RESUMO
Tityus obscurus has caused mild, moderate and severe accidents of medical relevance in the eastern Brazilian Amazon and French Guiana. Tityus obscurus has sexual dimorphism although males and females have uniform black coloration. In the Amazon, one of the habitats of this scorpion is seasonally flooded forests (igapós and várzeas). However, most stings occur in terra firme forest areas (non-flooded region), where most rural communities are located. Adults and children stung by T. obscurus may experience an "electric shock" sensation for more than 30 h after the sting. Our data shows that people inhabiting remote forest areas, including rubber tappers, fishermen and indigenous people, with no access to anti-scorpion serum, use parts of native plants, such as seeds and leaves, against pain and vomiting caused by scorpion stings. Although there is a technical effort to produce and distribute antivenoms in the Amazon, many cases of scorpion stings are geographically unpredictable in this region, due to the lack of detailed knowledge of the natural distribution of these animals. In this manuscript, we compile information on the natural history of T. obscurus and the impact of its envenoming on human health. We identify the natural sites that host this scorpion in the Amazon, in order to warn about the risk of human envenoming. The use of specific antivenom serum is the recommended treatment for accidents involving venomous animals. However, atypical symptoms not neutralized by the available commercial antivenom are reported in the Amazon region. Facing this scenario, we present some challenges to the study of venomous animals in the Amazon rainforest and possible experimental bottlenecks and perspectives for establishing a method aimed at producing an efficient antivenom.
Assuntos
Picadas de Escorpião , Venenos de Escorpião , Masculino , Criança , Adulto , Animais , Feminino , Humanos , Antivenenos/uso terapêutico , Escorpiões , Venenos de Escorpião/toxicidade , BiologiaRESUMO
Venom from Amazonian scorpions of the genus Tityus contains components capable of eliciting a distinct clinical, mostly neurological, syndrome. This contrasts with the mainly autonomic manifestations produced after envenomation by congeneric southern and northern South American species. Herein, we summarize Pan-Amazonian scorpionism by synthesizing available toxinological, clinical, and molecular data gathered from all affected areas in Amazonia, including Brazil, Ecuador, Colombia, Peru, Venezuela, and French Guiana. We searched multiple databases, as well as our own records, for reports of scorpion envenomations in Amazonia by confirmed Tityus spp., and compared the clinical manifestations. To help uncover clinical and venom relationships among problematic species, we explored phylogenetic relationships with a rate-calibrated analysis of mitochondrial COI data from available species. The possible existence of diversity gradients for venom toxic and immunogenic components despite the predicted strong phylogenetic association among species is underscored by discussed clinical and toxinological findings. A multicentric effort, involving all nations affected by this neglected disease, is urgently needed to offer alternatives for treating and understanding this pathology, including the preparation of neutralizing antibodies with a broad range of efficacy.
RESUMO
Scorpions of the Neotropical genus Tityus are responsible for most severe envenomations in the Caribbean, South America, and Lower Central America (LCA). Although Tityus is taxonomically complex, contains high toxin polymorphism, and produces variable clinical manifestations, treatment is limited to antivenoms produced against species with restricted distributions. In this study, we explored the compositional and antigenic diversity of Tityus venoms to provide improved guidelines for the use of available antivenoms at a broader geographic scale. We used immunoblotting, competitive ELISA, and in vivo studies to compare reactivity against commercial antivenoms from Brazil, Venezuela, and Mexico, as well as MALDI-TOF mass spectrometry, cDNA sequencing, and phylogenetic analyses to assess venom sodium channel-active toxin (NaTx) content from medically important Tityus populations inhabiting Brazil, Colombia, Costa Rica, Ecuador, Panama, Trinidad and Tobago, and Venezuela. Additionally, we raised rabbit antibodies against Tityus venoms from LCA to test for cross-reactivity with congeneric species. The results suggest that Tityus spp. possess high venom antigenic diversity, underlying the existence of four toxinological regions in Tropical America, based on venom composition and immunochemical criteria: LCA/Colombia/Amazonia (Region I), Venezuela (Region II), southeast South America (Region III), and a fourth region encompassing species related to toxinologically divergent Tityus cerroazul. Importantly, our molecular and cross-reactivity results highlight the need for new antivenoms against species inhabiting Region I, where scorpions may produce venoms that are not significantly reactive against available antivenoms.
