Ciguatoxins are a class of toxic polycyclic polyethers found in fish that cause ciguatera. There are several different chemicals in this class. "CTX" is often used as an abbreviation. Ciguatoxins do not harm the fish that carry them, but they are poisonous to humans. They cannot be smelled or tasted and cannot be destroyed by cooking. Rapid testing for this toxin in food is not standard.

Some ciguatoxins lower the threshold for opening voltage-gated sodium channels in synapses of the nervous system. Opening a sodium channel cause depolarization which could sequentially cause paralysis, heart contraction and changing the senses of heat and cold. Such poisoning from ciguatoxins is known as ciguatera.

Causes

Ciguatoxins are lipophillic, able to cross the blood brain barrier, and can cause both central and peripheral neurologic symptoms. Ciguatoxins cause a type of food poisoning called ciguatera. People can get ciguatera by eating normally safe, bottom-feeding, coral reef fish that have collected the poison from the food chain. This poisoning tends to occur near areas of disturbed reef, including severe weather and waterfront construction. Many different types of fish can be contaminated.

The most common are large predatory reef fish, such as moray eels, snappers, groupers, barracuda, jacks, surgeons, Spanish mackerel, and humphead wrasse. There are no good “rules of thumb” for detecting tainted fish. They look, taste, and smell normal. The best way to avoid eating contaminated fish is to avoid eating the organs or head of large fish that came from an area around a reef.

Fish with ciguatoxin come from the southeastern United States, Bahamian, and Caribbean regions, Hawaii, and subtropical and tropical areas worldwide including the central Pacific and northern Australia. Barracuda, amberjack, horse-eye jack, black jack, other large species of jack, king mackerel, large groupers, and snappers are particularly likely to contain ciguatoxin. Many other species of large fish-eating fish may also contain ciguatoxin.

Signs and Symptoms

The symptoms of acute ciguatera fish poisoning may begin as soon as 30 minutes after eating contaminated fish. The initial symptoms may include itching, tingling, and numbness of the lips, tongue, hands, and/or feet. Other symptoms during the first six to 17 hours are abdominal cramps, nausea, vomiting, diarrhea, and/or a red skin rash (pruritus). Chills, hot and cold temperature reversal, generalized weakness, restlessness, dizziness, wheezing, blurred vision, abnormal sensitivity to light (photophobia), muscle aches (myalgias), and/or joint pain (arthralgias) may also develop.

Therapies

The treatment for ciguatera fish poisoning is usually the immediate pumping out of all stomach contents (gastric lavage). If this treatment is not available, then vomiting should be induced by the administration of syrup of ipecac. Persistent nausea and vomiting must be treated with the intravenous administration of fluids to avoid dehydration. If shock, convulsions or respiratory failure occurs, immediate appropriate medical measures must be instituted. Dextran (a polysaccharide drug), Normal Human Serum Albumin, or blood transfusion may be necessary to treat shock. Meperidine may also be prescribed for pain. Other treatment is symptomatic and supportive. Travelers to endemic areas should be cautioned about the risk of contracting ciguatera fish poisoning.

The Journal of “Clinical Pharmacology and Toxicology Research” is using Editorial Tracking System to maintain quality and transparency to the author in the peer-review process. Review processing will be performed by the editorial board members of the Journal of “Clinical Pharmacology and Toxicology Research” or by Reviewers (outside experts in the field). Two independent reviewer’s approval (Minimum reviewer’s approval) followed by editor approval is obligatory for acceptance of any manuscript excluding an editorial.

On the occasion of its 3 years, Successful Journey, Journal of Clinical Pharmacology and Toxicology decided to provide a partial waiver on its article processing charges to promote quality research from across the nations of the globe to encourage the latest research in the field of Infections, Diseases and Medicine. Journal of Clinical Pharmacology and Toxicology is also planning to release a special issue on its new approaches.

Regards,

Mary Wilson,

Editorial office,

Clinical Pharmacology and Toxicology Research

E-mail: pharmatoxicol@eclinicalsci.com