Tetrodotoxin poisoning caused by Goby fish consumption in southeast China: a retrospective case series analysis

You, Jie; Yue, YaJun; Xing, Feng; Xia, Wei; Lai, Shaoyang; Zhang, FengLei

doi:10.6061/clinics/2015(01)05

Cited by 17 publications

(9 citation statements)

References 35 publications

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“…However, based on personal communication (Luis Botana), the patient reported to have ingested an undefined part of the digestive gland. You et al (2015) conducted a case series analysis of an outbreak of TTX poisoning associated with consumption of goby fish in three towns of the Guangdong province of China in 2012. The number of cases that were hospitalised was 22 (9 males, 13 females, aged 31-78 years), showing mild to severe symptoms but no deaths.…”

Section: Human Observationsmentioning

confidence: 99%

Risks for public health related to the presence of tetrodotoxin (TTX) and TTX analogues in marine bivalves and gastropods

Knutsen¹,

Alexander²,

Barregård³

et al. 2017

EFS2

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Tetrodotoxin (TTX) and its analogues are produced by marine bacteria and have been detected in marine bivalves and gastropods from European waters. The European Commission asked EFSA for a scientific opinion on the risks to public health related to the presence of TTX and TTX analogues in marine bivalves and gastropods. The Panel on Contaminants in the Food Chain reviewed the available literature but did not find support for the minimum lethal dose for humans of 2 mg, mentioned in various reviews. Some human case reports describe serious effects at a dose of 0.2 mg, corresponding to 4 lg/kg body weight (bw). However, the uncertainties on the actual exposure in the studies preclude their use for derivation of an acute reference dose (ARfD). Instead, a group ARfD of 0.25 lg/kg bw, applying to TTX and its analogues, was derived based on a TTX dose of 25 lg/kg bw at which no apathy was observed in an acute oral study with mice, applying a standard uncertainty factor of 100. Estimated relative potencies for analogues are lower than that of TTX but are associated with a high degree of uncertainty. Based on the occurrence data submitted to EFSA and reported consumption days only, average and P95 exposures of 0.00-0.09 and 0.00-0.03 lg/kg bw, respectively, were calculated. Using a large portion size of 400 g bivalves and P95 occurrence levels of TTX, with exception of oysters, the exposure was below the group ARfD in all consumer groups. A concentration below 44 lg TTX equivalents/kg shellfish meat, based on a large portion size of 400 g, was considered not to result in adverse effects in humans. Liquid chromatography with tandem mass spectroscopy (LC-MS/MS) methods are the most suitable for identification and quantification of TTX and its analogues, with LOQs between 1 and 25 lg/kg.

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Section: Human Observationsmentioning

confidence: 99%

Risks for public health related to the presence of tetrodotoxin (TTX) and TTX analogues in marine bivalves and gastropods

Knutsen¹,

Alexander²,

Barregård³

et al. 2017

EFS2

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“…We know that humans have eaten pufferfish since antiquity, because pufferfish bones have been unearthed from kitchen middens that date back to the Stone Age [ 4 , 5 , 6 ]. TTX poisonings have been reported in Japan, as well as in Australia, Bangladesh, Brazil, China, Singapore, Spain, Taiwan, Thailand, and the United States [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The symptoms of TTX poisoning depend on the amount of toxin ingested.…”

Section: Introductionmentioning

confidence: 99%

Urinary Excretion of Tetrodotoxin Modeled in a Porcine Renal Proximal Tubule Epithelial Cell Line, LLC-PK1

et al. 2017

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This study examined the urinary excretion of tetrodotoxin (TTX) modeled in a porcine renal proximal tubule epithelial cell line, LLC-PK1. Time course profiles of TTX excretion and reabsorption across the cell monolayers at 37 °C showed that the amount of TTX transported increased linearly for 60 min. However, at 4 °C, the amount of TTX transported was approximately 20% of the value at 37 °C. These results indicate that TTX transport is both a transcellular and carrier-mediated process. Using a transport inhibition assay in which cell monolayers were incubated with 50 µM TTX and 5 mM of a transport inhibitor at 37 °C for 30 min, urinary excretion was significantly reduced by probenecid, tetraethylammonium (TEA), l-carnitine, and cimetidine, slightly reduced by p-aminohippuric acid (PAH), and unaffected by 1-methyl-4-phenylpyridinium (MPP+), oxaliplatin, and cefalexin. Renal reabsorption was significantly reduced by PAH, but was unaffected by probenecid, TEA and l-carnitine. These findings indicate that TTX is primarily excreted by organic cation transporters (OCTs) and organic cation/carnitine transporters (OCTNs), partially transported by organic anion transporters (OATs) and multidrug resistance-associated proteins (MRPs), and negligibly transported by multidrug and toxic compound extrusion transporters (MATEs).

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“…The main occurrences of PFP from TTXs are in warm water regions, especially in the Pacific and Indian oceans. Food poisoning incidents in these regions have arisen following ingestion of contaminated fish, gastropods and crabs, e.g., [ 7 , 12 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. In these regions the toxicity of the fish and shellfish are greatly affected by changes to the marine environment, given the exogenous nature of the toxins [ 2 ].…”

Section: Prevalence Of Tetrodotoxinsmentioning

confidence: 99%

Potential Threats Posed by Tetrodotoxins in UK Waters: Examination of Detection Methodology Used in Their Control

et al. 2015

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Tetrodotoxin is a neurotoxin responsible for many human fatalities, most commonly following the consumption of pufferfish. Whilst the source of the toxin has not been conclusively proven, it is thought to be associated with various species of marine bacteria. Whilst the toxins are well studied in fish and gastropods, in recent years, there have been a number of reports of tetrodotoxin occurring in bivalve shellfish, including those harvested from the UK and other parts of Europe. This paper reviews evidence concerning the prevalence of tetrodotoxins in the UK together with methodologies currently available for testing. Biological, biomolecular and chemical methods are reviewed, including recommendations for further work. With the recent development of quantitative chromatographic methods for these and other hydrophilic toxins, as well as the commercial availability of rapid testing kits, there are a number of options available to ensure consumers are protected against this threat.

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Tetrodotoxin poisoning caused by Goby fish consumption in southeast China: a retrospective case series analysis

Cited by 17 publications

References 35 publications

Risks for public health related to the presence of tetrodotoxin (TTX) and TTX analogues in marine bivalves and gastropods

Risks for public health related to the presence of tetrodotoxin (TTX) and TTX analogues in marine bivalves and gastropods

Urinary Excretion of Tetrodotoxin Modeled in a Porcine Renal Proximal Tubule Epithelial Cell Line, LLC-PK1

Potential Threats Posed by Tetrodotoxins in UK Waters: Examination of Detection Methodology Used in Their Control

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