Biyolojik Silah Olarak Toksinler

Öz

Ölümcül olan kolayca ve düşük maliyet ile büyük miktarlarda üretilebilen, aerosol formda stabil olan, kolaycageniş alanlara yayılabilen ve insandan insana bulaşan etkenler ideal biyolojik silah ajanıdırlar. Botulinum,stafilokokkal enterotoksin B, ricin ve trikotesen mikotoksin gibi biyolojik toksinler, insandan insana bulaşma özelliğidışında tüm bu özelliklere sahiptirler. Bu derlemede, biyolojik silah olarak kullanılması muhtemel toksinler biyolojiközellikleri, biyolojik silah potansiyeleri, oluşturdukları klinik belirtiler, tanı, korunma ve tedavileri açısından gözdengeçirilmiştir

Anahtar Kelimeler

• Toksin, biyolojik silah, botulinum, stafilokokkal enterotoksin B, risin, trikotesen mikotoksin (T-2), sa k s i t o k s i n

Toxins As Agents Of Biological Weapons

Abstract

Agents that are lethal, easy and inexpensive to produce in large quantities, stable in aerosol for/with the abilityto be dispersed over wide areas, communicable from person to person are the ideal biologic warfare agent. Withthe exception of communicable from human to human, the biologic toxins such as Botulinum, staphylococcalenterotoxin B, ricin, and trichothecene mycotoxins possess all the properties mentioned. In this review, severalpotential biological warfare toxins in regard to their biology, potential for weaponization, and the clinical features,diagnosis, prevention, and treatment of the diseases that they cause have been reviewed

Keywords

• Toxin, biowarfare agents, botulinum, staphylococcal enterotoxin B, ricin, trichothecene mycotoxin (T-2), sa x i t o x i n

References

1. 1. Von Lubitz KJE Dag. Bioterrorism: Field Guide to Disease Identification and Initial Patient Management. Taylor & Francis 2005.
2. 2. Kedlaya D. Botulinum Toxin: Overview. http://www.emedicine.com/pmr/topic216.htm. Erişim Tarihi: 26.12.2006
3. 3. WHO guidance. Public health response to biological and chemical weapons. Annex 2: Toxins. 2004.
4. 4. Medical Aspects of Chemical and Biological Warfare. In: Textbook of Military Medicine. Sidell FR, Takafuji ET, Franz DR, eds. Washington, DC: Office of the Surgeon General; 1997; 1(3): 603-76.
5. 5. Biological Toxins. In: USAMRIID’s Medical Management of Biological Causalties Handbook. Eds: Darling RG, Woods Jon B. 5th ed. Department of Defense 2004: 80-100.
6. 6. White SM. Chemical and biological weapons. Implications for anaesthesia and intensive care. Br J Anaesth. 2002; 89(2): 306-24.
7. 7. Bigalke H, Rummel A. Medical aspects of toxin weapons. Toxicology 2005; 30; 214(3): 210-20.
8. 8. Arnon SS,Schechter R, Inglesby TV et al. Botulinum Toxin as a Biological Weapon. Medical and Public Health Management. JAMA. 2001; 285:1059-70.

