Ricin Poisoning

Abstract

ROWING AWARENESS AND concern about ricin, a potent biologic toxin, as a possible terrorist weapon has necessitated a comprehensive review of this poison. 1 The Centers for Disease Control and Prevention (CDC) categorizes ricin as a Category B agent (second-highest priority), as it is moderately easy to disseminate, resulting in low mortality but moderate to high morbidity, and requires specific enhancement of the CDC's diagnostic and disease surveillance capacity. 2 Such agents are not routinely encountered, so heightened awareness in the health care community and a strong public health infrastructure are necessary for detection and response. We therefore have summarized the literature on ricin poisoning and provided recommendations for clinicians and public health professionals dealing with a ricin attack against a civilian population. EVIDENCE ACQUISITION Using PubMed, we searched MEDLINE and OLDMEDLINE databases from January 1950 to August 2005 using the keywords ricin, ricinus communis, ricinine, plant toxins, castor beans, castor dust, and castor oil. Keywords were used alone and with the modifiers toxicity, poisoning, diagnosis, clinical effects, treatment , warfare, chemical terrorism, and weapon. The Chemical and Biological Information Analysis Center (http: //www.cbiac.apgea.army.mil) database was searched for historical and military literature related to ricin tox-CME available online at www.jama.com Context The recent discoveries of ricin, a deadly biologic toxin, at a South Carolina postal facility, a White House mail facility, and a US senator's office has raised concerns among public health officials, physicians, and citizens. Ricin is one of the most potent and lethal substances known, particularly when inhaled. The ease with which the native plant (Ricinus communis) can be obtained and the toxin extracted makes ricin an attractive weapon. Objectives To summarize the literature on ricin poisoning and provide recommendations based on our best professional judgment for clinicians and public health officials that are faced with deliberate release of ricin into the environment. Literature Acquisition Using PubMed, we searched MEDLINE and OLDMEDLINE databases (January 1950-August 2005). The Chemical and Biological Information Analysis Center database was searched for historical and military literature related to ricin toxicity. Book chapters, unpublished reports, monographs, relevant news reports, and Web material were also reviewed to find nonindexed articles. Results Most literature on ricin poisoning involves castor bean ingestion and experimental animal research. Aerosol release of ricin into the environment or adulteration of food and beverages are pathways to exposure likely to be exploited. Symptoms after ingestion (onset within 12 hours) are nonspecific and may include nausea, vomiting, diarrhea, and abdominal pain and may progress to hypotension, liver failure, renal dysfunction, and death due to multiorgan failure or cardiovascular collapse. Inhalation (onset of symptoms is likely within 8 hou...

Ricin Toxicity to Intestinal Cells Leads to Multiple Cell Death Pathways Mediated by Oxidative Stress

“…Consistent with previous research highlighting the significant impact of ricin on the gastrointestinal tract [ 6 , 24 , 25 , 26 , 27 ], our results demonstrate a dose- and time-dependent viability reduction in both HT29 and Caco-2 cells after ricin exposure. Due to the characteristics of intestinal transit, prolonged contact between ricin and enterocytes in vivo is not possible.…”

Antibody to Ricin A Chain Hinders Intracellular Routing of Toxin and Protects Cells Even after Toxin Has Been Internalized

“…When cells encounter ricin, we observe that a substantial proportion of the cell-associated toxin is internalized within 15 min, and plateaus in 40–60 min (figure 5), results that are substantially the same as observed in earlier studies using lower concentrations (100 ng/ml) of 125 I-labeled ricin [27], [28]. To kill a cell, ricin must be transported in a retrograde fashion through the protein synthetic pathway, via the Golgi, ER, and finally the ribosome, where the A chain’s enzymatic activity catalytically removes adenine 4324 from the 18S rRNA, at the rate of 1500 ribosomes per min [37], [38]. Figures 5,8, and 9 show ricin has entered these cellular compartments within an hour, in accordance with ultrastructural studies performed previously by others [21], [22], [23], [24], [25], [26].…”

Comparative evaluation of mahua ( Bassia latifolia ) oil cake and castor bean ( Ricinus communis ) seed as fish toxicants for tilapia ( Oreochromis mossambicus ) and panchax ( Aplocheilus panchax ) with residual toxicity assessment on Labeo bata

“…Susceptibility of the test fish to the piscicides was highly variable as tilapia was more susceptible than panchax under both the piscicides tested especially in CBS. Such variability in response with ricin in CBS has earlier been reported in higher animals by Audi et al (2005) and Cook, David, and Griffiths (2006).…”