Scorpions and scorpion sting envenoming (scorpionism) in the Arab Countries of the Middle East

Emerging therapeutic applications of scorpion venom peptides in the Middle East and North Africa: A comprehensive review

The predominantly arid and semi-arid climate, with high temperatures and vast desert areas in the Middle East and North Africa (MENA) region, creates a favorable environment for scorpions, resulting in diversity of species of different genera. Animal venom, particularly scorpion venom, poses a health risk to victims who are envenomed. However, its abundance of bioactive protein molecules also makes it a promising source for new drug development. Numerous studies worldwide have revealed that venom-based molecules exhibit diverse therapeutic activities, including anticancer, antidiabetic, antimicrobial, anti-hypertensive, immunomodulatory, and analgesic properties. Researchers from MENA region are also actively contributing to this global challenge. In this review, we will explore the abundance and diversity of scorpions in the MENA region and examine recent studies on the therapeutic activities of molecules extracted from their venom. Nonetheless, additional research is needed to address the challenges of developing effective natural drugs from scorpion venom.

Assessing the role of medical entomology in general medicine education in Iran: expert perspectives and curriculum implications

INTRODUCTION

The Ministry of Health, Treatment and Medical Education in Iran has tried integrating the primary science curriculum with the clinical program. This means educational reform has been implemented in most medical schools in Iran. In the study of the medical entomology Discipline, prioritization of educational needs, and determination of appropriate solutions to improve the status of the entomology Discipline in the Faculty of Medicine and Health, the basis of experts' opinions were examined and analyzed.

OBJETIVO

Insert the subject of medical entomology into the Medicine Discipline at the Faculty of Medicine and Health.

METHODOLOGY

The Nominal Group Technique (NGT), which was the papers for recording the opinions of the professors, was done after the focus group. In the focus group, the professors discussed the results obtained from the NGT. This method used the Delphi technique to exchange opinions (disagreement and consensus of experts).

RESULTS

According to the findings of this study, after two technical sessions of the Nominal group, the weak and strong points and required subjects for revision of the chapters of the medical entomology curriculum were determined. Medical entomology in Iranian universities of medical sciences is one of the important topics of medical parasitology Disciplines for general medical students because it provides information about Disease-vector insects and ways to control them (Results two rounds of Delphi).

CONCLUSION

The educational program of the entomology Discipline needs to be revised and evaluated after the implementation of the revised program.

Evaluation of Antivenom Therapy for Middle East Scorpion Envenomations

INTRODUCTION

Scorpion envenomation is a leading cause of envenomation in our region. Antivenom has been used successfully to treat the systemic manifestations of envenomations inflicted by toxic scorpions. Toxic scorpions common in our area include Leiurus quinquestriatus , Androctonus australis , and Buthus occitanus . This study describes the outcomes of children envenomated by these scorpions, and treated with SCORPIFAV, a polyvalent scorpion antivenom F(ab') 2 (equine), used since 2016 at our institution.

METHODS

A retrospective chart review of all children admitted with symptoms and signs of scorpion envenomation to Soroka University Medical Center, between September 1, 2019, and December 1, 2020, who received antivenom SCORPIFAV. Our center has a protocol mandating antivenom therapy for all patients manifesting autonomic excitation, agitation, and anxiety, or more pronounced symptoms, following suspected scorpion envenomation.

RESULTS

Three hundred patients were seen in the pediatric emergency department for scorpion envenomation during the study period, and 49 required antivenom (SCORPIFAV) as per departmental policy. Four of 49 developed allergic reactions during antivenom treatment: 2 manifested minor skin rashes treated with antihistamines only, and a further 2 required intramuscular adrenaline. There were no deaths in the study cohort and all patients recovered fully, with complete resolution of symptoms, signs, and laboratory features.

CONCLUSIONS

Patients treated with antivenom exhibited rapid resolution of symptoms without severe hypersensitivity. We recommend broadened availability of antivenom at sites where it is needed.

