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Katwaroo A, Austin K, Bharat A, Chatoo V, Ramcharan P, Seecheran V, Seecheran R, Giddings S, Seecheran NA. Scorpion-Induced Acute Coronary Syndrome: A Stinging Complication. J Investig Med High Impact Case Rep 2024; 12:23247096241261255. [PMID: 38884537 PMCID: PMC11185030 DOI: 10.1177/23247096241261255] [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: 03/13/2024] [Revised: 05/15/2024] [Accepted: 05/27/2024] [Indexed: 06/18/2024] Open
Abstract
The Tityus trinitatis, a black scorpion species endemic to the fauna of Trinidad, has been implicated in envenomation with devastating clinical sequelae such as acute pancreatitis and major adverse cardiovascular events. We present the first in-Caribbean case of a 59-year-old Caribbean South Asian male with human immunodeficiency virus who presented with a non-ST-segment-elevation acute coronary syndrome after being stung, which was managed with comprehensive, guideline-directed medical therapy. The clinician should be cognizant of scorpion-induced acute coronary syndrome (ACS) as a potential sequela of envenomation and its clinical management.
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Affiliation(s)
- Arun Katwaroo
- Trinidad Institute of Medical Technology, St. Augustine, Tobago
| | - Kristianne Austin
- South West Regional Health Authority, San Fernando, Trinidad and Tobago
| | - Alexandria Bharat
- South West Regional Health Authority, San Fernando, Trinidad and Tobago
| | - Varun Chatoo
- North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago
| | - Priya Ramcharan
- North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago
| | - Valmiki Seecheran
- North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago
| | | | - Stanley Giddings
- The University of the West Indies, St. Augustine, Trinidad and Tobago
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Mechkarska M, Cunning TS, Taggart MG, Ternan NG, Leprince J, Coquet L, Jouenne T, Tena-Garcés J, Calvete JJ, Conlon JM. Identification of an Antimicrobial Peptide from the Venom of the Trinidad Thick-Tailed Scorpion Tityus trinitatis with Potent Activity against ESKAPE Pathogens and Clostridioides difficile. Antibiotics (Basel) 2023; 12:1404. [PMID: 37760701 PMCID: PMC10525828 DOI: 10.3390/antibiotics12091404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Envenomation by the Trinidad thick-tailed scorpion Tityus trinitatis may result in fatal myocarditis and there is a high incidence of acute pancreatitis among survivors. Peptidomic analysis (reversed-phase HPLC followed by MALDI-TOF mass spectrometry and automated Edman degradation) of T. trinitatis venom led to the isolation and characterization of three peptides with antimicrobial activity. Their primary structures were established asTtAP-1 (FLGSLFSIGSKLLPGVFKLFSRKKQ.NH2), TtAP-2 (IFGMIPGLIGGLISAFK.NH2) and TtAP-3 (FFSLIPSLIGGLVSAIK.NH2). In addition, potassium channel and sodium channel toxins, present in the venom in high abundance, were identified by CID-MS/MS sequence analysis. TtAP-1 was the most potent against a range of clinically relevant Gram-positive and Gram-negative aerobes and against the anaerobe Clostridioides difficile (MIC = 3.1-12.5 µg/mL). At a concentration of 1× MIC, TtAP-1 produced rapid cell death (<15 min against Acinetobacter baumannii and Staphylococcus aureus). The therapeutic potential of TtAP-1 as an anti-infective agent is limited by its high hemolytic activity (LC50 = 18 µg/mL against mouse erythrocytes) but the peptide constitutes a template for the design of analogs that maintain the high bactericidal activity against ESKAPE pathogens but are less toxic to human cells. It is suggested that the antimicrobial peptides in the scorpion venom facilitate the action of the neurotoxins by increasing the membrane permeability of cells from either prey or predator.
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Affiliation(s)
- Milena Mechkarska
- Department of Life Sciences, Faculty of Science and Technology, St. Augustine Campus, The University of The West Indies, St. Augustine, Trinidad and Tobago
| | - Taylor S. Cunning
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK; (T.S.C.); (M.G.T.); (N.G.T.)
| | - Megan G. Taggart
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK; (T.S.C.); (M.G.T.); (N.G.T.)
| | - Nigel G. Ternan
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK; (T.S.C.); (M.G.T.); (N.G.T.)
| | - Jérôme Leprince
- Université Rouen Normandie, INSERM, NorDiC UMR 1239, HeRacLeS, US 51, PRIMACEN, F-76000 Rouen, France;
| | - Laurent Coquet
- Université Rouen Normandie, INSA Rouen Normandie, CNRS, PBS UMR 6270, HeRacLeS US 51 UAR 2026 PISSARO, F-76000 Rouen, France; (L.C.); (T.J.)
| | - Thierry Jouenne
- Université Rouen Normandie, INSA Rouen Normandie, CNRS, PBS UMR 6270, HeRacLeS US 51 UAR 2026 PISSARO, F-76000 Rouen, France; (L.C.); (T.J.)
| | - Jordi Tena-Garcés
- Evolutionary and Translational Venomics Laboratory, Consejo Superior de Investigaciones Científicas (CSIC), 46010 Valencia, Spain; (J.T.-G.); (J.J.C.)
| | - Juan J. Calvete
- Evolutionary and Translational Venomics Laboratory, Consejo Superior de Investigaciones Científicas (CSIC), 46010 Valencia, Spain; (J.T.-G.); (J.J.C.)
