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Abbes M, Montana M, Curti C, Vanelle P. Ricin poisoning: A review on contamination source, diagnosis, treatment, prevention and reporting of ricin poisoning. Toxicon 2021; 195:86-92. [PMID: 33711365 DOI: 10.1016/j.toxicon.2021.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/12/2021] [Accepted: 03/04/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Ricin, a toxic glycoprotein derived from the castor bean plant, is one of the most potent poisons known in the world. Ricin intoxication is a fatal and uncommon medical condition and recently its use as a potential bioterrorism agent has also been reported. This study aims to identify the main characteristics of diagnosed ricin poisoning cases worldwide in order to raise awareness of this toxin among the population and clinicians. METHODS A collection of human case studies of ricin intoxication in the world was produced. The databases Pubmed, Sciencedirect and Google Scholar were used to extract articles from January 1980 to June 2020. RESULTS Fifty ricin-intoxicated patients worldwide described in the literature have been identified. Most cases were found in Asia (19 cases), Europe (12 cases) and America (15 cases). Intoxication was mostly accidental (37 cases). Intoxication by castor bean is characterized by acute gastroenteritis-like disease as primary manifestations leading to severe fluid and electrolyte imbalance. The mechanism of death was peripheral vascular collapse and progressing multiple organ failure occurring 10h-72h after intoxication. The questioning of patients and family made it possible to retrieve an history of castor seeds or castor oil ingestion Patients received symptomatic treatment consisting mostly to rehydration with intravenous fluids and digestive decontamination performed with activated charcoal and/or gastric lavage within one day after the ingestion, to reduce gastrointestinal absorption of ricin. This decontamination treatment administered early has been very effective. Only six deaths were observed. DISCUSSION Currently, no antidote, vaccine, or other specific effective treatment is available for ricin poisoning or prevention. Prompt treatment with supportive care was necessary to limit morbidity and mortality. To date, patient education is essential to prevent this accidental poisoning. CONCLUSION Clinicians and health care professionals should have a high level of suspicion when faced with an outbreak of serious respiratory or gastrointestinal illness.
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Affiliation(s)
- Melissa Abbes
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Oncopharma, Hôpital de la Timone, Marseille, France
| | - Marc Montana
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Oncopharma, Hôpital de la Timone, Marseille, France; Aix Marseille Univ, CNRS, Institut de Chimie Radicalaire ICR, UMR, 7273, Laboratoire de Pharmaco-Chimie Radicalaire, Marseille, France
| | - Christophe Curti
- Aix Marseille Univ, CNRS, Institut de Chimie Radicalaire ICR, UMR, 7273, Laboratoire de Pharmaco-Chimie Radicalaire, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Service Central de la Qualité et de l'Information Pharmaceutiques (SCQIP), Marseille, France
| | - Patrice Vanelle
- Aix Marseille Univ, CNRS, Institut de Chimie Radicalaire ICR, UMR, 7273, Laboratoire de Pharmaco-Chimie Radicalaire, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Service Central de la Qualité et de l'Information Pharmaceutiques (SCQIP), Marseille, France.
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Isenberg SL, Carter MD, Miller MA, Noras AI, Mojica MA, Carlson ST, Bulathsinghala CP, Thomas JD, Johnson RC. Quantification of Ricinine and Abrine in Human Plasma by HPLC-MS-MS: Biomarkers of Exposure to Ricin and Abrin. J Anal Toxicol 2018; 42:630-636. [PMID: 29931062 PMCID: PMC6214751 DOI: 10.1093/jat/bky040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/30/2018] [Indexed: 12/25/2022] Open
Abstract
Ricin and abrin are toxic ribosome-inactivating proteins found in plants. Exposure to these toxins can be detected using the biomarkers ricinine and abrine, which are present in the same plant sources as the toxins. The concentration of the biomarkers in urine and blood will be dependent upon the purification of abrin or ricin, the route of exposure, and the length of time between exposure and sample collection. Here, we present the first diagnostic assay for the simultaneous quantification of both ricinine and abrine in blood matrices. Furthermore, this is the first-ever method for the detection of abrine in blood products. Samples were processed by isotope-dilution, solid-phase extraction, protein precipitation and quantification by HPLC-MS-MS. This analytical method detects abrine from 5.00 to 500 ng/mL and ricinine from 0.300 to 300 ng/mL with coefficients of determination of 0.996 ± 0.003 and 0.998 ± 0.002 (n = 22), respectively. Quality control material accuracy was determined to have <10% relative error, and precision was within 19% relative standard deviation. The assay's time-to-first result is three hours including sample preparation. Furthermore, the method was applied for the quantification of ricinine in the blood of a patient who had intentionally ingested castor beans to demonstrate the test was fit-for-purpose. This assay was designed to support the diagnosis of ricin and abrin exposures in public health investigations.
