综述与专论: 河鲀毒素的检测技术与应用

河鲀毒素（tetrodotoxin， TTX）是毒性极强的小分子生物碱类毒素，包括中国在内的亚洲沿海国家因误食TTX污染食品而中毒的事件时有发生，其发病迅速且无特效解毒剂，对环境安全、食品安全与社会安全造成极大的威胁。通过检测食品与环境中的TTX含量可以实现TTX的风险预警，可有效防范TTX中毒事件的发生。本文梳理了4类TTX的检测技术，分析比较了传统的生物检测法、化学检测法、免疫检测法之间的优势、不足与实际应用进展，介绍了基于适配体技术的新型检测技术的兴起、发展与广阔的应用前景，对生物安全领域中TTX风险的管理与控制有现实意义。     

Saxitoxin and tetrodotoxin. Electrostatic effects on sodium channel gating current in crayfish axons.

The effects of extracellular saxitoxin (STX) and tetrodotoxin (TTX) on gating current (IgON) were studied in voltage clamped crayfish giant axons. At a holding potential (VH) of -90 mV, integrated gating charge (QON) was found to be 56% suppressed when 200 nM STX was added to the external solution, and 75% suppressed following the addition of 200 nM TTX. These concentrations of toxin are sufficiently high to block greater than 99% of sodium channels. A smaller suppression of IgON was observed when 1 nM STX was used (KD = 1-2 nM STX). The suppression of IgON by external toxin was found to be hold potential dependent, with only minimal suppression observed at the most hyperpolarized hold potentials, -140 to -120 mV. The maximal effect of these toxins on IgON was observed at hold potentials where the QON vs. VH plot was found to be steepest, -100 to -80 mV. The suppression of IgON induced by TTX is partially relieved following the removal of fast inactivation by intracellular treatment with N-bromoacetamide (NBA). The effect of STX and TTX on IgON is equivalent to a hyperpolarizing shift in the steady state inactivation curve, with 200 nM STX and 200 nM TTX inducing shifts of 4.9 +/- 1.7 mV and 10.0 +/- 2.1 mV, respectively. Our results are consistent with a model where the binding of toxin displaces a divalent cation from a negatively charged site near the external opening of the sodium channel, thereby producing a voltage offset sensed by the channel gating apparatus.     

Gene expression patterns in peripheral blood leukocytes in patients with recurrent ciguatera fish poisoning: Preliminary studies

Ciguatera fish poisoning (ciguatera) is a common clinical syndrome in areas where there is dependence on tropical reef fish for food. A subset of patients develops recurrent and, in some instances, chronic symptoms, which may result in substantial disability. To identify possible biomarkers for recurrent/chronic disease, and to explore correlations with immune gene expression, peripheral blood leukocyte gene expression in 10 ciguatera patients (7 recurrent and 3 acute) from the U.S. Virgin Islands, and 5 unexposed Florida controls were evaluated. Significant differences in gene expression were noted when comparing ciguatera patients and controls; however, it was not possible to differentiate between patients with acute and recurrent disease, possibly due to the small sample sizes involved.     

Tonic and phasic guanidinium toxin-block of skeletal muscle Na channels expressed in Mammalian cells

The blockage of skeletal muscle sodium channels by tetrodotoxin (TTX) and saxitoxin (STX) have been studied in CHO cells permanently expressing rat Nav1.4 channels. Tonic and use-dependent blockage were analyzed in the framework of the ion-trapped model. The tonic affinity (26.6 nM) and the maximum affinity (7.7 nM) of TTX, as well as the "on" and "off" rate constants measured in this preparation, are in remarkably good agreement with those measured for Nav1.2 expressed in frog oocytes, indicating that the structure of the toxin receptor of Nav1.4 and Nav1.2 channels are very similar and that the expression method does not have any influence on the pore properties of the sodium channel. The higher affinity of STX for the sodium channels (tonic and maximum affinity of 1.8 nM and 0.74 nM respectively) is explained as an increase on the "on" rate constant (approximately 0.03 s(-1) nM(-1)), compared to that of TTX (approximately 0.003 s(-1) nM(-1)), while the "off" rate constant is the same for both toxins (approximately 0.02 s(-1)). Estimations of the free-energy differences of the toxin-channel interaction indicate that STX is bound in a more external position than TTX. Similarly, the comparison of the toxins free energy of binding to a ion-free, Na(+)- and Ca(2+)-occupied channel, is consistent with a binding site in the selectivity filter for Ca(2+) more external than for Na(+). This data may be useful in further attempts at sodium-channel pore modeling.     