Severity of scorpion envenomation in Saudi Arabia: A systematic review

Over the course of five years, 72,168 scorpion stings were recorded in Saudi Arabia. Though a number of articles have been published on scorpion stings in the country, no review studies have sought to determine the severity of scorpion envenomation using a standardized scale. The purpose of this systematic review is, thus, to explore the signs and symptoms of scorpion envenomation victims in Saudi Arabia and classify them using the Abroug's severity scale. This review identified 49 articles published between January 1953 and September 2024 on scorpion sting incidents in Saudi Arabia. Out of this total, 26 (53.1 %) articles met the systematic review criteria. The selected articles were reviewed by an emergency physician, a pediatrician, an assistant professor, and a consultant in toxicology, knowing that all examined articles were published in peer reviewed journals indexed in PubMed, EMBASE, Scopus, Web of science and CINAHL. Preset keywords and medical subject headings (MeSH terms) were used for the review. Three reviewed studies reported that 20-52 % of scorpion victims are asymptomatic. Other studies confirmed that Class I local manifestations, such as pain, erythema, swelling, and burning are present in the majority of scorpion sting victims (47.4-100 %). Class II systemic symptoms, such as hypertension, tachycardia, restlessness, cold extremities, gastrointestinal abnormalities and priapism, were reported in 15 studies, while bleeding was recorded in 2 patients in the same study. More complicated Class III cases manifested neurological deteriorations (seizures, neurotoxicity and unconsciousness), pulmonary edema, and pulmonary/cardiac arrest. Jointly, the studies revealed that a total of 16,745 scorpion sting victims were admitted and hospitalized for more than 24 h, and hospital stay duration varied, for all patients, between 3 h and 4 weeks. Around 1371 cases in six studies refused treatment and were discharged against medical advice. Fifteen victims across ten studies died from the scorpion stings. Children and patients with pre-existing clinical conditions generally reported more severe signs and symptoms. Study findings showed that practitioners should be aware of the early warning signs of pulmonary edema, cardiac toxicity and myocarditis, which are not uncommon post scorpion envenomation. Practitioners should also take into consideration that electrolyte imbalances might occur, but they do not usually pose serious clinical problems. Hemorrhages might happen, but they are mostly treatable. In conclusion, it is advised that practitioners utilize the standardized Abroug's classification for grading signs and symptoms of scorpion stings.

Immunosuppressive therapies in scorpion envenomation: new perspectives for treatment

Scorpion envenoming is a relevant and neglected public health problem in some countries. The use of antivenom is widespread in many regions, targeting specific species of scorpions. However, the uncontrolled proliferation and adaptation of these animals to urban environments, combined with limited access to treatments in remote areas and delays in antivenom administration contribute to a significant number of fatalities from scorpion-related incidents. In recent decades, new research has revealed that the immune system plays an important role in triggering immunopathological reactions during scorpion envenoming, which places it as a therapeutic target; however, few clinical studies have been conducted. This work provides a review of the main immunopathological aspects of scorpion envenoming, as well as the clinical trials conducted to date on the use of corticosteroids for the treatment of scorpionism. We highlight emerging treatment perspectives as well as the need for further clinical trials. The use of corticosteroids in scorpionism, when appropriate, could significantly enhance access to treatment and help reduce fatalities associated with scorpion stings.

Drug Repositioning for Scorpion Envenomation Treatment Through Dual Inhibition of Chlorotoxin and Leiurotoxin

Scorpion envenomation, a grave public health concern, is primarily driven by the potent neurotoxins chlorotoxin and leiurotoxin present in Leiurus species venom. Developing effective treatments is crucial to mitigate its impact. Utilizing a drug-repositioning bioinformatics-based approach, potential inhibitors of these neurotoxins were identified from Food and Drug Administration (FDA)-approved drugs. Through virtual screening and subsequent molecular dynamics simulations, their ability to stabilize the peptides over time was evaluated. Among the compounds scrutinized, bolazine emerged as a promising candidate, demonstrating significant affinity for both neurotoxins, indicating potential dual inhibitory activity. Molecular dynamics simulations further corroborated the enhanced stability of bolazine complexes compared to neurotoxins alone. These findings suggest the feasibility of repurposing existing drugs to develop new therapeutic strategies to treat scorpion envenomation. Such interventions hold promise in alleviating the severe health repercussions of scorpion stings and meeting the urgent demand for effective remedies in affected communities.

Distribution mapping of deadly scorpions in Iran

Scorpion sting is a problem all over the world and becomes an acute problem when it is associated with death. Iran is known as a region with a large number of scorpions and, of course, with many cases of scorpion stings per year. So far, 11 scorpion species in Iran have been identified as dangerous, of which there are only three species for which deaths have been reported. Due to the importance of these three species, we prepared a distribution map of these three types of scorpions and discuss the implications of these findings in the larger context of dangerous scorpion stings in Iran.

