Serum levels of cytokines in patients envenomed by Tityus serrulatus scorpion sting

Magalhães, Mônica Moreira de; Pereira, M. E. S.; Amaral, Carlos Faria Santos; Rezende, Nilton Alves de; Campolina, Daniel; Bucaretchi, Fábio; Gazzinelli, Ricardo T.; Cunha-Melo, José Renan

doi:10.1016/s0041-0101(98)00251-7

Cited by 112 publications

(67 citation statements)

References 18 publications

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“…Despite the small seasonal variations, the great difference between European and Africanized venoms is not in the quality but rather in the inoculated quantity resulting from massive attacks [16][17][18] . This causes serious envenomations and the development of an acute syndrome characterized by the release of a large quantity of pro-inflammatory mediators, including cytokines, thus causing a sharp inflammatory response that triggers disturbances in the immune system, heart, liver, kidneys, central nervous system, bone marrow, blood vessels, and skeletal muscles, among others [19][20][21][22][23][24][25][26][27][28][29][30][31][32] . As we do not yet have…”

Section: Introductionmentioning

confidence: 99%

Africanized honeybee stings: how to treat them

Almeida

Olivo

Mendes

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction:In 1956, Africanized honeybees (AHB) migrated from Brazil to other regions of the Western Hemisphere, including South, Central, and North America, except for Canada. Despite being productive, they are highly aggressive and cause fatal accidents. This study aimed to evaluate patients at the Clinical Hospital of Botucatu Medical School (HC-FMB) and to propose treatment guidelines. Methods: From 2005 to 2006, the clinical and laboratorial aspects of 11 patients (7 male and 4 female) and the anatomopathological aspects of one patient who had died in 2003 were analyzed. Results: The age of the surviving patients varied from 5 to 87 years, with a mean of 42.5 years. The majority of accidents occurred in the afternoon, and the number of stings ranged from 20 to 500. The principal signs and symptoms were pain and local inflammatory signs, nausea, tachycardia, and vomiting. Biochemical findings presented increased levels of creatine phosphokinase, lactate dehydrogenase, and aspartate/alanine aminotransferase. An 11-year-old male patient died upon entering the attic of a two-storey building where he was attacked by a swarm, receiving more than 1,000 stings. He was sent to HC-FMB where he was treated, but he died 24h later. Observed at the autopsy were erythematous-purpuric skin lesions besides necrosis at the sting locations, rhabdomyolysis, focal myocardial necrosis, tubular hydropic degeneration and focal tubular acute necrosis of the kidneys, myoglobinuria, and centrolobular necrosis in the liver. Conclusions: Accidents caused by multiple AHB stings always constitute a medical emergency. As there is no specific antivenom, we have developed guidelines, including first aid, drugs, and the proper removal of stingers.

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Section: Introductionmentioning

confidence: 99%

Africanized honeybee stings: how to treat them

Almeida

Olivo

Mendes

et al. 2011

Rev. Soc. Bras. Med. Trop.

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“…Several researchers have explained the severity of scorpion envenomation in children by demonstrating the occurrence of myocarditis, high blood pressure, tachyarrhythmia followed by bradycardia, serious pulmonary edema, congestive heart failure and respiratory insufficiency in victims (10,32,(36)(37)(38). A study evaluated 41 Egyptian children who were accidentally envenomed by scorpions and reported the occurrence of severe clinical manifestations, in addition to myocarditis (17 patients), increased CK and CK-MB activities, increased troponin-I levels, and a mortality rate of 12.5% (23). The influence of age on the pharmacokinetics and biodistribution of isolated toxins from T.…”

Section: Resultsmentioning

confidence: 99%

Cardiorespiratory evaluation of juvenile rats experimentally envenomed with Tityus serrulatus venom

