Medicinal plants from Mexico used in the treatment of scorpion sting.

Scorpion sting envenomation is a major public health in Mexico. Rural communities rarely have antivenoms in the health centers, therefore, the people commonly resort to using medicinal plants to treat the symptoms of envenoming caused by scorpion venom, but this knowledge has not yet been reported in detail. In this review, we carry out a review of the medicinal plants used in Mexico against scorpion stings. PubMed, Google, Science Direct, and the Digital Library of Mexican Traditional Medicine (DLMTM) were used to collect data. The results showed the use of at least 48 medicinal plants distributed in 26 families, where Fabaceae (14.6%), Lamiaceae (10.4%), and Asteraceae (10.4%) have the maximum representation. The application of leaves (32%) was preferred followed by roots (20%), stem (17.3%), flowers (16%), and bark (8%). In addition, the most common method of use to treat scorpion stings is decoction (32.5%). The oral and topical routes of administration have similar percentages of use. In vitro and in vivo studies of Aristolochia elegans, Bouvardia ternifolia, and Mimosa tenuiflora were found, which showed an antagonistic effect on the contraction of the ileum caused by the venom of C. limpidus, likewise, they increased the LD50 of said venom and even B. ternofila showed reduced albumin extravasation. The results of these studies demonstrate the promising use of medicinal plants for future pharmacological applications; nevertheless, validation, bioactive compound isolation and toxicity studies are necessary to support and improve therapeutics.

Ethnomedicines for the treatment of scorpion stings: A perspective study.

ETHNOPHARMACOLOGICAL RELEVANCE: Scorpion sting is a public health concern with limited clinical symptomatic treatment. The clinical treatment uses anti-scorpion antivenom and prazosin (α-adrenergic inhibitor), often in combination with insulin, to reduce scorpion venom-induced hyperglycemia and other complications. However, these therapies also possess some limitations, necessitating urgent exploration of ethnomedicines, mainly traditional medicinal plants, to treat scorpion stings. Unfortunately, several conventional treatments are not scientifically validated, thus raising questions about their quality and utility. Therefore, pharmacological re-assessment of such medicinal plants to alleviate scorpion stings' complications is essential. AIM OF THE STUDY: The principal objectives of this study are to provide a brief overview of medically important scorpions of the world, outline the extant traditional practices, and comprehensively review plants used in conventional ethnic medicines to treat scorpion stings over time. Modern technological advances in identifying and characterizing plant bioactive molecules are also mentioned in this review. MATERIALS AND METHODS: The traditionally used medicinal plants against scorpion stings were reviewed from the available literature in the database. The Plant List (http://www.theplantlist.org/) was used to validate the scientific names of the plants mentioned in this study. The search targeted literature on conventional treatments and crude plant extracts or their bioactive components with proven neutralization capacity against scorpion stings. Search words used were 'scorpion sting,' 'treatment for a scorpion sting,' 'antivenom and scorpion sting,' 'traditional treatment for scorpion stings, and 'natural compounds against scorpion stings'. RESULTS: A list of more than 200 medicinal plants traditionally used in several countries for treating scorpion stings is presented in this review. Though some myth-based remedies are practiced to treat scorpion stings, no empirical evidence exists to validate this aspect of traditional knowledge. Only 38 traditional medicinal plant extracts have been tested under in-vivo and in-vitro conditions to determine their neutralization potency of scorpion envenomation. Although a few bioactive plant constituents showing scorpion venom neutralization potency have been characterized, they are not yet commercially available for clinical application. CONCLUSIONS: There is tremendous potential locked in medicinal plants' traditional knowledge for scorpion envenomation treatment. Translating this knowledge into the clinical application will require pharmacological reassessment, in tandem with isolation and characterization of active compounds to prove their prophylactic prowess. Almost equally important would be the formulation of stringent strategies to conserve such medicinal plants from overexploitation.

Mangaba (Hancornia speciosa Gomes) fruit juice decreases acute pulmonary edema induced by Tityus serrulatus venom: Potential application for auxiliary treatment of scorpion stings.