New perspective for pathomechanism and clinical applications of animal toxins: Programmed cell death

Various animal toxins pose a significant threat to human safety, necessitating urgent attention to their treatment and research. The clinical potential of programmed cell death (PCD) is widely regarded as a target for envenomation, given its crucial role in regulating physiological and pathophysiological processes. Current research on animal toxins examines their specific components in pathomechanisms and injuries, as well as their clinical applications. This review explores the relationship between various toxins and several types of PCD, such as apoptosis, necroptosis, autophagy, ferroptosis, and pyroptosis, to provide a reference for future understanding of the pathophysiology of toxins and the development of their potential clinical value.

Study of the Acute Toxicity of Scorpion Leiurus macroctenus Venom in Rats

Background

The expansion of the territory of human habitation leads to inevitable interference in the natural range of distribution of one or another species of animals, some of which may be dangerous for human life. Scorpions-the Arachnida class and order Scorpiones-can be considered as such typical representatives. Scorpions of the Buthidae family pose a particular danger to humans. However, LD50 has not yet been defined for many species of this family, in particular, new representatives of the genus Leiurus. Leiurus macroctenus is a newly described species of scorpion distributed in Oman, and the toxicity of its venom is still unknown. Estimating the LD50 of the venom is the first and most important step in creating the antivenom and understanding the medical significance of the researched animal species. The purpose of this study was to determine the lethal dose (LD100), the maximum tolerated dose (LD0), and the average lethal dose (LD50) in rats when using Leiurus macroctenus scorpion venom.

Methods and Results

15 sexually mature scorpions were used in the study, which were kept in the same conditions and milked by a common method (electric milking). For the study, 60 male rats were used, which were injected intramuscularly with 0.5 ml of venom solution with a gradual increase in the dose (5 groups, 10 rats in each), and 10 rats were injected intramuscularly with physiological solution as control group. LD calculations were done using probit analysis method in the modification of the method by V.B. Prozorovsky. The LD0 of Leiurus macroctenus scorpion venom under the conditions of intramuscular injection was 0.02 mg/kg, LD100 was 0.13 mg/kg, and LD50 was 0.08 ± 0.01 mg/kg.

Conclusions

The analysis of scientific publications and other sources of information gives reason to believe that Leiurus macroctenus has one of the highest values of LD50 not only among scorpions but also among all arthropods in the world. All these point to the significant clinical importance of this species of scorpion and require further research that will concern the toxic effect of its venom on various organ systems. Determining the LD50 of the venom for new scorpion species is crucial for creating effective antivenoms and understanding the medical implications of envenomation by this species.

Proteomic analysis and lethality of the venom of Aegaeobuthus nigrocinctus, a scorpion of medical significance in the Middle East

The scorpion Aegaeobuthus nigrocinctus inhabits areas in Turkey and the Levant region of the Middle East where severe/lethal envenomings have been reported. Previous research indicated its extreme venom lethality to vertebrates and distinct envenomation syndrome. We report on the composition of A. nigrocinctus venom from Lebanese specimens using nESI-MS/MS, MALDI-TOF MS, SDS-PAGE and RP-HPLC. Venom lethality in mice was also assessed (LD50 = 1.05 (0.19-1.91) mg/kg, i.p), confirming A. nigrocinctus venom toxicity from Levantine populations. Forty-seven peaks were resolved using RP-HPLC, 25 of which eluted between 20 and 40 % acetonitrile. In reducing SDS-PAGE, most predominant components were <10 kDa, with minor components at higher molecular masses of 19.6, 26.1, 46.3 and 57.7 kDa. MALDI-TOF venom fingerprinting detected 20 components within the 1,000-12,000 m/z range. Whole venom 'shotgun' bottom-up nLC-MS/MS approach, combined with in-gel tryptic digestion of SDS-PAGE bands, identified at least 67 different components belonging to 15 venom families, with ion channel-active components (K+ toxins (23); Na+ toxins (20); Cl- toxins (2)) being predominant. The sequence of a peptide (named α-KTx9.13) ortholog to Leiurus hebraeus putative α-KTx9.3 toxin was fully determined, which exhibited 81-96 % identity to other members of the α-KTx9 subfamily targeting Kv1.x and Ca2+-activated K+ channels. Chlorotoxin-like peptides were also identified. Our study underscores the medical significance of A. nigrocinctus in the region and reveals the potential value of its venom components as lead templates for biomedical applications. Future work should address whether available antivenoms in the Middle East are effective against A. nigrocinctus envenoming in the Levant area.

