Interleukin-1 receptor-induced PGE2 production controls acetylcholine-mediated cardiac dysfunction and mortality during scorpion envenomation.
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ABSTRACT:
SUBMITTER: Reis MB
PROVIDER: S-EPMC7595177 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Interleukin-1 receptor-induced PGE<sub>2</sub> production controls acetylcholine-mediated cardiac dysfunction and mortality during scorpion envenomation.
Reis Mouzarllem B MB Rodrigues Fernanda L FL Lautherbach Natalia N Kanashiro Alexandre A Sorgi Carlos A CA Meirelles Alyne F G AFG Silva Carlos A A CAA Zoccal Karina F KF Souza Camila O S COS Ramos Simone G SG Matsuno Alessandra K AK Rocha Lenaldo B LB Salgado Helio C HC Navegantes Luiz C C LCC Kettelhut Ísis C ÍC Cupo Palmira P Gardinassi Luiz G LG Faccioli Lúcia H LH
Nature communications 20201028 1
Scorpion envenomation is a leading cause of morbidity and mortality among accidents caused by venomous animals. Major clinical manifestations that precede death after scorpion envenomation include heart failure and pulmonary edema. Here, we demonstrate that cardiac dysfunction and fatal outcomes caused by lethal scorpion envenomation in mice are mediated by a neuro-immune interaction linking IL-1 receptor signaling, prostaglandin E<sub>2,</sub> and acetylcholine release. IL-1R deficiency, the tr ...[more]
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Project description:BackgroundScorpion envenomation is associated with several complications. One of the most serious complications is the cardiac involvement in the form of myocarditis that remains the main reason for mortalities associated with scorpion envenomation. The present review aims to elucidate clinical and paraclinical findings associated with scorpion-related myocarditis, and to explore different management strategies and subsequent outcomes.MethodsWe searched PubMed, Web of Science, Scopus, and Google Scholar for articles related to keywords of myocarditis associated with scorpion envenomation up to May 1, 2022. Each article was carefully reviewed by two independent researchers. In case of disagreement for inclusion, we sought a third researcher opinion.ResultsA total of 703 cases from 30 case reports and 34 case series were included in our review. Myocarditis associated with scorpion envenomation was usually reported in children presenting with cardiopulmonary symptoms including pulmonary edema (60.7%) and shock or hypotension (45.8%). The most common ECG findings are sinus tachycardia (82%) followed by ST-T changes (64.6%). The management typically included inotropes (especially dobutamine), prazosin, diuretics, nitroglycerine and digoxin, when indicated. Mechanical ventilation was required in 36.7% of the patients. Mortality in confirmed scorpion-related myocarditis cases is estimated at 7.3%. Almost all survived cases showed rapid recovery and improvement in the left ventricular function.ConclusionEven though myocarditis associated with scorpion envenomation is rare, it remains a serious and in some of cases a fatal consequence of scorpion sting. In case of relative presentations, particularly in envenomed children, diagnosis of myocarditis should be considered. Early screening using serial cardiac markers and echocardiography can guide the treatment. Prompt treatment that focuses on cardiogenic shock and pulmonary edema usually results in a favorable outcome.
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Project description:IntroductionArizona has the highest incidence of scorpion envenomation reported to US poison control centers (PCCs). Most cases reported are from a residence, but specific details are limited.MethodsSpecialists at Arizona's two PCCs prospectively completed the Factors of Envenomation in Arizona Residences Survey (FEARS) for residential scorpion exposures reported during 4-week periods in the summer and winter. Based on these results, a second questionnaire, FEARS-2, targeting indoor residential exposures was then administered.ResultsAmong 382 FEARS responses, no significant differences were found between summer and winter exposures, except for rainfall in the previous 24 hours. Scorpions had previously been seen in 81.8% of exposures, and 29.4% reported a previous envenomation at the residence. Most exposures occurred indoors (86.5%) and in a bedroom (42.5%), where the scorpion was in the bed in 54.7% of cases. Among all stings in a bed, 72.7% occurred while sleeping. Children were stung more often in a family room (38.6% vs. 14.5%; p < .00001) and by a scorpion on the floor (53.5% vs. 35.0%; p = .0014). Distal extremities were stung most often, particularly the foot (34.5%), with most being while barefoot (81.9%).ConclusionA variety of characteristics and associations involving residential scorpion envenomations were identified. These details can be used to guide public education and primary prevention efforts to help decrease residential scorpion exposures.
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Project description:ObjectivesThis study was conducted to provide better insights into the demographic and epidemiological characteristics of scorpion envenomation in an endemic area in Algeria and to identify the model that best predicted daily scorpion sting counts.MethodsDaily sting data from January 1, 2013 to August 31, 2016 were extracted from questionnaires designed to elicit information on scorpion stings from the two emergency medical service providers in Touggourt, Algeria. Count regression models were applied to the daily sting data.ResultsA total of 4,712 scorpion sting cases were documented, of which 70% occurred in people aged between 10 years and 49 years. The male-to-female ratio was 1.3. The upper and lower limbs were the most common locations of scorpion stings (90.4% of cases). Most stings (92.8%) were mild. The percent of people stung inside dwellings was 68.8%. The hourly distribution of stings showed a peak between 10:00 a.m. and 11:00 a.m. The daily number of stings ranged from 0 to 24. The occurrence of stings was highest on Sundays. The incidence of scorpion stings increased sharply in the summer. The mean annual incidence rate was 542 cases per 100,000 inhabitants. The fitted count regression models showed that a negative binomial hurdle model was appropriate for forecasting daily stings in terms of temperature and relative humidity, and the fitted data agreed considerably with the actual data.ConclusionsThis study showed that daily scorpion sting data provided meaningful insights; and the negative binomial Hurdle model was preferable for predicting daily scorpion sting counts.
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Project description:BackgroundScorpion venom induces systemic inflammation characterized by an increase in cytokine release and chemokine production. There have been few experimental studies assessing the effects of scorpion venom on adipose tissue function in vivo.Methodology/principal findingsTo study the adipose tissue inflammation (ATI) induced by Androctonus australis hector (Aah) venom and to assess possible mechanisms of ATI, mice (n = 6, aged 1 month) were injected with Aah (0.45 mg/kg), toxic fraction of Aah (FTox-G50; 0.2 mg/kg) or saline solution (control). Inflammatory responses were evaluated by ELISA and cell sorting analyses in adipose tissue 45 minutes and 24 hours after injection. Quantitative real-time PCR was used to assess the regulation of genes implicated in glucose uptake. The titers of selected inflammatory cytokines (IL-1β, IL-6 and TNF-α) were also determined in sera and in insulin target tissues. The serum concentration of IL-1β rose 45 minutes after envenomation and returned to basal level after 24 hours. The pathophysiological effects of the venom after 24 hours mainly involved M1-proinflammatory macrophage infiltration in adipose tissue combined with high titers of IL-1β, IL-6 and TNF-α. Indeed, TNF-α was strongly induced in both adipose tissue and skeletal muscle. We studied the effects of Aah venom on genes implicated in insulin-stimulated glucose uptake. Insulin induced a significant increase in the expression of the mRNAs for hexokinase 2 and phosphatidylinositol 3-kinase in both skeletal muscle and adipose tissue in control mice; this upregulation was completely abolished after 24 hours in mice envenomed with Aah or FTox-G50.Conclusions/significanceOur findings suggest that Aah venom induces insulin resistance by mechanisms involving TNF-α-dependent Map4k4 kinase activation in the adipose tissue.
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