Scorpionism represents a serious public health problem due to its increasing incidence. In Brazil, Tityus serrulatus is a species of major medical importance, especially in children and the elderly, as envenomation may induce serious acute pulmonary edema. "Mangaba" (Hancornia speciosa Gomes) fruit juice is popularly used in the treatment of several inflammatory disorders. The objective of this study was to analyze the chemical composition of fruit juice of H. speciosa by HPLC-DAD-MS/MS, as well as to evaluate its anti-inflammatory potential and antioxidant activity, and analyze the biochemical and hematological parameters in acute pulmonary edema induced by T. serrulatus venom (TsV) in mice. Mice were challenged with TsV (30 µg/kg, subcutaneously) and were treated with dexamethasone (2 mg/kg, intraperitoneally) or fruit juice (pre- or post-treatment protocols, by intra-gastric route at 100 and 200 mg/kg), and 2 h later were anesthetized for blood, lung, and kidney collection, for several biochemical analyses. Results showed that the juice decreased edema, myeloperoxidase levels, vascular permeability, and production of cytokines (IL-1ß, IL-6, and TNF-α) in lung tissue. Also, the juice reduced the concentration of nitrite and malondialdehyde oxidative stress markers in renal tissue. Amylase, lactate dehydrogenase, aspartate aminotransferase, and creatine kinase seric levels were reduced when the animals were treated with the juice. HPLC-DAD-MS/MS analysis identified 13 phenolic derivatives. The results suggest that the juice was able to decrease the inflammatory effects induced by T. serrulatus, demonstrating that the use of juice can be relevant for the treatment of scorpion stings.

Ethnomedicinal uses of plants for the treatment of snake and scorpion bite in Northern Pakistan.

ETHNO-PHARMACOLOGICAL RELEVANCE: Medicinal plants represent one of the most accessible resources available for snake and scorpion bite among the rural communities of Northern Pakistan. This first ethno-botanical study aimed to document the indigenous knowledge and practices of using plants for snake and scorpion bite disorders in Northern Pakistan. METHODS: Ethno-medicinal data is documented from 187 informants using semi-structured interviews. The data is analyzed using quantitative ethno-botanical indices of frequency citation (FC) and relative Frequency of Citation (RFC). In addition to this, the ethno-medicinal findings of this survey were compared with 10 previous published studies in order to report novel uses of medicinal plants against snake and scorpion bite disorders. RESULTS: In total 62 medicinal plants belonging to 40 families are reported against snake and scorpion bite in this study. Our results showed that Asteraceae is the most used family (10 species), dominant life form is herb (48.38%), leaves were the most used plants part (18 Use-reports) and the paste is most used method of administration (22 reports). The range of RFC was 0.08-0.27 about the use of documented species. Compared to previous published studies, 33.87% similarity index while 66.12% novelty index is reported. About 40 plant species are first time reported with medicinal uses against snake and scorpion bite from Northern Pakistan. CONCLUSIONS: This study presents useful traditional knowledge of rural communities for the control of snake and scorpion bite using medicinal plants. The study mainly focused on ethno-medicinal documentation to preserve the valuable traditional knowledge that can be used in future phytochemical and pharmacological studies on medicinal plants of the area.

[Scorpion envenomation treated in the Infectious and Tropical Diseases at the Donka National Hospital, Guinea]. / Les envenimations scorpioniques traitées dans le service des maladies infectieuses et tropicales de l'hôpital national Donka, Guinée.

A retrospective descriptive study was conducted from 1(st) October 2010 to 30 November 2012 on the records of patients admitted for scorpion envenomation in the Department of Infectious and Tropical Diseases at the Donka National Hospital. The objective of this study is to describe the epidemiological profile and clinical characteristics of scorpion envenomation in Maritime Guinea, from scorpion stings recently covered in this service. We collected 75 cases of scorpion envenomation. The median age was 21.5 with interquartile 8 and 20 and sex ratio was 1.29. The upper limbs were involved in 55% of cases, followed by the lower limbs (35%), trunk (6%), head and neck (4%). We observed 63% of patients with local signs, 30% mild and general clinical signs of 7% severe systemic symptoms. All patients received an analgesic and a heterologous antitoxin, associated with an antibiotic (87% of patients), a corticosteroid (72%), diazepam (13%) and furosemide (34.6%). The incidence of scorpion envenomation is not negligible despite underreporting of cases, most often treated in traditional medicine.

[Use of medicinal plants against scorpionic and ophidian venoms]. / Utilisation des plantes médicinales contre l'envenimation scorpionique et ophidienne.