| | - J. Michael Conlon
- Diabetes Research Centre, School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK;
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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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Mast Cells Modulate the Immune Response and Redox Status of the Gastrointestinal Tract in Induced Venom Pathogenesis. Inflammation 2021; 45:509-527. [PMID: 34608585 DOI: 10.1007/s10753-021-01562-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
The pathogenesis of Androctonus autralis hector (Aah) scorpion venom involved cellular and molecular mechanisms resulting in multi-organ dysfunction. However, little is reported about the effects of venom on the gastrointestinal axis. Mast cells (MCs) are known to play a crucial role in modulating immune response of the gut. This study aims to investigate the involvement of this cell type in venom-induced gastric and intestinal disorders in a time course (3 and 24h). The obtained results revealed that Aah scorpion venom induced inflammatory cell infiltration as shown by the increase of the myeloperoxidase and eosinophil peroxidase activities. Overexpression of the c-kit receptor (CD117) severely imbalanced the redox status with depletion of antioxidant systemic accompanied by gastrointestinal tissue damage. Moreover, an increased level of lactate dehydrogenase in the serum was correlated with tissue injuries. Pharmacological inhibition of MCs targeting tyrosine kinase (TK) reduces the generation of reactive oxygen species and normalizes catalase, and gluthation S-transferase activities to their physiological levels. In addition, histopathological alterations were restored after pretreatment with c-kit receptor inhibitor associated with a considerable reduction of MC density. Interestingly, obtained results indicate that MCs might be involved in gastric modulation and intestinal inflammation through c-kit signaling following sub-cutaneous Aah venom injection.
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Das B, Saviola AJ, Mukherjee AK. Biochemical and Proteomic Characterization, and Pharmacological Insights of Indian Red Scorpion Venom Toxins. Front Pharmacol 2021; 12:710680. [PMID: 34650430 PMCID: PMC8505525 DOI: 10.3389/fphar.2021.710680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/16/2021] [Indexed: 12/16/2022] Open
Abstract
The Indian red scorpion (Mesobuthus tamulus) is one of the world's deadliest scorpions, with stings representing a life-threatening medical emergency. This species is distributed throughout the Indian sub-continent, including eastern Pakistan, eastern Nepal, and Sri Lanka. In India, Indian red scorpions are broadly distributed in western Maharashtra, Saurashtra, Kerala, Andhra Pradesh, Tamil Nadu, and Karnataka; however, fatal envenomations have been recorded primarily in the Konkan region of Maharashtra. The Indian red scorpion venom proteome comprises 110 proteins belonging to 13 venom protein families. The significant pharmacological activity is predominantly caused by the low molecular mass non-enzymatic Na+ and K+ ion channel toxins. Other minor toxins comprise 15.6% of the total venom proteome. Indian red scorpion stings induce the release of catecholamine, which leads to pathophysiological abnormalities in the victim. A strong correlation has been observed between venom proteome composition and local (swelling, redness, heat, and regional lymph node involvement) and systemic (tachycardia, mydriasis, hyperglycemia, hypertension, toxic myocarditis, cardiac failure, and pulmonary edema) manifestations. Immediate administration of antivenom is the preferred treatment for Indian red scorpion stings. However, scorpion-specific antivenoms have exhibited poor immunorecognition and neutralization of the low molecular mass toxins. The proteomic analysis also suggests that Indian red scorpion venom is a rich source of pharmacologically active molecules that may be envisaged as drug prototypes. The following review summarizes the progress made towards understanding the venom proteome of the Indian red scorpion and addresses the current understanding of the pathophysiology associated with its sting.
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Affiliation(s)
- Bhabana Das
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur, India
| | - Anthony J. Saviola
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ashis K. Mukherjee
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur, India
- Institute of Advanced Study in Science and Technology, Guwahati, India
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Involvement of the Endothelin Receptor Type A in the Cardiovascular Inflammatory Response Following Scorpion Envenomation. Toxins (Basel) 2020; 12:toxins12060389. [PMID: 32545475 PMCID: PMC7374423 DOI: 10.3390/toxins12060389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023] Open
Abstract
Elevated levels of endothelin-1 (ET-1) were recorded in sera of scorpion sting patients. However, no studies focused on the mechanism of ET-1 involvement in the pathogenesis of scorpion envenomation, particularly in the cardiovascular system which is seriously affected in severe cases of scorpion stings. Inflammation induced by Androctonus australis hector (Aah) scorpion venom in the heart together with the aorta was studied in mice pretreated with a specific endothelin A receptor (ETA-R) inhibitor. ETA-R inhibition resulted in the attenuation of the high amounts of cytokine (tumor necrosis factor alpha (TNF-α) and interleukin-17 (IL-17)) recorded in the sera of envenomed mice. The recovery of the oxidative stress marker balance and matrix metalloproteinase (MMP) expression were also observed, concomitantly with the reduction of tissular neutrophil infiltration. Additionally, the cardiac and the aortic tissue alterations, and the metabolic enzymes (creatine kinase (CK) and muscle–brain isoform creatine kinase (CK-MB)) overspread into sera were significantly attenuated. Obtained results suggest the implication of endothelin throughout its ETA receptors in the inflammatory response observed in the cardiovascular components during scorpion envenomation. Further knowledge is needed to better understand the implication of the endothelin axis and to improve the therapeutic management of severe scorpion sting cases.
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Ward MJ, Ellsworth SA, Nystrom GS. A global accounting of medically significant scorpions: Epidemiology, major toxins, and comparative resources in harmless counterparts. Toxicon 2018; 151:137-155. [DOI: 10.1016/j.toxicon.2018.07.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 01/18/2023]
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Nakib I, Martin-Eauclaire MF, Laraba-Djebari F. Involvement of Cholinergic and Adrenergic Receptors in Pathogenesis and Inflammatory Response Induced by Alpha-Neurotoxin Bot III of Scorpion Venom. Inflammation 2016; 39:1670-80. [PMID: 27395044 DOI: 10.1007/s10753-016-0401-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bot III neurotoxin is the most lethal α neurotoxin purified from Buthus occitanus tunetanus scorpion venom. This toxin binds to the voltage-gated sodium channel of excitable cells and blocks its inactivation, inducing an increased release of neurotransmitters (acetylcholine and catecholamines). This study aims to elucidate the involvement of cholinergic and adrenergic receptors in pathogenesis and inflammatory response triggered by this toxin. Injection of Bot III to animals induces an increase of peroxidase activities, an imbalance of oxidative status, tissue damages in lung parenchyma, and myocardium correlated with metabolic disorders. The pretreatment with nicotine (nicotinic receptor agonist) or atropine (muscarinic receptor antagonist) protected the animals from almost all disorders caused by Bot III toxin, especially the immunological alterations. Bisoprolol administration (selective β1 adrenergic receptor antagonist) was also efficient in the protection of animals, mainly on tissue damage. Propranolol (non-selective adrenergic receptor antagonist) showed less effect. These results suggest that both cholinergic and adrenergic receptors are activated in the cardiopulmonary manifestations induced by Bot III. Indeed, the muscarinic receptor appears to be more involved than the nicotinic one, and the β1 adrenergic receptor seems to dominate the β2 receptor. These results showed also that the activation of nicotinic receptor leads to a significant protection of animals against Bot III toxin effect. These findings supply a supplementary data leading to better understanding of the mechanism triggered by scorpionic neurotoxins and suggest the use of drugs targeting these receptors, especially the nicotinic one in order to counteract the inflammatory response observed in scorpion envenomation.