Assuntos
Antivenenos/imunologia , Picadas de Escorpião/epidemiologia , Venenos de Escorpião/imunologia , Escorpiões/classificação , Animais , Colômbia/epidemiologia , Filogenia , Coelhos , Picadas de Escorpião/tratamento farmacológico , Venenos de Escorpião/toxicidade , Especificidade da EspécieRESUMO
Tityus obscurus has caused mild, moderate and severe accidents of medical relevance in the eastern Brazilian Amazon and French Guiana. Tityus obscurus has sexual dimorphism although males and females have uniform black coloration. In the Amazon, one of the habitats of this scorpion is seasonally flooded forests (igapós and várzeas). However, most stings occur in terra firme forest areas (non-flooded region), where most rural communities are located. Adults and children stung by T. obscurus may experience an “electric shock” sensation for more than 30 h after the sting. Our data shows that people inhabiting remote forest areas, including rubber tappers, fishermen and indigenous people, with no access to anti-scorpion serum, use parts of native plants, such as seeds and leaves, against pain and vomiting caused by scorpion stings. Although there is a technical effort to produce and distribute antivenoms in the Amazon, many cases of scorpion stings are geographically unpredictable in this region, due to the lack of detailed knowledge of the natural distribution of these animals. In this manuscript, we compile information on the natural history of T. obscurus and the impact of its envenoming on human health. We identify the natural sites that host this scorpion in the Amazon, in order to warn about the risk of human envenoming. The use of specific antivenom serum is the recommended treatment for accidents involving venomous animals. However, atypical symptoms not neutralized by the available commercial antivenom are reported in the Amazon region. Facing this scenario, we present some challenges to the study of venomous animals in the Amazon rainforest and possible experimental bottlenecks and perspectives for establishing a method aimed at producing an efficient antivenom.
RESUMO
Venom from Amazonian scorpions of the genus Tityus contains components capable of eliciting a distinct clinical, mostly neurological, syndrome. This contrasts with the mainly autonomic manifestations produced after envenomation by congeneric southern and northern South American species. Herein, we summarize Pan-Amazonian scorpionism by synthesizing available toxinological, clinical, and molecular data gathered from all affected areas in Amazonia, including Brazil, Ecuador, Colombia, Peru, Venezuela, and French Guiana. We searched multiple databases, as well as our own records, for reports of scorpion envenomations in Amazonia by confirmed Tityus spp., and compared the clinical manifestations. To help uncover clinical and venom relationships among problematic species, we explored phylogenetic relationships with a rate-calibrated analysis of mitochondrial COI data from available species. The possible existence of diversity gradients for venom toxic and immunogenic components despite the predicted strong phylogenetic association among species is underscored by discussed clinical and toxinological findings. A multicentric effort, involving all nations affected by this neglected disease, is urgently needed to offer alternatives for treating and understanding this pathology, including the preparation of neutralizing antibodies with a broad range of efficacy.
RESUMO
Venom from Amazonian scorpions of the genus Tityus contains components capable of eliciting a distinct clinical, mostly neurological, syndrome. This contrasts with the mainly autonomic manifestations produced after envenomation by congeneric southern and northern South American species. Herein, we summarize Pan-Amazonian scorpionism by synthesizing available toxinological, clinical, and molecular data gathered from all affected areas in Amazonia, including Brazil, Ecuador, Colombia, Peru, Venezuela, and French Guiana. We searched multiple databases, as well as our own records, for reports of scorpion envenomations in Amazonia by confirmed Tityus spp., and compared the clinical manifestations. To help uncover clinical and venom relationships among problematic species, we explored phylogenetic relationships with a rate-calibrated analysis of mitochondrial COI data from available species. The possible existence of diversity gradients for venom toxic and immunogenic components despite the predicted strong phylogenetic association among species is underscored by discussed clinical and toxinological findings. A multicentric effort, involving all nations affected by this neglected disease, is urgently needed to offer alternatives for treating and understanding this pathology, including the preparation of neutralizing antibodies with a broad range of efficacy.(AU)
Assuntos
Animais , Filogenia , Escorpiões , Toxicologia , Anticorpos NeutralizantesRESUMO
Abstract Venom from Amazonian scorpions of the genus Tityus contains components capable of eliciting a distinct clinical, mostly neurological, syndrome. This contrasts with the mainly autonomic manifestations produced after envenomation by congeneric southern and northern South American species. Herein, we summarize Pan-Amazonian scorpionism by synthesizing available toxinological, clinical, and molecular data gathered from all affected areas in Amazonia, including Brazil, Ecuador, Colombia, Peru, Venezuela, and French Guiana. We searched multiple databases, as well as our own records, for reports of scorpion envenomations in Amazonia by confirmed Tityus spp., and compared the clinical manifestations. To help uncover clinical and venom relationships among problematic species, we explored phylogenetic relationships with a rate-calibrated analysis of mitochondrial COI data from available species. The possible existence of diversity gradients for venom toxic and immunogenic components despite the predicted strong phylogenetic association among species is underscored by discussed clinical and toxinological findings. A multicentric effort, involving all nations affected by this neglected disease, is urgently needed to offer alternatives for treating and understanding this pathology, including the preparation of neutralizing antibodies with a broad range of efficacy.
