Review Article

Toxicity Mechanism of Dangerous Scorpion Stings in Iran


Background: Considering the importance of scorpions and recognizing the mechanisms of toxicity caused by their medically important species in Iran and adopting the best therapeutic approach based on these mechanisms, this study was performed by reviewing the clinical manifestations of scorpion stings.

Methods: The research was conducted by searching for articles and researches in related websites (PubMed, EMBASE, Scopus, Web of Science and CINAHL) and using domestic and international authoritative journals using the keywords of scorpion, clinical manifestations, in a review method. Finally, 104 qualified sources were selected and after review­ing and criticizing these studies, the author's point of view was presented.

Results: Clinical manifestations of Scorpion sting toxicity vary due to the existence of two toxic classes of neurotoxins and cytotoxins or hemotoxins in these arthropods in Iran. The number and distribution of species with neurotoxic ven­om are higher than the scorpions with cytotoxic venom and are reported throughout Iran. Scorpions with cytotoxic ven­om are mostly widespread in south and southwest of Iran.

Conclusion: Treatment and prevention of scorpion stings in Iran and neighboring countries in the Middle East should be planned based on the mechanism of toxicity and the presence of toxic classes with neurotoxic or cytotoxic venoms.

1. Isbister GK, Bawaskar HS (2014) Scorpion envenomation. N Engl J Med. 371(5): 457–463.
2. Prendini L (2011) Order Scorpiones CL Koch, 1850. In: Zhang, Z.-Q.(Ed.) An¬i-mal biodiversity: An outline of higher-level classification and survey of taxo-nom¬ic richness. Zootaxa. 3148(1): 115–117.
3. Rein-Ove J (2014) Scorpion Files [Inter-net]. Norwegian University of Science and Tech¬nology, Tronheim. Available at: http://www ntnu no/ub/scorpion-files.
4. Santos MS, Silva CG, Neto BS, Júnior CRG, Lopes VH, Júnior AGT, Bezerra DA, Lu¬na JV, Cordeiro JB, Júnior JG (2016) Clin¬ical and epidemiological aspects of scorpionism in the world: a systematic re¬view. Wilderness Environ Med. 27(4): 504–518.
5. Marks CJ, Muller GJ, Sachno D, Reuter H, Wium CA, Du Plessis CE, Van Hoving DJ (2019) The epidemiology and sever-ity of scorpion envenoming in South Af-rica as managed by the Tygerberg Poi-sons Information Centre over a 10 year period. Afr J Emerg Med. 9(1): 21–24.
6. Santibáñez-López CE, Francke OF, Ureta C, Possani LD (2015) Scorpions from Mex¬ico: From species diversity to venom com¬plexity. Toxins (Basel). 8(1): 2.
7. Pucca MB, Oliveira FN, Schwartz EF, Arantes EC, Lira-da-Silva RM (2015) Scorpionism and Dangerous Species of Brazil. In: Gopalakrishnakone P, Pos¬sani L, F Schwartz E, Rodríguez de la Vega R (eds) Scorpion Venoms. Toxi¬nol¬ogy, vol 4. Springer, Dordrecht.
8. Bentur Y, Taitelman U, Aloufy A (2003) Evaluation of scorpion stings: the poison center perspective. Vet Hum Toxicol. 45 (2): 108–111.
9. Abd El F, El Shehaby D, Elghazally S, Hetta H (2019) Toxicological and epidem¬io¬log¬ical studies of scorpion sting cases and morphological characterization of scor¬pions (Leiurusquin questriatus and An¬droctonus crassicauda) in Luxor. Egypt Toxicol Rep. 6: 329–335.
10. Yadav R, Alim M, Yadav Y, Singh D, Ku¬mar A (2020) Retrospective Study of Chil¬dren with Scorpion Envenomation in a Tertiary Care Center of North India. Asia
Pac J Med Toxicol. 9(3): 91–96.
11. Bawaskar HS, Bawaskar PH (2011) Effi-cacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Meso¬bu-thus tamulus) sting: randomised open la-bel clinical trial. BMJ. 342: c7136.
12. Mahadevan S (2000) Scorpion sting. In¬di-an Pediatr. 37(5): 504–514.
13. Barahoei H, Navidpour S, Aliabadian M, Siahsarvie R, Mirshamsi O (2020) Scor-pions of Iran (Arachnida: Scorpiones): Annotated checklist, DELTA database and identification key. J Insect Biodivers Syst. 6(4): 375–474.
