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.
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21
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Silva de Oliveira SM, Bertani R, Quispe Torrez PP, Lopes de Sousa PR, Martinez Quiroga MM, Bertolozzi MR, Oscar de Siqueira Franca F. Electric shock sensation in the first reports of envenomations by Tityus strandi in the Brazilian Amazon. Toxicon 2020; 178:8-12. [PMID: 32094100 DOI: 10.1016/j.toxicon.2020.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 11/16/2022]
Affiliation(s)
| | - Rogerio Bertani
- Special Laboratory of Ecology and Evolution, Instituto Butantan, São Paulo, SP, Brazil
| | - Pasesa Pascuala Quispe Torrez
- Advanced Tropical Medicine Center, Santarém, PA/Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | - Mariana Margarita Martinez Quiroga
- Advanced Tropical Medicine Center, Santarém, PA/Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Maria Rita Bertolozzi
- Department of Nursing in Public Health, School of Nursing, University of São Paulo, São Paulo, SP, Brazil
| | - Francisco Oscar de Siqueira Franca
- Advanced Tropical Medicine Center, Santarém, PA/Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Brazil; Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
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22
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Borges A, Lomonte B, Angulo Y, Acosta de Patiño H, Pascale JM, Otero R, Miranda RJ, De Sousa L, Graham MR, Gómez A, Pardal PP, Ishikawa E, Bonilla F, Castillo A, de Avila RAM, Gómez JP, Caro-López JA. Venom diversity in the Neotropical scorpion genus Tityus: Implications for antivenom design emerging from molecular and immunochemical analyses across endemic areas of scorpionism. Acta Trop 2020; 204:105346. [PMID: 31982434 DOI: 10.1016/j.actatropica.2020.105346] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 10/25/2022]
Abstract
Scorpions of the Neotropical genus Tityus are responsible for most severe envenomations in the Caribbean, South America, and Lower Central America (LCA). Although Tityus is taxonomically complex, contains high toxin polymorphism, and produces variable clinical manifestations, treatment is limited to antivenoms produced against species with restricted distributions. In this study, we explored the compositional and antigenic diversity of Tityus venoms to provide improved guidelines for the use of available antivenoms at a broader geographic scale. We used immunoblotting, competitive ELISA, and in vivo studies to compare reactivity against commercial antivenoms from Brazil, Venezuela, and Mexico, as well as MALDI-TOF mass spectrometry, cDNA sequencing, and phylogenetic analyses to assess venom sodium channel-active toxin (NaTx) content from medically important Tityus populations inhabiting Brazil, Colombia, Costa Rica, Ecuador, Panama, Trinidad and Tobago, and Venezuela. Additionally, we raised rabbit antibodies against Tityus venoms from LCA to test for cross-reactivity with congeneric species. The results suggest that Tityus spp. possess high venom antigenic diversity, underlying the existence of four toxinological regions in Tropical America, based on venom composition and immunochemical criteria: LCA/Colombia/Amazonia (Region I), Venezuela (Region II), southeast South America (Region III), and a fourth region encompassing species related to toxinologically divergent Tityus cerroazul. Importantly, our molecular and cross-reactivity results highlight the need for new antivenoms against species inhabiting Region I, where scorpions may produce venoms that are not significantly reactive against available antivenoms.
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