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Rapid detection of convallatoxin using five digoxin immunoassays
S L Fink1, T E Robey, A F Tarabar
1Department of Laboratory Medicine, Yale School of Medicine , New Haven, CT , USA.
Clinical Toxicology (Philadelphia, Pa.)
|July 2, 2014
Summary
Digoxin assays can detect convallatoxin from lily of the valley ingestion, aiding rapid diagnosis. However, digoxin immune Fab is not an effective antidote for convallatoxin poisoning.
Area of Science:
- Toxicology
- Pharmacology
- Analytical Chemistry
Background:
- Plant-derived cardiac glycosides, like convallatoxin, pose significant poisoning risks.
- Existing digoxin assays detect some plant glycosides, but their utility for convallatoxin is unproven.
- Digoxin immune Fab efficacy as an antidote for convallatoxin is unknown.
Purpose of the Study:
- Evaluate digoxin assays for convallatoxin cross-reactivity.
- Determine in vivo detection of convallatoxin.
- Assess digoxin immune Fab as a convallatoxin antidote.
Main Methods:
- Assessed cross-reactivity of convallatoxin and oleandrin with five digoxin immunoassays.
- Measured apparent digoxin levels in serum from convallatoxin-treated mice.
- Determined in vitro binding of convallatoxin to digoxin immune Fab.
Main Results:
- Convallatoxin and oleandrin showed variable cross-reactivity with digoxin assays.
- Apparent digoxin levels were detected in intoxicated mice.
- Convallatoxin did not bind to digoxin immune Fab.
Conclusions:
- Digoxin immunoassays can detect botanical cardiac glycosides like convallatoxin, aiding exposure assessment.
- Digoxin immune Fab is unlikely to be therapeutically beneficial for convallatoxin poisoning.
