IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-10-03 DOI: 10.1016/j.toxicon.2024.108117

Jing Zhang , Zhen Peng , Dong Cheng , Wenhuan Yao , Hui Li , Qi Zhang , Ruisen Guo , Kunyan Li , Longrui Zou , Jia-Sheng Wang , Qiang Jia , Tianliang Zhang , Jun Zhou

Aflatoxin B₁ (AFB₁) can induce serious liver toxicity in human. While completely avoiding AFB₁ exposure is difficult, dietary intake of natural products may be leveraged to mitigate its adverse health effects. The roots of Lepidium meyenii (Maca) is rich in beneficial polysaccharides. Here we first evaluated dietary safety of MPs and then investigated MPs mitigating effects on the liver toxicity of AFB₁. A 28-day sub-acute administration of Maca polysaccharides (MPs) demonstrated to be safe in mice at dose 0.2–1.2 g/kg.bw/day that significantly elevated mice stamina. Also, no toxicity was observed in human PC12 cells treated with MPs 25–100 μg/mL which successfully alleviated cobalt-caused cell apoptosis by ∼20%. In terms of anti-AFB₁ hepatoxicity function, MPs 0.4–1.6 g/kg.bw/day significantly alleviated liver tissue damage, lipid accumulation, ROS damage, NF-κB p65, secretion of cytokines such as IL-6 and TNF-α in AFB₁-treated mice. Flow cytometry found that MPs treatment recovered the elevation of F4/80 in the primary macrophages of AFB₁-treated mice. At molecular level, MPs treatment activated liver NRF-2/GPX/SOD anti-oxidant system. In human macrophage model, MPs restored the inflammatory AhR/STAT3 pathway and mRNA expressions of Tnf-a, Inos, Arg-1 disrupted by AFB₁. Our findings not only add to the current understanding on the toxicity mechanism of AFB₁, but also provide references to the development of dietary intervention strategy using MPs.

黄曲霉毒素 B1（AFB1）可导致人体肝脏严重中毒。虽然很难完全避免接触黄曲霉毒素 B1，但可以通过从膳食中摄取天然产品来减轻其对健康的不利影响。玛咖（Lepidium meyenii）的根部含有丰富的有益多糖。在这里，我们首先评估了MPs的膳食安全性，然后研究了MPs对AFB1肝脏毒性的缓解作用。对小鼠进行为期 28 天的亚急性给药，结果表明，剂量为 0.2∼1.2 克/千克体重/天的玛咖多糖对小鼠是安全的，能显著提高小鼠的耐力。此外，用 25 ∼ 100 μg/mL 的 MPs 处理人 PC12 细胞也未观察到毒性，成功地缓解了钴引起的细胞凋亡 ∼ 20%。在抗 AFB1 肝毒性功能方面，0.4∼1.6 克/千克体重/天的 MPs 能显著减轻 AFB1 处理小鼠的肝组织损伤、脂质积累、ROS 损伤、NF-κB p65、细胞因子如 IL-6 和 TNF-α 的分泌。流式细胞术发现，MPs 处理可恢复 AFB1 处理小鼠初级巨噬细胞中 F4/80 的升高。在分子水平上，MPs 处理可激活肝脏 NRF-2/GPX/SOD 抗氧化系统。在人巨噬细胞模型中，MPs 恢复了被 AFB1 破坏的 AhR/STAT3 通路和 Tnf-a、Inos、Arg-1 的 mRNA 表达。我们的研究结果不仅加深了人们对 AFB1 毒性机理的认识，还为利用 MPs 制定膳食干预策略提供了参考。

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引用次数: 0

Aflatoxin B1 downregulates ARID3 genes to overcome senescence for inducing hepatocellular carcinoma 黄曲霉毒素 B1 下调 ARID3 基因，克服衰老诱发肝细胞癌。

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-10-02 DOI: 10.1016/j.toxicon.2024.108114

Dilkash Ara, Srinivas Dheeravath, Sathish Kumar Mungamuri

Aflatoxins are major food contaminants, which cause hepatotoxicity, eventually leading to Hepatocellular carcinoma. Activated AFB1 forms adducts with DNA, which in turn activates checkpoint control. We show that AFB1 activates PI3K-Akt signaling, which is critical for cell survival. Simultaneous activation of both DNA checkpoint and proliferative signaling leads to Oncogene-Induced Senescence, a major tumorigenesis barrier. AFB1 downregulates ARID3A and ARID3B proteins to overcome this senescence program to induce hepatic tumors.

