Toxicon最新文献

{"title":"Effects of Androctonus mauritanicus envenomation on an experimental mouse model of pregnancy and on mouse offspring","authors":"Mehdi Ait Laaradia ,&nbsp;Sara Oufquir ,&nbsp;Jawad Laadraoui ,&nbsp;Zineb El Gabbas ,&nbsp;Zakaria Tazart ,&nbsp;Mohamed Daoudi ,&nbsp;Loubna Elyazouli ,&nbsp;Abderrahman Chait","doi":"10.1016/j.toxicon.2025.108328","DOIUrl":"10.1016/j.toxicon.2025.108328","url":null,"abstract":"<div><div>Scorpion envenomation is a public health issue in Morocco, where <em>Androctonus mauritanicus</em> is considered the most dangerous scorpion. This scorpion is well adapted to urban environments, and the likelihood of human exposure to its venom is increasingly high, including during pregnancy.</div><div>This study was designed to investigate whether a single subcutaneous injection of venom at a moderate envenomation dose in pregnant mice could lead to detrimental effects on maternal reproductive performance and offspring development.</div><div>Prior to examining developmental neurotoxicity, we assessed the acute toxicity of <em>Androctonus mauritanicus</em> venom in mice. Subsequently, the venom (200 μg/kg) was administered to pregnant mice on gestational day 5 (GD5), 10 (GD10), or 15 (GD15). Using neurobehavioral, developmental, hematological, and biochemical approaches, we investigated the consequences of <em>Androctonus mauritanicus</em> envenomation in pregnant mice. Additionally, we examined the role of oxidative stress in the venom's deleterious effects on reproductive performance and offspring development.</div><div>Our results show that <em>Androctonus mauritanicus</em> venom induces similar envenomation symptoms in pregnant and non-pregnant mice but causes vaginal bleeding and abortions when administered on gestational days 10 and 15. The venom also triggered biochemical, hematological, and enzymatic disruptions. Viability indices, lactation, and offspring growth were significantly reduced, along with noticeable morphological delays. Finally, sensorimotor functions of offspring exposed to venom in utero were severely impaired, affecting their social behavior, sensory maturation, and motor coordination.</div><div>Based on the findings of this study, <em>Androctonus mauritanicus</em> venom administration during pregnancy at a moderate dose can lead to significant effects on physical development and reflex maturation during the postnatal period.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108328"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury, coagulopathy, and deep vein thrombosis following a haemotoxic snakebite: A case report from a resource-limited setting","authors":"Md. Asaduzzaman ,&nbsp;Sazeda Akter ,&nbsp;Jafrin Sultana ,&nbsp;Nayem Hasan ,&nbsp;Zarin Tasrin Haque Tasin ,&nbsp;Sadia Satara Zaman ,&nbsp;Soumitra Roy ,&nbsp;M.M. Jahangir Alam ,&nbsp;Fazle Rabbi Chowdhury","doi":"10.1016/j.toxicon.2025.108324","DOIUrl":"10.1016/j.toxicon.2025.108324","url":null,"abstract":"<div><h3>Background</h3><div>The green pit viper (<em>Trimeresurus gramineus</em>) is a venomous snake commonly encountered in South Asia, particularly in Bangladesh, and responsible for many snakebite incidents. Management of its envenoming is challenging due to the lack of a specific antivenom, requiring symptomatic and supportive care to address complications. The following case report represents the complexities in managing such envenomation with associated renal and venous thrombotic complications.</div></div><div><h3>Case presentation</h3><div>A 35-year-old female was admitted with left lower-limb swelling and ecchymosis following a snakebite. She was transferred from a primary-level hospital with acute kidney injury (serum creatinine 4.0 mg/dL) and venom-induced consumption coagulopathy (VICC) (high levels of d-dimer (15 mg/L), prothrombin time (28 seconds) and activated partial thromboplastin time (&gt;120 sec). Duplex ultrasound confirmed presence of femoral vein thrombosis. The patient was treated with fresh frozen plasma along with other supportive measures. His renal function improved, with creatinine levels normalizing in days.