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Affiliation(s)
- Imene Nakib
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, BP 32, El-Alia Bab Ezzouar, 16111, Algiers, Algeria
| | - Marie-France Martin-Eauclaire
- Aix-Marseille University, CNRS UMR7290 CRN2M, IFR Jean-Roche, Université de la Méditerranée, Faculté de Médecine Nord, Bd Pierre Dramard, 13916, Marseille, Cedex 20, France
| | - Fatima Laraba-Djebari
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, BP 32, El-Alia Bab Ezzouar, 16111, Algiers, Algeria.
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Behavioral, histopathological and biochemical impairments observed in mice envenomed by the scorpion: Hottentota gentili (Pallary, 1924). Toxicon 2015; 103:19-29. [DOI: 10.1016/j.toxicon.2015.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/21/2015] [Accepted: 06/08/2015] [Indexed: 11/17/2022]
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Chaïr-Yousfi I, Laraba-Djebari F, Hammoudi-Triki D. Androctonus australis hector venom contributes to the interaction between neuropeptides and mast cells in pulmonary hyperresponsiveness. Int Immunopharmacol 2015; 25:19-29. [PMID: 25601496 DOI: 10.1016/j.intimp.2015.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 01/06/2015] [Accepted: 01/09/2015] [Indexed: 11/28/2022]
Abstract
Lung injury and respiratory distress syndrome are frequent symptoms observed in the most severe cases of scorpion envenomation. The uncontrolled transmigration of leukocyte cells into the lung interstitium and alveolar space and pulmonary edema may be the cause of death. Mast cells can release various inflammatory mediators known to be involved in the development of lung edema following scorpion venom injection. The present study was designed to determine the evidence of neurokinin 1 (NK1) receptor and the involvement of mast cell activation to induce pulmonary edema and to increase vascular permeability after Androctonus australis hector (Aah) venom administration. To this end, mast cells were depleted using compound 48/80 (C48/80). Furthermore, the involvement of tachykinin NK1 receptors expressed on mast cell membranes was elucidated by their blocking with an antagonist. On the other hand, the ability of Aah venom to increase vascular permeability and to induce edema was also assessed by measuring the amount of Evans blue dye (EBD) extravasation in bronchoalveolar lavage (BAL) fluid and in the lungs of mice. Pulmonary edema, as assessed by the levels of EBD extravasation, was completely inhibited in compound 48/80-treated animals. Depletion by stimuli non-immunological C48/80 component markedly reduced induced inflammatory response following the venom administration. The mast cells seem to play an important role in the development of lung injury and the increase of vascular permeability in mice following the subcutaneous administration of Aah scorpion venom through the NK1 receptor.
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Affiliation(s)
- Imène Chaïr-Yousfi
- University of Sciences and Technology Houari Boumediene, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, Algiers, Algeria
| | - Fatima Laraba-Djebari
- University of Sciences and Technology Houari Boumediene, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, Algiers, Algeria.
| | - Djelila Hammoudi-Triki
- University of Sciences and Technology Houari Boumediene, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, Algiers, Algeria
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Lamraoui A, Adi-Bessalem S, Laraba-Djebari F. Modulation of Tissue Inflammatory Response by Histamine Receptors in Scorpion Envenomation Pathogenesis: Involvement of H4 Receptor. Inflammation 2014; 37:1689-704. [DOI: 10.1007/s10753-014-9898-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pediatric scorpion envenomation in the United States: morbidity, mortality, and therapeutic innovations. Pediatr Emerg Care 2013; 29:98-103; quiz 104-5. [PMID: 23283277 DOI: 10.1097/pec.0b013e31827b5733] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the Southwestern United States, the venom of the scorpion Centruroides sculpturatus (common name bark scorpion) can cause serious and potentially fatal neurotoxicity, with young children most vulnerable to its effects. Historically, advances in the quality of supportive care have made significant improvements in morbidity and mortality. In recent years, the development of effective antivenom therapies has changed the landscape of caring for these patients. This article reviews the background, pathophysiology, diagnosis, and treatment options for C. sculpturatus envenomation. Recent advances in immunotherapy and subsequent implications for pediatric emergency care providers are discussed.
