Oxidative stress and apoptosis markers in scorpion envenomed children

Abstract EN

-Background : scorpion envenomation is a common medical problem dealt with in our pediatric practice.

Infants are at risk for severe autonomic dysfunction.

Methods : 40 children in Upper Egypt (3-12 years old) were admitted to the Pediatric Intensive Care Unit for scorpion envenomation.

They were compared with 25 apparently healthy children of match able age and sex as controls.

Out of the studied victims, 24 children (60%) showed signs of severe envenomation and multiple organ dysfunctions (MOD), while 16 victims (40%) showed signs of mild envenomation.

The serum levels of apoptotic markers, soluble Fas (sFas), soluble Fas ligand (sFasL), nitric oxide (NO) and lipid peroxides (LPO) were determined for both victims and controls.

Scoring of MOD was evaluated using Logistic Organ Dysfunction System Score (LODS) for the severely envenomed victims.

Results: All victims showed significantly higher mean levels of sFas, LPO and NO in comparison to the controls.

The level of sFasL was not detectable in the sera of the healthy control group.

The case fatality rate was 15%.

The severely envenomed children with MOD as well as the non-survivors showed significantly higher serum levels of sFas, sFasL, LPO and NO in comparison to the mild envenomed victims and the surviving victims of severe cases, respectively.

The LODS score of the severely envenomed victims showed significant positive correlations with sFas and LPO.

As well as a significant positive correlation was detected between sFas and NO. Conclusion : scorpion envenomation can increase apoptosis as shown by up-regulation of sFas / sFasL system associated by elevation of LPO and NO.

This deregulation of apoptosis was increased with the severity of scorpion envenomation and its extent increased as MOD score and fatal outcome increased.

Therefore, sFas and oxidative stress markers may be of value in predicting the outcome of these cases.

The increase in the extent of apoptosis detected seems to play a role in the outcome of scorpion envenomation, and hence, modulation of this deregulation could benefit these victims.