The scorpionic and ophidian envenomations are a serious public health problem in Tunisia especially in Southeastern regions. In these regions Artemisia campestris L is a plant well known which has a very important place in traditional medicine for its effectiveness against alleged venom of scorpions and snakes. In this work, we tested for the first time, the anti-venomous activity of Artemisia campestris L against the scorpion Androctonus australis garzonii and the viper Macrovipera lebetina venoms. Assays were conducted by fixing the dose of extract to3 mg/mouse while doses of venom are variable. The leaves of Artemisia campestris L were extracted by various organic solvents (Ether of oil, ethyl acetate, methanol and ethanol) and each extract was tested for its venom neutralizing capacity. For the ethanolic extract, a significant activity with respect to the venoms of scorpion Androctonus australis garzonii (Aag), was detected. Similarly, a significant neutralizing activity against the venom of a viper Macrovipera lebetina (Ml), was obtained with the dichloromethane extract. These results suggest the presence of two different type of chemical components in this plant: those neutralizing the venom of scorpion are soluble in ethanol whereas those neutralizing the venom of viper are soluble in dichloromethane.

The secretagogue effect of the poison from Centruroides limpidus limpidus on the pancreas of mice and the antagonistic action of the Bouvardia ternifolia extract.

In Mexican traditional medicine the plant species Bouvardia ternifolia is used as remedy to treat patients who have been stung by scorpions. In the preceding study, the methanol extract from the roots of this plant was capable of reducing the poisonous effect of Centruroides limpidus limpidus on mice. The poisoning from scorpion C. limpidus limpidus includes manifestations associated with the pancreatitis. This study evaluated the effect produced by the hexane and methanol extract from the root of B. ternifolia upon the acutely inflamed pancreas induced by the venom of C. limpidus limpidus on rats, and the release of amylase in the isolated pancreas of mice. The intravenous administration of venom induced the extravasation of labelled albumin, in a dose dependant manner. The pre-administration of both extracts of Bouvardia ternifolia reduced significantly (p < 0.05) the extravasation by 60%. Upon measuring the secretagogue effect of the venom in the isolated pancreas of mice, the EC50 of the venom was 3.76 x 10(-3) mg ml(-1), whilst in the presence of the methanol and hexane extracts, this EC50 was 9.13 x 10(-3) mg ml(-1) and 0.01629 mg ml(-1). In conclusion, the C. limpidus limpidus venom possesses a secretagogue effect of amylase on the pancreas of mice and produces an inflamed pancreas which is effectively antagonised by the hexane and methanol extracts from the roots of B. ternifolia.

Antitoxin activity of plants used in Mexican traditional medicine against scorpion poisoning.

Scorpions, especially in urban areas of tropical and subtropical regions, present a common risk of poisoning. In Mexico, scorpion envenomation is considered a public health problem. Despite the frequency of scorpion sting cases, there are to date no uniform criteria for their treatment. In Mexican traditional medicine, different plant species have been widely used as a remedy for treating scorpion poisoning. The aim of this work was to evaluate the effect of Bouvardia ternifolia, Aristolochia elegans and Vitex mollis extracts on Centruroides limpidus limpidus venom lethality in mice, and to determine their antagonist activity on guinea pig ileum. The hexane and methanol extract from B. ternifolia modified the LD50 of C. limpidus limpidus venom from 0.750 +/- 0.08 to 1.64 +/- 0.19 and 1.16 +/- 0.14 mg/kg, respectively. The extracts of A. elegans produced lower antitoxic activity, while extracts of V. mollis did not show any protection. On in vitro test, addition of B. ternifolia and A. elegans extracts strongly inhibited, in a concentration-dependent manner, the ileum contractions induced by venom. In general, the results demonstrated the effectiveness of these two plant species in modifying the lethality of C. limpidus limpidus venom in mice.

Medicinal and ethnoveterinary remedies of hunters in Trinidad.

BACKGROUND: Ethnomedicines are used by hunters for themselves and their hunting dogs in Trinidad. Plants are used for snakebites, scorpion stings, for injuries and mange of dogs and to facilitate hunting success. RESULTS: Plants used include Piper hispidum, Pithecelobium unguis-cati, Bauhinia excisa, Bauhinia cumanensis, Cecropia peltata, Aframomum melegueta, Aristolochia rugosa, Aristolochia trilobata, Jatropha curcas, Jatropha gossypifolia, Nicotiana tabacum, Vernonia scorpioides, Petiveria alliacea, Renealmia alpinia, Justicia secunda, Phyllanthus urinaria,Phyllanthus niruri,Momordica charantia, Xiphidium caeruleum, Ottonia ovata, Lepianthes peltata, Capsicum frutescens, Costus scaber, Dendropanax arboreus, Siparuma guianensis, Syngonium podophyllum, Monstera dubia, Solanum species, Eclipta prostrata, Spiranthes acaulis, Croton gossypifolius, Barleria lupulina, Cola nitida, Acrocomia ierensis (tentative ID). CONCLUSION: Plant use is based on odour, and plant morphological characteristics and is embedded in a complex cultural context based on indigenous Amerindian beliefs. It is suggested that the medicinal plants exerted a physiological action on the hunter or his dog. Some of the plants mentioned contain chemicals that may explain the ethnomedicinal and ethnoveterinary use. For instance some of the plants influence the immune system or are effective against internal and external parasites. Plant baths may contribute to the health and well being of the hunting dogs.