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Del Brutto OH. Neurological effects of venomous bites and stings: snakes, spiders, and scorpions. HANDBOOK OF CLINICAL NEUROLOGY 2013; 114:349-68. [PMID: 23829924 DOI: 10.1016/b978-0-444-53490-3.00028-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Snake and spider bites, as well as scorpion sting envenoming, are neglected diseases affecting millions of people all over the world. Neurological complications vary according to the offending animal, and are often directly related to toxic effects of the venom, affecting the central nervous system, the neuromuscular transmission, the cardiovascular system, or the coagulation cascade. Snake bite envenoming may result in stroke or muscle paralysis. Metalloproteinases and other substances (common in vipers and colubrids) have anticoagulant or procoagulant activity, and may induce ischemic or hemorrhagic strokes. The venom of elapids is rich in neurotoxins affecting the neuromuscular transmission at either presynaptic or postsynaptic levels. The clinical picture of scorpion sting envenoming is dominated by muscle weakness associated with arterial hypertension, cardiac arrythmias, myocarditis, or pulmonary edema. These manifestations occur as the result of release of catecholamines into the bloodstream or due to direct cardiac toxicity of the venom. Cerebrovascular complications have been reported after the sting of the Indian red scorpion. Intracranial hemorrhages occur in the setting of acute increases in arterial blood pressure related to sympathetic overstimulation, and cerebral infarctions are related to either cerebral hypoperfusion, consumption coagulopathy, vasculitis, or cardiogenic brain embolism. Three main syndromes result from spider bite envenoming: latrodectism, loxoscelism, and funnel-web spider envenoming. Latrodectism is related to neurotoxins present in the venom of widow spiders. Most cases present with headache, lethargy, irritability, myalgia, tremor, fasciculation, or ataxia. Loxoscelism is caused by envenoming by spiders of the family Sicariidae. It may present with a stroke due to a severe coagulopathy. The venom of funnel-web spiders also has neurotoxins that stimulate neurotransmitter release, resulting in sensory disturbances and muscle paralysis. Proper management of the envenomed patient, including prompt transport to the hospital, correction of the hemostatic disorder, ventilatory support, and administration of antivenom, significantly reduce the risk of neurological complications which, in turn, reduce the mortality and improve the functional outcome of survivors.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espiritu Santo, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital Clinica Kennedy, Guayaquil, Ecuador.
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Hmila I, Cosyns B, Tounsi H, Roosens B, Caveliers V, Abderrazek RB, Boubaker S, Muyldermans S, El Ayeb M, Bouhaouala-Zahar B, Lahoutte T. Pre-clinical studies of toxin-specific Nanobodies: Evidence of in vivo efficacy to prevent fatal disturbances provoked by scorpion envenoming. Toxicol Appl Pharmacol 2012; 264:222-31. [DOI: 10.1016/j.taap.2012.07.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 06/30/2012] [Accepted: 07/30/2012] [Indexed: 11/15/2022]
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Abstract
Scorpion stings are common in many tropical countries. Although most scorpion stings cause only localized pain without life-threatening envenoming, about one third of stings cause systemic envenoming which can result in death. Children are particularly sensitive to scorpion envenoming. The severity of scorpion stings is related to the presence of neurotoxins in the venom that cause a sudden release of neurotransmitters from the autonomic nervous system, predominantly sympathetic. There is also a strong inflammatory response that worsens symptoms, including those of a respiratory nature. Several vital functions may be directly affected, including the cardiovascular, respiratory, and neuromuscular systems. Hypertension is constant at the beginning of systemic envenoming and sometimes has a severe cardiac and respiratory impact. Although controversial, immunotherapy is the only etiological treatment. Administered early, it prevents many complications and improves the outcome. New antivenoms are highly purified immunoglobulin fragments, the efficacy and safety of which are excellent. As a consequence, adverse reactions to antivenoms are now very rare and usually mild, which should limit any reluctance regarding their routine use. Symptomatic treatment is still necessary to support immunotherapy, especially in cases of delayed arrival at hospital. A combination of both approaches should be considered, based on local resources and constraints.
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Affiliation(s)
- Jean-Philippe Chippaux
- UMR 216 (Institute of Research for Development and University Paris Descartes, Sorbonne Paris Cité), Cotonou, Bénin, France.
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Zayerzadeh E, Koohi MK, Mirakabadi AZ, Fardipoor A, Kassaian SE, Rabbani S, Anvari MS. Amelioration of cardio-respiratory perturbations following Mesobuthus eupeus envenomation in anesthetized rabbits with commercial polyvalent F(ab')2 antivenom. Toxicon 2011; 59:249-56. [PMID: 22118980 DOI: 10.1016/j.toxicon.2011.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 11/01/2011] [Accepted: 11/02/2011] [Indexed: 10/15/2022]
Abstract
Immunotherapy is the only specific treatment for scorpion sting. In the present study, protective effects of polyvalent antivenom against hemodynamic disturbances, biomarkers (troponin T, creatinine kinase isoenzyme MB, Lactate dehydrogenase) changes, electrocardiogram abnormalities and histopathological complications in heart and lung induced by Mesobuthus eupeus scorpion venom was investigated in anesthetized rabbits. Twenty four rabbits were randomized into four equal groups: six rabbits in control group received 1 ml ultra-pure water subcutaneously (group 1). Group two received LD50 of venom (4.5 mg/kg). In the third and fourth groups, 5 ml of scorpion antivenom was administrated intravenously simultaneous with venom injection and 60 min following envenomation, respectively. Results of the present study indicate significant decrease in hemodynamic parameters following envenomation in the second group of animals. Venom injection caused edema, myocytolysis, coagulation necrosis, hemorrhage in heart as well as edema, hemorrhage and vascular thrombus in lungs. Although envenomed rabbits presented rises in LDH and TnT but no alteration in CK-MB was observed. Electrocardiogram monitoring of rabbits showed ST elevation and inverted T waves. Simultaneous administration of antivenom and venom prevented entirely the clinical signs, hemodynamic disturbances, markers changes, ECG abnormalities and histopathological damages. Delayed immunotherapy gradually ameliorated clinical signs, hemodynamic disturbances and markers changes related to envenomation. Histopathological evaluation showed slight alterations such as mild myocytolysis in heart and mild edema in lung following delayed immunotherapy. In conclusion, scorpion antivenom administration has preventive, neutralizing and curative properties for M. eupeus scorpion envenomation, if it would be applied at optimum time, dose and route.