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Affiliation(s)
- Samantha L. Isenberg
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Melissa D. Carter
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael A. Miller
- Department of Emergency Medicine, Texas A&M, Christus Spohn Emergency Medicine Residency Program, Corpus Christi, TX
| | - Aleksandra I. Noras
- Oak Ridge Institute for Science and Education at the Centers for Disease Control and Prevention, Atlanta, GA
| | - Mike A. Mojica
- Battelle Memorial Institute at the Centers for Disease Control and Prevention, Atlanta, GA
| | - Sean T. Carlson
- Department of Emergency Medicine, Texas A&M, Christus Spohn Emergency Medicine Residency Program, Corpus Christi, TX
| | | | - Jerry D. Thomas
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rudolph C. Johnson
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
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Falach R, Israeli O, Gal Y, Sapoznikov A, Shifman O, Ehrlich S, Aftalion M, Beth-Din A, Sabo T, Kronman C. Identifying exposures to ribosome-inactivating proteins in blood samples: amplification of ricin-induced ribosomal damage products enables sensitive detection of active toxin and circulating depurinated 28S rRNA. Forensic Toxicol 2018. [DOI: 10.1007/s11419-018-0414-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Caride-Miana E. [Ingestion of castor seeds in attempting suicide]. Semergen 2017; 43:e21-e22. [PMID: 27507012 DOI: 10.1016/j.semerg.2016.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/08/2016] [Accepted: 06/29/2016] [Indexed: 10/21/2022]
Affiliation(s)
- E Caride-Miana
- Servicio de Urgencias, Hospital Marina Baixa, Villajoyosa, Alicante, España.
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Diaz JH. Poisoning by Herbs and Plants: Rapid Toxidromic Classification and Diagnosis. Wilderness Environ Med 2017; 27:136-52. [PMID: 26948561 DOI: 10.1016/j.wem.2015.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 10/28/2015] [Accepted: 11/15/2015] [Indexed: 02/05/2023]
Abstract
The American Association of Poison Control Centers has continued to report approximately 50,000 telephone calls or 8% of incoming calls annually related to plant exposures, mostly in children. Although the frequency of plant ingestions in children is related to the presence of popular species in households, adolescents may experiment with hallucinogenic plants; and trekkers and foragers may misidentify poisonous plants as edible. Since plant exposures have continued at a constant rate, the objectives of this review were (1) to review the epidemiology of plant poisonings; and (2) to propose a rapid toxidromic classification system for highly toxic plant ingestions for field use by first responders in comparison to current classification systems. Internet search engines were queried to identify and select peer-reviewed articles on plant poisonings using the key words in order to classify plant poisonings into four specific toxidromes: cardiotoxic, neurotoxic, cytotoxic, and gastrointestinal-hepatotoxic. A simple toxidromic classification system of plant poisonings may permit rapid diagnoses of highly toxic versus less toxic and nontoxic plant ingestions both in households and outdoors; direct earlier management of potentially serious poisonings; and reduce costly inpatient evaluations for inconsequential plant ingestions. The current textbook classification schemes for plant poisonings were complex in comparison to the rapid classification system; and were based on chemical nomenclatures and pharmacological effects, and not on clearly presenting toxidromes. Validation of the rapid toxidromic classification system as compared to existing chemical classification systems for plant poisonings will require future adoption and implementation of the toxidromic system by its intended users.
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Affiliation(s)
- James H Diaz
- Department of Environmental and Occupational Health Sciences, School of Public Health; Department of Anesthesiology/Critical Care, School of Medicine, Louisiana State University Health Sciences Center (LSUHSC) in New Orleans, New Orleans, LA.