14. Mohammadi Bavani M, Rafinejad J, Hanafi-Bojd AA, Oshaghi MA, Navidpour S, Dabiri F, Badakhshan M, Ghorbani E, Bagheri M (2017) Spatial distribution of medically important scorpions in north west of Iran. J Arthropod Borne Dis. 11 (3): 371–382.
15. Ghorbani A, Mansouri B, Baradaran M (2021) Effects of climate variables on the incidence of scorpion stings in Iran for five years. J Venom Anim Toxins Incl Trop Dis. 27:e20200110.
16. Nejati J, Mozafari E, Saghafipour A, Ki-yani M (2014) Scorpion fauna and ep¬i-de¬miological aspects of scorpionism in south¬eastern Iran. Asian Pac J Trop Biomed. 4: S217–S21.
17. Dehghani R, Charkhloo E, Seyyedi-Bid-goli N, Chimehi E, Ghavami-Ghameshlo M (2018) A review on scorpionism in Iran. J Arthropod Borne Dis. 12(4): 325 –333.
18. Vatanpour H, Jalali A, Rowan EG, Rahim F (2013) Effects of Odontobuthus dori-ae scorpion venom on mouse sciatic nerve. Iran J Pharm Res. 12(Suppl): 145–151.
19. Radmanesh M (1990) Androctonus crassi-cauda sting and its clinical study in Iran. J Trop Med Hyg. 93(5): 323–326.
20. Bawaskar H, Bawaskar P (2012) Scorpion sting: update. J Assoc Physicians India. 60: 46–55.
21. Sanaei-Zadeh H (2017) Painless stings of yellow Iranian scorpions. Iran Red Cres-cent Med J. 19(4): e42645.
22. Kassiri H, Dehghani R, Kaviani M, Dehghani M, Kasiri M (2020) First re-port of Hottentotta schach (Arachnida: Scorpionida: Buthidae) as a new record from Isfahan Province, Central Iran. J En¬tomol Res. 44(1): 153–156.
23. Dehghani R, Fathi B (2012) Scorpion sting in Iran: a review. Toxicon. 60(5): 919–933.
24. Radmanesh M (1990) Clinical study of Hemiscor¬pion lepturus in Iran. J Trop Med Hyg. 93(5): 327–332.
25. Dehghani R, Kamiabi F, Mohammadi M (2018) Scorpionism by Hemiscorpius spp. in Iran: a review. J Venom Anim Toxins Incl Trop Dis. 24: 8.
26. Shahi M, Rafinejad J, Az-Khosravi L, Moosavy SH (2015) First report of death due to Hemiscorpius acanthocercus en¬ven¬omation in Iran: Case report. Elec¬tron Physician. 7(5): 1234.
27. Najafian M, Ghorbani A, Zargar M, Bara-daran M, Baradaran N (2020) Scorpion stings in pregnancy: an analysis of out-comes in 66 envenomed pregnant pa-tients in Iran. J Venom Anim Toxins Incl Trop Dis. 26: e20190039.
28. Ben Nasr H, Hammami T, Sahnoun Z, Rebai T, Bouaziz M, Kassis M, Zeghal K (2007) Scorpion envenomation symp-toms in pregnant women. J Venom Anim Toxins Incl Trop Dis. 13: 94–102.
29. Radmanesh M (1998) Cutaneous mani¬fes-tations of the Hemiscorpius lepturus sting: a clinical study. Int J Dermatol. 37(7): 500–507.
30. Pipelzadeh MH, Dezfulian AR, Jalali MT, Mansouri AK (2006) In vitro and in vi¬vo studies on some toxic effects of the ven-om from Hemiscorpious lepturus scor-pion. Toxicon. 48(1): 93–103.
31. Maleki M, Dounighi NM (2020) Purifi-cation and characterization of a novel type of neurotoxic peptides from the venom of the Iranian scorpion Hemiscorpius lepturus. Iran J Basic Med Sci. 23(2): 195–201.
32. Radmanesh M (1990) Surveying scorpion sting in general. Darou va Darman Jour-nal. 8: 26–30.
33. Bagheri Ziari S, Shahbazzadeh D, Sardari S, Sabatier J-M, Pooshang Bagheri K (2021) Discovery of a new analgesic pep¬tide, leptucin, from the iranian scorpion, Hemiscorpius lepturus. Molecules. 26(9): 2580.