The Na+ channel in mammalian cardiac cells. Two kinds of tetrodotoxin receptors in rat heart membranes

The properties of interaction of both tetrodotoxin (TTX) and tritiated ethylenediamine tetrodotoxin [3H] en-TTX) were studied in rat heart membranes at different stages of development and in cultured cells. Studies by electrophysiology and by 22Na+ flux measurements on cardiac cultured cells indicate that the functional form of the Na+ channel is of low affinity for TTX (250-700 nM). Binding experiments (bioassay and [3H]en-TTX binding) on cultured cardiac cells from newborn rats indicate the presence of both high and low affinity binding sites for TTX with dissociation constants (Kd) of 1.6 and 135 nM, respectively. On homogenates of hearts taken just after birth, [3H]en-TTX binding reveals no high affinity binding site for TTX but the presence of a low affinity binding site with a Kd of 125 nM. This result was confirmed by kinetic studies and competition experiments. Conversely, binding studies on homogenates and extensively purified membranes from adult ventricles reveal the presence of both high and low affinity binding sites for TTX with Kd values of 1.5 and 170 nM, respectively. The maximum binding capacity for the low affinity binding sites is 45 times higher than that of the high affinity binding sites. High affinity sites do not exist at the fetal stage or at birth, but after 5 days their number gradually increases to reach a maximum level around 45 days after birth. Conversely, the number of low affinity binding sites is essentially invariant between birth and adulthood. Monolayers of cardiac cells from hearts at 2 days after birth which have no high affinity TTX-binding sites in vivo develop both high and low affinity binding sites for TTX in vitro. The results presented here are the first direct demonstration of the coexistence in rat heart plasma membrane of two families of binding sites for TTX.     

北京怀柔“4.23”急性可乐定中毒事件临床救治体会

本研究旨在观察群体性急性可乐定中毒的流行病学特点、临床表现及救治方法,尤其是评价血液灌流（hemoperfusion,HP）治疗急性可乐定中毒的有效性和安全性.通过对北京怀柔4.23急性可乐定中毒事件行流行病学调查,分析所有80例患者的所有流行病学资料,研究病情较重的34例患者的临床表现、治疗方案、预后情况.采用HA230树脂血液灌流器数次HP治疗前后血可乐定、尿可乐定浓度的变化,计算血可乐定浓度下降率,及与常规内科治疗相比HP的排毒效率.观察治疗前患者血压、心率及其他实验室指标如血小板、心肌酶谱、肝酶谱的变化并评价疗效及副作用.研究发现急性可乐定中毒具有隐蔽性强,发病潜伏期短,症状重等特点,HP治疗可显著降低血可乐定水平,短暂升高尿可乐定水平.患者临床症状亦显著改善,血可乐定的下降率为（81±12）%,所有患者经间断HP治疗1～3次后血、尿可乐定水平接近正常.随着患者血可乐定浓度渐趋正常,其临床症状及实验室指标亦能明显改善,短期HP治疗无明显副作用,随访观察半月余,未观察到后遗症.群体性可乐定中毒常常具有危害人群广,症状重风险大,诊治难度大的特点,重者致人死亡,或者造成社会极大恐慌.研究群体性可乐定中毒有浓厚的军事医学意义,HP是治疗可乐定中毒安全有效的治疗手段.     

