Southcott R V
Contemp Neurol Ser. 1975;12:165-258.
The concept of the sea as a source of noxious agents is perhaps not a familiar one to clinical neurologists, judging by the lack of reference to these agents in standard textbooks. Chemical, physiologic, and pharmacologic laboratories are increasingly investigating the properties of marine toxins, finding in them compounds with interesting and novel structures or unusual physiologic effects. Such substances are seen as possible agents for biologic and, more particularly, physiologic research, and as possible sources of new pharmaceuticals. These include hormone-like substances and antiviral or antitumor agents. Despite these specialized developments, which are in large measure a consequence of the technological advances of the present century, the clinician is at times directly concerned with the effects of marine toxic substances. For example, in Japan, puffer fish or tetrodotoxic poisoning is one of the major causes of deaths from food poisoning. Another marine toxin that has caused many explosive outbreaks of food poisoning. with many deaths in various parts of the world, comes from clams or mussels. This toxin, saxitoxin, is produced by species of marine protozoa including Gonyaulax, and is concentrated in filter-feeding molluscs. These two examples were of significant interest in medicine long before the technologic developments of the twentieth century. In the last few decades, entirely new problems of marine intoxication have arisen as a result of marine pollution from the disposal of industrial wastes in the sea. The most striking example of a man-made marine intoxication has been the outbreak of Minamata disease. In Minamata, Japan, the disposal of mercury-contaminated industrial wastes from a plastics factory into an enclosed bay, followed by human consumption of the contaminated fishes, crabs, or shellfish, led to many instances of acute cerebral degeneration. With the increasing exploration of the sea for both pleasure and economic exploitation, which is a feature of the second half of the twentieth century, it may be expected that the frequency and variety of human intoxications by marine creatures will be increased. This chapter reviews the neurologic effects of noxious substances of marine biologic origin. The subject is now developing so rapidly that overall surveys, such as this, of the general animal life of theocens will soon be beyond the scope of a single review. Nevertheless, it is hoped that the references given will enable the interested reader to pursue particular aspects further.
从标准教科书中对这些有害物质缺乏提及来看,临床神经学家可能对海洋作为有害物质来源的概念并不熟悉。化学、生理学和药理学实验室越来越多地研究海洋毒素的特性,发现其中含有结构有趣且新颖或具有异常生理效应的化合物。这些物质被视为生物学研究尤其是生理学研究的可能试剂,以及新药物的可能来源。这些包括类激素物质以及抗病毒或抗肿瘤药物。尽管这些专门的进展在很大程度上是本世纪技术进步的结果,但临床医生有时会直接关注海洋有毒物质的影响。例如,在日本,河豚或河豚毒素中毒是食物中毒死亡的主要原因之一。另一种导致多次食物中毒爆发并在世界各地产众多人死亡的海洋毒素来自蛤或贻贝。这种毒素,即石房蛤毒素,由包括裸甲藻在内的海洋原生动物物种产生,并集中在滤食性软体动物中。早在20世纪技术发展之前,这两个例子在医学上就备受关注。在过去几十年中,由于向海洋排放工业废物导致的海洋污染,出现了全新的海洋中毒问题。人为造成的海洋中毒最突出的例子是水俣病的爆发。在日本水俣,一家塑料厂将受汞污染的工业废物排放到一个封闭的海湾,随后人们食用受污染的鱼类、螃蟹或贝类,导致许多急性脑变性病例。随着20世纪下半叶以娱乐和经济开发为目的对海洋的探索不断增加,可以预期人类因海洋生物中毒的频率和种类将会增加。本章回顾海洋生物源有害物质的神经学影响。这个主题目前发展如此迅速,以至于像这样对海洋生物总体情况的全面综述很快将超出单一综述的范围。然而,希望所提供的参考文献能使感兴趣的读者进一步深入研究特定方面。