Acute disseminated encephalomyelitis due to abrus precatorius poisoning – A case report

Ninan, Elizabeth C.; James, Emmanuel

doi:10.1016/j.jsps.2018.11.016

Cited by 12 publications

(5 citation statements)

References 19 publications

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“…Abrin is a toxin of public health concern due to its high lethality, easy availability, lack of antidote, and potential for use as a bioterrorism agent. The use of abrin in attempted murders, biothreat scenarios, and accidental and suicidal poisonings has been reported by several studies [ 10 , 22 , 23 , 24 ]. Despite the high toxicity, current treatment for abrin poisoning is mainly symptomatic.…”

Section: Discussionmentioning

confidence: 99%

Neutralizing Monoclonal Antibody, mAb 10D8, Is an Effective Detoxicant against Abrin-a Both In Vitro and In Vivo

et al. 2022

Toxins

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Abrin is a types II ribosome-inactivating protein (RIP) isolated from Abrus precatorious seeds, which comprises a catalytically active A chain and a lectin-like B chain linked by a disulfide bond. Four isotoxins of abrin have been reported with similar amino-acid composition but different cytotoxicity, of which abrin-a is the most potent toxin. High lethality and easy availability make abrin a potential bioterrorism agent. However, there are no antidotes available for managing abrin poisoning, and treatment is only symptomatic. Currently, neutralizing antibodies remain the most effective therapy against biotoxin poisoning. In this study, we prepared, identified, and acquired a high-affinity neutralizing monoclonal antibody (mAb) 10D8 with a potent pre- and post-exposure protective effect against cytotoxicity and animal toxicity induced by abrin-a or abrin crude extract. The mAb 10D8 could rescue the mouse injected intraperitoneally with a 25 × LD50 dose of abrin-a from lethality and prevent tissue damages. Results indicated that 10D8 does not prevent the binding and internalization of abrin-a to cells but inhibits the enzymatic activity of abrin-a and reduces protein synthesis inhibition of cells. The high affinity, good specificity, and potent antitoxic efficiency of 10D8 make it a promising candidate for therapeutic antibodies against abrin.

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Section: Discussionmentioning

confidence: 99%

Neutralizing Monoclonal Antibody, mAb 10D8, Is an Effective Detoxicant against Abrin-a Both In Vitro and In Vivo

et al. 2022

Toxins

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“…Reported neurological complications include headache, hallucinations, mydriasis, papilloedema, tetany, seizures, coma, and encephalitis-like syndrome [ 7 , 8 ]. There are few cases of late-onset CNS immune-mediated demyelination, making us initially suspect it as the underlying pathological process in our patient [ 9 – 11 ]. CNS demyelination is due to abrin's immunomodulatory and immunostimulatory properties [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…CNS demyelination is due to abrin's immunomodulatory and immunostimulatory properties [12,13]. Abrin-induced demyelination is reported to respond completely to methylprednisolone and plasma exchange [9][10][11]. A case of osmotic demyelination due to direct effects of abrin in the absence of serum sodium abnormalities was reported previously in a 2-year-old [14].…”

Section: Discussionmentioning

confidence: 99%

A Case of Poisoning with Abrus precatarius Complicated with Bilateral Basal Ganglia Haemorrhage

Rajaratnam

Dissanayake

Kularatne

et al. 2022

Case Reports in Neurological Medicine

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Abrus precatarius is a tropical climber, whose seeds contain abrin, which is known to cause toxicity in humans. We report a case of a young girl, who presented with haemorrhagic enterocolitis, bilateral septal vein thrombosis, and basal ganglia haemorrhage leading to seizures and coma, following ingestion of toxic A. precatarius seeds. To the best of our knowledge, this is the first ever case to describe such an intracranial complication of abrin poisoning.

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“…For the majority of cases, the link to A. precatorius was demonstrated by circumstantial evidence based on details of the case report; e.g., known or observed uptake of plant seeds or the finding of plant material, but explicitly not by the detection of abrin. In four out of 23 cases, diagnostic assays successfully detected and identified the low molecular weight molecule L -abrine ( N -methyl-L-tryptophan) in urine as a surrogate marker for abrin intoxication [ 18 , 19 , 20 , 74 ]. In none of the cases was abrin itself detected.…”

Section: Discussionmentioning

confidence: 99%

Differentiation, Quantification and Identification of Abrin and Abrus precatorius Agglutinin

Worbs

Kampa

Skiba

et al. 2021

Toxins

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Abrin, the toxic lectin from the rosary pea plant Abrus precatorius, has gained considerable interest in the recent past due to its potential malevolent use. However, reliable and easy-to-use assays for the detection and discrimination of abrin from related plant proteins such as Abrus precatorius agglutinin or the homologous toxin ricin from Ricinus communis are sparse. To address this gap, a panel of highly specific monoclonal antibodies was generated against abrin and the related Abrus precatorius agglutinin. These antibodies were used to establish two sandwich ELISAs to preferentially detect abrin or A. precatorius agglutinin (limit of detection 22 pg/mL for abrin; 35 pg/mL for A. precatorius agglutinin). Furthermore, an abrin-specific lateral flow assay was developed for rapid on-site detection (limit of detection ~1 ng/mL abrin). Assays were validated for complex food, environmental and clinical matrices illustrating broad applicability in different threat scenarios. Additionally, the antibodies turned out to be suitable for immuno-enrichment strategies in combination with mass spectrometry-based approaches for unambiguous identification. Finally, we were able to demonstrate for the first time how the developed assays can be applied to detect, identify and quantify abrin from a clinical sample derived from an attempted suicide case involving A. precatorius.

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Acute disseminated encephalomyelitis due to abrus precatorius poisoning – A case report

Cited by 12 publications

References 19 publications

Neutralizing Monoclonal Antibody, mAb 10D8, Is an Effective Detoxicant against Abrin-a Both In Vitro and In Vivo

Neutralizing Monoclonal Antibody, mAb 10D8, Is an Effective Detoxicant against Abrin-a Both In Vitro and In Vivo

A Case of Poisoning with Abrus precatarius Complicated with Bilateral Basal Ganglia Haemorrhage

Differentiation, Quantification and Identification of Abrin and Abrus precatorius Agglutinin

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