河豚毒素的起源及其研究进展

河豚毒素(tetrodotoxin,TTX)是一种毒性很强、相对分子质量小的非蛋白毒素,最初从豚科鱼中发现,故被命名为河豚毒素。1985年有人提出了河豚鱼TTX的体外起源因素,认为所有能产生TTX的生物都与其体内能分泌TTX的微生物有着密切联系,但有部分研究人员证实东方在孵化期间能自行产生TTX。TTX为典型的Na 通道阻断剂,中毒者往往肢体麻木、瘫痪、甚至死亡;但另一方面,TTX具有镇痛、镇静、降压等功效,在临床上的应用十分广泛。本文简要介绍TTX的起源、毒性作用机制、毒性控制、临床及药理学上的应用,及其存在的问题和应用前景。     

Effects of tetrodotoxin on heart cell aggregates. Phase resetting and annihilation of activity.

The influence of relatively low concentrations of tetrodotoxin (TTX) on phase resetting of spontaneous activity of embryonic chick atrial heart cell aggregates by brief duration current pulses was investigated experimentally and theoretically. The maximal upstroke velocity, Vmax, of the spontaneous action potential was reduced by TTX in a concentration-dependent manner for [TTX] less than 10(-7) M. However, the beat rate was unaffected in this concentration range. Application of a depolarizing current pulse of brief duration during a critical region of the spontaneous cycle annihilated activity in some preparations exposed to [TTX] approximately 10(-7) M. These results were analyzed with the model of electrical activity described in the previous paper (Clay, J.R., R.M. Brochu, and A. Shrier. 1990. Biophys. J. 58:609-621) based on a tonic block of the INa channel by TTX with a dissociation constant, KD, of 50 nM.     

Evidence for a nucleus accumbens CCK2 receptor regulation of rat ventral pallidal GABA levels: a dual probe microdialysis study

We employed dual probe microdialysis in the nucleus accumbens and ipsilateral ventral pallidum of the halothane anaesthetized rat to investigate the effect of intra-accumbens perfusion with the sulphated octapeptide cholecystokinin (CCK-8S, 10-1000 nM, 60 min) alone and in the presence of the selective CCK1 and CCK2 receptor antagonists L-364,718 (10 and 100 nM) and PD134308 (10 nM), tetrodotoxin (TTX, 1000 nM) and the GABA(A) receptor antagonist bicuculline (1000 nM), on dialysate GABA levels in the ventral pallidum. Intra-accumbens perfusion with the 100 and 1000 nM concentration of CCK-8S was associated with a significant decrease (-16+/-3% and -23+/-3% vs basal, respectively) in ventral pallidum GABA levels. The CCK-8S (1000 nM) induced decrease in ventral pallidal dialysate GABA levels was abolished when PD134308, TTX and bicuculline, but not L-364,718, were included into the perfusion medium of the accumbens probe. The data indicate that nucleus accumbens CCK-8S exerts a CCK2 receptor mediated inhibition of ventral pallidal GABA levels. Furthermore, the TTX and bicuculline sensitivity of this effect suggests that this is possibly mediated via CCK2 receptors probably located on local GABA interneurons.     

基于分子模拟的河鲀毒素核酸适配体的连续优化*

河鲀毒素(tetrodotoxin, TTX)是一种生物碱类神经毒素,其中毒事件在世界范围内广泛发生,严重危害到人类健康,但尚无特效解毒剂,因此TTX的检测对食品安全领域有重大意义。为了得到更高效的TTX识别元件,在分子模拟指导下对SELEX筛选所得的核酸适配体TTX-27进行了连续优化。首先,使用Mini-hairpin结构替换阻碍TTX结合的茎环结构,使TTX更易与截短型适配体结合,然后将T39、C40碱基突变为C39、T40碱基,并对C39进行了2'-OH修饰,以增强结合区域碱基与TTX的氢键作用和范德瓦耳斯相互作用。微量热泳动(microscale thermophoresis, MST)实验证实,经截短、碱基突变和化学修饰的各适配体变体的亲和力均有提高,其中化学修饰变体TTX-D2-X-R结合TTX的解离平衡常数K_d为1.08 nmol/L,相较于TTX-27的亲和力提高了75.5倍。表明基于分子模拟的截短-突变-化学修饰是核酸适配体post-SELEX优化的有效途径,所得的适配体变体TTX-D2-X-R在TTX检测领域有着潜在的应用价值。     