34. Mirakabbadi AZ, Zolfagharian H, He-dayat A, Jalali A (2007) Clinical and bio¬chem¬ical manifestation produced by scorpion (Hemiscorpius lepturus) venom in ex¬per¬imental animals. J Venom Anim Toxins Incl Trop Dis. 13: 758–765.
35. Rahmani A, Jalali A (2012) Symptom pat-terns in adult patients stung by scorpions with emphasis on coagulopathy and he-mo¬glubinuria. J Venom Anim Toxins Incl Trop Dis. 18: 427–431.
36. Valavi E, Ansari MA (2008) Hemolytic uremic syndrome following Hemiscor-pius lepturus (scorpion) sting. Indian J Nephrol. 18(4): 166–168.
37. Hedayat B, Rahmani AH, Matinrad M, Nazari P (2018) The Epidemiologic and Clinical Study on Hemiscorpius Lep-turus (Gadim) Envenomation with Focus on Clin¬ical Manifestations, Prognosis Fac¬tors, and Outcomes. Asia Pac J Med Toxicol. 7(4): 97–100.
38. Dehghani R, Arani MG (2015) Scorpion sting prevention and treatment in an¬cient Iran. J Tradit Complement Med. 5(2): 75–80.
39. Torabi E, Behdani M, Hosseininejad Chafi M, Moazzami R, Sabatier J-M, Khalaj V, Shahbazzadeh D, Pooshang Bagheri K (2017) Characteristics and lethality of a novel recombinant dermonecrotic ven¬om phospholipase D from Hemiscorpius lep-turus. Toxins. 9(3): 102.
40. Mashak Z, Nemat R, Mahboobian B (2000) Epidemiologic Survey Of Scorpion Sting In Abozar Hospital, Ahwaz Province, Iran Between 1989–1990. Hakim. 3(3): 215–223.
41. Malhotra K, Chadha J, Mirdehghan M, Tandon H (1978) Acute renal failure fol-lowing scorpion sting. Am J Trop Med Hyg. 27(3): 623–626.
42. Jalali A, Pipelzadeh MH, Sayedian R, Rowan E (2010) A review of epide¬mio-log¬ical, clinical and in vitro physi¬ologi¬cal studies of envenomation by the scor¬pion Hemiscorpius lepturus (Hemiscor¬pi¬idae) in Iran. Toxicon. 55(2–3): 173–179.
43. Mostafazadeh B, Gorbani A, Mogaddaspour M, Khoddami Vishteh HR (2017) The effect of plasmapheresis on treating dis¬seminated intravascular coagulation (DIC) caused by a Hemiscorpius lepturus (Gadim) sting. Clin Toxicol. 55(8): 902–907.
44. Rafizadeh S, Rafinejad J, Rassi Y (2013) Epidemiology of scorpionism in Iran dur¬ing 2009. J Arthropod Borne Dis. 7(1): 66–70.
45. Firoozfar F, Saghafipour A, Jesri N (2019) Scorpions and their human mortality report in Iran: a review article. Iran J Public Health. 48(12): 2140–2153.
46. Alhamoud MA, Al Fehaid MS, Alhamoud MA, Alzoayed MH, Alkhalifah AA, Menezes RG (2021) Scorpion Stings in Saudi Arabia: An Overview. Acta Bi¬o-med. 92(4): e2021273.
47. Feola A, Perrone MA, Piscopo A, Casella F, Della Pietra B, Di Mizio G (2020) Au¬topsy Findings in Case of Fatal Scor-pion Sting: A Systematic Review of the Literature. Healthcare (Basel). 8(3): 325.
48. Ward MJ, Ellsworth SA, Nystrom GS (2018) A global accounting of medically significant scorpions: Epidemiology, ma-jor toxins, and comparative resources in harmless counterparts. Toxicon. 151: 137–155.
49. Caliskan F, García BI, Coronas FI, Batista CV, Zamudio FZ, Possani LD (2006) Characterization of venom components from the scorpion Androctonus cras¬si-cauda of Turkey: peptides and genes. Toxicon. 48(1): 12–22.
50. Rahimi M, Sh Sh, Mirzaei Nasab R, Solta-ninejad K (2020) Scorpion Stings in Teh¬ran Province, Iran: A Seven-year Hos¬pi¬tal-based Study. Int J Med Toxicol Forensic Med. 10(4): 30274.