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Lila BA, Laraba-Djebari F. Enhanced immune sera and vaccine: Safe approach to treat scorpion envenoming. Vaccine 2011; 29:8951-9. [DOI: 10.1016/j.vaccine.2011.09.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Revised: 09/09/2011] [Accepted: 09/11/2011] [Indexed: 11/28/2022]
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Suntravat M, Yusuksawad M, Sereemaspun A, Pérez JC, Nuchprayoon I. Effect of purified Russell's viper venom-factor X activator (RVV-X) on renal hemodynamics, renal functions, and coagulopathy in rats. Toxicon 2011; 58:230-8. [PMID: 21704055 PMCID: PMC3304456 DOI: 10.1016/j.toxicon.2011.05.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 05/11/2011] [Accepted: 05/17/2011] [Indexed: 12/21/2022]
Abstract
Acute renal failure (ARF) is the most frequent and a serious complication in victims of Russell's viper snakebites. Russell's viper venom-factor X activator (RVV-X) has been identified as a main procoagulant enzyme involving coagulopathy, which might be responsible for changes in renal hemodynamics and renal functions. Here, we purified RVV-X from crude Russell's viper venom to study renal hemodynamics, renal functions, intravascular clot, and histopathological changes in Sprague-Dawley rats. Changes in renal hemodynamics and renal functions were evaluated by measuring the mean arterial pressure, glomerular filtration rate (GFR), effective renal plasma flow (ERPF), effective renal blood flow (ERBF), renal vascular resistance (RVR), and fractional excretion of electrolytes. After 10 min, rats receiving both crude venom and purified RVV-X decreased GFR, ERPF, and ERBF and increased RVR. These changes correlated to renal lesions. Along with the determination of intravascular clot, rats injected with purified RVV-X increased the average D-dimer level and reached a peak at 10 min, declined temporarily, and then reached another peak at 30 min. The temporal association between clots and renal dysfunction was observed in rats within 10 min after the injection of purified RVV-X. These findings suggested RVV-X as a major cause of renal failure through intravascular clotting in the renal microcirculation.
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Affiliation(s)
- Montamas Suntravat
- Snake bite and Venom Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Biology Department, National Natural Toxins Research Center, Texas A&M University-Kingsville, MSC 158, 975 West Avenue B, Kingsville, TX 78363, USA
| | - Mariem Yusuksawad
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Amornpun Sereemaspun
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - John C. Pérez
- Biology Department, National Natural Toxins Research Center, Texas A&M University-Kingsville, MSC 158, 975 West Avenue B, Kingsville, TX 78363, USA
| | - Issarang Nuchprayoon
- Snake bite and Venom Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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Borges A, Rojas-Runjaic FJ, Diez N, Faks JG, Op den Camp HJ, De Sousa L. Envenomation by the Scorpion Tityus breweri in the Guayana Shield, Venezuela: Report of a Case, Efficacy and Reactivity of Antivenom, and Proposal for a Toxinological Partitioning of the Venezuelan Scorpion Fauna. Wilderness Environ Med 2010; 21:282-90. [DOI: 10.1016/j.wem.2010.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 06/03/2010] [Accepted: 06/04/2010] [Indexed: 11/30/2022]
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Borges A, Op den Camp HJM, De Sanctis JB. Specific activation of human neutrophils by scorpion venom: a flow cytometry assessment. Toxicol In Vitro 2010; 25:358-67. [PMID: 20969948 DOI: 10.1016/j.tiv.2010.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 09/22/2010] [Accepted: 10/12/2010] [Indexed: 01/21/2023]
Abstract
Acute lung injury following envenomation by Tityus scorpion species is due in part to activation of the inflammatory response leading to release of cytotoxic leukocyte-derived products, including cytokines and possibly reactive oxygen species (ROS). Tityus zulianus envenomation in Venezuela produces cardiorespiratory complications and death by lung injury whereas stings by Tityus discrepans produce mainly gastrointestinal and pancreatic alterations. To ascertain the role played by granulocytes in the envenomation by T. zulianus (TzV) and T. discrepans (TdV), human peripheral blood neutrophils, eosinophils, and monocytes were exposed to scorpion venoms (0.001-5 μg/mL) and the kinetics (5-15 min) of peroxide production determined by flow cytometry, using 2',7'-dichlorodihydrofluorescein diacetate (succinimidyl ester) as a fluorescent substrate. TzV induced a significantly (p<0.01) more potent increase in peroxide production in neutrophils (for 5 and 10 min of incubation), and to a lesser extent in monocytes (5-15 min), compared to TdV. TzV induced necrosis in neutrophils at doses higher than 5 μg/mL. No effect was observed on eosinophils, suggesting that TzV specifically targets neutrophil intracellular ROS production. The TzV-stimulated pathway is protein kinase C-dependent because it was almost completely (>90%) abolished by staurosporine. The stimulatory effect is associated with the lowest molecular mass venom peptides as gel filtration fractions TzII and TzIII significantly enhanced peroxide production. The combined used of the intracellular ROS agonist, phorbol myristate acetate (PMA), and TzV produced a modest but significant increase in peroxide production suggesting the possibility of overlapping signaling cascades amongst PMA and TzV. Up-regulation of intracellular neutrophil ROS production may be an important in vivo target for TzV which could have a role to play in the cardiorespiratory complications elicited after envenomation by this species.
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Affiliation(s)
- Adolfo Borges
- Instituto de Medicina Experimental, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.
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21
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Sezen Y, Guntekin U, Iscan A, Kapakli H, Buyukhatipoglu H, Kucukdurmaz Z. Rapidly improving, severe, acute myocarditis after a scorpion bite: an extremely rare complication and successful management. Am J Emerg Med 2010; 28:844.e3-5. [PMID: 20837272 DOI: 10.1016/j.ajem.2009.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Accepted: 12/07/2009] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yusuf Sezen
- Department of Cardiology, Harran University School of Medicine, Sanliurfa, Turkey.
