[Theoretical and experimental bases for treatment of scorpion envenomations]

Improving the efficacy of envenomation treatment depends on what is known about active molecules present in venoms. Regarding scorpions, studies carried out mainly on the most poisonous species have shown that the toxicity and mortality were due to small proteins-toxins--able to interfere with the normal process of the ionic channels. In certain cases, using the mouse model, it has been shown that over 90% of mortality was due to toxins operating on the sodium channels implicated in the action potential of the excitable cells. Pharmacokinetic studies have shown the diversity of their mode of action implying an adaptation of the means and tools intended to neutralise them. The toxins active on the sodium channels represent a family of proteins from 60 to 65 amino acids linked by 4 disulphide bridges with a very strong antigenic polymorphism; this has certain implications in terms of paraspecificity of antivenoms. The problem is even more complicated when one considers the variation of toxin quantity from one animal to another of the same species. Another approach is to identify the most active and represented toxins in venoms for each antigenic group and to develop a means of neutralizing them. It would also be possible to define toxoids for use either in the production of the antivenoms or as immunological protection for individuals at risk. Lastly, where symptomatic treatment is concerned, certain drugs such as aspirin, quinine or dandrolene have been shown definitely to increase the value of the LD50 in the mouse.