title: Diarrhea in ciguatera fish poisoning: preliminary evaluation of pathophysiological mechanisms.
abstract: Ciguatera fish poisoning is a clinical syndrome consisting of a combination of gastrointestinal and neurological symptoms occurring after eating toxin-containing tropical reef fish; it is a major cause of morbidity in Hawaii, the South Pacific, Australia, and the Caribbean. In an effort to define pathophysiological mechanisms responsible for the diarrheal component of the illness, we examined the effect of crude and fractionated toxin preparations on isolated rabbit ileal tissue in a Ussing chamber model. Both the crude toxin preparation (prepared from toxic Ctenochaetus strigosus) and 10% and 50% methanol-chloroform toxin fraction (prepared from a pool of toxic fish samples) gave a striking increase in transepithelial electrical potential difference and short-circuit current. Enterotoxic activity seemed to be mediated by calcium. When examined by light microscopy, the intestinal mucosa was not damaged by the toxin preparations used. Our data demonstrate that toxins involved in ciguatera fish poisoning directly stimulate intestinal fluid secretion without accompanying tissue damage and suggest that calcium is the "second messenger" mediating the process.
authors.affiliation: Department of Medicine, University of Maryland School of Medicine, Baltimore.
authors.forename: A
authors.initials: A
authors.lastname: Fasano
authors.forename: Y
authors.initials: Y
authors.lastname: Hokama
authors.forename: R
authors.initials: R
authors.lastname: Russell
authors.forename: J G
authors.initials: JG
authors.lastname: Morris
mesh_terms: D000818:Animals; D001681:Biological Assay; D002118:Calcium / Q000494:pharmacology; D002135:Calcium-Binding Proteins / Q000494:pharmacology; D002922:Ciguatoxins / Q000633:toxicity*; D003967:Diarrhea / Q000209:etiology* / Q000503:physiopathology; D015194:Diffusion Chambers, Culture; D004305:Dose-Response Relationship, Drug; D004594:Electrophysiology; D007082:Ileum / Q000187:drug effects; D007413:Intestinal Mucosa / Q000187:drug effects; D007419:Intestinal Secretions / Q000187:drug effects; D008297:Male; D008954:Models, Biological; D011817:Rabbits
chemical_list: D002135:Calcium-Binding Proteins; C025673:calciphorin; D002922:Ciguatoxins; D002118:Calcium