title: A cell-based assay for screening of antidotes to, and antivenom against Chironex fleckeri (box jellyfish) venom.
abstract: BACKGROUND
  Chironex fleckeri is a large box jellyfish that has been labelled the 'most venomous animal' in the world. We have recently shown that the primary effect of C. fleckeri venom in vivo is cardiovascular collapse. This study utilised a cell-based assay to examine the effects of C. fleckeri venom on the proliferation of a rat aortic smooth muscle cell line. In addition, the ability of CSL box jellyfish antivenom and/or various potential treatment strategies to neutralise the effects of the venom was examined.
  
  
  METHODS
  A7r5 cells were cultured in media containing venom. The effect of CSL box jellyfish antivenom (5 U/mL), CSL polyvalent snake antivenom (5 U/mL), lanthanum (5 microM), MgSO(4) (50 mM), verapamil (5 microM) or felodipine (5 microM) was examined. Cell viability was determined using a Cell titer 96 AQueous One Solution cell proliferation assay.
  
  
  RESULTS
  Incubation of A7r5 cells with serially diluted venom (2-0.004 microg/mL) caused a concentration-dependent inhibition of cell proliferation with an IC(50) value of 0.056 microg/mL. This response was not affected by the absence of calcium or the presence of lanthanum in the media. Box jellyfish antivenom (5 U/mL) prevented the inhibition of cell proliferation caused by the venom. Verapamil (5 microM) had no significant effect on the inhibition. In contrast, felodipine (5 microM) or MgSO(4) (50 mM) potentiated the effects of the venom and partially negated the protective effect of the antivenom.
  
  
  CONCLUSIONS
  This study displayed the ability to utilise a cell-based assay to determine the effects of C. fleckeri venom on vascular cell viability. It showed that CSL box jellyfish can neutralise the effects of the venom but only if added prior to the venom. In addition, potential adjunct therapies verapamil, felodipine and MgSO(4) were found to be ineffective, with felodipine and MgSO(4) potentiating the detrimental effects of the venom.
authors.affiliation: Department of Pharmacology, Monash University, Victoria, 3800 Australia.
authors.forename: Nicki
authors.initials: N
authors.lastname: Konstantakopoulos
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Isbister
authors.forename: Jamie E
authors.initials: JE
authors.lastname: Seymour
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Hodgson
mesh_terms: D000818:Animals; D000931:Antidotes / Q000494:pharmacology*; D000997:Antivenins / Q000494:pharmacology*; D001011:Aorta / Q000166:cytology; D001681:Biological Assay; D002460:Cell Line; D049109:Cell Proliferation / Q000187:drug effects; D002470:Cell Survival / Q000187:drug effects; D003064:Cnidarian Venoms / Q000633:toxicity*; D037462:Cubozoa; D015736:Felodipine / Q000494:pharmacology; D008278:Magnesium Sulfate / Q000494:pharmacology; D009131:Muscle, Smooth, Vascular / Q000166:cytology; D032389:Myocytes, Smooth Muscle / Q000166:cytology / Q000187:drug effects*; D051381:Rats; D014700:Verapamil / Q000494:pharmacology
chemical_list: D000931:Antidotes; D000997:Antivenins; D003064:Cnidarian Venoms; D008278:Magnesium Sulfate; D014700:Verapamil; D015736:Felodipine