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New biomarkers in scorpion stings
Juliana Sartorelo Almeida1, Cecilia Gomez Ravetti2, Vandack Alencar Nobre2
1Toxicology Department from Hospital João XXIII, Minas Gerais Toxicological Information and Assistance Center (CIAToxMG), Belo Horizonte, Brazil; Interdisciplinary Research Center in Intensive Care Medicine (NIIMI), Brazil.
New biomarkers, soluble suppression tumorigenicity 2 (sST2) and heart-type fatty-acid-binding protein (FABP3), show promise in detecting cardiac dysfunction from scorpion stings in children, similar to troponin.
Area of Science:
- Cardiology
- Pediatric Toxicology
- Biomarker Research
Background:
- Scorpion stings cause significant mortality, particularly in children, with cardiac dysfunction being a primary cause of death.
- Current diagnostic methods for scorpion sting-induced cardiac dysfunction include echocardiograms and established biomarkers like troponin, CKMB, and BNP.
- There is a need for more sensitive and accessible tools for early detection of cardiac damage in pediatric scorpion sting victims.
Purpose of the Study:
- To evaluate the diagnostic accuracy of soluble suppression tumorigenicity 2 (sST2) and heart-type fatty-acid-binding protein (FABP3) in identifying cardiac dysfunction in pediatric patients following scorpion stings.
- To compare the efficacy of sST2 and FABP3 with traditional biomarkers such as troponin in detecting cardiac lesions.
Main Methods:
- A prospective cross-sectional study involving 49 pediatric patients (0-19 years) with scorpion stings and signs of severity.
- Serum or plasma samples were analyzed for sST2 and FABP3 levels using standardized kits.
- Cardiac dysfunction was assessed using cardiac ultrasound, with biomarker results compared against ultrasound findings.
Main Results:
- Left ventricular dysfunction was detected in 26.5% of patients, with 7 cases being severe.
- Both sST2 (AUC 0.77) and FABP3 (AUC 0.81) demonstrated an association with left ventricular dysfunction.
- The determined cut-off values for sST2 and FABP3 showed a high sensitivity (92.3%), comparable to ultrasensitive troponin (AUC 0.89, sensitivity 84.6%).
Conclusions:
- sST2 and FABP3 are associated with acute cardiac dysfunction in pediatric scorpion sting patients.
- These novel biomarkers exhibit significant sensitivity in detecting cardiac damage, offering a potential alternative or adjunct to troponin testing.
- Early detection of cardiac lesions and subclinical dysfunction using sST2 and FABP3 may facilitate timely and effective interventions in managing scorpion sting envenomation.
