~) Pergamon 0163-7258(94)00055-7 Pharmac.Ther. Vol. 64, pp. 509-528, 1994 Copyright© 1994Elsevier ScienceLtd Printed in Great Britain.All rights reserved 0163-7258/94 $26.00 Associate Editor: A. L. HARVEY A REVIEW OF STONEFISH VENOMS AND TOXINS M. C. E. GWEE,* P. GOPALAKRISHNAKONE,t R. YUEN,:~ H. E. KHOO:~ and K. S. Y. LOW* Venom and Toxin Research Group, Departments of Pharmacology,* Anatomyt and Biochemistry,~ Faculty of Medicine, National University of Singapore, Kent Ridge, Singapore 0511 A~tract--Venoms from stonefish (genus Synanceja) have marked effects on the cardiovascular and neuromuscular systems and on vascular permeability; the venoms also exhibit haemolytic and hyaluronidase activity. Recently, a toxic protein, stonustoxin (SNTX), was purified from the venom of S. horrida: the primary lethal action of SNTX has been attributed to its potent endothelium-dependent vasorelaxant activity causing a rapid, marked and irreversible hypotension; the other actions of SNTX resemble those of the stonefish crude venoms. Keywords~Stonefish (Synanceja), venoms, systemic effects, stonustoxin, endothelium-depen- dent vasorelaxation. CONTENTS 1. Introduction 1.1. General biology and distribution 1.1.1. Identification 1.1.2. Habitat and habits 1.2. Venom gland structure 2. Clinical Aspects 2.1. Clinical features of human envenomation 2.2. Prevention, first aid and treatment 2.2.1. First aid 2.2.2. Medical treatment (Sutherland, 1983) 2.3. Stonefish antivenom 2.3.1. Indications for use 2.3.2. Dosage and administration 2.4. Complications of stonefish sting 2.5. Prevention 3. Biochemistry of Stonefish Venoms 3.1. Biochemical properties 3.2. Stonustoxin: isolation, purification and characterization 3.2.1. Physico-chemical properties 3.2.2. Chemical properties 3.2.3. Enzymic activity 3.2.4. Monoclonal antibodies 3.2.5. Comparison of stonustoxin with S. trachynis cytolysin 3.3. Enzyme activity 3.3.1. Hyaluronidase 510 510 511 511 511 514 515 515 515 515 515 515 515 516 516 516 516 517 517 517 518 518 518 518 518 Abbreviations--L-NAME, N°-nitro-L-arginine methyl ester; pL isoelectric point; NO, nitrous oxide; SNTX, stonustoxin; TBS, tris-buffered saline. 509