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Natural Sodium Channel Poison By: Abby(Qihang) Gan, Syed Hasan, Ji Yoon Park, Ji Hee Choi PHM142 Fall 2016 Instructor: Dr. Jeffrey Henderson November 23, 2016 Sodium Channels - Integral membrane proteins that form ion channels - conducts sodium ions through plasma membrane - Highly selective - Classification: - voltage-gated sodium channels - ligand-gated sodium channels Voltage-gated Sodium Channels - Responsible for action potential initiation and propagationin excitable cells - Unclear physiological role in unexcitablecells Ligand-gated Sodium Channels ● Found in neuromuscular junctions as nicotinic receptors ○ Ligands =acetylcholine ● Response: create change in membrane potential first Natural Poisons - Types: - blockers peptides non-peptides lipoproteins gating-modifiers, etc. - Examples: - Tetrodotoxin (TTX) - Saxitoxin (STX) - Batrachotoxin (BTX) Tetrodotoxin (TTX) ● Extremely potent neurotoxin (than cyanide) ● Found in various animals: pufferfish, blue-ringed octopus, crabs, marine snails, frogs, newts, etc ○ Pufferfish: important since considered delicacy in Japan (called “Fugu”); ■ Preparation by specially licensed chefs ■ TTX concentrated in organs (esp. liver & ovaries) ● Produced by bacteria living in a mutualistic symbiosis with animals ○ ie. Vibrio and Pseudomonas TTX - Mechanism of action ● Very high affinity for voltage-gated sodium channels ● Binds and blocks the ion channel ○ Hypothesis: binding of guanidinium group (TTX) with carboxylate groups (residues in channel) ● No sodium influx = no depolarization = no action potentials ○ Lead to muscle paralysis ● Pufferfish: immune to TTX ○ Point mutation in sodium channel TTX - Symptoms of poisoning ● ● ● Symptoms show up in 10 min ~ 6 hours Initial symptoms: ○ paraesthesia (tingling, pins & needles) of lips & tongue ○ numbness of face and fingers ○ headache ○ excessive sweating ○ salivation ○ nausea ○ emesis ○ diarrhea ○ GI pain Death: in 20 minutes ~ 24 hours ● Later symptoms: ○ hypotension ○ speech difficulties ○ muscular weakness ○ difficulty moving ○ paralysis ○ difficulty breathing ○ respiratory arrest ○ death TTX - Treatment ● ● ● No antidote Treatment is primarily supportive: ○ Monitor vitals ○ Secure airway: endotracheal intubation if respiratory arrest ○ Establish IV line: if medication needed ○ Administer activated charcoal: bind toxin and possibly utilize gastric lavage Those who survive the first 24 hours generally recover ○ Recovery can take days Saxitoxin (STX) - water soluble, non-peptide neurotoxin - paralytic shellfish toxins - dinoflagellates and cyanobacteria - shellfish - humans saxitoxin Saxidomus gigantea Saxitoxin - mechanism of action - voltage gated sodium channels - direct blockage of ion pore - also calcium and potassium channels Saxitoxin - symptoms and treatment - tingling/burning lips, mouth, and throat; facial numbness perspiration, diarrhea, vomiting muscular weakness, loss of motor coordination, paralysis respiratory arrest, cardiovascular shock, death no clinically approved treatment Batrachotoxin (BTX) ● One of most potent natural toxin ● Neurotoxic and cardiotoxic steroidal alkaloid ● Found in certain species of frogs, beetles, birds: ○ ○ ○ ○ ○ Poison dart frog Melyrid beetles Pitohui Blue-capped ifrit Little shrikethrush ● Colourless, milky secretions from glands on back and behind ears ○ released when agitated, threatened, or in pain Batrachotoxin - mechanism of action ● Effects in PNS and in heart ● Irreversible binding to voltage-gated sodium channels ● Keep channel open → by lowering threshold potential ● Paralysis Batrachotoxin - symptoms and treatment ● Severe effect in heart: ○ ○ ○ ○ ○ impairment in cardiac function arrhythmias extrasystoles ventricular fibrillation heart arrest ● No effective permanent antidote ○ hypothesis: bind only in open conformation ● Temporary treatment: TTX or STX ○ ○ receptor antagonist competitive antagonist Summary ● Sodium channels: highly selective, ion channel with two classes→ voltage-gated and ligand-gated ○ ● important in action potentialinitiation Natural Poisons: no permanent antidote; effects toneural, muscular, respiratory and cardiovascular system ○ ○ ○ TTX: found in pufferfish ■ Direct blocker of sodium channels withhigh affinity ■ No sodium influx = no depolarization = no action potentials leading to paralysis STX: found in paralyticshellfish ■ Direct blocker of sodiumchannels ■ also affect calcium and potassiumchannels BTX: found in poison dartfrogs ■ irreversibly bind causing permanent opening ofchannel ■ leading to paralysis of muscles and effectsin heart References ● ● ● ● ● ● ● ● ● ● ● ● ● http://www.chm.bris.ac.uk/motm/ttx/ttx.htm http://www.life.umd.edu/grad/mlfsc/zctsim/ionchannel.html http://emedicine.medscape.com/article/818763-overview http://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750019.html http://emedicine.medscape.com/article/818763-treatment#showall https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663416/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877881/ http://www.jyi.org/wp-content/uploads/JYI-Volume-23-Issue-2-Faber-Samantha_Saxitoxin-and-the-induction-of-paralytic-she llfish-poisoning4.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705384/ http://www.dereilanatureinn.ca/lagoon/marine-guide/b-5.htm http://www.wou.edu/las/physci/ch350/Projects_2006/Grimes/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC430544/ http://www.chm.bris.ac.uk/motm/batrachotoxin/batrah.htm