McGlasson David L, Green Jonathon A, Stoecker William V, Babcock James L, Calcara David A
Wilford Hall Medical Center, Lackland AFB, TX 78236-9908, USA.
Clin Lab Sci. 2009 Fall;22(4):216-22.
Diagnosis of Loxosceles reclusa envenomations is currently based upon clinical presentation. An enzyme-linked immunosorbent assay (ELISA) can detect surface Loxosceles venom at the envenomation site, allowing diagnostic confirmation. The length of time that venom on the skin is recoverable non-invasively is unknown.
To investigate duration of recoverable venom antigen, whole venom and fractionated sphingomyelinase D venom aliquots were injected subcutaneously in New Zealand White rabbits. Cotton and Dacron swabs were compared for venom recovery over a 21-day period using a surface swab technique.
Significant amounts of Loxosceles reclusa antigen were found on the surface of rabbit skin after experimental injection of whole venom and sphingomyelinase D. The duration of recoverable antigen using this experimental model appears to be at least two weeks and as long as 21 days in some cases.
Because the duration of the recoverable antigen is seen to be at least two weeks, the ELISA venom test appears capable of detecting venom on most patients presenting with Loxosceles envenomations. This detection system will allow the physician more accurate determination of whether the lesion is from a brown recluse spider or some other agent that can cause this type of necrotic ulcer.
目前，褐蛛咬伤的诊断基于临床表现。酶联免疫吸附测定（ELISA）能够检测咬伤部位的褐蛛表面毒液，从而实现诊断确认。皮肤表面毒液可通过非侵入性方法回收的时间长度尚不清楚。
为了研究可回收毒液抗原的持续时间，将全毒液和经分离的鞘磷脂酶D毒液等分试样皮下注射到新西兰白兔体内。使用表面擦拭技术，比较了棉拭子和涤纶拭子在21天内回收毒液的情况。
在实验性注射全毒液和鞘磷脂酶D后，在兔皮肤表面发现了大量褐蛛抗原。使用该实验模型，可回收抗原的持续时间似乎至少为两周，在某些情况下长达21天。
由于可回收抗原的持续时间至少为两周，ELISA毒液检测似乎能够检测出大多数出现褐蛛咬伤症状患者身上的毒液。这种检测系统将使医生能够更准确地确定病变是否由褐蛛或其他可导致此类坏死性溃疡的因素引起。