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Simon S, Worbs S, Avondet MA, Tracz DM, Dano J, Schmidt L, Volland H, Dorner BG, Corbett CR. Recommended Immunological Assays to Screen for Ricin-Containing Samples. Toxins (Basel) 2015; 7:4967-86. [PMID: 26703725 PMCID: PMC4690108 DOI: 10.3390/toxins7124858] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 11/04/2015] [Accepted: 11/04/2015] [Indexed: 01/20/2023] Open
Abstract
Ricin, a toxin from the plant Ricinus communis, is one of the most toxic biological agents known. Due to its availability, toxicity, ease of production and absence of curative treatments, ricin has been classified by the Centers for Disease Control and Prevention (CDC) as category B biological weapon and it is scheduled as a List 1 compound in the Chemical Weapons Convention. An international proficiency test (PT) was conducted to evaluate detection and quantification capabilities of 17 expert laboratories. In this exercise one goal was to analyse the laboratories’ capacity to detect and differentiate ricin and the less toxic, but highly homologuous protein R. communis agglutinin (RCA120). Six analytical strategies are presented in this paper based on immunological assays (four immunoenzymatic assays and two immunochromatographic tests). Using these immunological methods “dangerous” samples containing ricin and/or RCA120 were successfully identified. Based on different antibodies used the detection and quantification of ricin and RCA120 was successful. The ricin PT highlighted the performance of different immunological approaches that are exemplarily recommended for highly sensitive and precise quantification of ricin.
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Affiliation(s)
- Stéphanie Simon
- CEA Saclay, Institute of Biology and Technologies of Saclay, Laboratory for Immunoanalytical Researches, Gif-sur-Yvette 91191 cedex, France.
| | - Sylvia Worbs
- Biological Toxins, Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353 Berlin, Germany.
| | - Marc-André Avondet
- Federal Department of Defence, Civil Protection and Sport-SPIEZ Laboratory, Spiez 3700, Switzerland.
| | - Dobryan M Tracz
- Bacteriology & Enteric Diseases Division, National Microbiology Laboratory, Public Health Agency of Canada,Winnipeg, MB R3E 3R2, Canada.
| | - Julie Dano
- CEA Saclay, Institute of Biology and Technologies of Saclay, Laboratory for Immunoanalytical Researches, Gif-sur-Yvette 91191 cedex, France.
| | - Lisa Schmidt
- Bacteriology & Enteric Diseases Division, National Microbiology Laboratory, Public Health Agency of Canada,Winnipeg, MB R3E 3R2, Canada.
| | - Hervé Volland
- CEA Saclay, Institute of Biology and Technologies of Saclay, Laboratory for Immunoanalytical Researches, Gif-sur-Yvette 91191 cedex, France.
| | - Brigitte G Dorner
- Biological Toxins, Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353 Berlin, Germany.
| | - Cindi R Corbett
- Bacteriology & Enteric Diseases Division, National Microbiology Laboratory, Public Health Agency of Canada,Winnipeg, MB R3E 3R2, Canada.
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
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Kaland ME, Klein-Schwartz W, Anderson BD. Toxalbumin exposures: 12 years' experience of U.S. poison centers. Toxicon 2015; 99:125-9. [PMID: 25817002 DOI: 10.1016/j.toxicon.2015.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/19/2015] [Accepted: 03/25/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Toxalbumins are natural plant toxins purported to be highly toxic. The purpose was to evaluate toxalbumin exposures reported to U.S. poison centers to determine plants involved and their toxicities. METHODS A retrospective review of National Poison Data System data on acute toxalbumin exposures with known outcomes from 2000 through 2011 was performed. RESULTS There were 1164 exposures. The majority involved one route (1135; 97.5%), mostly ingestions (904; 79.7%) or dermal (166; 14.3%). Most patients developed no effects (694; 59.6%) or minor effects (374; 32.1%). Moderate or major effects occurred in 8.3% with 66.6% ingestions and 23.9% dermal. There were no deaths. Exposures to the plants Ricinus communis and Robinia pseudoacacia were most common (33.8% and 32.9%, respectively), with gastrointestinal effects from R. communis (vomiting 19.6%, diarrhea 8.9%, nausea 7.9%) and dermal effects from R. pseudoacacia (puncture 28.7%, dermal irritation/pain 27.9%, and edema 13.3%). CONCLUSIONS While toxalbumin plant exposures were generally well-tolerated, continued evaluation of risk is warranted since plants were primarily identified by the public. Major effects occurred in under 1% of cases overall, and not at all following unintentional ingestions. These findings should help allay concerns that unintentional ingestions of toxalbumin plants by young children will cause serious toxicity and possibly death.
