Hypertension and identification of toxin in human urine and serum following a cluster of mussel-associated paralytic shellfish poisoning outbreaks
Hypertension and identification of toxin in human urine and serum following a cluster of mussel-associated paralytic shellfish poisoning outbreaks
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DOI：
10.1016/s0041-0101(96)00154-7
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发表时间：
1997-05-01
期刊：
影响因子：
2.8
通讯作者：
Hall, S
中科院分区：
文献类型：
--
作者：
Gessner, BD;Bell, P;Hall, S
在1994年阿拉斯加科迪亚克岛发生4起麻痹性贝类中毒事件后，对病人的医疗记录进行了审查，并进行了访谈。在3个独立的实验室用4种不同的石房蛤毒素结合试验对尿液和血清标本进行了分析，用高效液相色谱法测定了特定毒素同系物的存在。3例需要机械通气，1例死亡，平均收缩压和舒张压峰值为172（范围128-247）和102（范围78-165）mmHg，并且血压测量值对应于摄入的毒素剂量，所有四种不同的实验室方法在急性疾病期间检测到血清中的毒素为2.8-47 nM，在急性症状消退后检测到尿液中的毒素为65-372 nM。特定麻痹性贝类毒素的成分在贻贝和人类生物标本之间存在差异，这表明人类已经发生了毒素代谢。本研究的结果表明，石房蛤毒素类似物可能会导致严重的高血压。此外，我们证明，石房蛤毒素可以在人体生物标本中检测到，纳摩尔血清毒素水平可能会导致严重的疾病，人体代谢的毒素可能会发生。麻痹性贝类毒素在24小时内从血清中清除，尿液被确定为人体毒素排泄的主要途径。(C)1997年爱思唯尔科学有限公司
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. (C) 1997 Elsevier Science Ltd.