9. 9. Patocka J, Splino M. Botulinum Toxin: From Poison to Medicinal Agent. The ASA Newsletter 2002: 88.
10. 10. Whitby M, Street AC, Ruff TA, Fenner F. Biological agents as weapons 1: smallpox and botulism. MJA 2002; 176 (9): 431-433.
11. 11. Zalinskas RA. Iraq's biological weapons. The past as future?. JAMA1997; 278: 418–24.
12. 12. Franz DR, Jahrling PB, McClain DJ et al. Clinical recognition and management of patients exposed to biological warfare agents. Clin Lab Med. 2001 Sep; 21(3): 435-73.
13. 1 3 . Brin MF. Botulinum toxin: chemistry, pharmacology, toxicity, and immunology. Muscle Nerve Suppl 1997; 6: 46-68.
14. 14. Schmitt CK, KC Meysick, AD O’Brien. Bacterial Toxins: Friends or Foes?. Emerg Infect Dis 1999; 5(2): 224–34.
15. 15. Shapiro RL, Hatheway C, Swerdlow DL. Botulism in the United States: A Clinical and Epidemiologic Review. Ann Intern Med. 1998; 129: 221-8.
16. 1 6 . Anynomous. Recognition of illness associated with the intentional release of biological agent. MMWR; 2001: 50: 893-7.
17. 1 7 . Dinges MM, Orwin PM, Schlievert PM. Exotoxins of Staphyloccoccus aureus. Clin Microbiol Rev 2000; 1 3 : 16- 34.
18. 18. Staphylococcal Enterotoxin B. In: sentinel laboratory guidelines for suspected agents of bioterrorism. American Society for Microbiology.Erişim tarihi: 05.01.2007.
19. 19. Staphylococcus aureus. In Foodborne Pathogenic Microorganisms and Natural Toxins Handbook. U.S. Food & Drug Administration, Center for Food Safety & Applied Nutrition, January 1992.
20. 20. Mollick JA, Cook RG, Rich RR. Class II MHC molecules are specific receptors for staphylococcus enterotoxin A. Science. 1989; 19; 244(4906): 817-20,
21. 21. Fraser JD. High-affinity binding of staphylococcal enterotoxins A and B to HLA-DR. Nature 1989 May 18; 339 (6221): 221-3.
22. 22. Greenfield RA, Brown BR, Hutchins JB et al. Microbiological, Biological and Chemical Weapons of Warfare and Terrorism. Am J Med Sci 2002; 323: 326-340.
23. 23. Rusnak JM, Kortepeter M, Ulrich R, Poli M, Boudreau E. Laboratory Exposures to Staphylococcal Enterotoxin B. Emerg Infect Dis 2004; 10(9):1544–9.
24. 24. Mattix ME, RE Hunt, CL Wilhelmsen, Johnson AJ, WB Baze. Aerosolized staphylococcal enterotoxin B–induced pulmonary lesions in rhesus monkeys (Macaca mulatta). Toxicol Pathol 1995; 23(3): 262–8.
25. 25. Lowell GH, RW Kaminski, S Grate et al. Intranasal and intramuscular proteosome–staphylococcal enterotoxin B (SEB) toxoid vaccines: Immunogenicity and efficacy against lethal SEB intoxication in mice. Infect Immun 1996; 64(5): 1706–13.
26. 26. Casadevall A. Passive antibody administration (immediate immunity) as a specific defense against biological weapons. Emerg Infect Dis 2002; 8: 833–41.
27. 27. Lord JM, Roberts LM, Robertus JD. Ricin: structure, mode of action, and some current applications. FASEB J. 1994; 8: 201-8.
28. 28. Doan LG. Ricin: mechanism of toxicity, clinical manifestations, and vaccine development. A review. J Toxicol Clin Toxicol. 2004; 42(2): 201-8.
29. 29. Spivak L, Hendrickson RG. Ricin. Crit Care Clin 2005; 21(4): 815-24.
30. 30. Kirby R. Ricin Toxin: A military History. CML Army Chem Rev 2004; 4: 2-4
31. 31. http://www.ansci.cornell.edu/plants/toxicagents/ricin/ricin.html.Erişim tarihi: 05.01.2007.
32. 32. Audi J, Belson M,Patel M, Schier J,Osterloh J. Ricin poisoning: a comprehensive review. JAMA. 2005; 294 (18): 2342-51.
33. 33. Henghold WB. Other biologic toxin bioweapons: ricin, staphylococcal enterotoxin B, and trichothecene mycotoxins. Dermatol Clin. 2004 Jul; 22(3): 257-62.
34. 34. Steyn PS. Mycotoxins: general view, chemistry, structure. Toxicol Lett 1995; 82-83:843-851.
35. 35. Locasto DA, Allswede MP, Stein TM. T-2 Mycotoxins. http://www.emedicine.com/emerg/topic890.htm. Erişim tarihi: 24.12.2006.
36. 36. McGovern TW, Christopher GW. Biological warfare and its cutaneous manifestations. In: The Electronic Textbook of Dermatology [Textbook online] 2001; (http://telemedicine.org/BioWar/biologic.htm. Erişim tarihi: 25.12.2006).
37. 37. http://www.iaqm.com/trichothecene.html. Erişim tarihi: 12.12.2006
38. 38. Croft WA, Jastromski BM, Croft AL, Peters HA. Clinical confirmation of trichothecene mycotoxicosis in patient urine. J Environ Biol 2002; 23: 301-20.
39. 3 9 . Citterio B, Manzano M, Mifreni M, Comi G. Natural fish and shellfish poisons. Ann Microbiol Enzimol 1992; 4 2 : 2 0 3 - 1 6 .
40. 40. Eastaugh J, Shepherd S. Infectious and toxic syndromes from fish and shellfish consumption. Arch Intern Med 1989;149:1735-40.
41. 41. What are dinofilagellates?.http:www.geo.ucalgaryca/~macrae/polinology/ dinofilagellates /dinofilagellates. html. Erişim tarihi: 06.03.2005.
42. 42. Sakamoto S, Ogata T, Sato S, Kodama M, Takeuchi T. Causative organism of paralytic shellfish toxins other than toxic dinofilagellates. Marine – Ecology 1992; 89: 229-35.
43. 43. Concon JM. Toxicology of Marine Foods. In: Food Toxicology. Marcel Dekker, INC.PP. 1988: 511- 42.
44. 44. Aran N. Gıda Kaynaklı Mikrobiyel Toksinler. Gıda Sanayi 1993; 7(1): 31 - 46.
45. 45. Sakamoto Y, Lokey R, Krzanovski J. Shellfish and fish poisoning related to the toxic dinofilagellates. South Med J 1987; 80: 860-70.
46. 46. Rheinstein PH, Klontz KL. Shellfish–Borne İllnesses. Am Fam Phy 1993; 47: 1837 - 40.
47. 47. Hughes JM, Merson MH. Fish and shellfish poisoning. N Engl J Med 1976; 295: 1117-20.
48. 48. Noble RC. Death on the half – shell: The health hazards of eating shellfish. Perspect Biol Med. 1990; 33: 3.
49. 49. Molecule of The Month: SAXITOXIN. http:www.chm.bris.ac.uk/motm/stx/saxi.htm. Erişim tarihi: 06.01.2007.
50. 50. Ellenhorn MJ, Barceloux DG. Medical Toxicology. Elsevier Science Publishers Company Inc. USA. 1988
51. 51. Epidemiologic Notes and Reports Paralytic Shellfish Poisoning -- Massachusetts and Alaska, 1990. MMWR March 15, 1991; 40(10); 157-61.
52. 52. Ralonde R. Paralytic Shellfish Poisoning: The Alaska Problem. Alaska’s Marine Resources 1996; 8(2): 8-18.