</div></div><div><h3>Conclusion</h3><div>The management of green pit viper envenomation requires close monitoring of coagulation parameters and renal function, along with supportive care. The occurrence of unusual complications, such as deep vein thrombosis, necessitates a conservative and individualized approach to treatment. Further research is needed to better understand the pathophysiology and improve the therapeutic strategies for managing the sequelae of such envenomations.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108324"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revealing the key organelle in the pathophysiology and clinical applications of animal toxins: Mitochondria","authors":"Linfeng Wang ,&nbsp;Jiahao Liu ,&nbsp;Sheng Zhou ,&nbsp;Jiaqi Sun ,&nbsp;Meiling Liu ,&nbsp;Jianqi Zhao ,&nbsp;Lixia Cheng ,&nbsp;Zejing Wen ,&nbsp;Xiaowen Bi ,&nbsp;Chunhong Huang","doi":"10.1016/j.toxicon.2025.108323","DOIUrl":"10.1016/j.toxicon.2025.108323","url":null,"abstract":"<div><div>Animal toxins present an enormous threat to global health, necessitating urgent attention to their management and research. Mitochondria have been identified as a key focus in understanding the pathophysiology and clinical applications of animal toxins. This review provides a comprehensive analysis of the relationship between mitochondria and animal toxins from multiple dimensions, aiming to promote the toxicological research on animal toxins, investigate and evaluate their potential clinical applications, and identify novel drug targets for the development of new antitoxin drugs.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108323"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate change increases public health risks from Tityus scorpion stings in Brazil","authors":"Renata de Freitas Barroso ,&nbsp;Vitória Luiza Cardoso ,&nbsp;Ana Gabriela Alves ,&nbsp;André Felipe de Araújo Lira ,&nbsp;Rhainer Guillermo Ferreira ,&nbsp;Lourenço Faria Costa ,&nbsp;Everton Tizo-Pedroso","doi":"10.1016/j.toxicon.2025.108326","DOIUrl":"10.1016/j.toxicon.2025.108326","url":null,"abstract":"<div><div>Urban environments provide <em>Tityus</em> scorpions with abundant prey and shelter, leading to increased human-scorpion encounters and associated public health risks. In this study, we model the distribution of seven medically relevant <em>Tityus</em> species and project the potential impacts of climate change on their distribution across Brazil by 2060. We compiled 1103 occurrence records from the GBIF, iNaturalist, SpeciesLink, and SiBBr databases and applied ecological niche modeling using climate projections for 2041–2060 from WorldClim. Model validation yielded high AUC values, demonstrating a strong agreement between observed distributions and model predictions. Future climate scenarios predict a reduction in <em>Tityus serrulatus</em> habitat suitability. Despite this reduction, models indicate an increase in high-suitability areas, suggesting a possible local expansion in optimal habitats. Conversely, <em>T</em>. <em>metuendus</em>, <em>T. obscurus</em>, and <em>T. silvestris</em> are expected to undergo a significant increase in habitat suitability, potentially expanding into previously unsuitable areas due to temperature and precipitation shifts. <em>Tityus stigmurus</em> is also projected to benefit from climate change with an increase in suitable habitats, although its expansion is more restricted compared to the other species. In contrast, <em>T. bahiensis</em> and <em>T. trivittatus</em> are expected to face a reduction in habitat suitability. These findings highlight that climate-driven habitat reduction may concentrate scorpion populations in densely populated areas, exacerbating public health risks. Therefore, targeted governmental interventions are crucial to mitigate the escalating threat posed by <em>Tityus</em> scorpions in urban settings under climate change scenarios.