The pathology of Chironex fleckeri venom and known biological mechanisms
Melissa Piontek,
Jamie E. Seymour,
Yide Wong,
Tyler Gilstrom,
Jeremy Potriquet,
Ernest Jennings,
Alan Nimmo,
John J. Miles
Affiliations
Melissa Piontek
James Cook University, Cairns, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia; Corresponding author. James Cook University, Cairns, Queensland, Australia.
Jamie E. Seymour
James Cook University, Cairns, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia; Centre for Molecular Development of Therapeutics, James Cook University, Cairns, Queensland, Australia
Yide Wong
James Cook University, Cairns, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
Tyler Gilstrom
James Cook University, Cairns, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
Jeremy Potriquet
James Cook University, Cairns, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
Ernest Jennings
James Cook University, Cairns, Queensland, Australia
Alan Nimmo
James Cook University, Cairns, Queensland, Australia
John J. Miles
James Cook University, Cairns, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia; Centre for Molecular Development of Therapeutics, James Cook University, Cairns, Queensland, Australia; Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, Queensland, Australia; Corresponding author. James Cook University, Cairns, Queensland, Australia.
The large box jellyfish Chironex fleckeri is found in northern Australian waters. A sting from this cubozoan species can kill within minutes. From clinical and animal studies, symptoms comprise severe pain, welts, scarring, hypotension, vasospasms, cardiac irregularities and cardiac arrest. At present, there is no cure and opioids are used to manage pain. Antivenom is available but controversy exists over its effectiveness. Experimental and combination therapies performed in vitro and in vivo have shown varied efficacy. These inconsistent results are likely a consequence of the different methods used to extract venom. Recent omics analysis has shed light on the systems of C. fleckeri venom action, including new toxin classes that use pore formation, cell membrane collapse and ion channel modulation. This review covers what is known on C. fleckeri pathomechanisms and highlights current gaps in knowledge. A more complete understanding of the mechanisms of C. fleckeri venom-induced pathology may lead to novel treatments and possibly, the discovery of novel cell pathways, novel drug scaffolds and novel drug targets for human disease.