Palytoxin is a complex marine natural product containing 71 asymmetric centers. Palytoxin, isolated from soft coral, is considered to be one of the most toxic non-peptide substances known, second only to maitotoxin (5).
belongs to the class of organic compounds known as terpene glycosides. These are prenol lipids containing a carbohydrate moiety glycosidically bound to a terpene backbone.
Palytoxin targets the sodium-potassium pump protein by binding to the molecule such that the molecule is locked in a position where it allows passive transport of both the sodium and potassium ions, thereby destroying the ion gradient that is essential for most cells. It also diminishing the supply of oxygen to
the myocardium, and can cause death within minutes. (5, 3).
Palytoxin poisoning can cause multiple clinical effects, including paresthesia, dysguesia, hypertension, respiratory depression, and coma. Other health effects include tachycardia, unstable blood pressure, hemolysis (destruction of red blood cells). The onset of symptoms is rapid, and death usually follows just minutes after. Early death is probably due to intense spasm of the coronary vascular smooth muscle, resulting in marked reduction in blood flow. This may be an early manifestation of what later becomes a general necrotizing effect of palytoxin on blood vessels, which ultimately causes cell destruction throughout the body. The delayed deaths may be the result of a less profound but widespread decrease in blood flow and oxygen supply, causing
ischemia and, ultimately, anoxia in major organ systems. Palytoxin can cause marked irritation and tissue injury when applied topically to the skin or eyes of animals. (5, 2).
Symptoms
Typical symptoms of palytoxin poisoning are angina-like chest pains, asthma-like breathing difficulties, and an electrocardiogram showing an exaggerated T wave (5).
Treatment
Treatment in humans is symptomatic and supportive. Vasodilators, such as papverine and isosorbide nitrate, can be used as antidotes. The patient can be treated supportively with corticosteroids and a histamine antagonist after dermal exposure. (5, 1)
