Medical Toxicologist MIRTA ELENA RYCZEL October 2003
ALGAE Cyanophitas - (cyano = blue) Cyanophyta or blue-green algae • • • • Prokaryotes (no true nucleus) Unicellular autotrophic isolated monasteri es or filamentous, flat or globular live humid environments (land) and aquatic ( freshwater or saltwater), very adaptable. Are planktonic. From 1 micron to sever al microns Its origin dates from 3000 million years (Precambrian) Some species m ay form sapropels (parent substance of oil) can withstand temperatures up to 85 ° C • in eutrophic conditions may develop into large masses called flowers of wa ter ( Green Nile and Red Sea) produce antibiotic substances (allelopathic) to st op or reduce the development of other planktonic creatures. Have pigments: Chlor ophyll, cficocianinas and c-allophycocyanin (green), c-phycoerythrin (red) and b eta carotene. They form resistant spores commercial importance (fertilizers), ph armaceuticals (diets for weight loss) and health of humans and animals • • • • • • • • • • • • • • • • • • • • • • • • • Merismopedia Gleocapsa Mycrocystis Chroococcus Dermocarpa Chamaesiphon Pleurocas pa Anabaena Nostoc Oscillatoria Spirulina Lyngbya Rivulara Calothrix Scytonema S tigonem Plectonema CLASSIFICATION: Cyanophitas: • 50% of blooms or blooms produce toxins. • Within the same gender may be or may not produce toxins. The cause of this feature. BACKGROUND OF POISONING IN HUMAN DRINKING WATER • • • • • • • 1931: USA - drinking water - Ohio and Potomac Rivers - 5,000 to 8, 000 people affected 1968: Schwimmer: compilation of numerous cases of enf. GI 19 75: Washington - water reservoir - 23 dialysis patients in 1979: Australia (Palm Island) - drinking water treated with sulphates death of algae and release of toxins: 141 patients in 1981: Australia (Armidale) - water supply surface - ele vated liver enzyme levels in the population 1985: USA: Carmichael brings togethe r case studies: nausea, vomiting, diarrhea, fever, eye infections, ear and throa t blooms after exposure to 1993: China - Supply with surface water - Increased i ncidence of liver cancer in people who drink surface water compared to groundwat er 1993: Australia: 600 000 wages are lost annually because of the toxic cyanoba cteria 1994: Sweden - Malmo: illegal use of untreated water in the sugar industr y accidental pollution Drinking Water: 121 people: nausea, vomiting, diarrhea, muscle cramps. GI disorders was also observed in dogs and cats • • BACKGROUND OF POISONING IN HUMAN IN RECREATIONAL WATER • 1959: Saskatchewan: 13 people: headache, nausea, muscle aches, diarrhea with pain - identification of M icrocystis spp in stools of a patient • 1989: England: 10 soldiers became ill af ter practice blooms in aquatic areas: two had pneumonia requiring hospitalizatio n in Intensive Care • 1995: Australia: retrospective study of 852 people: diarrh ea, vomiting, flu symptoms, skin rashes, mouth ulcers, fever, irritation of eyes and ears - time: 2-7 days after exposure -> density of bacteria> longer contact time> increased symptoms OTHER ROUTES OF EXPOSURE • 1996: Brazil - Caruaru - HEMODIALYSIS: 126 patients exposed to microcystin by water hemodialysis: 108 patients had symptoms, of whom 60 died with symptoms of acute neurotoxicity (5 February) and subacute hepatotoxicity (55 March to August ) • Presentations: • Gastrointestinal Symptoms and signs: malaise, myalgia, cram ps, nausea and vomiting, hepatomegaly. Rapidly progressive liver failure and fat al. Hyperbilirubinemia, increased liver enzymes, hypertriglyceridemia, neurologi cal symptoms and signs: tinnitus, vertigo, headaches, deafness, blindness and se izures Produce toxins that are classified • neurotoxins: chemically are known more than five different classes: Tetanus to: produce post synaptic neuromuscular blockade that prevents the degradation o f acetylcholine (symptoms similar to those of the organophosphates) - LD 50: 200 mg / kg - time: 1 to toxoid to 20 minutes (s): Chemically similar to the prev ious and with the same action - LD 50: 20 mg / kg PSP "Paralitic Shellfish Poi soning": Similar to the dinoflagellates Saxitoxin IPM producers. Inhibit nerve c onduction by blocking cellular sodium channels. Its action is very fast. LD50: 1 0 mg / kg It can be found at: Anabaena Aphanizomenon Lyngbia Cylindrospe rmopsis Produce toxins that are classified • hepatotoxins: These are the most frequent cause of toxicity related to cyanoba cteria. Chemically they are peptides. Cause necrosis and apoptosis of hepatocyte s, intrahepatic hemorrhage, with death from shock or severe hepatic insufficienc y. • Have a more slowly than the neurotoxins (hours to days) • Microcystin: LD50 : 60-70 mg / kg (mouse) is a cyclic heptapeptide. Microcystin YR - Microcystin L R - RR Microcystin • NODULARINAS: There are more than eight varieties produced b y: Mycrocistis, Anabaena, Nodularia, Oscillatoria, Nostoc, Cylindrospermopsis - • LD 50: 30 to 50 mg / kg Produce toxins that are classified in • Nephrotoxins: CILINDROSPERMINA: The species producing Cylindrospermopsis raciborskii and Ume nzaquia natans inhibits protein synthesis, and has proven renal damage in expe rimental animals. LD50: 2,500 mg / kg / d and 200 mg / kg / 5th 6 days • OTHER A CTION: ∀ • inhibition of phosphatases type 1 and 2A (PP) (microcystins and nodul arinas) • CARCINOGENESIS: liver tumors (China Mechanism of hepatotoxicity • Microcystin • 1. Absorption by the GI tract • 2. Ac receivers. Bile Join s Ac. Serine and threonine of the PP: these maintain the balance between the mon omerización (phosphorylation) / polymerization (desfoforilazión) for the preserv ation of the cytoskeleton - Maintain phosphorylation • 3. Interacts with the cat alytic subunit of PP in two steps that are rapidly reversible, but essential for liver damage • 4. hepatocyte intercellular contact loss by shrinkage of cells , and between the sinusoids • 5. vacuolar spaces training blood flow to thes e areas intra parenchymal hemorrhage hepatomegaly Edema Cyanophitas: Routes of Elimination and Pathology • Elimination: • conjugated bile endogenous glutathione and thiol (protein) • Th is process of conjugation and binding to thiol seems to compete with the mechani sm of action: Union reversible phosphatase • Autopsy: Loss of architecture liver edema (vacuolization) Anastomosis of b lood vessels ROUTE OF EXPOSURE • • SKIN: Recreation and / or industrial activities in contaminated water or foa m Bathing or showering with treated water but with blooms or free toxins DRINKIN G WATER: Accidental ingestion of water and natural water cyanobacteria blooms or free toxins Water treated with blooms or free toxins • • • • • INHALATION Labou r practices Shower Water Sports dried cyanobacteria Aspiration FOOD CONSUMPTION: molluscs or other aquatic products containing toxins Vegetables - if the toxins accumulated during sprinkler irrigation - HEMODIALYSIS: Using treated water con taining toxins • • • • • • • • • •