Evidence for a direct action of Tityus serrulatus scorpion venom on the cardiac muscle

Teixeira, Antônio Lúcio; Fontoura, B.F.; Freire-Maia, L.; Machado, Conceição R. S.; Camargos, Elizabeth R.S.; Teixeira, Mauro Martins

doi:10.1016/s0041-0101(00)00200-2

Cited by 76 publications

(39 citation statements)

References 30 publications

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“…inactivate sodium channels of cardiac cells (22). Cardiac troponin T elevation in one rabbit coupled with LDH elevation in serum of all animals is one of the interesting results of this study.…”

Section: Discussionmentioning

confidence: 57%

Cardiopulmonary complications induced by Iranian Mesobuthus eupeus scorpion venom in anesthetized rabbits

Zayerzadeh¹,

Koohi²,

Mirakabadi³

et al. 2010

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

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Scorpion envenomation is a life-threatening condition, especially in children and elderly individuals affected by respiratory and cardiovascular diseases. In this study, the toxic effects of median lethal dose (LD50) injections of Mesobuthus eupeus (Me) venom on the heart and lungs of anesthetized rabbits were investigated. Six rabbits were selected and alterations in their electrocardiogram, heart rate, respiration and blood pressure before and after venom injection were recorded. Cardiac troponin T (cTnT), creatinine kinase muscle-brain fraction (CK-MB) and lactate dehydrogenase (LDH) were measured at 0, 1 and 3 hours after envenomation and pathology studies were carried out postmortem. All the animals showed signs and symptoms of envenomation within 40 minutes and died 3 to 3.5 hours after venom injection. Pathology studies revealed alveolar edema in 100% of the rabbits and myocardial infarction in 16%. The main histopathological changes were myocytolysis, coagulation necrosis, focal hemorrhage, thrombus formation both in myocardium and on endocardial surfaces as well as inflammatory infiltrates in the heart and hemorrhage, vascular thrombus and interstitial inflammation in the lungs. ECG monitoring of rabbits showed ST elevation, ST depression and inverted T and Q waves. In addition, although cTnT levels increased in 16% of the animals and serum LDH was also augmented, none of these changes was statistically significant. The enzyme CK-MB also did not show any change after Me venom injection. In conclusion, the results of this study showed that Me venom killed animals in less than 3.5 hours through severe pulmonary damage and it appears that the deaths could not be attributed to cardiovascular lesions. Therefore, Me venom effects on the lungs are so important that they appear to be independent of heart damage.

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Section: Discussionmentioning

confidence: 57%

Cardiopulmonary complications induced by Iranian Mesobuthus eupeus scorpion venom in anesthetized rabbits

Zayerzadeh¹,

Koohi²,

Mirakabadi³

et al. 2010

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

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“…Elevated levels of proinfl ammatory cytokines and the neuropeptides endothelin-1 and neuropeptide Y (these in experimental animals) detected in scorpion envenoming may also potentiate myocardial dysfunction through their direct depressive effect on contractile cardiac function and by mediating coronary constriction, respectively (12) (13) . There is experimental evidence of a direct toxic effect of the venom on the inotropic properties of the heart, although this alone does not explain the reduced systolic performance (32) . The cardiac involvement observed manifests clinically mainly as a reversible acute left ventricle (LV) dysfunction of different degrees of severity, with altered global or regional mobility occurring soon after the sting, and possible progression to APE.…”

Section: Complications Of Scorpion Envenomingmentioning

confidence: 99%

Clinical update on scorpion envenoming

Cupo

2015

Rev. Soc. Bras. Med. Trop.

110

126

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Scorpion stings are currently the leading cause of venom-related injury to humans in Brazil and are a signifi cant public health problem globally. Only scorpions of the Tityus genus are of medical importance in Brazil, and Tityus serrulatus is responsible for the most serious envenomations and deaths. The toxic effects of scorpion envenomation are due to a massive release of sympathetic and parasympathetic neurotransmitters; the severity is related to cardiac and hemodynamic changes, with cardiogenic shock and pulmonary edema contributing to the main causes of death. The pathophysiology of cardiac involvement has been discussed for decades and has been attributed to adrenergic discharge and a possible toxic effect of venom on the myocardium, while acute pulmonary edema may have a cardiogenic and/or non-cardiogenic origin. Currently, the clinical data point to catecholamine excess as the cause for reversible scorpion cardiomyopathy. These data include electrocardiographic changes, profi ling of cardiac enzymes and troponin I, echocardiographic data with global or regional left ventricle dysfunction, and myocardial perfusion alterations compatible with spasm in the coronary microcirculation. Furthermore, recent data on cardiac magnetic resonance imaging fi ndings, which are similar to those observed for stress-induced cardiomyopathy, have also been linked to catecholamine excess. The effi ciency of antivenom serum treatment is controversial in the literature. Our experience in Brazil is that the management of patients with systemic manifestations of scorpion stings is based on three approaches, all of which are extremely important. These include symptomatic treatment, antivenom serum, and cardiorespiratory support.

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“…Sympathetic nervous system activation 9,10 and direct effects of the venom on the myocardium [11][12] are thought to be responsible for myocardial damage and systolic dysfunction. Histopathological findings in fatal human scorpion envenomation have shown unequivocal evidence of coagulative myocytolysis 5,7,13 .…”

Section: Introductionmentioning

confidence: 99%

Terapia de resgate com amiodarona em crianças com grave disfunção ventricular esquerda causada por veneno de escorpião

Santiago¹,

Dávila²,

Dávila³

et al. 2010

Arq. Bras. Cardiol.

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Evidence for a direct action of Tityus serrulatus scorpion venom on the cardiac muscle

Cited by 76 publications

References 30 publications

Cardiopulmonary complications induced by Iranian Mesobuthus eupeus scorpion venom in anesthetized rabbits

Cardiopulmonary complications induced by Iranian Mesobuthus eupeus scorpion venom in anesthetized rabbits

Clinical update on scorpion envenoming

Terapia de resgate com amiodarona em crianças com grave disfunção ventricular esquerda causada por veneno de escorpião

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