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22
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A high molecular weight protein Bengalin from the Indian black scorpion (Heterometrus bengalensis C.L. Koch) venom having antiosteoporosis activity in female albino rats. Toxicon 2010; 55:455-61. [DOI: 10.1016/j.toxicon.2009.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 09/19/2009] [Accepted: 09/22/2009] [Indexed: 11/20/2022]
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23
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Borges A, Bermingham E, Herrera N, Alfonzo MJ, Sanjur OI. Molecular systematics of the neotropical scorpion genus Tityus (Buthidae): the historical biogeography and venom antigenic diversity of toxic Venezuelan species. Toxicon 2009; 55:436-54. [PMID: 19799925 DOI: 10.1016/j.toxicon.2009.09.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 08/30/2009] [Accepted: 09/18/2009] [Indexed: 11/30/2022]
Abstract
We provide a mitochondrial DNA-based phylogenetic hypothesis for 21 Tityus species collected in Venezuela, Trinidad, Brazil and Panama, including 12 taxa known to be toxic to humans. Our phylogenetic reconstruction is based on 850 nucleotides of the combined cytochrome oxidase subunit I and 16S rRNA genes for most species, and centered on Venezuelan scorpions owing to the detailed taxonomic and biogeographic information available for Tityus in this region. The principal phylogenetic result was the strong support for mtDNA clades representing geographical groupings associated with the Perijá mountain range, the Mérida Andes, or the central and eastern coastal ranges in Venezuela, suggesting that vicariance has been a potent force in the diversification of local scorpions. Venezuelan Tityus species have been organized by González-Sponga into three artificial morphological groups, "androcottoides", "discrepans", and "nematochirus", based on the array of ventral carinae in metasomal segments II-IV. We also incorporated a fourth morphological group ("Tityus clathratus"), recently documented in Venezuela. Our results do not support the clustering of the species in the "androcottoides" and "discrepans" morphological groups, which include the majority of taxa of medical importance, but provided support for the "nematochirus" species group. T. clathratus was found to cluster with the Brazilian T. serrulatus and T. bahiensis. Divergence times of most clades are consistent with major events in the geological history of northern Venezuela and suggest that many Venezuelan Tityus species formed in the late Miocene and the Pliocene. In turn, we used the Tityus mtDNA phylogeny to determine the potential utility of phylogenetic systematics to predict Tityus venom antigenic reactivity by testing the recognition of T. nororientalis, T. discrepans, T. zulianus, T. perijanensis, and T. clathratus venoms by anti-T. discrepans horse antibodies. Cross-reactivity was significantly higher for the closely related eastern (T. nororientalis) and central coastal (T. discrepans) species in comparison to the distantly related Andean (T. zulianus) and Perijá (T. perijanensis) species. Reactivity of T. clathratus low mol. mass toxic components towards anti-T. serrulatus and anti-T. discrepans antivenoms was low, suggesting that venom components produced by the subgenus Archaeotityus (which encompass "clathratus" species) diverge antigenically from other Tityus scorpions.
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Affiliation(s)
- Adolfo Borges
- Instituto de Medicina Experimental, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.
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Sami-Merah S, Hammoudi-Triki D, Martin-Eauclaire MF, Laraba-Djebari F. Combination of two antibody fragments F(ab′)2/Fab: An alternative for scorpion envenoming treatment. Int Immunopharmacol 2008; 8:1386-94. [DOI: 10.1016/j.intimp.2008.05.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 05/18/2008] [Accepted: 05/19/2008] [Indexed: 11/26/2022]
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25
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Adi-Bessalem S, Hammoudi-Triki D, Laraba-Djebari F. Pathophysiological effects of Androctonus australis hector scorpion venom: tissue damages and inflammatory response. ACTA ACUST UNITED AC 2008; 60:373-80. [PMID: 18519162 DOI: 10.1016/j.etp.2008.03.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 03/05/2008] [Indexed: 12/28/2022]
Abstract
In this study, the effects of sublethal dose of Androctonus australis hector (Aah) venom on the enzymatic activities (creatine phospho-kinase and lactate dehydrogenase) and histopathological changes of heart and lungs' organs were determined 24h following envenoming NMRI mice. The effects of Aah venom on the lytic activity of the complement system, plasma cytokine rates (IL1-beta, IL-6, TNF-alpha, IL-4 and IL-10) and the peripheral blood cell infiltration were also studied. Microscopically, treated animals showed severe myocardial edema, hemorrhages and necroses and severe acute bronchopneumonia with alveolar edema and hemorrhages. High serum levels of lactate dehydrogenase and creatine kinase correlate to the tissue lesions. The results showed fast kinetics of production of pro-inflammatory (IL1-beta, IL-6, TNF-alpha) and anti-inflammatory (IL-4 and IL-10) cytokines at 30min in blood sera. An increase in serum lytic activity of envenomed animals and leucocytosis in peripheral blood with predominance of mononuclear and neutrophil cells were also observed. In conclusion, the results reported in the present study suggest that pathophysiological manifestations of Aah envenomation may be mediated sequentially or simultaneously by cytokines and the complement system, which in turn activate leukocyte to produce tissue damage.
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Affiliation(s)
- Sonia Adi-Bessalem
- Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumédienne Bab Ezzouar, 16111, BP 63, El Alia, Alger, Algeria
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26
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El-Alfy AT, Ahmed AA, Fatani AJ, Kader F. Amelioration of the cardiovascular manifestations of the yellow scorpion Leiurus quinquestriatus envenomation in rats by red grape seeds proanthocyanidins. Toxicon 2008; 51:321-33. [DOI: 10.1016/j.toxicon.2007.07.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2007] [Revised: 07/02/2007] [Accepted: 07/03/2007] [Indexed: 10/23/2022]
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27
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Cupo P, Figueiredo AB, Filho AP, Pintya AO, Tavares Júnior GA, Caligaris F, Marin-Neto JA, Hering SE, Simões MV. Acute left ventricular dysfunction of severe scorpion envenomation is related to myocardial perfusion disturbance. Int J Cardiol 2007; 116:98-106. [PMID: 16828898 DOI: 10.1016/j.ijcard.2006.02.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2005] [Revised: 02/07/2006] [Accepted: 02/24/2006] [Indexed: 11/23/2022]
Abstract
BACKGROUND Scorpion envenomation (SE) may present severe cardiac dysfunction with acute pulmonary edema and cardiogenic shock. The pathophysiology of this acute heart failure is still controversial. We aimed at assessing the contribution of the myocardial ischemia to the left ventricular dysfunction in SE by using 99mTc-Sestamibi myocardial perfusion scintigraphy (MPS). METHODS Twelve children (7 males, 1-12 years old) presenting severe Tityus serrulatus envenomation were prospectively submitted to MPS within 72 h (acute) and 15 days (follow-up) after the event. MPS images were interpreted using a visual semi-quantitative uptake score (0 = normal, 4 = absent). Echocardiography was used for the assessment of left ventricular (LV) ejection fraction (EF) and regional wall motion (WM) by using a semi-quantitative score (0 = normal, 4 = akinesia). A 16-segment LV model was used. RESULTS Initial echocardiography showed marked WM abnormalities with a mean score of 31.4+/-13.9, and a reduced EF (36+/-16%). All patients exhibited myocardial perfusion (MP) defects. The mean MP uptake score was 14.6+/-7.8. A significant topographic association between MP and WM changes was obtained (p<0.0001, Fischer exact test). A positive correlation was obtained between the summed WM and MP scores (R=0.68, p=0.016). Follow-up evaluation showed a significant improvement of LVEF (65+/-10%) and WM score (3.9+/-4.2), parallel to the normalization of MP. CONCLUSIONS These observations strongly support the participation of transitory myocardial ischemia in the mechanism of the acute cardiac dysfunction caused by severe scorpion envenoming. Micro vascular spasm related to the catecholamine over stimulation may be the pathophysiologic link triggering the myocardial perfusion disturbance in this syndrome.