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Affiliation(s)
| | | | - Bruce D Anderson
- Maryland Poison Center, University of Maryland School of Pharmacy, USA
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Thornton SL, Darracq M, Lo J, Cantrell FL. Castor bean seed ingestions: a state-wide poison control system's experience. Clin Toxicol (Phila) 2014; 52:265-8. [PMID: 24579983 DOI: 10.3109/15563650.2014.892124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Ingestions of the seed of the castor bean plant (Ricinus communis) carries the risk of toxicity from ricin, a potent inhibitor of protein synthesis. OBJECTIVE We sought to describe characteristics of castor bean seed exposures reported to a state-wide poison control system. METHODS This was an observational case series. A state-wide poison control system's database was reviewed for exposures to castor bean plant seeds from 2001 to 2011. Case notes were reviewed and data collected, when available, included age, gender, circumstances surrounding exposure, number of castor beans consumed, whether beans were chewed or crushed, symptoms described, laboratory values (aspartate aminotransferase [AST], alanine aminotransferase [ALT], prothrombin time [PT] and international normalized ratio [INR]), duration of follow-up, treatment, and patient outcomes. RESULTS Eighty-four cases were identified. Ingestions were unintentional in 50 cases (59%) cases and intentional in 34 (40%) cases. A median of 10 seeds (range: 1-20) were ingested in intentional cases versus 1 seed (range: 1-40) in unintentional cases. In 49 (58%) of cases the seeds were reported to have been chewed or crushed. Gastrointestinal symptoms were the most commonly reported symptoms. Vomiting (n = 39), nausea (n = 24), diarrhea (n = 17), and abdominal pain (n = 16) predominated. One patient developed hematochezia and vomiting after reportedly ingesting and intravenously injecting castor bean seeds. Laboratory values were documented in 17 (20%) cases. Only one abnormality was noted; an asymptomatic patient one week following ingestion had AST/ALT of 93 U/L and 164 U/L, respectively. Ricinine was confirmed in the urine of two patients. Twenty-three (27%) cases received activated charcoal. Seventy-two (86%) of cases were calls from health care facilities or referred to health care facilities by the poison control center. Twenty-two (26%) cases were admitted for a median of 2 days (range: 1-10). Admitted cases ingested a median of 8.5 seeds (range: 1-20). Intentional ingestions were followed for median of 37.5 h (range: 0.5-285.5) while unintentional cases were followed for 14 h (range: 1-182). No delayed symptoms, serious outcomes, or deaths were reported. DISCUSSION Due to the presence of ricin, there is concern for serious outcomes after ingestions of the seeds of the castor bean plant. In this study GI symptoms were most commonly reported but serious morbidity or mortality was not present. The true risk of castor bean plant seed ingestions should continue to be re-evaluated. CONCLUSION In this retrospective review, gastrointestinal symptoms were the most common symptoms described after reported exposures to castor bean seeds. These exposures were not associated with serious morbidity, mortality, or delayed symptoms.
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Affiliation(s)
- S L Thornton
- Poison Control Center, University of Kansas Hospital , Kansas city, KS , USA
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Røen BT, Opstad AM, Haavind A, Tønsager J. Serial ricinine levels in serum and urine after ricin intoxication. J Anal Toxicol 2013; 37:313-7. [PMID: 23592744 DOI: 10.1093/jat/bkt026] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ricinine is an alkaloid present in the castor bean plant (Ricinus communis) that can be used as a biomarker for ricin poisoning. Serial ricinine levels are reported in the serum and urine of a patient suffering from intentional ricin intoxication. The patient was brought to the hospital 4 h after injection and oral intake of a castor bean extract, but died 38 h later, despite intensive medical care. Ricinine was isolated from the samples by solid-phase extraction and quantitatively determined by isotopic dilution liquid chromatography-mass spectrometry. The ricinine level in serum declined from 33 to 23 ng/mL between 10 and 29 h post-exposure. Three urine samples collected from 12 to 41 h after ricin intoxication showed ricinine concentrations in the range of 20-58 ng/mL. The creatinine corrected values (21-30 µg/g) indicated a concentration-time profile with a maximum ricinine level in urine between 12 and 29 h after exposure.
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Affiliation(s)
- Bent Tore Røen
- Norwegian Defence Research Establishment (FFI), P.O. Box 25, N-2027 Kjeller, Norway.