Severe envenoming by the Indian red scorpion Mesobuthus tamulus: the use of prazosin therapy.

We describe the clinical course and outcome in 46 victims of severe scorpion envenoming treated with prazosin (P), and compare them with earlier patients treated with conventional therapy (C) (n = 45) and nifepidine (N) (n = 28). The incidence of complicating left ventricular failure was 29% for C, 35% for N and 6.5% for P; that of acute pulmonary oedema was 46% for C, 14% for N and zero for P; mortality was 25% for C, 3.5% for N and zero for P. Although this is a historical study, prazosin appears to significantly reduce morbidity and shorten recovery time. Experience in other countries suggests that antivenom is helpful in controlling many of these problems, but in rural India serotherapy remains largely unavailable, and prazosin is a mainstay of treatment.

Vasodilators: scorpion envenoming and the heart (an Indian experience).

Our aim was to assess clinically whether there was any benefit in adding a single dose of sublingual nifedipine (a slow calcium channel blocker) to prazosin in the management of the cardiovascular manifestations of envenoming by the Indian red scorpion (Mesobuthus tamulus). A total of 163 patients stung by this species was admitted to hospital at Mahad between January 1991 and October 1993. Cardiovascular abnormalities were hypertension (59), of whom 42 had bradycardia and 17 had tachycardia; pulmonary oedema (14), of whom eight had hypertension and six hypotension; supraventricular tachycardia (eight), of whom three had hypotension and one died. Of the remaining patients, 78 demonstrated severe excruciating local pain at the site of sting but had no systemic involvement. Nineteen patients with hypertension and tachycardia were given a single dose of sublingual nifedipine plus prazosin on admission, then prazosin alone repeated 6 hourly. Five patients with massive life-threatening pulmonary oedema recovered after being given intravenous sodium nitroprusside. Prazosin alone helped to alleviate cardiovascular manifestations in the remaining 52 victims. One patient was admitted in a deep coma, 12 hr after the sting, and died. Eight victims whose blood pressure had been controlled in hospital by nifedipine plus prazosin developed acute pulmonary oedema necessitating additional doses of prazosin for recovery. Fifty-two victims treated with prazosin alone did not develop pulmonary oedema and the drug appeared to hasten the recovery. In the presence of high blood pressure, tachycardia, a murmur and impending myocardial failure, nifedipine appeared to contribute to cardiopulmonary instability and to augment myocardial oxygen consumption. In this situation calcium channel blockers should probably be avoided.

Scorpion envenoming and the role of insulin.

Scorpion envenoming results in a severe autonomic storm with a massive release of catecholamines, increased angiotensin II and inhibition of insulin secretion. These hormonal alterations could be responsible for the pathogenesis of a variety of clinical manifestations. Under these conditions, scorpion envenoming essentially results in a syndrome of fuel-energy deficits and an inability to utilize the existing metabolic substrates by vital organs causing multi-organ system failure and death. Based on our animal experiments in which insulin administration reversed the metabolic and ECG changes induced by scorpion envenoming and treating the poisonous scorpion sting victims with insulin, we consider that insulin has a primary metabolic role in preventing and reversing the cardiovascular, haemodynamic, and neurological manifestations and pulmonary oedema induced by scorpion envenoming. The use of continuous infusion of regular crystalline insulin at the rate of 0.3 U/g glucose and glucose at the rate of 0.1 g/kg/hr, with supplementation of potassium as needed and maintenance of fluid electrolytes and acid-based balance, has become a routine protocol in our setting for treating the victims of scorpion envenoming.

Treatment of cardiovascular manifestations of human scorpion envenoming: is serotherapy essential?

Death due to sting by the red scorpion is not uncommon in parts of India. Extensive clinical study has shown that fatality is due to cardiovascular involvement as a result of autonomic storm. Prazosin and nifedipine helped to counter the physiological actions of scorpion venom on the sympathetic nervous system. Scorpion antivenom remains unobtainable for human scorpionism in India.