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Affiliation(s)
- Palmira Cupo
- Pediatrics Division, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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28
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Winkel KD, Tibballs J, Molenaar P, Lambert G, Coles P, Ross-Smith M, Wiltshire C, Fenner PJ, Gershwin LA, Hawdon GM, Wright CE, Angus JA. Cardiovascular actions of the venom from the Irukandji (Carukia barnesi) jellyfish: effects in human, rat and guinea-pig tissues in vitro and in pigs in vitro. Clin Exp Pharmacol Physiol 2005; 32:777-88. [PMID: 16173936 DOI: 10.1111/j.1440-1681.2005.04258.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
1. We have investigated the cardiovascular pharmacology of the crude venom extract (CVE) from the potentially lethal, very small carybdeid jellyfish Carukia barnesi, in rat, guinea-pig and human isolated tissues and anaesthetized piglets. 2. In rat and guinea-pig isolated right atria, CVE (0.1-10 microg/mL) caused tachycardia in the presence of atropine (1 micromol/L), a response almost completely abolished by pretreatment with tetrodotoxin (TTX; 0.1 micromol/L). In paced left atria from guinea-pig or rat, CVE (0.1-3 microg/mL) caused a positive inotropic response in the presence of atropine (1 micromol/L). 3. In rat mesenteric small arteries, CVE (0.1-30 microg/mL) caused concentration-dependent contractions that were unaffected by 0.1 micromol/L TTX, 0.3 micromol/L prazosin or 0.1 micromol/L omega-conotoxin GVIA. 4. Neither the rat right atria tachycardic response nor the contraction of rat mesenteric arteries to CVE were affected by the presence of box jellyfish (Chironex fleckeri) antivenom (92.6 units/mL). 5. In human isolated driven right atrial trabeculae muscle strips, CVE (10 microg/mL) tended to cause an initial fall, followed by a more sustained increase, in contractile force. In the presence of atropine (1 micromol/L), CVE only caused a positive inotropic response. In separate experiments in the presence of propranolol (0.2 micromol/L), the negative inotropic effect of CVE was enhanced, whereas the positive inotropic response was markedly decreased. 6. In anaesthetized piglets, CVE (67 microg/kg, i.v.) caused sustained tachycardia and systemic and pulmonary hypertension. Venous blood samples demonstrated a marked elevation in circulating levels of noradrenaline and adrenaline. 7. We conclude that C. barnesi venom may contain a neural sodium channel activator (blocked by TTX) that, in isolated atrial tissue (and in vivo), causes the release of transmitter (and circulating) catecholamines. The venom may also contain a 'direct' vasoconstrictor component. These observations explain, at least in part, the clinical features of the potentially deadly Irukandji syndrome.
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Affiliation(s)
- Kenneth D Winkel
- Department of Pharmacology, The University of Melbourne, Melbourne, Victoria, Australia
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Bahloul M, Kallel H, Rekik N, Ben Hamida C, Chelly H, Bouaziz M. [Cardiovascular dysfunction following severe scorpion envenomation. Mechanisms and physiopathology]. Presse Med 2005; 34:115-20. [PMID: 15687982 DOI: 10.1016/s0755-4982(05)88241-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The seriousness of scorpion envenomation results essentially from left cardiac function with pulmonary oedema and/or a state of shock. Adrenergic myocarditis, toxic myocarditis and myocardial ischemia are the 3 mechanisms that explain the cardiac dysfunction. Myocardial ischemia is not only due to the release of catecolamines but also the effect of the cytokines and/or neuropeptide Y on the coronary vessels. The cardiac damage can be due or enhanced by the depressive effect of the cytokines on the myocardial cells. The frequently observed hyperglycaemia only enhances the state of the already damaged myocardium.
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Affiliation(s)
- Mabrouk Bahloul
- Service de réanimation médicale, CHU Habib Bourguiba, Sfax, Tunisie.
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30
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Dousset E, Carrega L, Steinberg JG, Clot-Faybesse O, Jouirou B, Sauze N, Devaux C, Autier Y, Jammes Y, Martin-Eauclaire MF, Guieu R. Evidence that free radical generation occurs during scorpion envenomation. Comp Biochem Physiol C Toxicol Pharmacol 2005; 140:221-6. [PMID: 15907767 DOI: 10.1016/j.cca.2005.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2004] [Revised: 02/07/2005] [Accepted: 02/07/2005] [Indexed: 10/25/2022]
Abstract
Although it is well established that symptomatology, morbidity and death following scorpion envenomation are due to increases in neurotransmitter release secondary to toxins binding to voltage-sensitive sodium channels, the mechanism by which venom action is involved in damaging heart, liver, lungs and kidneys remains unclear. We hypothesized that scorpion toxins could induce the generation of high levels of free radicals responsible for membrane damage in organs targeted by venom action. We have investigated lipid peroxidation in different organs, through the evaluation of thiobarbituric acid reactive substances (TBARS), after experimental envenomation of rats by toxic fractions of Androctonus australis Hector venom. We have shown that scorpion toxins cause considerable lipid peroxidation in most vital organs. We also evaluated the protective effects of antioxidants in mice injected with lethal doses of toxins. Among the drugs tested, N-acetylcysteine (NAC) was effective in protecting the mice when injected prior to toxin application. However, the free radical scavenging properties of NAC seem less implicated in these protective effects than its ability to increase the fluidity of bronchial secretions. We therefore conclude that free radical generation only plays a minor role in the toxicity of scorpion venom.
