Gessner B D, Bell P, Doucette G J, Moczydlowski E, Poli M A, Van Dolah F, Hall S
Alaska Division of Public Health, Anchorage 99501, USA.
Toxicon. 1997 May;35(5):711-22. doi: 10.1016/s0041-0101(96)00154-7.
Following four outbreaks of paralytic shellfish poisoning on Kodiak Island, Alaska, during 1994, medical records of ill persons were reviewed and interviews were conducted. Urine and serum specimens were analyzed at three independent laboratories using four different saxitoxin binding assays. High-performance liquid chromatography was used to determine the presence of specific toxin congeners. Among 11 ill persons, three required mechanical ventilation and one died. Mean peak systolic and diastolic blood pressure measurements were 172 (range 128-247) and 102 (range 78-165) mmHg, respectively, and blood pressure measurements corresponded with ingested toxin dose. All four different laboratory methodologies detected toxin in serum at 2.8-47 nM during acute illness and toxin in urine at 65-372 nM after acute symptom resolution. The composition of specific paralytic shellfish poisons differed between mussels and human biological specimens, suggesting that human metabolism of toxins had occurred. The results of this study indicate that saxitoxin analogues may cause severe hypertension. In addition, we demonstrate that saxitoxins can be detected in human biological specimens, that nanomolar serum toxin levels may cause serious illness and that human metabolism of toxin may occur. Clearance of paralytic shellfish poisons from serum was evident within 24 hr and urine was identified as a major route of toxin excretion in humans.
1994年阿拉斯加科迪亚克岛发生四起麻痹性贝类中毒事件后，对患病人员的病历进行了审查并开展了访谈。在三个独立实验室使用四种不同的石房蛤毒素结合测定法对尿液和血清样本进行了分析。采用高效液相色谱法测定特定毒素同系物的存在情况。11名患病人员中，3人需要机械通气，1人死亡。平均收缩压和舒张压峰值测量值分别为172（范围128 - 247）和102（范围78 - 165）mmHg，血压测量值与摄入的毒素剂量相符。在急性发病期间，所有四种不同的实验室方法均检测出血清中石房蛤毒素浓度为2.8 - 47 nM，急性症状缓解后尿液中石房蛤毒素浓度为65 - 372 nM。贻贝和人类生物样本中特定麻痹性贝类毒素的组成不同，这表明毒素发生了人体代谢。本研究结果表明，石房蛤毒素类似物可能导致严重高血压。此外，我们证明石房蛤毒素可在人类生物样本中检测到，纳摩尔级别的血清毒素水平可能导致严重疾病，并且毒素可能发生人体代谢。血清中麻痹性贝类毒素在24小时内明显清除，尿液被确定为人类毒素排泄的主要途径。