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108326"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of commercial tannic acid against the toxic effects of Bothrops jararacussu venom","authors":"Luis Carlos Simas Pereira Júnior ,&nbsp;Eduardo Coriolano de Oliveira ,&nbsp;Eladio Flores Sanchez ,&nbsp;André Lopes Fuly","doi":"10.1016/j.toxicon.2025.108325","DOIUrl":"10.1016/j.toxicon.2025.108325","url":null,"abstract":"<div><div>Snakebite envenomation is a neglected public health issue affecting thousands of victims worldwide. In Brazil, the genus <em>Bothrops</em> is responsible for 88 % of snakebites; bites from the species <em>B. jararacussu</em> present at a high frequency and are associated with high lethality and morbidity rates. <em>B. jararacussu</em> injects a large volume of venom, leading to massive tissue necrosis, hemorrhage, and eventually death. Antivenom is the only available treatment for neutralizing such toxic effects; it effectively prevents death but not the physical sequelae caused by muscle damage. Antivenom has other drawbacks, such as fever and anaphylactic reactions, high production costs, and the need for controlled storage temperatures. Thus, complementary treatments are sought to overcome these disadvantages of antivenoms. Here, we assessed the effects of commercial tannic acid on the major toxic activities of <em>B. jararacussu</em> venom, such as its proteolytic, plasma coagulation, edematogenic, hemorrhagic, and lethal effects. Overall, the incubation of tannic acid with <em>B. jararacussu</em> venom inhibited the venom's <em>in vitro</em> coagulant and proteolytic effects and <em>in vivo</em> hemorrhagic and edematogenic activities; however, it failed to prevent against lethality. Antibothropic serum protected mice from <em>B. jararacussu</em> venom–induced death and inhibited edema by approximately 45 % but did not protect against hemorrhage. In conclusion, tannic acid efficiently neutralized the main toxic activities of <em>B. jararacussu</em> venom, which causes severe envenomation in some South American countries. Thus, tannic acid is a candidate for managing <em>Bothrops</em> snakebites and, alongside antivenom, may hasten and improve victim recovery.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108325"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful management of severe coagulopathy in a dog following Cerastes gasperettii (Arabian horned Viper) envenomation: First clinical case description in Israel","authors":"Green Iris ,&nbsp;Kelmer Efrat ,&nbsp;Mazon Yael ,&nbsp;Aroch Itamar ,&nbsp;Klainbart Sigal","doi":"10.1016/j.toxicon.2025.108321","DOIUrl":"10.1016/j.toxicon.2025.108321","url":null,"abstract":"<div><div>This report describes the first documented clinical case of a confirmed, naturally occurring <em>Cerastes gasperettii</em> (<em>C. gasperettii</em>; Arabian horned viper) envenomation, providing valuable insight into the limited literature on this important species. The case describes a five-year-old pointer dog from the Arave Valley, Israel. Clinical signs included progressive soft tissue swelling and lethargy. Laboratory findings revealed severe coagulopathy, mild renal impairment, and evidence of microangiopathic hemolysis. Despite the unavailability of species-specific antivenom, treatment management with canine fresh frozen plasma, crystalloid therapy, and supportive care, resulted in full recovery within 36 hours. This case contributes significantly to understanding the clinical manifestations, therapeutic strategies, and potential pathophysiological mechanisms of <em>C. gasperettii</em> envenomation.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108321"},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicinal chemistry and detoxification of poisonous plants in traditional medicine: A comprehensive review","authors":"Inder Pal Singh,&nbsp;Ankur Kumar Tanwar,&nbsp;Debanjan Chatterjee,&nbsp;Uma Ranjan Lal","doi":"10.1016/j.toxicon.2025.108307","DOIUrl":"10.1016/j.toxicon.2025.108307","url":null,"abstract":"<div><h3>Introduction</h3><div>Poisonous and toxic plants are used in different traditional systems of medicine for medicinal preparations after certain processing (detoxification) method. However, the correlation between plant toxicity and their chemical constituents remains unexplored for many of these plants. A thorough study on bioactive constituents from poisonous plants could also benefit their proper utilization and improve their usage systematically.