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Affiliation(s)
- E Dousset
- Laboratoire des Déterminants Physiologiques de l'Activité Physique (UPRES EA 3285), Institut Fédératif de Recherche E-J Marey (IFR 107), Faculté des Sciences du Sport, Université de la Méditerranée (Aix-Marseille II), Marseille, France
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Mazzei de Dàvila CA, Dàvila DF, Donis JH, de Bellabarba GA, Villarreal V, Barboza JS. Sympathetic nervous system activation, antivenin administration and cardiovascular manifestations of scorpion envenomation. Toxicon 2002; 40:1339-46. [PMID: 12220720 DOI: 10.1016/s0041-0101(02)00145-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED We performed two-dimensional echocardiograms and determined plasma norepinephrine levels on admission and at 24h after hospitalization, in 16 children with scorpion envenomation. All patients came from areas where scorpions have been identified as Tityus zulianus and received antivenin at the site of the accident or upon admission. Based on the presence or absence of cardiovascular manifestations, patients were divided into two groups. GROUP A 10 patients had cardiovascular manifestations of pulmonary edema. Four patients had mild pulmonary edema (Left ventricular ejection fraction: 0.43+/-0.19) and six had moderate to severe pulmonary edema (Ejection fraction: 0.31+/-0.09. p=NS, M+/-SD). Plasma norepinephrine was elevated on admission (1279+/-824) and decreased at 24h in seven of eight patients (474+/-140 pg/ml, p<0.03). GROUP B Six patients had no cardiovascular manifestations. These patients had normal chest X-rays and normal echocardiograms. Plasma norepinephrine was not elevated (188+/-180 pg/ml). Time interval from the accident to antivenin administration was significantly longer in Group A compared to Group B (4.5+/-3.3 vs 1.2+/-0.4h, p<0.03) and correlated directly with the absolute change in plasma norepinephrine (r=0.76, p<001). Consequently, we strongly recommend very early administration of antivenin in the medical management of scorpion envenomation by T. zulianus.
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Affiliation(s)
- Carmen A Mazzei de Dàvila
- Unidad de Cuidados Intensivos Pediátricos, Departamento de Fisiopatologi;a, Instituto de Investigaciones Cardiovasculares, Universidad de Los Andes, Aprartado Postal 590, Mérida 5101, Venezuela.
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Benvenuti LA, Douetts KV, Cardoso JLC. Myocardial necrosis after envenomation by the scorpion Tityus serrulatus. Trans R Soc Trop Med Hyg 2002; 96:275-6. [PMID: 12174777 DOI: 10.1016/s0035-9203(02)90097-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A 4 years old boy died a few hours after he had been stung by a scorpion (Tityus serrulatus). At necropsy, there were multiple foci of coagulative myocytolysis in the myocardium and pulmonary oedema. Myocardial necrosis was probably associated with the sympathetic storm induced by scorpion envenomation, and may have contributed to cardiac failure and death.
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Affiliation(s)
- L A Benvenuti
- Laboratory of Pathology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr Eneas de Carvalho Aguiar 44, São Paulo, SP, 05403-000, Brazil.
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Lans C, Harper T, Georges K, Bridgewater E. Medicinal and ethnoveterinary remedies of hunters in Trinidad. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2001; 1:10. [PMID: 11737880 PMCID: PMC60997 DOI: 10.1186/1472-6882-1-10] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2001] [Accepted: 11/30/2001] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ethnomedicines are used by hunters for themselves and their hunting dogs in Trinidad. Plants are used for snakebites, scorpion stings, for injuries and mange of dogs and to facilitate hunting success. RESULTS Plants used include Piper hispidum, Pithecelobium unguis-cati, Bauhinia excisa, Bauhinia cumanensis, Cecropia peltata, Aframomum melegueta, Aristolochia rugosa, Aristolochia trilobata, Jatropha curcas, Jatropha gossypifolia, Nicotiana tabacum, Vernonia scorpioides, Petiveria alliacea, Renealmia alpinia, Justicia secunda, Phyllanthus urinaria,Phyllanthus niruri,Momordica charantia, Xiphidium caeruleum, Ottonia ovata, Lepianthes peltata, Capsicum frutescens, Costus scaber, Dendropanax arboreus, Siparuma guianensis, Syngonium podophyllum, Monstera dubia, Solanum species, Eclipta prostrata, Spiranthes acaulis, Croton gossypifolius, Barleria lupulina, Cola nitida, Acrocomia ierensis (tentative ID). CONCLUSION Plant use is based on odour, and plant morphological characteristics and is embedded in a complex cultural context based on indigenous Amerindian beliefs. It is suggested that the medicinal plants exerted a physiological action on the hunter or his dog. Some of the plants mentioned contain chemicals that may explain the ethnomedicinal and ethnoveterinary use. For instance some of the plants influence the immune system or are effective against internal and external parasites. Plant baths may contribute to the health and well being of the hunting dogs.
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Affiliation(s)
- Cheryl Lans
- Group Technology and Agrarian Development, Hollandseweg 1, 6706 KN Wageningen University, the Netherlands
| | - Tisha Harper
- School of Veterinary Medicine, Faculty of Medical Sciences, University of the West Indies, Mt. Hope, Trinidad and Tobago
| | - Karla Georges
- School of Veterinary Medicine, Faculty of Medical Sciences, University of the West Indies, Mt. Hope, Trinidad and Tobago
| | - Elmo Bridgewater
- School of Veterinary Medicine, Faculty of Medical Sciences, University of the West Indies, Mt. Hope, Trinidad and Tobago
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