An Electrophysiological Study of Acute Tetrodotoxin Poisoning

To evaluate the electrophysiological changes in patients with acute tetrodotoxin (TTX) poisoning from ingestion of globefish (Tetraodontidae) patients exposed to TTX were compared with age-matched controls. The cohort of TTX-poisoning cases was clinically subdivided into mild, moderate, or severe cases. The motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV), F-wave, H-reflex, and somatosensory-evoked potentials (SEP) of the median, ulnar, and common peroneal nerve (CPN) were determined using established techniques. Four of the 64 (6.3%) TTX-poisoning cases died and were omitted from the final analysis. The MCV and SCV of the median, ulnar, and CPN nerves in all the TTX-poisoning cases were significantly slower than the healthy controls. Severe cases of TTX poisoning had more significant reduction in nerve function. Thus, electroneurophysiological analysis could be used to determine the extent, course, and range of nerve system damage in patients with acute TTX poisoning.     

The link between feeding ecology and lead poisoning in white-tailed eagles

Lead poisoning affects numerous threatened raptors and is a major cause of death in white-tailed eagles (Haliaeetus albicilla). A major reason for intoxication is assumed to be lead fragments ingested while feeding on game animals killed by lead-based projectiles. However, empirical evidence on the relevance of carrion in raptor diets remains scarce. We therefore investigated the link between raptor feeding ecology and lead poisoning, with white-tailed eagles as a model species for scavenging birds. We collected data on seasonal diet composition and food availability of 7 territorial white-tailed eagle pairs in northeastern Germany. We also analyzed stomach contents (SCs) of 126 eagles found dead from 1996 to 2008 throughout Germany. Multiple regression models revealed that fish were the primary prey for eagles, and waterfowl and carcasses of game mammals comprised a large portion of alternative diet components. Eagles used individual foraging tactics, adjusted to local food supply, to maximize profitability. They showed a type II functional response to fish availability. When fish availability sharply declined, eagles switched to waterfowl and carrion. The consumption of game mammal carrion increased over autumn and winter and was positively correlated with a concomitant seasonal increase in the incidence of lead poisoning in eagles throughout Germany. The stomachs of lead-poisoned eagles predominantly contained game ungulate remains. These results indicate that carcasses of game mammals were the major sources of lead fragments. The link between raptor feeding ecology and lead poisoning is the specific functional response of raptors to changing food availability or poor habitat quality, leading to scavenging on lead-contaminated carrion. This shows that carrion constitutes a considerable threat to white-tailed eagles and other birds with similar feeding habits as long as it contains lead bullet fragments. Conservation management of scavenging birds would be substantially improved if carrion was free of lead bullet fragments. One method to achieve this is the widespread introduction of lead-free ammunition. © 2012 The Wildlife Society.     

Role of electrical activity and trophic factors during cholinergic development in dissociated cultures

The role of electrical activity in the developmental regulation of cholinergic neurons was investigated in dissociated spinal cord--dorsal root ganglion (SC-DRG) cultures. Application of tetrodotoxin (TTX) during the first 6 days after plating had no effect on choline acetyltransferase (CAT) activity. Suppression of electrical activity during the 7th day decreased CAT to 68% of control. These decreases in CAT activity were still apparent 2 weeks after removal of the TTX. GABAergic neurons, as indicated by glutamic acid decarboxylase activity and high affinity [3H]GABA uptake, were not affected by TTX treatment. Addition of 8-bromo-cAMP or conditioned medium obtained from SC-DRG cultures at certain developmental periods produced dose-dependent increases in CAT levels on TTX-treated cultures as compared with those treated with TTX alone. Similar studies with 8-bromo-cGMP revealed no significant effects on CAT activity. Vasoactive intestinal peptide (VIP) produced a dose-dependent increase in CAT activity when added to cultures between days 12 and 14. Similar studies conducted on younger cultures (days 5-7) or older cultures (days 21-23) revealed no increases in CAT activity. Addition of 0.1 nM VIP to TTX-treated cultures resulted in CAT levels which were not significantly different from those of electrically active controls. These data suggest that cyclic AMP, VIP, and trophic substances in conditioned medium may have roles in the mechanism of cholinergic toxicity produced by electrical blockade of developing spinal cord neurons.     