From fangs to antidotes: A scoping review on snakebite burden, species, and antivenoms in the Eastern Mediterranean Region

BACKGROUND

Snake bites cause considerable morbidity and mortality worldwide, yet evidence from low- and middle-income countries remains fragmented. This is particularly the case in Eastern Mediterranean Region where available data on snake bites is relatively weak. Without reliable data, it is difficult to make the case for greater visibility and investment to address the snakebite burden in this Region. A scoping review was therefore conducted to summarize evidence on snake bites in countries of the Eastern Mediterranean.

METHODOLOGY/PRINCIPAL FINDINGS

The review employed manual and electronic searching methods of four databases plus Google Scholar, ultimately including 196 records from 20 countries published between 2000 and 2023. More than half originated from Iran, Morocco, and Pakistan. Many records lacked information on permanent sequalae, disability, snake species, and types and sources of antivenoms. When identified, offending snakes belonged to 30 species. Use of more than 12 types of antivenoms were described across the Region, and some were not specific to indigenous species.

CONCLUSION/SIGNIFICANCE

Despite the relatively large number of publications identified, the data were concentrated in just a few countries in the Region, and there was little or no information available for the remainder. As is the case worldwide, disability associated with snake bites was poorly characterized and quantified across the Region. There is an urgent need for concrete action at national and regional levels to enhance epidemiological surveillance, research, and the collection of clinical, disability and outcomes data to inform policy and public health investment. Greater regional cooperation and collaboration is also crucial for addressing this neglected disease throughout the Region.

The role of social media in public health awareness during times of war in Sudan: snakebites and scorpion stings

BACKGROUND

Snakebite envenomation (SBE) and scorpion sting envenomation (SSE) are significant neglected tropical diseases that primarily affect impoverished communities in rural areas of developing nations. A lack of understanding about snake and scorpion species and their distribution exacerbates the disabilities and fatalities caused by SBE and SSE. In Sudan, particularly in regions affected by ongoing conflicts where healthcare resources are scarce, social media platforms offer a cost-effective approach to addressing public health challenges. Our aim in this study is to highlight the benefits of using social media for data collection and health promotion in such environments.

METHODS

We present a cost-effective communication and data collection strategy implemented at the Toxic Organisms Research Centre (TORC) of the University of Khartoum, focusing on a Facebook group, "Scorpions and Snakes of Sudan", as our primary social media platform. Additionally, we discuss the lessons learned and the initial impact of this strategy on enhancing population health literacy.

RESULTS

The group community is composed of ~ 5000 members from 14 countries. During the period from January 2023 to January 2024, we received 417 enquiries about snakes and scorpions belonging to 11 families and composed of 55 species. In addition, 53 other enquiries covered a range of organisms and their tracks (e.g., spiders, skinks, chameleons, foxes, sun spiders, centipedes, lizards, moth larvae, and insect tracks). The first photographic evidence of Malpolon monspessulanus in Sudan was via the group activities. The rare species Telescopus gezirae, the Blue Nile cat snake, is also documented via the group member's queries. Recognizing the evolving nature of social media use in public health, we also address the current limitations and evidence gaps that need to be addressed to effectively translate best practices into policy.

CONCLUSION

In conclusion, utilizing Facebook as an institutional platform to share scientific information in simple Arabic language underscores the proactive roles that citizens, scientists, and public health stakeholders can play in leveraging social media for eHealth, eAwareness, and public health initiatives. This approach highlights the potential for collaborative efforts, particularly during crises, to maximize the benefits of social media in advancing public health.

Traditional knowledge of animal-derived medicines used by Gelao community in Northern Guizhou, China

INTRODUCTION

This study aims to document and preserve the traditional medicinal knowledge of the Gelao community in Northern Guizhou, China, providing valuable insights for modern pharmacological research and the development of these traditional remedies.

METHODS

Our methodology encompassed a blend of literature review, community interviews, and participatory observation to delve into the traditional knowledge of animal-derived medicines among the Gelao community. We employed quantitative ethnological and ecological assessment techniques to evaluate the significance of these practices. Informed consent was secured before conducting interviews, with a focus on ascertaining the types of medicines familiar to the informants, including their local names, sources, methods of preparation, application techniques, diseases treated, frequency of use, and safety considerations.