51. Dehghani R, Khamechian T, Dehghani A, Limoee M, Limoee M, Hossini H (2020) Investigation of the Behavioral and Clin¬ical Effects of Black Scorpion Venom in Albino Rats. Iran J Toxicol. 14(3): 165–170.
52. Kassiri H, Dehghani R, Doostifar K, Saberi H, Dehghani M (2020) Micro habitat of Androctonus crassicauda (Arachnida: Scor¬pionida: Buthidae) in Isfahan, Khuzestan and Kerman Provinces, Iran. J Entomol Res. 44(3): 489–494.
53. Dehghani R, Kassiri H (2017) Geo¬graph-ical distribution of scorpion Odon¬tobu-thus doriae in Isfahan Province, central Iran. J Arthropod Borne Dis. 11(3): 433–440.
54. Razi E, Malekanrad E (2008) Asymmetric pulmonary edema after scorpion sting: a case report. Rev Inst Med Trop Sao Paulo. 50: 347–350.
55. Jalali A, Vatanpour H, Hosseininasab Z, Rowan EG, Harvey AL (2007) The ef-fect of the venom of the yellow Iranian scorpion Odontobuthus doriae on skel-etal muscle preparations in vitro. Toxi-con. 50(8): 1019–1026.
56. Dehghani R, Djadid ND, Shahbazzadeh D, Bigdelli S (2009) Introducing Comp-sobuthus matthiesseni (Birula, 1905) scor¬pion as one of the major stinging scor¬pi¬ons in Khuzestan, Iran. Toxicon. 54(3): 272–275.
57. Farzanpey R (1994) Scorpion sting and the fallowing of it. Pajouhesh va Sazandegi. 259(3): 123–125.
58. Radmanesh M, Shaffiee S (1989) Clinical study of Apistobuthus pterygocercus sting. Journal of Daru and Darman. 6(63): 9–10.
59. Petricevich VL (2010) Scorpion venom and the inflammatory response. Mediators Inflamm. 2010: 903295.
60. Nencioni ALA, Beraldo Neto E, Freitas LAd, Dorce VAC (2018) Effects of Bra¬zilian scorpion venoms on the central nervous system. J Venom Anim Toxins Incl Trop Dis. 24: 3.
61. Horta CCR, Magalhaes BdF, Oliveira-Mendes BBR, Carmo AOd, Duarte CG, Felicori LF, Machado-de-Avila RA, Chavez-Olortegui C, Kalapothakis E (2014) Molecular, immunological, and biological characterization of Tityus ser-rulatus venom hyaluronidase: new in-sights into its role in envenomation. PLoS Negl Trop Dis. 8(2): e2693.
62. Quintero-Hernández V, Jiménez-Vargas J, Gurrola G, Valdivia H, Possani L (2013) Scorpion venom components that affect ion-channels function. Toxicon. 76: 328–342.
63. Al-Asmari AK, Kunnathodi F, Al Saadon K, Idris MM (2016) Elemental analysis of scorpion venoms. J Venom Res. 7: 16–20.
64. Israel MR, Tay B, Deuis JR, Vetter I (2017) Sodium channels and venom peptide phar¬macology. Adv Pharmacol. 79: 67–116.
65. Stevens M, Peigneur S, Tytgat J (2011) Neurotoxins and their binding areas on voltage-gated sodium channels. Front Phar¬macol. 2: 71.
66. Ahmadi S, Knerr J, Argemi L, Bordon K, Pucca M, Cerni F, Arantes E, Çaliskan F, Laustsen A (2020) Scorpion venom: detriments and benefits. Biomedicines. 8(5): 118.
67. Bosmans F, Tytgat J (2007) Voltage-gated sodium channel modulation by scorpion α-toxins. Toxicon. 49(2): 142–158.
68. Jolodar A (2019) Molecular Characteriza-tion of a Three-disulfide Bridges Beta-like Neurotoxin from Androctonus cras-si¬cauda Scorpion Venom. Arch Razi Inst. 74(2): 135–142.
69. Bawaskar H, Bawaskar P (1998) Indian red scorpion envenoming. Indian J Pe-diatr. 65(3): 383–391.
70. Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, Hamida CB, Kallel H, Bouaziz M (2013) Pulmonary edema following scorpion enven-omation: mechanisms, clinical manifestations, di¬agnosis and treatment. Int J Cardiol. 162 (2): 86–91.
71. Castillo A, Attaluri P (2018) Acute res¬pir-a¬tory failure following scorpion stings: Anaphylaxis or severe systemic enven-omation? The Southwest Respiratory and Critical Care Chronicles. 6(22): 47–50.