黄曲霉毒素是一种主要的食品污染物，可引起肝中毒，最终导致肝细胞癌。活化的 AFB1 与 DNA 形成加合物，进而激活检查点控制。我们的研究表明，AFB1 可激活 PI3K-Akt 信号传导，这对细胞存活至关重要。DNA 检查点和增殖信号的同时激活会导致癌基因诱导衰老，这是肿瘤发生的一个主要障碍。AFB1 可下调 ARID3A 和 ARID3B 蛋白，从而克服这种衰老程序，诱发肝肿瘤。

引用次数: 0

Study on Translational toxicology of Senna obtusifolia aqueous extract 番泻叶水提取物的转化毒理学研究

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-30 DOI: 10.1016/j.toxicon.2024.108113

Xin Guo , Liping Gong , Chong Guo , Taotao Cai , Nana Huang , Xianhui Shen , Lisong Sheng , Rongrong Li , Yanqing Wang , Xinmei Zhao , Wenhe Guo , Rong Sun

In recent years, the clinical adverse drug reactions (ADR) reports of Senna obtusifolia have been constantly emerging, especially hepatotoxicity. However, it is unclear whether the liver is the only or main toxic target organ. In this study, we conducted a repeated administration experiment with the Senna obtusifolia Aqueous Extract (SE) and PCA analysis was used to determine the primary toxic target organs. The results revealed that the liver was the main toxic target organ and we also verifid the hepatotoxicity in vitro. The mechanism of hepatotoxicity was predicted by network toxicology technology, which was verified by ELISA, qPCR, western blotting and other methods.The results showed that SE could increase the serum levels of TNF-α, IL-6, IL-1β, the mRNA expression levels of ACT1, TRAF6, NF-κB P65 and the protein expression levels of TRAF6, NF-κB P65, P-P65 in rat livers and HepG2 cells, which indicated that SE induced hepatotoxicity might be related to inflammatory response.

近年来，番泻叶的临床药物不良反应（ADR）报告不断涌现，尤其是肝毒性。然而，肝脏是否是唯一或主要的毒性靶器官尚不清楚。在本研究中，我们对番泻叶水提取物（SE）进行了重复给药实验，并使用 PCA 分析来确定主要毒性靶器官。结果显示，肝脏是主要的毒性靶器官，我们还在体外验证了肝毒性。利用网络毒理学技术预测了肝毒性的机制，并通过 ELISA、qPCR、Western 印迹等方法进行了验证。结果表明，SE能提高大鼠肝脏和HepG2细胞中血清TNF-α、IL-6、IL-1β的水平，ACT1、TRAF6、NF-κB P65的mRNA表达水平，以及TRAF6、NF-κB P65、P-P65的蛋白表达水平，这表明SE诱导的肝毒性可能与炎症反应有关。

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引用次数: 0

Predicting the drivers of Bothrops snakebite incidence across Brazil: A Spatial Analysis 预测巴西全国两栖动物蛇咬伤发病率的驱动因素：空间分析

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-28 DOI: 10.1016/j.toxicon.2024.108107

Franciely Fernanda Barbosa da Silva , Thais de Andrade Moura , Tuany Siqueira-Silva , José María Gutiérrez , Pablo Ariel Martinez

Snakebite envenoming poses a significant public health challenge on a global basis, affecting millions of people annually and leading to complications that may result in fatalities. Brazil stands as one of the countries most impacted by snakebite envenoming, with snakes of the Bothrops genus being responsible for most bites. The current study aimed to identify the determinants of Bothrops snakebite incidence across different regions of Brazil. An ecological study was conducted using municipality-aggregated data, with snakebite incidence as the dependent variable. The study period comprised the years 2015–2021. We constructed Species Distribution Models (SDMs) for Bothrops species, and information was collected on precipitation, runoff, maximum and minimum temperatures, native forest, historical forest loss, agriculture, and pasture in each Brazilian municipality. These data were employed to assess the association between snakebite incidence and biotic, climatic, and landscape factors. The data were analyzed using Generalized Least Squares (GLS) regression. The SDMs demonstrated good performance. The average annual snakebite incidence during the study period ranged from zero to 428.89 per 100,000 inhabitants, depending on the municipality. Higher incidence rates were concentrated primarily in municipalities in the northern region of the country. In this study, we found that nationwide, areas with extensive native forests and those that have historically experienced significant loss of forest cover exhibited higher snakebite incidence rates. Additionally, areas with higher temperatures and precipitation levels, as well as greater climatic suitability for the species B. jararaca, showed significantly higher snakebite incidence rates in the South and Southeast of Brazil, respectively. These associations may be linked to increased snake abundance and active behavior, as well as to engagement in activities favoring human-snake contact in these areas. The findings of this study can contribute to the improvement of prevention and control strategies for this public health issue in Brazil.