</div></div><div><h3>Methods</h3><div>A thorough search of research articles and data bases (Science Direct, PubMed, SciFinder, and Google Scholar) have been done for phytoconstituents and their toxicity aspects. Emphasis was upon searching chemistry of detoxification aspects of traditional poisonous plant materials.</div></div><div><h3>Results</h3><div>Exploration and correlation with traditional system of medicine would help for future drug research and development. The detoxification methods of poisonous plants have been reported but the chemical changes occurring after detoxification remains unexplored for majority of these plants. To understand the safe and informed usage of these poisonous medicinal plants, it is important to investigate their chemical constituents, toxicity phenotypes, mode of action, underlying mechanisms, and detoxification processing techniques. In the present review, poisonous plants of traditional systems of medicine with their constituents and toxicity have been compiled.</div></div><div><h3>Conclusion</h3><div>We discussed poisonous medicinal plants and their toxicity, ways to lessen their toxicity, and discover the processes that underlie detoxification and process of detoxification, and the chemical modification of constituents as a result of detoxification. These provide information on how to employ poisonous medicinal plants safely and sensibly in clinics, how to control the quality of toxic herbs. Limited references were available for <em>Papaver somniferum</em> and <em>Cannabis sativa</em> for their restricted (narcotics) use. This review will give valuable insights for researchers in traditional medicine.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108307"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial injury and its association with venom-induced coagulopathy following Bothrops atrox snakebite envenomation","authors":"Marco Aurélio Sartim ,&nbsp;Maria Raimunda da Costa ,&nbsp;Karolaine Oliveira Bentes ,&nbsp;Victor Irungu Mwangi ,&nbsp;Thiago Serrão Pinto ,&nbsp;Samella Oliveira ,&nbsp;Jady Shayene Mota Cordeiro ,&nbsp;José Wilson do Nascimento Corrêa ,&nbsp;João Marcos Bemfica Barbosa Ferreira ,&nbsp;Gisely Cardoso de Melo ,&nbsp;Jacqueline Sachett ,&nbsp;Wuelton Marcelo Monteiro","doi":"10.1016/j.toxicon.2025.108312","DOIUrl":"10.1016/j.toxicon.2025.108312","url":null,"abstract":"<div><h3>Backgound</h3><div>In Brazil, the highest incidences of snakebite envenomation (SBE) occur in the Amazon region, caused mostly by <em>Bothrops atrox</em>. Among the effects of envenomation, cardiac alterations are not a frequent outcome but are highly linked to severe cases.</div></div><div><h3>Objective</h3><div>The present study investigated the serum profile of cardiac injury markers (fatty acid binding protein 3 - H-FABP3, N-terminal type B natriuretic peptide - NTproBNP, creatine kinase-MB - CPK-MB, and troponin I) following <em>Bothrops</em> SBEs and their association with venom-induced coagulopathy.</div></div><div><h3>Methods</h3><div>Plasma markers were evaluated from blood collected at admission (before antivenom - T0) and 48h after antivenom (T48) from 80 <em>B. atrox</em> SBE patients treated at a tertiary hospital in Manaus, Brazilian Amazon, and 20 healthy donors.</div></div><div><h3>Results</h3><div>Markers were found increased, above reference range or compared to sex- and age-matched healthy controls, including FABP3 in at least 98.7% of patients, Troponin I 12.5%, and CK-MB in 8.8%. Regarding correlations to coagulation markers, alpha 2-antiplasmin concentrations were negatively correlated with FABP3 levels (T0), whereas FDP, tissue factor, and plasma factor VII levels were positively correlated with troponin I concentrations. Moreover, the group of patients with increased troponin I levels presented significantly higher FDP concentrations, factor VII levels, and risk for systemic bleeding at T0, whereas higher D-dimer concentrations at T48.