Identification of phytolaccosides in biological samples from pokeweed intoxication patients using liquid chromatography-tandem mass spectrometry.

In Phytolaccaceae family, Phytolacca americana L. (American pokeweed) and P. esculenta Van Houtte (Chinese pokeweed) are the two representative species among the genus. Pokeweeds have triterpenoid saponins as toxic compounds in every part of the plant. The saponins phytolaccoside A, B, D, E, and G were isolated from P. americana, and esculentoside H, J, L, K, M, I, and N were isolated from P. esculenta. Along with saponins, their aglycones (phytolaccagenin, phytolaccagenic acid, esculentic acid and jaligonic acid) were also isolated from P. americana and P. esculenta. Two people who unknowingly ate misidentified pokeweed plant roots were transferred to the emergency room. Urine and gastric content after irrigation were collected from the first patient (patient 1), and blood and urine were collected from the second patient (patient 2). The samples were analyzed to identify toxic substances with liquid chromatography-tandem mass spectrometry (LC-MS/MS). In the blood sample, 1.9 ng/mL of esculentoside A and 1.5 ng/mL of esculentoside C were detected, while the concentration of esculentoside B and H were below the LLOQ. In gastric contents and ingested roots, esculentoside A, B, C, and H were identified. Esculentoside A, C, and H were identified in the urine of patient 1, and esculentoside A and C were identified in the urine sample of patient 2. The developed analytical method was validated for parameters such as linearity, limit of detection, precision, accuracy, matrix effect, recovery, and process efficiency, and they showed clear and unbiased results.

Vaccination as a possible means of preventing lantana poisoning.

The toxic triterpene acids lantadene A and lantadene B were isolated from Lantana camara and conjugated to bovine serum albumen or haemocyanin. The conjugates were emulsified with complete Freund's adjuvant and injected into sheep and cattle. Vaccinated animals produced antibodies against the toxic compounds. Cholestasis was less severe in vaccinated than in non-vaccinated sheep challenged with a toxic dose of lantana. The results indicated a mild protective effect of vaccination against the hepatotoxic effects of lantana toxins.

Current ideas on the pathophysiology and treatment of lantana poisoning of ruminants.

Lantana poisoning in ruminants results from the ingestion of toxic varieties of the plant Lantana camara, which contain the triterpene acids lantadene A and lantadene B. Poisoning results in intrahepatic cholestasis and the consequences of the liver injury include jaundice, photosensitisation and ruminal stasis. The decreased ruminal motility causes toxic material to be retained in the rumen and continuous absorption of toxins from the rumen maintains the disease. Lantana poisoning can best be treated by preventing further absorption of toxins. This can be achieved by giving a large quantity of activated charcoal into the rumen together with a large volume of a multiple electrolyte solution to stimulate ruminal motility and rehydrate the animal. Treatment for photosensitive dermatitis should also be given.