Reis Mouzarllem Barros, Arantes Eliane Candiani
Departamento de Ciências BioMoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Sao Paulo, Brazil.
Front Toxicol. 2024 Nov 19;6:1503055. doi: 10.3389/ftox.2024.1503055. eCollection 2024.
Scorpion envenoming is a relevant and neglected public health problem in some countries. The use of antivenom is widespread in many regions, targeting specific species of scorpions. However, the uncontrolled proliferation and adaptation of these animals to urban environments, combined with limited access to treatments in remote areas and delays in antivenom administration contribute to a significant number of fatalities from scorpion-related incidents. In recent decades, new research has revealed that the immune system plays an important role in triggering immunopathological reactions during scorpion envenoming, which places it as a therapeutic target; however, few clinical studies have been conducted. This work provides a review of the main immunopathological aspects of scorpion envenoming, as well as the clinical trials conducted to date on the use of corticosteroids for the treatment of scorpionism. We highlight emerging treatment perspectives as well as the need for further clinical trials. The use of corticosteroids in scorpionism, when appropriate, could significantly enhance access to treatment and help reduce fatalities associated with scorpion stings.
在一些国家,蝎子蜇伤是一个重要但被忽视的公共卫生问题。抗蛇毒血清在许多地区广泛使用,针对特定种类的蝎子。然而,这些动物在城市环境中不受控制地繁殖和适应,加上偏远地区治疗机会有限以及抗蛇毒血清给药延迟,导致大量与蝎子相关的事件死亡。近几十年来,新的研究表明,免疫系统在蝎子蜇伤期间引发免疫病理反应中起重要作用,这使其成为一个治疗靶点;然而,很少有临床研究。这项工作综述了蝎子蜇伤的主要免疫病理方面,以及迄今为止使用皮质类固醇治疗蝎蜇伤的临床试验。我们强调了新兴的治疗前景以及进一步进行临床试验的必要性。在蝎蜇伤中适当使用皮质类固醇可以显著增加治疗机会,并有助于减少与蝎子蜇伤相关的死亡。