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Are the toxicological effects of scorpion envenomation related to tissue venom concentration?

The pharmacokinetics of 125I-labelled Androctonus amoreuxi venom and its lethal fraction was studied in rabbits. Comparative pharmacokinetic studies of labelled A. amoreuxi, Leisurus quinquestriatus and Buthotus judaicus venoms were carried out in guinea-pigs. The pharmacokinetics of A. amoreuxi venom was also studied in rats. Groups of rats were injected with labelled A. amoreuxi venom and killed at frequent time intervals for the determination of the relative tissue venom concentration as a function of time. Several groups of rabbits were injected with A. amoreuxi venom and serial blood samples withdrawn at time intervals comparable with those used in the pharmacokinetic studies for the determination of serum glucose, insulin, cortisol, total proteins, albumin, globulins, cholesterol, total bilirubin, urea, uric acid, bicarbonate, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase, sodium, potassium, calcium and phosphorus. The packed cell volume, and total and differential leucocyte counts were also determined. In another series of experiments continuous monitoring of the electrocardiograms of rabbits following venom injection was made to correlate any abnormalities with tissue venom concentration. All three venoms and the lethal fraction showed an open two-compartment behaviour with rapid distribution half-lives ranging between 4 and 7 min and overall elimination half-lives of 4.2 to 13.4 hr. The behaviour of A. amoreuxi venom was not markedly different in the three species of animals used. In a given species (guinea-pigs) the behaviour of the three venoms was not markedly different. Correlation of the ECG changes with cardiac venom concentration showed that arrhythmias and infarction occurred at times when cardiac concentration was very low, indicating that the cardiac abnormalities might result from indirect factors. Comparison of the course of the biochemical changes with venom concentration in the central compartment indicated that the site of action of the venom is not located in the central compartment. Correlation of the intensity of the biochemical effects with venom concentration in the peripheral compartment revealed an apparent delay in the onset and peak of action. This was explained by assuming that the tissue compartment could be divided into a rapidly accessible and a slowly accessible compartment with the venom acting through the slowly accessible compartment. There was also the possibility of the venom acting indirectly through the release of other substances or transformation to an intermediate.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Relationship between plasmatic levels of various cytokines, tumour necrosis factor, enzymes, glucose and venom concentration following Tityus scorpion sting.

A sandwich enzyme-linked immunosorbent assay was developed for measuring Tityus venom levels in plasma. The method proved capable of distinguishing patients with only local symptoms from controls, and was used to quantify venom in 205 accidental human envenomations. Our results show that the severity of envenoming is related to the patient plasma venom concentration. This depends on time elapsed between the sting and when the plasma was drawn. We observed that 46 and 49% of patients with moderate to severe symptoms (MS, n=41) showed hyperamylasemia and hyperglycemia, respectively. In addition, 39% of cases with MS symptoms had partial thromboplastin time values prolonged or shorted and 6.5% of patients with local symptoms (LS, n=164) had only prolonged prothrombin time values. Interleukin 6 (IL6) increased significantly in patients with MS symptoms. IL6 values increased with hyperamylasemia, envenoming severity and time hyperamylasemia.

Amylases↗

Best evidence topic report. Scorpion envenomation: does antivenom reduce serum venom concentrations?

A short cut review was carried out to determine if anitvenom reduces serum venom concentrations. Using the reported search, 69 papers were found, of which four presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Animals↗