RESUMO
Scorpion envenomations are a major public health problem in Brazil, whose most dangerous cases are attributable to the genus Tityus. This study was designed to compare the clinical and demographic features of envenomations by 77tyus obscurus in two areas of the state of Pará located in the Amazon basin. Were compared demographic findings, local and systemic signs and symptoms of human envenomations caused by T. obscurus that occurred in western and eastern areas of the state.(AU)
Assuntos
Animais , Intoxicação/complicações , Neurologia , Venenos/análise , Escorpiões/fisiologiaRESUMO
Scorpion envenomations are a major public health problem in Brazil, whose most dangerous cases are attributable to the genus Tityus. This study was designed to compare the clinical and demographic features of envenomations by 77tyus obscurus in two areas of the state of Pará located in the Amazon basin. Were compared demographic findings, local and systemic signs and symptoms of human envenomations caused by T. obscurus that occurred in western and eastern areas of the state.
Assuntos
Animais , Intoxicação/complicações , Neurologia , Venenos/análise , Escorpiões/fisiologiaRESUMO
Scorpion envenomations are a major public health problem in Brazil, whose most dangerous cases are attributable to the genus Tityus. This study was designed to compare the clinical and demographic features of envenomations by 77tyus obscurus in two areas of the state of Pará located in the Amazon basin. Were compared demographic findings, local and systemic signs and symptoms of human envenomations caused by T. obscurus that occurred in western and eastern areas of the state.
Assuntos
Animais , Intoxicação/complicações , Neurologia , Venenos/análise , Escorpiões/fisiologiaRESUMO
No período janeiro de 1985 e julho de 1996 foram observados 102 casos de paracoccidioidomicose em hospital de Belém, PA. Treze pacientes eram crianças entre 3 e 13 anos de idade, com predomínio do sexo feminino (8:5). Todos apresentavam a forma disseminada subaguda da micose. E comentada a alta prevalência da micose em crianças em áreas endêmicas da Regiäo Amazônica
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Paracoccidioidomicose/epidemiologia , PrevalênciaRESUMO
As águas da Baía do Marajó, tornam-se doce nos meses de maior precipitaçäo pluviométrica e salobra no outro período, o que torna possível o encontro de arraias da família Potamotrygonidae e exemplares de águas marítimas, as quais säo providas de ferrões pontiagudos e retrosserilhados que, ao penetrarem nas vítimas, danificam o tegumento que recobre as células glandulares de veneno, expondo os tecidos a toxina, levando ao aparecimento de manifestações clínicas. Empregou-se um modelo obsevacional e descritivo da prevalência, para avaliar os aspectos clínicos e epidemiológicos de 116 acidentes por arraias, ocorridos nos Distritos de Mosqueiro e Outeiro, Belém-Pará, no período de julho de 1999 a agosto de 2001. Estes ocorreram, principalmente, em Mosqueiro (80,2 porcento) com maior frequência no sexo masculino (63,8 porcento), no grupo etário dos adolescentes e adultos (38,8 porcento e 50,0 porcento), respectivamente, no mês de julho (37,9 porcento). Em todas as marés houve vítimas, porém, com menor frequência na preamar (4,3 porcento). A maioria dos acidentes ocorreu no fundo do rio com areia (49,1 porcento) e no período vespertino (62,1 porcento). As arraias mais capturadas nas praias de Mosqueiro foram da família Potamotrygonidae. As vítimas socorridas na primeira hora em 79,3 porcento dos casos, sendo o membro inferior a regiäo mais atingida em 84,5 porcento, particularmente o pé (75,0 porcento). Todos os pacientes apresentaram manifestações clínicas locais, com dor em 99,1 porcento e cianose em 42,2 porcento dos casos. Os sintomas sistêmicos estiveram presentes em 14,6 porcento, sendo a tontura (6,0 porcento), e a sudorese (5,2 porcento) os mais encontrados. A pressäo arterial acima do normal presente em 6,0 porcento, e a taquicardia em 9,5 porcento. O debridamento foi o manejo cirúrgico mais utilizado (94,5 porcento). Retornaram para avaliaçäo somente 18,1 porcento dos pacientes, dos quais, 33,4 porcento evoluiram com necrose e 28,6 porcento com infecçäo local. Näo houve significância estatística na correlaçäo entre evoluçäo clínica, os tratamento instituídos e o tempo entre o acidente e o início do atendimento médico. Conclui-se que acidentes por arraias säo um importante agravo de saúde para a populaçäo que apesar das complicações locais, as vítimas näo apresentam quadro grave. O período das águas salobras parece que influencia no aumento dos casos(AU)