TTX accumulation in pufferfish

Tetrodotoxin (TTX) has been detected in a variety of animals. The finding of TTX in the trumpet shell Charonia sauliae strongly suggested that its origin was its food, a TTX-bearing starfish Astropecten polyacanthus. Since then, the food chain has been consistently implicated as the principal means of TTX intoxication. To identify the primary producer of TTX, intestinal bacteria isolated from several TTX-bearers were investigated for their TTX production. The results demonstrated that some of them could produce TTX. Thus the primary TTX producers in the sea are concluded to be marine bacteria. Subsequently, detritus feeders and zooplankton can be intoxicated with TTX through the food chain, or in conjunction with parasitism or symbiosis. The process followed by small carnivores, omnivores or scavengers, and by organisms higher up the food chain would result in the accumulation of higher concentrations of TTX. Finally, pufferfish at the top of the food chain are intoxicated with TTX. This hypothesis is supported by the fact that net cage and land cultures produce non-toxic pufferfish that can be made toxic by feeding with a TTX-containing diet.     

西加毒素的危害及其检测技术

西加毒素是由少数几种海洋底栖微藻产生,具有极强毒性的生物毒素,它能够通过食物链传递而累计在多种珊瑚鱼体内,继而造成人类因食用鱼类而中毒。近年来,随着珊瑚鱼类在世界范围内的广泛贸易,西加毒素中毒已经成为全球性的健康问题。为给预防西加毒素引起的食物中毒提供借鉴,对西加毒素的分子结构、化学性质、生物来源、制毒机理、中毒症状和对人类的危害进行了综述。就目前主要的检测方法进行了技术特性的介绍,并对常用检测方法的优缺点进行了比较分析。     

Actions of chiriquitoxin on frog skeletal muscle fibers and implications for the tetrodotoxin/saxitoxin receptor

Chiriquitoxin (CqTX) from the Costa Rican frog Atelopus chiriquensis differs from tetrodoxin (TTX) only in that a glycine residue replaces a methylene hydrogen of the C-11 hydroxymethyl function. On the voltage-clamped frog skeletal muscle fiber, in addition to blocking the sodium channel and unrelated to such an action, CqTX also slows the activation of the fast potassium current in approximately 40% of the muscle fiber population. At pH 7.25, CqTX is as potent as TTX in blocking the sodium channel, with an ED50 of 3.8 nM. Its ED50's at pH 6.50 and 8.25 are 6.8 and 2.3 nM, contrasted with 3.8 and 4.3 nM for TTX. These differences are attributable to changes in the chemical states in the glycine residue. The equipotency of CqTX with TTX at pH 7.25 is explainable by an intramolecular salt bridge between the amino and carboxyl groups of the glycine function, all other surface groups in TTX and CqTX being the same. From available information on these groups and those in saxitoxin (STX), the TTX/STX binding site is deduced to be in a pocket 9.5 A wide, 6 A high, and 5 A deep. The glycine residue of CqTX probably projects out of the entrance to this pocket. Such a view of the binding site could also account for the actions of STX analogues, including the C-11 sulfated gonyautoxins and the 21-sulfocarbamoyl analogues. In the gonyautoxins the sulfate groups are equivalently placed as the glycine in CqTX, whereas in the sulfocarbamoyl toxins the sulfate groups extend the carbamoyl side-chain, leading to steric hinderance to productive binding.     

Associations between omega-3 poly-unsaturated fatty acids from fish consumption and severity of depressive symptoms: an analysis of the 2005-2008 National Health and Nutrition Examination Survey

Fish is the primary source of dietary omega-3 poly-unsaturated fatty acids EPA and DHA, which have been reported to reduce depressive symptoms in clinical trials. We assessed the association between fish consumption and depressive symptoms in a nationally representative sample of 10,480 adults from the 2005-2008 National Health and Nutrition Examination Survey. Depressive symptoms were classified by severity using the Patient Health Questionnaire. Fish meal consumption reported in 30-day food frequency questionnaires, and EPA+DHA intake computed from 24-h dietary recalls were evaluated in relation to depressive symptoms using multivariable ordinal logistic regression. Consumption of breaded fish showed an increased risk of greater depressive symptom severity, while all fish, non-breaded fish, and shell fish were not associated. Any EPA+DHA intake was significantly associated with fewer depressive symptoms. Exposure-response analyses revealed no clear patterns for any intake measures. Inconsistent patterns of associations in our study may be partially explained by exposure misclassification.     