被蛇咬伤对全球公共卫生构成重大挑战，每年有数百万人受到影响，并可能导致并发症，造成死亡。巴西是受蛇咬伤影响最严重的国家之一，其中大部分咬伤都是由两栖类蛇造成的。本研究旨在确定巴西不同地区蛇咬伤发生率的决定因素。研究采用了城市分类数据，以蛇咬伤发生率为因变量，开展了一项生态学研究。研究期间为 2015 年至 2021 年。我们为两栖类物种构建了物种分布模型（SDM），并收集了巴西各市的降水、径流、最高和最低气温、原始森林、历史森林损失、农业和牧场等信息。利用这些数据来评估蛇咬伤发生率与生物、气候和景观因素之间的关联。数据采用广义最小二乘法（GLS）回归进行分析。SDM表现出良好的性能。在研究期间，平均每年每 10 万居民中的蛇咬伤发生率从零到 428.89 不等，具体取决于各个城市。较高的发病率主要集中在该国北部地区的城市。在这项研究中，我们发现在全国范围内，原生森林广布的地区和森林覆盖率曾大幅下降的地区蛇咬伤发病率较高。此外，在巴西南部和东南部，气温和降水量较高的地区，以及气候更适合B. jararaca物种的地区，蛇咬伤发病率也分别显著较高。这些关联可能与蛇的数量增加、行为活跃以及在这些地区从事有利于人蛇接触的活动有关。这项研究的结果有助于改善巴西针对这一公共卫生问题的预防和控制策略。

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引用次数: 0

Machine-learning based prediction model for acute kidney injury induced by multiple wasp stings 基于机器学习的多黄蜂蜇伤急性肾损伤预测模型

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-28 DOI: 10.1016/j.toxicon.2024.108112

Wen Wu , Yupei Zhang , Yilan Zhang , Xingguang Qu , Zhaohui Zhang , Rong Zhang

Acute kidney injury (AKI) following multiple wasp stings is a severe complication with potentially poor outcomes. Despite extensive research on AKI's risk factors, predictive models for wasp sting-related AKI are limited. This study aims to develop and validate a machine learning-based clinical prediction model for AKI in individuals with wasp stings. In this retrospective cohort study, conducted at a tertiary teaching hospital in Yichang, China, from July 2013 to April 2023, 214 patients with wasp sting injuries were analyzed. Using least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression, prognostic variables for AKI were identified. A nomogram incorporating these four variables was constructed. The model's performance was assessed through internal validation, leave-one-out cross-validation, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). Among 214 patients affected by wasp stings, 34.6% (74/214) developed AKI. Following LASSO regression and multivariate logistic regression, the number of stings, presence of gross hematuria, systemic inflammatory response index (SIRI), and platelet count were identified as prognostic factors. A nomogram was constructed and evaluated for its predictive accuracy, showing an area under the curve (AUC) of 0.757 (95% CI 0.711 to 0.804) and a concordance index (C-index) of 0.75. Validation confirmed the model's reliability and superior discrimination ability over existing models, as demonstrated by NRI, IDI, and DCA. The developed nomogram effectively predicts AKI risk in wasp sting patients, facilitating early identification and management of those at risk.

