Tetrodotoxin

 

Tetrodotoxin (TTX) 

Substance

- Till 2019, around 28 analogs of TTX are known, but only 12 were detected in marine organisms [1]. Potent marine neurotoxin with bacterial origin: ( Pseudoalteromonas tetraodonis), a marine bacterium normally associated with the production of tetrodotoxin in pufferfish[2]).

- in some puffer fish, gastropods(腹足動物), and bivalves(雙殼類)[1].

- heat-stable and acid-stable, nonprotein, alkaloid toxin 

Common name or Trade name

 河豚毒素

Involving system

- blocking voltage-activated sodium channels, terminating nerve conduction and muscle action potentials, leading to progressive paralysis and, in extreme cases, to death from respiratory failure [3].

Presentation [4, 5]

-  Peri-oral paraesthesia (65%--72%)

- weakness of both lower limbs (59—62%%).

- paraesthesia all over the body (49%--64%).

- headache (41%--47%),

- difficulty in respiration (38%)

- nausea and vomiting (22%), blurring of vision (19%)

- vertigo (16%)  

 

Antidote and Treatment

-       Palliative / supportive treatment

-       No antidote. no specific treatment [4]

Disposition 

-       Mortality rate: 12--22%. [4, 5, 6]

REFERENCES

1.     Tamele IJ, Silva M, Vasconcelos V. The Incidence of Tetrodotoxin and Its Analogs in the Indian Ocean and the Red Sea. Mar Drugs. 2019 Jan 5;17(1):28. doi: 10.3390/md17010028. PMID: 30621279; PMCID: PMC6357042.

2.     Lee RD, Jospin G, Lang JM, Eisen JA, Coil DA. Draft Genome Sequence of Pseudoalteromonas tetraodonis Strain UCD-SED8 (Phylum Gammaproteobacteria). Genome Announc. 2015 Nov 5;3(6):e01276-15. doi: 10.1128/genomeA.01276-15. PMID: 26543114; PMCID: PMC4645199.

3.     Cole JB, Heegaard WG, Deeds JR, McGrath SC, Handy SM; Centers for Disease Control and Prevention (CDC). Tetrodotoxin poisoning outbreak from imported dried puffer fish--Minneapolis, Minnesota, 2014. MMWR Morb Mortal Wkly Rep. 2015 Jan 2;63(51):1222-5. PMID: 25551594.

4.     Ahasan HA, Mamun AA, Karim SR, Bakar MA, Gazi EA, Bala CS. Paralytic complications of puffer fish (tetrodotoxin) poisoning. Singapore Med J. 2004 Feb;45(2):73-4. PMID: 14985845.

5.     Chowdhury FR, Nazmul Ahasan HA, Mamunur Rashid AK, Al Mamun A, Khaliduzzaman SM. Tetrodotoxin poisoning: a clinical analysis, role of neostigmine and short-term outcome of 53 cases. Singapore Med J. 2007 Sep;48(9):830-3. PMID: 17728964.

6.     Islam QT, Razzak MA, Islam MA, Bari MI, Basher A, Chowdhury FR, Sayeduzzaman AB, Ahasan HA, Faiz MA, Arakawa O, Yotsu-Yamashita M, Kuch U, Mebs D. Puffer fish poisoning in Bangladesh: clinical and toxicological results from large outbreaks in 2008. Trans R Soc Trop Med Hyg. 2011 Feb;105(2):74-80. doi: 10.1016/j.trstmh.2010.10.002. Epub 2010 Dec 3. PMID: 21129761.

edited by Yu-Jang Su  March 24, 2021.