</div></div><div><h3>Conclusions</h3><div>Our findings show that <em>Bothrops</em> SBE is responsible for myocardial injury, although not associated with severe outcomes, and its directly associated to venom-induced coagulopathy, indicating troponin-I and FABP3 as possible markers to screen patients for more detailed cardiac alterations.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108312"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sulfhydryl-loaded bacterial cellulose nanoparticles alleviated intestinal damage caused by mycotoxin patulin in apple juice","authors":"Jingyimei Liang ,&nbsp;Yuxuan Zhao ,&nbsp;Tianli Yue","doi":"10.1016/j.toxicon.2025.108310","DOIUrl":"10.1016/j.toxicon.2025.108310","url":null,"abstract":"<div><div>Patulin (PAT), a toxic fungal metabolite, can directly damage the intestinal barrier and gut homeostasis via altering microbiota composition. Although there are several attempts for the control of PAT <em>in vitro</em>, there are currently few studies on the improvement of intestinal damage caused by patulin using <em>in vivo</em> assay. In this study, a nanoparticle formulation of spherical bacterial cellulose was obtained by dynamic fermentation of <em>Acetobacter xylinum</em> to prepare bacterial cellulose nanoparticles (BCNs) and then modified with 3-mercaptotetraethoxysilane to produce BCN(SH), to increase PAT adsorption <em>in vitro</em>. Meanwhile, results revealed that BCN(SH)s protected the small intestinal microbial barrier and can be used by microorganisms, such as <em>Bacteroides</em>, <em>Firmicutes</em>, and <em>Actinomycetes</em>, to produce short-chain fatty acids (SCFAs). BCN(SH)s appears as a promising edible material that can be used to alleviate intestinal damage from patulin, and has yet to be tested in other gut intoxication models.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"258 ","pages":"Article 108310"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Modified Scoping Review of Interventions for Global Post Stroke Spasticity.","authors":"Areerat Suputtitada, Supattana Chatromyen, Carl Pc Chen, David M Simpson","doi":"10.1016/j.toxicon.2025.108311","DOIUrl":"https://doi.org/10.1016/j.toxicon.2025.108311","url":null,"abstract":"<p><strong>Purpose: </strong>Stroke is a major global health concern, and post-stroke spasticity (PSS) can severely impair mobility and quality of life. This modified scoping review synthesizes the most current evidence up to 2024 for interventions targeting PSS, employing GRADE methodology and a packed bubble chart adapted from the Evidence Alert Traffic Light System to rigorously evaluate the state of evidence to assist global healthcare professionals and policymakers in developing context-sensitive strategies that are both effective and feasible within their specific healthcare environments.</p><p><strong>Methods: </strong>From a pool of 2,420 studies, 53 met our inclusion criteria and were subjected to a detailed analysis, representing 44 distinct interventions.</p><p><strong>Findings: </strong>In our findings, oral medications showed limited efficacy with potential adverse effects. Therefore, prioritizing GRADE A treatments with green traffic light like low-dose botulinum toxin type A (BoNT-A) injections, early intervention, and multimodal therapies of GRADE A can significantly reduce spasticity, as well as alleviate pain and shed light to enhance functional recovery. These treatments have a further advantage of requiring minimal therapy duration and personnel. Intrathecal baclofen (ITB) has demonstrated efficacy in managing severe spasticity following bilateral strokes, surpassing the effectiveness of oral medicines. Nevertheless, in settings with limited resources, therapies graded from A to C and indicated by green to yellow traffic lights can still be employed to control spasticity and accomplish rehabilitation goals, even though they require daily sessions that demand substantial time and personnel.</p><p><strong>Summary: </strong>Our study provides valuable insights into efficacious therapies for PSS and highlights areas requiring additional research to enhance clinical decision-making.</p>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":" ","pages":"108311"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}