多次被黄蜂蜇伤后出现急性肾损伤（AKI）是一种严重的并发症，可能会导致不良后果。尽管对 AKI 的风险因素进行了广泛研究，但针对黄蜂蜇伤相关 AKI 的预测模型却很有限。本研究旨在开发并验证一种基于机器学习的临床预测模型，用于预测马蜂蜇伤患者的 AKI。这项回顾性队列研究于 2013 年 7 月至 2023 年 4 月在中国宜昌的一家三级教学医院进行，共分析了 214 名被马蜂蜇伤的患者。通过最小绝对收缩和选择算子（LASSO）回归和多变量逻辑回归，确定了AKI的预后变量。结合这四个变量构建了一个提名图。该模型的性能通过内部验证、留空交叉验证、净再分类改进（NRI）、综合判别改进（IDI）和决策曲线分析（DCA）进行了评估。在 214 名受黄蜂蜇伤的患者中，34.6%（74/214）发生了 AKI。经过 LASSO 回归和多变量逻辑回归，蜇伤次数、有无毛细血尿、全身炎症反应指数 (SIRI) 和血小板计数被确定为预后因素。该模型的曲线下面积 (AUC) 为 0.757（95% CI 0.711 至 0.804），一致性指数 (C-index) 为 0.75。NRI、IDI 和 DCA 的验证证实了该模型的可靠性和优于现有模型的辨别能力。所开发的提名图能有效预测马蜂蜇伤患者的 AKI 风险，有助于早期识别和管理高危人群。

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引用次数: 0

A case of Western Gaboon viper (Bitis rhinoceros) envenomation: Successful treatment with South African Institute for Medical Research (SAIMR) antivenom after North American crotalid antivenom failure 一例西部加蓬蝰蛇（Bitis rhinoceros）中毒病例：在北美蛇毒抗蛇毒血清失效后，南非医学研究所（SAIMR）抗蛇毒血清成功治疗了该病。

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-27 DOI: 10.1016/j.toxicon.2024.108108

Hannah St. Francis , Raizada A. Vaid , Roger Rothenberg , Robert S. Hoffman , Sarah G. Mahonski , Vincent J. Calleo , Rana Biary , Capwell E. Taylor , Joshua Z. Silverberg

We report a case of Western Gaboon viper (Bitis rhinoceros) envenomation in which the patient's symptoms progressed despite treatment with North American crotalid antivenom but improved after receiving South African Institute for Medical Research (SAIMR) polyvalent antivenom.

A 59-year-old man was hospitalized after reportedly being bitten by a Gaboon viper (Bitis gabonica). On arrival, he had normal vital signs, two puncture wounds on his left hand, and edema distal to the wrist. The hospital contacted the local poison center who conveyed that crotalid antivenom would be ineffective and recommended transfer to a snakebite center for species-appropriate antivenom. However, this recommendation was disregarded. Initial laboratory tests 2 hours after envenomation revealed a platelet count of 77 x 10⁹/L; other parameters were normal. He received six vials of crotalid antivenom (CroFab®) followed by three maintenance doses (total 12 vials). The next morning, swelling had progressed proximal to the elbow and platelets decreased to 37 x 10⁹/L. He was subsequently transferred and received SAIMR polyvalent antivenom. Six hours later, his platelets were 130 x 10⁹/L. The next morning, his swelling had significantly improved. He was discharged the following day. After discharge, it was discovered that the snake was a Bitis rhinoceros.

Bitis gabonica and Bitis rhinoceros are popular captive snakes in the United States. Bitis rhinoceros was formerly a sub-species of B. gabonica, and they are often referred to interchangeably. Their venoms cause tissue edema, coagulopathy, and in severe cases, hemorrhage, dysrhythmias, and death. Antivenom is not widely available in the United States often necessitating patient transfer or antivenom delivery. This case addresses the question of whether crotalid antivenom, which is ubiquitous in the United States, can treat B. gabonica and B. rhinoceros envenomations and highlights the need for consultation with a poison center to facilitate administration of species-appropriate antivenom.