RESULTS

Our research cataloged 55 varieties of animal-derived medicines utilized by the Gelao people. Out of these, 34 originate from wild animals, mainly encompassing small insects, reptiles, and aquatic species; the remaining 21 are derived from domesticated animals, largely involving their tissues, organs, and various physiological or pathological by-products. These medicines are primarily applied in treating pediatric ailments (13 types), internal disorders (11 types), gynecological issues (3 types), dermatological problems (7 types), ENT conditions (3 types), trauma-related injuries (5 types), joint and bone ailments (5 types), infections (2 types), dental issues (2 types), and urolithiasis (1 type), with three types being used for other miscellaneous conditions. Commonly utilized medicines, such as honey, Blaps beetle, chicken gallstones, and snake-based products, are preferred for their availability, edibility, and safety within the Gelao communities.

CONCLUSION

The Gelao community's traditional medicines represent a rich diversity of animal sources, showcasing extensive expertise and knowledge in their processing and clinical applications. This wealth of traditional knowledge offers novel perspectives for the contemporary pharmacological study and development of these remedies. Additionally, our research plays a crucial role in aiding the preservation and continuation of this invaluable cultural heritage.

Epidemiological study in Brazil: Scorpion sting cases in Natal, Rio Grande do Norte

Scorpion sting accidents are a public health problem in the state of Rio Grande do Norte, Brazil. The increasing and high incidence of cases in urban areas reveals the importance of studies to determine the epidemiological profile and the spatial distribution of these accidents. This is a retrospective study that describes and analyzes the cases of scorpion stings in the city of Natal, Rio Grande do Norte, Northeast Brazil, from 2007 to 2018. Data from the Information System database of Notifiable Diseases (SINAN) were obtained from the Secretary of Health of Rio Grande do Norte. 31,368 accidents due to scorpion stings were reported, more frequently in urban areas of Natal, whose Human Development Index is low. The cases occurred predominantly in hot and humid regions, mainly affecting women aged between 30 and 60 years. Most individuals sought medical attention within 3 h of the incident. The severity and mortality of the injured individuals varied according to the area of occurrence, age of the patient, and the local and systemic symptoms presented. Pain, numbness, and edema were the most frequent local symptoms, and systemic symptoms were frequently described as headache, hyperthermia and sweating. Therefore, scorpionism in the city of Natal is an environmental and public health problem, with a significant growth trend (p < 0.05). Through the data collected on the spatial distribution and risks, this approach allows the creation of effective control strategies to prevent accidents.

Neutralization Capacity of Tissue Alterations Caused by the Venoms of the Most Dangerous Scorpions in North Africa Using a Selective Antivenom

In North Africa, scorpion stings pose an urgent public health problem, particularly for children with high morbidity and mortality rates. The main species implicated are the Androctonus mauretanicus (Am), Androctonus australis hector (Aah), and Buthus occitanus (Bo). Immunotherapy is the specific therapeutic approach aimed at directly neutralizing toxins, despite their severity and rapid diffusion. In the present study, we evaluate, histologically and immunohistologically, the neutralization potency of the selective antivenom produced against, among other species, the Am, Aah, and Bo at the level of the tissue alterations in Swiss mice, as experimental subjects. Firstly, the lethal doses 50 test was conducted to assess the venom's toxic activity, and then the median effective dose of the antivenom was determined against each venom. The histological and immunohistological analyses were performed by injecting the sublethal dose of venom, the complex venom and antivenom, or the antivenom 2 h following inoculation of venom. Our study revealed the highest toxicity of the Am, followed by the Aah and then the Bo venom. The neutralizing ability and effectiveness of the antivenom to completely or partially neutralize the tissular damages were demonstrated in all organs studied: brain, heart, lungs, liver, and kidneys. Our results highlighted the important cytoplasmic and membranous staining in the heart compared to the brain tissue for the three scorpion venoms. Therefore, the scorpionic antivenoms are able to reach their target even at the tissue level. Immunotherapy represents the specific and recommended treatment against the scorpionic stings in North Africa.

