Lopes-Ferreira M, Moura-da-Silva A M, Mota I, Takehara H A
Laboratório de Imunopatologia, Instituto Butantan, São Paulo, Brazil.
Toxicon. 2000 Aug;38(8):1149-56. doi: 10.1016/s0041-0101(99)00211-1.
T. nattereri (niquim) is a venomous fish involved in many human accidents in Brazil. The clinical picture includes mild local erythema, severe edema, intense pain and rapid progression to necrosis. The present therapy with anti-inflammatory and analgesic drugs is ineffective and, therefore, we decided to assess serum therapy as an alternative treatment using an experimental antivenom. The antivenom used was raised in rabbits showing an ELISA antibody titer of 1:8,192,000 and its ability to neutralize lethality, necrosis, nociception and edema was evaluated both by pre-incubating the venom with antivenom before injection into mice or by independent injections of venom and antivenom. Lethality was completely neutralized by pre-incubation (ED(50)=141.5 microl/mg) while necrosis and nociception were neutralized by pre-incubation or the independent injection of antivenom. Edema was only partially prevented even when large amounts of antivenom were used. These data suggest that antivenom may be a promising treatment for patients stung by T. nattereri and suggest the viability of producing a horse antivenom for use in clinical trials.
纳氏多指马鲅（T. nattereri，俗称“niquim”）是一种有毒鱼类，在巴西导致了多起人类中毒事件。临床症状包括轻度局部红斑、严重水肿、剧痛以及迅速发展为坏死。目前使用抗炎和镇痛药的治疗方法无效，因此，我们决定评估血清疗法作为一种替代治疗方法，使用一种实验性抗蛇毒血清。所用抗蛇毒血清是在兔子体内产生的，ELISA抗体效价为1:8,192,000，通过在将毒液注射到小鼠体内之前将毒液与抗蛇毒血清预孵育，或通过分别注射毒液和抗蛇毒血清，评估其中和致死性、坏死、伤害感受和水肿的能力。通过预孵育可完全中和致死性（半数致死剂量（ED(50)）=141.5微升/毫克），而通过预孵育或单独注射抗蛇毒血清可中和坏死和伤害感受。即使使用大量抗蛇毒血清，水肿也只能得到部分预防。这些数据表明，抗蛇毒血清可能是治疗纳氏多指马鲅蜇伤患者的一种有前景的治疗方法，并表明生产用于临床试验的马抗蛇毒血清的可行性。