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Kumar RB, Suresh MX. A computational perspective of molecular interactions through virtual screening, pharmacokinetic and dynamic prediction on ribosome toxin A chain and inhibitors of Ricinus communis. Pharmacognosy Res 2012; 4:2-10. [PMID: 22224054 PMCID: PMC3250034 DOI: 10.4103/0974-8490.91027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/04/2011] [Accepted: 12/22/2011] [Indexed: 11/28/2022] Open
Abstract
Background: Ricin is considered to be one of the most deadly toxins and gained its favor as a bioweapon that has a serious social and biological impact, due to its widespread nature and abundant availability. The hazardous effects of this toxin in human being are seen in almost all parts of the organ system. The severe consequences of the toxin necessitate the need for developing potential inhibitors that can effectively block its interaction with the host system. Materials and Methods: In order to identify potential inhibitors that can effectively block ricin, we employed various computational approaches. In this work, we computationally screened and analyzed 66 analogs and further tested their ADME/T profiles. From the kinetic and toxicity studies we selected six analogs that possessed appropriate pharmacokinetic and dynamic property. We have also performed a computational docking of these analogs with the target. Results: On the basis of the dock scores and hydrogen bond interactions we have identified analog 64 to be the best interacting molecule. Molecule 64 seems to have stable interaction with the residues Tyr80, Arg180, and Val81. The pharmacophore feature that describes the key functional features of a molecule was also studied and presented. Conclusion: The pharmacophore features of the drugs provided suggests the key functional groups that can aid in the design and synthesis of more potential inhibitors.
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Affiliation(s)
- R Barani Kumar
- Department of Bioinformatics, Sathyabama University, Chennai, Tamil Nadu, India
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Worbs S, Köhler K, Pauly D, Avondet MA, Schaer M, Dorner MB, Dorner BG. Ricinus communis intoxications in human and veterinary medicine-a summary of real cases. Toxins (Basel) 2011; 3:1332-72. [PMID: 22069699 PMCID: PMC3210461 DOI: 10.3390/toxins3101332] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 09/26/2011] [Accepted: 09/30/2011] [Indexed: 12/11/2022] Open
Abstract
Accidental and intended Ricinus communis intoxications in humans and animals have been known for centuries but the causative agent remained elusive until 1888 when Stillmark attributed the toxicity to the lectin ricin. Ricinus communis is grown worldwide on an industrial scale for the production of castor oil. As by-product in castor oil production ricin is mass produced above 1 million tons per year. On the basis of its availability, toxicity, ease of preparation and the current lack of medical countermeasures, ricin has gained attention as potential biological warfare agent. The seeds also contain the less toxic, but highly homologous Ricinus communis agglutinin and the alkaloid ricinine, and especially the latter can be used to track intoxications. After oil extraction and detoxification, the defatted press cake is used as organic fertilizer and as low-value feed. In this context there have been sporadic reports from different countries describing animal intoxications after uptake of obviously insufficiently detoxified fertilizer. Observations in Germany over several years, however, have led us to speculate that the detoxification process is not always performed thoroughly and controlled, calling for international regulations which clearly state a ricin threshold in fertilizer. In this review we summarize knowledge on intended and unintended poisoning with ricin or castor seeds both in humans and animals, with a particular emphasis on intoxications due to improperly detoxified castor bean meal and forensic analysis.
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Affiliation(s)
- Sylvia Worbs
- Centre for Biological Security, Microbial Toxins (ZBS3), Robert Koch-Institut, Nordufer 20, Berlin 13353, Germany; (S.W.); (D.P.); (M.B.D.)
| | - Kernt Köhler
- Institute of Veterinary Pathology, Justus Liebig University Giessen, Frankfurter Street 96, Giessen 35392, Germany;
| | - Diana Pauly
- Centre for Biological Security, Microbial Toxins (ZBS3), Robert Koch-Institut, Nordufer 20, Berlin 13353, Germany; (S.W.); (D.P.); (M.B.D.)
| | - Marc-André Avondet
- Biology and Chemistry Section, Federal Department of Defence, Civil Protection and Sports DDPS SPIEZ LABORATORY, Austrasse 1, Spiez CH-3700, Switzerland; (M.-A.A.); (M.S.)
| | - Martin Schaer
- Biology and Chemistry Section, Federal Department of Defence, Civil Protection and Sports DDPS SPIEZ LABORATORY, Austrasse 1, Spiez CH-3700, Switzerland; (M.-A.A.); (M.S.)
| | - Martin B. Dorner
- Centre for Biological Security, Microbial Toxins (ZBS3), Robert Koch-Institut, Nordufer 20, Berlin 13353, Germany; (S.W.); (D.P.); (M.B.D.)
| | - Brigitte G. Dorner
- Centre for Biological Security, Microbial Toxins (ZBS3), Robert Koch-Institut, Nordufer 20, Berlin 13353, Germany; (S.W.); (D.P.); (M.B.D.)
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