Scorpion envenomation and inflammation: Beyond neurotoxic effects

• Published in: Toxicon (Oxford) 2019-09, Vol.167, p.174-179
• Main Authors: Reis, Mouzarllem Barros, Zoccal, Karina Furlani, Gardinassi, Luiz Gustavo, Faccioli, Lúcia Helena
• Format: Article
• Language: English
• Subjects: Eicosanoids; Humans; Immunity, Innate; Inflammation; Macrophages - drug effects; Scorpion Stings - immunology; Scorpion Stings - pathology; Scorpion venom; Scorpion Venoms - immunology; Scorpion Venoms - toxicity; TLRs; VAMPs
• ISSN: 0041-0101; 1879-3150
• DOI: 10.1016/j.toxicon.2019.06.219

Scorpion envenomation results in a wide range of clinical manifestations that are mostly attributed to the activation of the autonomic nervous system by venom toxins. In fact, sympathetic and parasympathetic disturbances play important roles during poisoning. However, scorpion venom also induces a complex hyperinflammatory state that occurs parallel to systemic inflammatory response syndrome and acute sepsis. After a scorpion sting, innate immune cells are exposed to the venom molecules, which bind to pattern recognition receptors and activate pro-inflammatory pathways that contribute toward the promotion of severe symptoms, such as pulmonary edema, and eventually lead to death. In this review, we highlight studies that pointed out inflammation as a major pathological facet of scorpion envenomation, so as to provide novel targets to improve therapeutics for scorpionism. [Display omitted] •Severe scorpion envenomation promotes intense inflammatory responses.•Scorpion venom is recognized by innate immune cells via Pattern Recognition Receptors (PRRs)•Systemic effects of scorpion envenomation include cytokine/eicosanoid storms.•Immune system hyperactivation controls development of severe symptoms.•Inflammatory pathways provide novel therapeutic targets to overcome fatal outcomes.