Pinto

Melo

Cruz

et al. 2010

J. Venom. Anim. Toxins incl. Trop. Dis

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Accidental envenomation caused by Tityus serrulatus scorpions is very common in Brazil and may result in serious cardiorespiratory alterations that are frequently fatal to children. In the present study, the effects of T. serrulatus venom on the cardiorespiratory system of recently weaned male Wistar rats were evaluated. Fifteen animals were distributed into three groups (n = 5). The control group A received 400 μL ultrapure water by subcutaneous injection, while the experimental groups B and C were injected with scorpion venom (100 and 450 μg, respectively, in 400 μL water). Electrocardiogram (ECG) traces were obtained prior to the experiment, at five-minute intervals up to 30 minutes after treatment. At 40 minutes after envenomation, the animals had severe acute symptoms and were subsequently anesthetized for blood collection by means of intracardiac puncture. Biochemical profiles for the cardiac muscle were established by colorimetric analysis of creatine kinase (CK) and CK-MB isoenzyme. Semiquantitative analysis of troponin was performed using the immunochromatographic assay. Following euthanasia, the lungs and hearts were removed and subjected to histopathological examination. All experimental animals had ECG alterations compatible with electrolytic imbalance, myocarditis and alterations of the cardiac conduction system. Envenomed animals had accentuated bradycardia at 25 and 30 minutes after venom inoculation. All experimental animals had myocardial lesions, which were confirmed by increased serum levels of CK and CK-MB, although there were no alterations in the serum concentration of troponin. Pulmonary hemorrhage was detected in whole lungs and microscopically confirmed by the presence of congested capillaries and erythrocytes in the alveolar parenchyma. In conclusion, T. serrulatus venom caused great cardiorespiratory damage to weaned rats.

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“…Magalhaes et al [28] suggested that scorpion envenomation may induce a systemic inflammatory response characterized by increased concentrations of inflammatory cytokines. Our results indicate that the toxins of Aah venom induce increases of seric IL-1 ␤ , IL-6 and IL-12 concentrations.…”

Section: Discussionmentioning

confidence: 99%

Immunomodulation of the Inflammatory Response Induced by Androctonus australis hector Neurotoxins: Biomarker Interactions

Raouraoua-Boukari

Sami-Merah

Hammoudi-Triki

et al. 2012

Neuroimmunomodulation

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Objective:Androctonus australis hector (Aah) is the most dangerous scorpion in the Maghreb countries. Its venom contains three major neurotoxins (Aah I, Aah II and Aah III), which are responsible for almost all the lethal effects caused in mammals. These toxins act on the voltage-gated sodium channels of excitable cells. The targets and the lethal effects of these toxins have been extensively studied. However, their effects on the induced immune response after envenoming have not deeply elicited. We therefore investigated the effects induced by Aah venom and its toxic components, mainly its main toxin Aah II, on the activation of the inflammatory process. Methods: Wistar rats were injected by intraperitoneal route with a sublethal dose of Aah venom, FTox-G50, the purified Aah II toxin or with 400 µl of sterile physiological saline solution. Immunological biomarkers such as MPO, NO and ICAM-1 were analyzed in serum in lung tissue. Cytokine levels were also determined in serum at 3, 6 and 24 h after envenoming. Results: We report in this study that intraperitoneal injection of the venom or its toxins (the whole toxic fraction or Aah II toxin) caused an inflammatory reaction involving increased neutrophil release into blood and neutrophil accumulation in lung tissue. This cell infiltration was associated with the release of NO, histamine, cytokines (IL-1, IL-6, IL-12, IL-4 and IL-5) and ICAM. Conclusion: Aah II binding to its targets, in this case Na⁺ channels, may induce a cascade of events such as inflammatory mediator release and neutrophil migration that could contribute to the exacerbation of the systemic inflammatory response and the development of lung injury following scorpion envenoming.

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Serum levels of cytokines in patients envenomed by Tityus serrulatus scorpion sting

Cited by 112 publications

References 18 publications

Africanized honeybee stings: how to treat them

Africanized honeybee stings: how to treat them

Cardiorespiratory evaluation of juvenile rats experimentally envenomed with Tityus serrulatus venom

Immunomodulation of the Inflammatory Response Induced by Androctonus australis hector Neurotoxins: Biomarker Interactions

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