72. Dutto M, Dutto L, Bertero M, Goyffon M (2012) Stings from Euscorpius flavicau-dis (De Geer, 1778) (Scorpiones, Euscor-piidae) during pregnancy: a clinical case report. J Venom Anim Toxins Incl Trop Dis. 18: 462–466.
73. Abourazzak S, Achour S, El Arqam L, Atmani S, Chaouki S, Semlali I, Sou-laymani Bencheikh R, Bouharrou A, Hida M (2009) Epidemiological and clinical characteristics of scorpion stings in chil¬dren in Fez, Morocco. J Venom Anim Toxins Incl Trop Dis. 15: 255–267.
74. Vazirianzadeh B, Farhadpour F, Hosse-inza¬deh M, Zarean M, Moravvej S (2012) An epidemiological and clinical study on scorpionism in hospitalized children in Khuzestan, Iran. J Arthropod Borne Dis. 6(1): 62–69.
75. Bawaskar H, Bawaskar P (1991) Cardio-vas¬cular manifestations of severe scor-pion sting in India (review of 34 chil-dren). Ann Trop Paediatr. 11(4): 381–387.
76. Ghafourian M, Ganjalikhanhakemi N, Hem¬mati AA, Dehghani R, Kooti W (2016) The effect of Hemiscorpius lepturus (Scor¬pionida: Hemiscorpiidae) venom on leu¬kocytes and the leukocyte subgroups in peripheral blood of rat. J Arthropod Borne Dis. 10(2): 159–167.
77. Kazemi-Lomedasht F, Khalaj V, Bagheri KP, Behdani M, Shahbazzadeh D (2017) The first report on transcriptome anal¬ysis of the venom gland of Iranian scor¬pion, Hemiscorpius lepturus. Toxicon. 125: 123–130.
78. Cordeiro FA, Coutinho BM, Wiezel GA, Bordon KdCF, Bregge-Silva C, Rosa-Garzon NG, Cabral H, Ueberheide B, Arantes EC (2018) Purification and en-zymatic characterization of a novel met-alloprotease from Lachesis muta rhom-beata snake venom. J Venom Anim Tox-ins Incl Trop Dis. 24: 32.
79. Gutierrez JM, Rucavado A (2000) Snake venom metalloproteinases: their role in the pathogenesis of local tissue damage. Biochimie. 82(9–10): 841–850.
80. Pipelzadeh MH, Jalali A, Taraz M, Pour-abbas R, Zaremirakabadi A (2007) An epidemiological and a clinical study on scorpionism by the Iranian scorpion Hemiscor¬pius lepturus. Toxicon. 50(7): 984–992.
81. Yazdkhasti M, Razi Jalali M, Khadjeh GH, Jafari H, Rezaie A (2021) Cardio-toxic effects of Hemiscorpius lepturus scorpion venom fractions in rats. Iran J Toxicol. 15(1): 27–36.
82. Viswanathan S, Prabhu C (2011) Scorpion sting nephropathy. NDT Plus. 4(6): 376–382.
83. Boju SL, Mogili HKR, Ram R, Vishnu-botla SK (2016) Nephrotic syndrome af-ter scorpion sting. CEN Case Rep. 5(1): 83–86.
84. Naqvi R, Naqvi A, Akhtar F, Rizvi A (1998) Acute renal failure developing after a scorpion sting. Br J Urol. 82(2): 295.
85. de Sousa Alves R, do Nascimento NRF, Barbosa PSF, Kerntopf MR, Lessa LMA, De Sousa CM, Martins RD, Sousa DF, De Queiroz MGR, Toyama MH (2005) Renal effects and vascular reactivity in¬duced by Tityus serrulatus venom. Tox¬icon. 46(3): 271–276.
86. Albuquerque PLMM, Magalhaes KdN, Sales TdC, Paiva JHHGL, Daher EdF, Silva Junior GBd (2018) Acute kidney injury and pancreatitis due to scorpion sting: case report and literature review. Rev Inst Med Trop Sao Paulo. 60: e30.
87. Saidani C, Hammoudi-Triki D, Laraba-Djeba¬ri F, Taub M (2016) In vitro stud-ies with renal proximal tubule cells show direct cytotoxicity of Androctonus aus-tralis hector scorpion venom triggered by oxidative stress, caspase activation and apoptosis. Toxicon. 120: 29–37.
