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Toxins 2017, 9(10), 311; doi:10.3390/toxins9100311

Treatments for Pulmonary Ricin Intoxication: Current Aspects and Future Prospects

1
Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona 76100, Israel
2
Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona 76100, Israel
*
Authors to whom correspondence should be addressed.
Academic Editors: Julien Barbier and Daniel Gillet
Received: 6 September 2017 / Revised: 26 September 2017 / Accepted: 29 September 2017 / Published: 3 October 2017
(This article belongs to the Special Issue Ribosome Inactivating Toxins)
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Abstract

Ricin, a plant-derived toxin originating from the seeds of Ricinus communis (castor beans), is one of the most lethal toxins known, particularly if inhaled. Ricin is considered a potential biological threat agent due to its high availability and ease of production. The clinical manifestation of pulmonary ricin intoxication in animal models is closely related to acute respiratory distress syndrome (ARDS), which involves pulmonary proinflammatory cytokine upregulation, massive neutrophil infiltration and severe edema. Currently, the only post-exposure measure that is effective against pulmonary ricinosis at clinically relevant time-points following intoxication in pre-clinical studies is passive immunization with anti-ricin neutralizing antibodies. The efficacy of this antitoxin treatment depends on antibody affinity and the time of treatment initiation within a limited therapeutic time window. Small-molecule compounds that interfere directly with the toxin or inhibit its intracellular trafficking may also be beneficial against ricinosis. Another approach relies on the co-administration of antitoxin antibodies with immunomodulatory drugs, thereby neutralizing the toxin while attenuating lung injury. Immunomodulators and other pharmacological-based treatment options should be tailored according to the particular pathogenesis pathways of pulmonary ricinosis. This review focuses on the current treatment options for pulmonary ricin intoxication using anti-ricin antibodies, disease-modifying countermeasures, anti-ricin small molecules and their various combinations. View Full-Text
Keywords: ricin; pulmonary intoxication; countermeasures; antitoxins; disease-modifying agents; anti-ricin small molecules ricin; pulmonary intoxication; countermeasures; antitoxins; disease-modifying agents; anti-ricin small molecules
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MDPI and ACS Style

Gal, Y.; Mazor, O.; Falach, R.; Sapoznikov, A.; Kronman, C.; Sabo, T. Treatments for Pulmonary Ricin Intoxication: Current Aspects and Future Prospects. Toxins 2017, 9, 311.

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