Proteomic profile of the venom of three dark-colored Tityus (Scorpiones: Buthidae) from the tropical rainforests of Costa Rica

OBJECTIVE

We aimed to elucidate the potential differences in the venom peptide sequences of three Tityus species from Costa Rican rainforests: T. jaimei, T. championi and T. dedoslargos, compared to T. cf. asthenes from Colombia, which could explain the low level of scorpionism in Costa Rica, evidenced by the lack of epidemiological data.

METHODOLOGY

We applied venom proteomics of peptides purified by RP-HPLC and compared the obtained sequences from venoms of these Tityus species to the sequences previously identified from Tityus inhabiting other Central and South American regions.

RESULTS

Venom proteome analysis evidences that most of the putative peptide toxins identified in Costa Rican dark-colored Tityus are very similar to those present in other T. (Atreus) from the region.

CONCLUSIONS

Our study suggests that, in the case of potential envenomation by Tityus in Costa Rica, the same level of toxicity should be observed, compared to other cases caused by members of the subgenus from other geographical localities. On the other hand, compared to countries with more accelerated urban expansion, Costa Rican Tityus still inhabit secondary rainforests and do not commonly share the same spaces with humans, so the lack of epidemiological evidence of medical emergencies caused by envenoming by this scorpion group could be more related to ecological and demographic factors and less attributed to the characteristics of the venom.

LmNaTx15, a novel scorpion toxin, enhances the activity of Nav channels and induces pain in mice

Polypeptide toxins are major bioactive components found in venomous animals. Many polypeptide toxins can specifically act on targets, such as ion channels and voltage-gated sodium (Nav) channels, in the nervous, muscle, and cardiovascular systems of the recipient to increase defense and predation efficiency. In this study, a novel polypeptide toxin, LmNaTx15, was isolated from the venom of the scorpion Lychas mucronatus, and its activity was analyzed. LmNaTx15 slowed the fast inactivation of Nav1.2, Nav1.3, Nav1.4, Nav1.5, and Nav1.7 and inhibited the peak current of Nav1.5, but it did not affect Nav1.8. In addition, LmNaTx15 altered the voltage-dependent activation and inactivation of these Nav channel subtypes. Furthermore, like site 3 neurotoxins, LmNaTx15 induced pain in mice. These results show a novel scorpion toxin with a modulatory effect on specific Nav channel subtypes and pain induction in mice. Therefore, LmNaTx15 may be a key bioactive component for scorpion defense and predation. Besides, this study provides a basis for analyzing structure-function relationships of the scorpion toxins affecting Nav channel activity.

Protein and peptide profiles of rats' organs in scorpion envenomation

Problem of scorpion envenomation becomes more alarming each year. Main effects of scorpion venom are commonly believed to be related to its neurotoxic properties, yet severe symptoms may also be developed due to the uncontrolled enzymatic activity and formation of various bioactive molecules, including middle-mass molecules (MMMs). MMMs are considered as endogenous intoxication markers, their presence may indicate multiple organ failure. Scorpions, belong to the Leiurus macroctenus species, are very dangerous, nevertheless, effects of their venom on protein and peptide composition within the tissues remains unclear. In this work we have focused the attention on changes in protein and MMM levels and peptide composition in various organs during Leiurus macroctenus envenomation. The results revealed a decrease in protein level during envenomation as well as a significant increment of MMM₂₁₀ and MMM₂₅₄ levels in all assessed organs. Quantitative and qualitative compositions of various protein and peptide factions were continually changing. All of this may suggest that Leiurus macroctenus sting causes considerable destruction of cell microenvironment across all essential organs, providing systemic envenomation. In addition, MMM level increment may indicate endogenous intoxication development. Peptides, formed during envenomation, may possess various bioactive properties, analysis of which constitutes an area of further studies.

Bioactive peptides from scorpion venoms: therapeutic scaffolds and pharmacological tools

Evolution and natural selection have endowed animal venoms, including scorpion venoms, with a wide range of pharmacological properties. Consequently, scorpions, their venoms, and/or their body parts have been used since time immemorial in traditional medicines, especially in Africa and Asia. With respect to their pharmacological potential, bioactive peptides from scorpion venoms have become an important source of scientific research. With the rapid increase in the characterization of various components from scorpion venoms, a large number of peptides are identified with an aim of combating a myriad of emerging global health problems. Moreover, some scorpion venom-derived peptides have been established as potential scaffolds helpful for drug development. In this review, we summarize the promising scorpion venoms-derived peptides as drug candidates. Accordingly, we highlight the data and knowledge needed for continuous characterization and development of additional natural peptides from scorpion venoms, as potential drugs that can treat related diseases.