我们报告了一例西部加蓬蝰蛇（Bitis rhinoceros）中毒病例，尽管患者接受了北美蛇毒抗蛇毒血清治疗，但症状仍在恶化，而在接受南非医学研究所（SAIMR）多价抗蛇毒血清治疗后，症状有所好转。据报道，一名 59 岁的男子被加蓬蝰蛇（Bitis gabonica）咬伤后被送往医院。到达医院时，他的生命体征正常，左手有两处刺伤，手腕远端水肿。医院联系了当地的毒物中心，毒物中心表示蝮蛇抗蛇毒血清无效，建议转到蛇咬伤中心注射适合该物种的抗蛇毒血清。但是，医院没有理会这一建议。被毒蛇咬伤两小时后，初步化验结果显示血小板计数为 77 x 109/L，其他指标正常。他接受了六瓶巴豆抗蛇毒血清（CroFab®），随后又接受了三次维持剂量（共 12 瓶）。第二天早上，肿胀向肘部近端发展，血小板降至 37 x 109/L。随后，他被转院并接受了 SAIMR 多价抗蛇毒血清治疗。六小时后，他的血小板为 130 x 109/L。第二天早上，他的肿胀明显好转。第二天他就出院了。出院后，人们发现这条蛇是一条犀牛蛇（Bitis rhinoceros）。Bitis gabonica 和 Bitis rhinoceros 是美国流行的人工饲养蛇类。Bitis rhinoceros 以前是 B. gabonica 的一个亚种，它们经常被互换使用。它们的毒液会导致组织水肿、凝血障碍，严重时还会导致出血、心律失常和死亡。抗蛇毒血清在美国并不普及，往往需要转送病人或提供抗蛇毒血清。本病例涉及的问题是，在美国随处可见的黄龙鱼抗蛇毒血清是否能够治疗加蓬犀牛和犀牛的蛇毒中毒，并强调了向毒物中心咨询的必要性，以方便使用适合物种的抗蛇毒血清。

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引用次数: 0

Comparative analysis of protein profiles in skin secretions of some Rana species: Preliminary insights into antimicrobial activity 一些蕉属物种皮肤分泌物中蛋白质谱的比较分析：对抗菌活性的初步认识

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-27 DOI: 10.1016/j.toxicon.2024.108110

Ebru Tanrıverdi O, Dinçer Ayaz, Yiğit Terzi

Protein profiles of skin secretions of Rana dalmatina (Agile Frog), Rana macrocnemis (Uludağ Frog), Rana tavasensis (Tavas Frog) and Rana holtzi (Taurus Frog) frog species belonging to the Rana genus distributed in the Anatolian region of Türkiye were determined for the first time using the Tricine-SDS-PAGE Electrophoresis method and Coomassie Brilliant Blue (CBB) staining. By the results, some peptides with mass ≤5 kDa were detected. Just one peptide with mass ≤5 kDa was found in the secretion of each R. dalmatina, R. macrocnemis, and R. tavasensis while there was two in R. holtzi secretion. The antibacterial activity of secretions was determined using plate well diffusion assay on E. coli, S. typhimurium, S. aureus, B. cereus and L. monocytogenes bacteria. R. dalmatina created the inhibition zone for S. typhimurium, S. aureus, B. cereus, and L. monocytogenes. The zones of inhibition by R. tavasensis and R. macrocnemis species secretions were observed on S. aureus, B. cereus, and L. monocytogenes. It was found that R. holtzi creates an inhibition zone only on B. cereus. The results showed that the secretion of none of the species doesn't have antibacterial activity on E. coli. The skin secretion of R. dalmatina showed the most activity against bacteria, while R. holtzi had the least.

采用 Tricine-SDS-PAGE 电泳法和 Coomassie Brilliant Blue (CBB) 染色法，首次测定了分布在土耳其安纳托利亚地区的蛙属物种 Rana dalmatina (Agile Frog)、Rana macrocnemis (Uludağ Frog)、Rana tavasensis (Tavas Frog) 和 Rana holtzi (Taurus Frog) 皮肤分泌物的蛋白质谱。结果发现了一些质量小于 5 kDa 的肽。dalmatina、R. macrocnemis和R. tavasensis的分泌物中都只有一个质量≤5 kDa的肽，而R. holtzi的分泌物中有两个。分泌物的抗菌活性是通过对大肠杆菌、鼠伤寒杆菌、金黄色葡萄球菌、蜡样芽孢杆菌和单核细胞增多性乳酸杆菌进行板孔扩散试验来确定的。R. dalmatina 对伤寒杆菌、金黄色葡萄球菌、蜡样芽孢杆菌和单核细胞增生性酵母菌产生了抑制区。R. tavasensis 和 R. macrocnemis 的分泌物对金黄色葡萄球菌、蜡样芽孢杆菌和单核细胞增生梭状芽孢杆菌均有抑制作用。结果发现，R. holtzi 只对蜡样芽孢杆菌产生抑制区。结果表明，没有一个物种的分泌物对大肠杆菌没有抗菌活性。R. dalmatina 的皮肤分泌物对细菌的活性最高，而 R. holtzi 的活性最低。

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引用次数: 0

An alternative method for comparing hemorrhagic activity of snake venoms following one of the 3R's principles 按照 3R 原则之一比较蛇毒出血活性的另一种方法

