Standardization of an enzyme linked immunosorbent assay (ELISA) for detecting circulating toxic venom antigens in patients stung by the scorpion Tityus serrulatus

Rezende, Nilton Alves de; Dias, Mariana Borges; Campolina, Daniel; Chávez-Olortégui, Carlos; Amaral, Carlos Faria Santos

doi:10.1590/s0036-46651995000100011

Cited by 20 publications

(9 citation statements)

References 15 publications

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“…The lack of such clinical and biologic studies could be due to the absence of suitable techniques for detecting and quantifying circulating venom in envenomed patients. An ELISA that measures venom levels after scorpion envenoming has been used for cases stung by Androctonus australis garzonii, B. occitanus tunetanus, and Tityus serrulatus, 4,21,22 but not for those stung by A. mauretanicus mauretanicus or B. occitanus.…”

Section: Introductionmentioning

confidence: 99%

Scorpion envenomation and serotherapy in Morocco.

Ghalim

El-Hafny²,

Sebti³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

108

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Abstract.A clinical and biologic study was conducted in Morocco to assess the efficiency of antivenom therapy for treating victims of scorpion stings. Epidemiologic and clinical data were collected from 275 patients envenomed by Androctonus mauretanicus mauretanicus and Buthus occitanus scorpions. Patients received antivenom or other drugs. Blood samples were collected at the time of hospital admission and 1 hr and 3 hr after treatment. Serum venom levels were quantified by using an ELISA. An association was found between clinical signs of envenoming and the level of venom in serum. Patients classified as grade II (moderate envenoming) had higher serum levels of venom level than patients classified as grade I (mild envenoming). At admission to the hospital, the mean venom concentration was not significantly different between the group not treated with antivenom, the group who received 2-5 ml of antivenom, and the group who received 10 ml of antivenom. A significant decrease in serum venom levels and an improvement in the clinical conditions were observed in patients administered 10 ml of antivenom. The lower decrease in serum venom levels in patients who received 2-5 ml of antivenom was due to lower doses of antivenom. No difference in the venom concentration was observed in patients who were not treated with antivenom. The absence of administration of antivenom increased the risk of developing clinical signs at the end of the hospitalization period. However, this risk was much higher when more than 1 hr elapsed between the time of the scorpion sting and the time of hospital admission. The results demonstrate that antivenom is effective in decreasing circulating venom and morbidity. Serotherapy is more efficient when given as soon as possible after envenomation and with adequate quantities of antivenom.In north Africa, as in numerous tropical countries, envenomation by scorpion stings is a major public health problem, particularly in children. [1][2][3][4] The black scorpion (Androctonus mauretanicus mauretanicus) and the yellow scorpion (Buthus occitanus) are the most dangerous scorpions and are responsible for the majority of stings in Morocco. The epidemiologic data are incomplete, but the number of scorpion stings is estimated to be 40,000 per year in Morocco.Scorpion venoms are a complex biochemical mixture containing numerous neurotoxic polypeptides. 5,6 These polypeptides enhance excitability of nerve and muscle cells in scorpion sting victims and also cause death, particularly in children. 7 The onset of clinical symptoms is rapid (within 5-30 min) following the sting. 8,9 Respiratory failure and cardiovascular manifestations are the usual causes of death. 9-11 The toxicity of A. mauretanicus mauretanicus venom is due to the presence of neurotoxins that are specifically active on sodium and potassium channels. 6,12 The severity of scorpion envenoming and the rapid diffusion of inoculated venom require that appropriate treatment be started as soon as possible after the sting. Most investigators consider a...

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Section: Introductionmentioning

confidence: 99%

Scorpion envenomation and serotherapy in Morocco.

Ghalim

El-Hafny²,

Sebti³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

108

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“…Selon la littérature, le scorpion pique accidentellement, indépendamment de l'âge ou du sexe [11][12][13][14][15]. Le TPP retrouvé dans notre étude (2 h) reste lent par rapport à la rapidité d'action du venin qui atteint rapidement la circulation gé-nérale [16][17][18][19]. Les manifestations cliniques de l'ES diffèrent d'une espèce de scorpion à une autre.…”

Section: Discussionunclassified

Les facteurs prédictifs du décès par envenimation scorpionique à la province d'El Kelâa des Sraghnas – Maroc

