Human fatalities from cyanobacteria: Chemical and biological evidence for cyanotoxins
Human fatalities from cyanobacteria: Chemical and biological evidence for cyanotoxins
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DOI：
10.2307/3454781
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发表时间：
2001-07-01
影响因子：
10.4
通讯作者：
Eaglesham, GK
中科院分区：
文献类型：
--
作者：
Carmichael, WW;Azevedo, SMFO;Eaglesham, GK
在距离伯南布哥州首府累西腓134公里的巴西卡鲁鲁（南纬8度17分，西经35度58分）的一个透析中心爆发了急性肝衰竭。在诊所，1996年2月13日至20日，131名患者中116名（89%）在常规血液透析治疗后出现视力障碍、恶心和呕吐。随后，100名患者出现急性肝功能衰竭，其中76人死亡。截至1996年12月，52例死亡可归因于一种现在称为卡鲁鲁综合症的常见综合症。对透析诊所水源的浮游植物进行检查，对诊所水处理系统进行分析，加上临床患者的血清和肝脏组织，鉴定出两组蓝藻毒素，即肝毒性环肽微囊藻毒素和肝毒性生物碱柱精子素。通过对这两种蓝藻毒素的动物研究，对受害者的症状和病理进行比较，我们得出结论，导致透析患者死亡的主要因素是静脉内暴露于微囊藻毒素，特别是微囊藻毒素- yr、-LR和-AR。根据肝脏浓度和暴露量，估计用于透析治疗的水中含有19.5杯/升微囊藻毒素。这是世界安全饮用水供应标准的19.5倍。卫生组织。
An outbreak of acute liver failure occurred at a dialysis center in Caruaru, Brazil (8 degrees 17 'S, 35 degrees 58 'W), 134 km from Recife, the state capital of Pernambuco. At the clinic, 116 (89%) of 131 patients experienced visual disturbances, nausea, and vomiting after routine hemodialysis treatment on 13-20 February 1996. Subsequently, 100 patients developed acute liver failure, and of these 76 died. As of December 1996, 52 of the deaths could be attributed to a common syndrome now called Caruaru syndrome. Examination of phytoplankton from the dialysis clinic's water source, analyses of the clinic's water treatment system, plus serum and liver tissue of clinic patients led to the identification of two groups of cyanobacterial toxins, the hepatotoxic cyclic peptide microcystins and the hepatotoxic alkaloid cylindrospermopsin. Comparison of victims' symptoms and pathology using animal studies of these two cyanotoxins leads us to conclude that the major contributing factor to death of the dialyses patients was intravenous exposure to microcystins, specifically microcystin-YR, -LR, and -AR. From liver concentrations and exposure volumes, it was estimated that 19.5 mug/L microcystin was in the water used for dialysis treatments. This is 19.5 times the level set as a guideline for safe drinking water supplies by the World. Health Organization.