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-26 DOI: 10.1016/j.toxicon.2024.108111

Lídia Jorge Tasima , Victor Koiti Kavazoi , Eduardo Oliveira Venancio de Lima , Kathleen Fernandes Grego , Anita Mitico Tanaka-Azevedo

Venom-induced hemorrhage analysis usually is performed by Minimum Hemorrhagic Dose (MHD), however a similar method can be used to compare venoms with fewer laboratory animals. Our work compared the MHD of five different venoms, with the size of hemorrhagic spot, finding good correlations in the results. Considering the 3Rs principle, we propose the use of the hemorrhagic spot method to compare hemorrhagic activity of snake venoms, rather than using the MHD method, since the first one needs 5 times less animals than the other.

毒液引起的出血分析通常是通过最小出血剂量（MHD）来进行的，但类似的方法也可用于比较实验动物数量较少的毒液。我们的研究比较了五种不同毒液的最小出血剂量与出血点的大小，发现结果之间存在良好的相关性。考虑到 3Rs 原则，我们建议使用出血点法来比较蛇毒的出血活性，而不是使用 MHD 法，因为前者所需的动物比后者少 5 倍。

引用次数: 0

Distribution mapping of deadly scorpions in Iran 伊朗致命蝎子分布图。

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-25 DOI: 10.1016/j.toxicon.2024.108109

Masoumeh Bardaran , Sedigheh Mohajer , Seyed Mahdi Kazemi

Scorpion sting is a problem all over the world and becomes an acute problem when it is associated with death. Iran is known as a region with a large number of scorpions and, of course, with many cases of scorpion stings per year. So far, 11 scorpion species in Iran have been identified as dangerous, of which there are only three species for which deaths have been reported. Due to the importance of these three species, we prepared a distribution map of these three types of scorpions and discuss the implications of these findings in the larger context of dangerous scorpion stings in Iran.

蝎子蜇伤在全世界都是一个问题，当蝎子蜇伤与死亡联系在一起时，蝎子蜇伤就成了一个尖锐的问题。众所周知，伊朗是一个蝎子众多的地区，当然每年也有许多蝎子蜇伤的病例。迄今为止，伊朗有 11 种蝎子被确认为危险蝎子，其中只有三种蝎子有死亡报告。鉴于这三种蝎子的重要性，我们绘制了这三种蝎子的分布图，并讨论了这些发现对伊朗危险蝎子蜇伤事件的影响。

引用次数: 0

Myocardial infarction during treatment of Crotalinae envenomation: A case report 治疗克罗塔林藻中毒期间的心肌梗死：病例报告

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon

Pub Date : 2024-09-19 DOI: 10.1016/j.toxicon.2024.108105

Jacob Robishaw-Denton , Jennifer Ramirez , Alisia Bahadir , Geoffrey Smelski

While myocardial infarction is a rare, but known, potential side effect of snakebite envenomation, snake antivenom has thus far not been associated with any cardiovascular adverse events. We report the case of a 71-year-old man who developed an anterolateral MI during administration of Crotalidae immune F(ab')2 (equine) (ANAVIP), given as treatment for Crotalidae envenomation. The patient required cardiac catheterization with stenting of the left anterior descending artery and was discharged two days later on long-term clopidogrel and aspirin. Treatment of MI in the setting of envenomation should mirror typical management, with consideration of additional antivenom if the ischemia is determined to be venom-induced. Clinicians should have a high index of suspicion for patients with chest pain after snake envenomation or administration of antivenom.

虽然心肌梗塞是蛇咬伤毒液中毒的一种罕见但已知的潜在副作用，但蛇毒抗蛇毒血清迄今尚未与任何心血管不良事件相关联。我们报告了一例 71 岁的男性病例，他在服用蛇毒血清免疫 F(ab')2 （马）（ANAVIP）治疗蛇毒中毒期间发生了前外侧心肌梗死。患者需要接受心导管检查并植入左前降支动脉支架，服用氯吡格雷和阿司匹林两天后出院。在毒液中毒的情况下治疗心肌梗死应参照典型的治疗方法，如果确定缺血是由毒液引起的，则应考虑使用额外的抗蛇毒血清。临床医生应对毒蛇咬伤或注射抗蛇毒血清后出现胸痛的患者高度怀疑。

引用次数: 0

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