Achour¹,

Khattabi²,

Oufir³

et al. 2009

Ann Toxicol Anal

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Résumé -L'analyse descriptive a porté sur les paramètres socio-démographiques (âge, sexe, temps post-piqûre (TPP)), cliniques et thérapeutiques. Nous avons effectué l'analyse univariée pour identifier les facteurs associés aux décès par envenimations scorpioniques (selon le test de chi 2 ou de Fischer, l'association est statistiquement significative si p < 0,05). Résultats : 240 patients ont été inclus dans notre étude, l'âge médian était de 12 ans, allant de 1 à 86 ans, le sex ratio était de 1,25. Le TPP médian était de 2 h allant de 10 min à 29 h. 9,6 % des patients ont présenté une détresse respiratoire, l'atteinte cardiovasculaire était présente dans 10,8 % des cas suivie par la détresse neurologique dans 10,4 % des cas. 11,3 % des cas étaient de classe III à l'admission. L'évolution était favorable dans 91,7 % des cas. 20 décès ont été enregistrés soit 8,3 % des cas. La fièvre, l'hypersudation, les vomissements et la tachypnée étaient statistiquement associés au décès (p < 0,05). Conclusion : Le décès par envenimation scorpionique à la province d'El Kelâa des Sraghnas reste fréquent malgré les efforts fournis, d'où l'intérêt de l'implantation de l'audit clinique des décès afin de déceler les insuffisances pour y remédier. Mots clés : Envenimation scorpionique, facteur prédictif, décès, Maroc Abstract -Objective: To identify the clinical signs associated with death by envenomation scorpions, based on hospital files of the hospital Essalama in El Kelâa des Sraghnas received during 2007. Patients and Methods:Prospective study of scorpions envenimation cases, from the hospital files designed and distributed by Moroccan Poison control centre. The study is conducted in adult and pediatric resuscitation. The descriptive analysis focused on the sociodemographic parameters (age, sex, time post sting (TPP)), clinical and therapeutical features. We conducted univariate analysis to identify predicting death factors by scorpion envenomation (chi 2 test or Fischer, the association is statistically significant if p < 0.05). Results: 240 patients were included in our study, the median age was 12 years ranging from 1 to 86 years. The sex ratio was 1.25. The median TPP was 2 h (from 10 min to 29 h). 9.6% of patients had respiratory distress; cardiovascular achievement was present in 10.8% cases followed by neurological distress in 10.4% of cases. 11.3% of cases were class III at admission. The outcome was favourable in 91.7% of cases. 20 deaths were recorded (8.3%). The fever, sweating, vomiting and tachypnea are statistically associated with death (p < 0.05). Conclusion:Death from scorpion envenomation in the province of El Kelâa des Sraghnas remains high despite the efforts, therefore, the clinical audit of deaths is needed to detect shortcomings to remedy.

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“…Having such a prominent data set enabled some studies to discriminate even between controls, mild, moderate and severe accidents, at statistically significant levels [ 21 , 43 ]. Other studies have also shown a correlation between envenoming grade and venom levels, but failed to discriminate controls from mild cases [ 19 , 36 , 39 ]. However, they are still relevant to helping clinicians in therapeutic decisions for a victim’s treatment.…”

Section: In Vitro Assays For Identification And/or Quantification mentioning

confidence: 99%

“…In many accidents with scorpions, clinical and biochemical laboratory analyses are insufficient to support the diagnosis [ 18 , 19 ]. In addition, although general symptoms occur soon after the sting, in some cases they can occasionally be delayed for several hours, which can complicate diagnosis [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Venomous Arachnid Diagnostic Assays, Lessons from Past Attempts

Dias-Lopes

Paiva

Guerra-Duarte

et al. 2018

Toxins

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Diagnostic tests for arachnid accidents remain unavailable for patients and clinicians. Together with snakes, these accidents are still a global medical concern, and are recognized as neglected tropical issues. Due to arachnid toxins’ fast mechanism of action, quick detection and quantification of venom is required to accelerate treatment decisions, rationalize therapy, and reduce costs and patient risks. This review aims to understand the current limitations for arachnid venom identification and quantification in biological samples. We benchmarked the already existing initiatives regarding test requirements (sample or biomarkers of choice), performances (time, detection limit, sensitivity and specificity) and their validation (on animal models or on samples from envenomed humans). Our analysis outlines unmet needs for improving diagnosis and consequently treatment of arachnid accidents. Hence, based on lessons from past attempts, we propose a road map for raising best practice guidelines, leading to recommendations for future progress in the development of arachnid diagnostic assays.

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Standardization of an enzyme linked immunosorbent assay (ELISA) for detecting circulating toxic venom antigens in patients stung by the scorpion Tityus serrulatus

Cited by 20 publications

References 15 publications

Scorpion envenomation and serotherapy in Morocco.

Scorpion envenomation and serotherapy in Morocco.

Les facteurs prédictifs du décès par envenimation scorpionique à la province d'El Kelâa des Sraghnas – Maroc

Venomous Arachnid Diagnostic Assays, Lessons from Past Attempts

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