Morphometric and meristic diversity of the species Androctonus crassicauda (Olivier, 1807) (Scorpiones: Buthidae) in Saudi Arabia

Intraspecific molecular and morphological variations among geographically isolated populations are useful for understanding the evolutionary processes, which is considered early stage of allopatric speciation. Also, the knowledge of the regional variation of scorpion venom composition is needed to improve antivenom therapeutic management. Androctonus crassicauda (Olivier, 1807) is the most common and medically important species in Arabia and the Middle East. Therefore, this study aimed to investigate the geographic morphological variation among A.crassicaudapopulations, regarding its geographical distribution in unexplored arid regions in Saudi Arabia. Samples were collected and examined morphologically under a dissecting microscope from different four eco-geographical regions. The results of ANOVA and multivariate statistical analyses provide strong evidence of geographical variation. The two populations from OTU3 and OUT4 showed the greatest degree of morphological difference from populations of OUT1 and OUT2. Each OTU3 and OTU4 populations showed significant speciation without overlapping in the two groups, while the remaining overlapped groups comprised two other populations. Several body variables influenced male separation, including carapace posterior width, metasoma 3rd length, and metasoma 2nd length. For females, telson length, metasoma 1st width, and sternite 7th width were highly influential variables. Such variation may suggest the existence of cryptic taxa within A. crassicauda populations in Saudi Arabia. Moreover, metasoma ratios can be used as good indicators in intraspecific variation studies of Scorpions.

Scorpion Venom Polypeptide Inhibits Pulmonary Epithelial-Mesenchymal Transition in Systemic Sclerosis-Interstitial Lung Disease Model Mice by Intervening TGF-β1/Smad Signaling Pathway

Objective

Interstitial lung disease (ILD) is an important complication of systemic sclerosis (SSc). The aim of this study was to investigate the effect and possible mechanism of polypeptide extract of scorpion venom (PESV) on SSc-ILD.

Methods

C57/BL6 mice were injected with bleomycin to establish a SSc-ILD model. Different concentrations of PESV solution were administered to SSc-ILD mice, and dexamethasone was used as a positive control. H&E staining and Masson staining were used to observe the pathological changes. The TGF-β1 expression level was detected by immunohistochemistry. The expression of epithelial-mesenchymal transition (EMT)-related proteins was detected by Western blot, and the expression of TGF-β1/Smad pathway-related proteins was also detected. The content of inflammatory cytokines in serum and BALF was determined by ELISA.

Results

Pathological analysis showed that PESV could alleviate SSc-ILD-induced pulmonary inflammation and fibrosis. Compared with the model group, the content of inflammatory cytokines IL-6 and TNF-α significantly decreased after PESV treatment. PESV could increase the expression of epithelial marker (E-cadherin) and reduce the expression of interstitial markers (collagen I, vimentin, N-cadherin, and a-SMA). In addition, PESV could reduce the expression level of TGF-β1/Smad pathway-related protein.

Conclusion

PESV can attenuate SSc-ILD by regulating EMT, and the effect was linked to the TGF-β1/Smad signaling pathway, which indicated that PESV may serve as a candidate drug for SSc-ILD.

Scorpion envenomation in the state of São Paulo, Brazil: Spatiotemporal analysis of a growing public health concern

Scorpion envenomation is a significant public health concern in São Paulo, Brazil, and its incidence and mortality have increased in recent decades. The present study analyzed documented scorpion envenomation notifications from 2008 to 2018 throughout the 645 municipalities of São Paulo. Annual incidence and mortality rates were calculated and stratified according to sex and age. The local empirical Bayesian method and Getis-Ord Gi* statistic were used to represent standardized incidence rates in the municipalities and to identify high- and low-risk agglomerates. The incidence rate of scorpion envenomation quintupled between 2008 and 2018. Overall, the risk was higher for man, and increased with age. Deaths due to envenomation, however, were concentrated almost entirely in children 0–9 years of age. Incidence maps showed that the risk of envenomation increased in almost all regions and municipalities of São Paulo throughout the study period. The highest incidence rates were found in the western, northwestern and northern regions of the state, in contrast to the São Paulo metropolitan area and southern and coastal regions. Hot spots were identified in the Presidente Prudente, Barretos, São José do Rio Preto, and Araçatuba regional health districts, which over time formed a single high-risk cluster. In spatial terms, however, deaths were randomly distributed. In this study, we identified areas and populations at risk of scorpion envenomation and associated–fatalities, which can be used to support decision-making by health services to reduce human contact with these arachnids and avoid fatalities, especially in children.