88. Krkic-Dautovic S, Begovic B (2007) Acute renal insufficiency and toxic hepatitis fol¬lowing scorpions sting. Med Arh. 61(2): 123–124.
89. Ranaweera G, Lokuhetty M, Bavanthan V, Nazar A (2015) Acute renal insuf¬fi-cien¬cy after scorpion sting. Ceylon Med J. 60(1): 31–32.
90. Dehghani R, Khamechian T, Vaziri¬anza-deh B, Vatandoost H, Moravvej S (2012) Toxic effects of scorpion, Hemiscorpius lepturus (Hemiscorpiidae) venom on mice. J Anim Plant Sci. 22(3): 593–596.
91. Movahed A, Fatemikia H, Tanha K, Es-maili A, Kim E, Dounighi NM, Zende-boodi S, Seyedian R (2018) Serological, pathological, and scintigraphic as¬sess-ment of Hemiscorpius lepturus effects on re¬nal dysfunction in rats. Iran J Basic Med Sci. 21(12): 1221–1225.
92. Dehghani R, Dadpour B, Kassiri H, Va-habzadeh M, Sadat Izadi-Avanji F, Mo-hammadzadeh N (2019) Effects of the crude venom of Hemiscorpius lepturus (Scorpionida: Hemiscorpiidae) on mor-tality rate of white mice. Biochem Cell Arch. 19(1): 337–341.
93. Pourkhalili K, Kim E, Mashayekhy NR, Kamyab M, Hoseiny SM, Evazy R, Miraka¬badi AZ, Seyedian R (2015) Car-diotoxic and arrhythmogenic effects of Hemiscorpius lepturus scorpion venom in rats. J Arthropod Borne Dis. 9(2): 215–225.
94. Zabihollahi R, Bagheri KP, Keshavarz Z, Motevalli F, Bahramali G, Siadat SD, Momen SB, Shahbazzadeh D, Aghasadeghi MR (2016) Venom com¬po-nents of Iranian scorpion Hemiscorpius lepturus inhibit the growth and repli¬ca-tion of human immunodeficiency virus 1 (HIV-1). Iran Biomed J. 20(5): 259–265.
95. Khaleghi Rostamkolaie L, Hamidinejat H, Razi Jalali M, Jafari H, Najafzadeh Varzi H, Seifi Abadshapouri M (2019) In vitro therapeutic effect of Hemiscorpius lep¬turus venom on tachyzoites of Toxo¬plasma gondii. J Parasit Dis. 43(3): 472–478.
96. Al-Malki ES, Abdelsater N (2020) In vitro Scolicidal effects of Androctonus cras-sicauda (Olivier, 1807) venom against the protoscolices of Echinococcus gran-u¬losus. Saudi J Biol Sci. 27(7): 1760–1765.
97. Lau JL, Dunn MK (2018) Therapeutic pep¬tides: Historical perspectives, current de¬velopment trends, and future directions. Bioorg Med Chem. 26(10): 2700–2707.
98. Maatuf Y, Geron M, Priel A (2019) The role of toxins in the pursuit for novel analgesics. Toxins (Basel). 11(2): 131.
99. Moghadasi Z, Shahbazzadeh D, Jamili S, Mosaffa N, Bagheri KP (2020) Signifi-cant anticancer activity of a venom frac-tion derived from the Persian Gulf sea anemone, Stichodactyla haddoni. Iran J Pharm Res. 19(3): 402–420.
100. Zarghami V, Ghorbani M, Bagheri KP, Shokrgozar MA (2021) Melittin anti¬mi-crobial peptide thin layer on bone im-plant chitosan-antibiotic coatings and their bac¬tericidal properties. Mater Chem Phys. 263: 124432.
101. Harvey A (2014) Toxins and drug dis-cov¬ery. Toxicon. 92: 193–200.
102. Carlsson KH, Jurna I (1987) Depression by flupirtine, a novel analgesic agent, of mo¬tor and sensory responses of the no¬ci-cep¬tive system in the rat spinal cord. Eur J Pharmacol. 143(1): 89–99.
IssueVol 17 No 2 (2023) QRcode
SectionReview Article
Poisoning; Mechanism; Hazardous; Scorpion envenomation; Iran

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Dehghani R, Ghorbani A, Varzandeh M, Karami-Robati F. Toxicity Mechanism of Dangerous Scorpion Stings in Iran. J Arthropod Borne Dis. 2023;17(2):105–119.