Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo 14040-903, Brazil.
Departamento de Patologia e Medicina Legal, Faculdade de Medicina de Ribeirão Preto, São Paulo 14049-900, Brazil.
Toxins (Basel). 2020 Mar 5;12(3):163. doi: 10.3390/toxins12030163.
causes numerous scorpion envenomation accidents and deaths worldwide. The symptoms vary from local to systemic manifestations, culminating in pulmonary edema and cardiogenic shock. Among these events, transitory hyperglycemia is a severe manifestation that influences pulmonary edema, hemodynamic alterations, and cardiac disturbances. However, the molecular mechanism that leads to increased glucose levels after envenomation remains unknown. This study aimed to investigate our hypothesis that hyperglycemia due to scorpion envenomation involves inflammatory signaling in the pancreas. The present study showed that venom induces the production of IL-1α and IL-1β in the pancreas, which signal via IL-1R and provoke nitric oxide (NO) production as well as edema in β-cells in islets. mice were protected from transitory hyperglycemia and did not present disturbances in insulin levels in the serum. These results suggest that the pathway driven by IL-1α/IL-1β-IL-1R-NO inhibits insulin release by β-cells, which increases systemic glucose concentration during severe scorpion envenomation. A supportive therapy that inhibits NO production, combined with antiserum, may help to prevent fatal outcomes of scorpion envenomation. Our findings provide novel insights into the design of supportive therapy with NO inhibitors combined with antiscorpion venom serum to overcome fatal outcomes of scorpion envenomation.
该毒素导致了全球范围内大量的蝎子螫伤事故和死亡。症状从局部表现到全身表现不等,最终导致肺水肿和心源性休克。在这些事件中,短暂性高血糖是一种严重的表现,会影响肺水肿、血液动力学改变和心脏紊乱。然而,导致螫伤后血糖升高的分子机制尚不清楚。本研究旨在验证我们的假说,即蝎子螫伤引起的高血糖与胰腺中的炎症信号有关。本研究表明,毒液会在胰腺中诱导产生白细胞介素-1α(IL-1α)和白细胞介素-1β(IL-1β),这些细胞因子通过白细胞介素-1 受体(IL-1R)发出信号,引发一氧化氮(NO)的产生,并导致胰岛中的β细胞水肿。IL-1 受体拮抗剂(IL-1Ra)处理的小鼠可以防止短暂性高血糖,并且血清中的胰岛素水平没有紊乱。这些结果表明,由 IL-1α/IL-1β-IL-1R-NO 驱动的途径抑制了β细胞的胰岛素释放,这会导致在严重的蝎子螫伤期间全身葡萄糖浓度升高。抑制 NO 产生的支持性治疗与抗蛇毒血清联合使用,可能有助于预防致命的蝎子螫伤后果。我们的发现为设计支持性治疗提供了新的思路,即使用 NO 抑制剂联合抗蝎毒血清,以克服蝎子螫伤的致命后果。