The Enzymatic Core of Scorpion Venoms

Enzymes are an integral part of animal venoms. Unlike snakes, in which enzymes play a primary role in envenomation, in scorpions, their function appears to be ancillary in most species. Due to this, studies on the diversity of scorpion venom components have focused primarily on the peptides responsible for envenomation (toxins) and a few others (e.g., antimicrobials), while enzymes have been overlooked. In this work, a comprehensive study on enzyme diversity in scorpion venoms was performed by transcriptomic and proteomic techniques. Enzymes of 63 different EC types were found, belonging to 330 orthogroups. Of them, 24 ECs conform the scorpion venom enzymatic core, since they were determined to be present in all the studied scorpion species. Transferases and lyases are reported for the first time. Novel enzymes, which can play different roles in the venom, including direct toxicity, as venom spreading factors, activators of venom components, venom preservatives, or in prey pre-digestion, were described and annotated. The expression profile for transcripts coding for venom enzymes was analyzed, and shown to be similar among the studied species, while being significantly different from their expression pattern outside the telson.

Terrestrial venomous animals, the envenomings they cause, and treatment perspectives in the Middle East and North Africa

The Middle East and Northern Africa, collectively known as the MENA region, are inhabited by a plethora of venomous animals that cause up to 420,000 bites and stings each year. To understand the resultant health burden and the key variables affecting it, this review describes the epidemiology of snake, scorpion, and spider envenomings primarily based on heterogenous hospital data in the MENA region and the pathologies associated with their venoms. In addition, we discuss the venom composition and the key medically relevant toxins of these venomous animals, and, finally, the antivenoms that are currently in use to counteract them. Unlike Asia and sub-Saharan Africa, scorpion stings are significantly more common (approximately 350,000 cases/year) than snakebites (approximately 70,000 cases/year) and present the most significant contributor to the overall health burden of envenomings, with spider bites being negligible. However, this review also indicates that there is a substantial lack of high-quality envenoming data available for the MENA region, rendering many of these estimates speculative. Our understanding of the venoms and the toxins they contain is also incomplete, but already presents clear trends. For instance, the majority of snake venoms contain snake venom metalloproteinases, while sodium channel-binding toxins and potassium channel-binding toxins are the scorpion toxins that cause most health-related challenges. There also currently exist a plethora of antivenoms, yet only few are clinically validated, and their high cost and limited availability present a substantial health challenge. Yet, some of the insights presented in this review might help direct future research and policy efforts toward the appropriate prioritization of efforts and aid the development of future therapeutic solutions, such as next-generation antivenoms.

DNA Barcoding for Scorpion Species from New Valley Governorate in Egypt Reveals Different Degrees of Cryptic Speciation and Species Misnaming

(1) Background: Scorpions (Arthropoda: Arachnida) represent a diverse group of invertebrates, accounting for a significant proportion of earth’s predators and ecosystems’ modulators. Surviving mostly in hardly reachable nests, and representing key hazards to human health, they attracted major interest for characterizing their eco-, morpho-, and genotypes. (2) Methods: Four scorpion species were collected from the New Valley governorate in Upper Egypt, where a high level of scorpionism and related neurological symptoms are found, that were Leiurus quinquestriatus, Androctonus amoreuxi, Orthochirus innesi, Buthacus leptochelys. They were DNA barcoded, genetically and phylogenetically analyzed through PCR amplification and sequencing of the mitochondrial cytochrome oxidase subunit 1 (COI) gene hypervariable 5′ region. (3) Results: New, morphologically authenticated scorpion barcodes could be added to the barcoding databases. However, several discrepancies and barcode database inadequacies could be revealed. Moreover, taxon-specific patterns for nitrogenous bases’ distribution could be identified, resulting in a significantly high percentage of COI barcode guanine in scorpionids, in comparison to araneids and opilions. (4) Conclusions: For a group of animals where both cryptic speciation and a high risk of human envenomation are evident, the findings of the current study strongly recommend continuous and comprehensive research efforts dealing with morphogenetic authentication for different species of scorpions.