Comparison of the urinary metabolites of prostacyclin and thromboxane of the 2- and 3-series in a Japanese fishing and a Japanese farming village

We measured PGI2-, PGI3-, and TXA2/3-M (the main urinary metabolites of prostacyclin and thromboxane of the two and three series) in 24-hour urine in a fishing village (21 participants) and a farming village (19 participants) in Japan, expecting to find more PGI3-M in the fishing village than in the farming village. The food consumption for three consecutive days prior to a blood collection was recorded and analyzed for eicosapentaenoic acid (EPA) content. Urine was collected for 24 hours prior to the blood sampling. When our studies were performed (April, 1985), catches of fish were the lowest on record around the fishing village, and the consumption of EPA in the fishing village was less than half of that in the farming village. EPA levels in red cell membrane phospholipids were higher in the fishing village than in the farming village. PGI2-, PGI3-, and TXA2/3-M levels were higher in the farming village than in the fishing village. There was a significant correlation between PGI2- and PGI3-M (r=0.80, n=40) and between PGI3-M and the EPA consumption during the day of urine collection (r=0.52, n=40). We conclude that PGI3 production is probably dependent less on the levels of EPA in tissues estimated by the EPA levels in red cell membranes than on the EPA consumption at the moment.     

Use-dependent block of sodium channels in frog myelinated nerve by tetrodotoxin and saxitoxin at negative holding potentials

Na+ currents were measured in myelinated frog nerve fibres in the presence of nanomolar concentrations of tetrodotoxin (TTX) or saxitoxin (STX) in the extracellular solution. The Na+ currents declined during a train of depolarizing pulses if the fibre was held at hyperpolarizing potentials between the pulses. At a pulse frequency of 0.8 Hz, the peak Na+ currents were reduced to 70 or 60% of the initial value in 9.3 nM TTX and 3.5 nM STX solutions, respectively. A decline of Na+ currents was also observed in two-pulse experiments. The peak Na+ current during a second test pulse did not depend on the duration (0.2 to 12 ms) of the first pulse. It decreased with increasing interval between the pulses, reached a minimum and increased again. The results are interpreted with a use-dependent blockage of Na+ channels by TTX or STX at negative holding potentials. The effects were described quantitatively, assuming a fast affinity increase of toxin receptors at Na+ channels triggered by Na+ activation followed by slow toxin binding to channels and relaxation of the receptor affinity.     

Bites by foreign venomous snakes in Britain.

In 1970-7 17 people in Britain were the victims of 32 bites by foreign venomous snakes. Crotalus atrox caused eight of these bites, Bitis arietans five, and the remaining 19 bites were caused by 12 different species. All the victims were bitten while handling the snake, and 24 bites were incurred by private individuals in their own homes. Poisoning was negligible in 17 of the 32 bites but life-threatening in at least two cases. Thus in the early stages snake bite may be unpredictable as a clinical problem. All victims of snake bite should be observed for at least 12 hours to assess the severity of poisoning and to ensure rational treatment. Local necrosis developed in six cases and resulted in prolonged illness in five of these cases; local incision was carried out and many have been a casual factor. Comprehensive stocks of antivenoms for treating bites by foreign venomous snakes are held by the National Health Services in Liverpool and London. Antivenom is indicated (a) for potentially serious systemic poisoning, as evidenced by hypotension, electrocardiographic changes, neurtrophilia, and acidosis (after viper or elapid bites), abnormal bleeding or non-clotting blood after viper bites; and ptosis or glossopharyngeal palsy after elapid bites; and (b) for bites from snakes whose venom causes local necrosis, to prevent or minimise this unpleasant complication. For effective antivenom treatment intravenous infusion is mandatory.