Strychnine
Strychnine
Strychnine
Marc Duque
Pol Torrent
Mateu Montserrat
Jorge Lzaro
Grau de Bioqumica
Universitat de Barcelona
Index:
Introduction ...................................................................................................................... 3
Strychnine structure, origin, synthesis, history and medical uses .................................... 3
Analysis of strychnine misunderstandings in literature and popular culture.................... 5
The Joker and his permanent grin. Mode of action of strychnine. ............................... 5
The incredible Colonel Aureliano Buenda. Strychnine symptoms and treatment. ... 11
Strychnine as a cardiac tonic and sleep powder ......................................................... 14
Conclusion ...................................................................................................................... 18
Bibliography ................................................................................................................... 19
Introduction
Poison is definitely among fictions greatest weapons. Strychnine, because of its
lethality and its painful way to kill, has captivated some of the most recognised authors
worldwide. Sir Arthur Conan Doyle, Agatha Christie, H. G. Wells or Gabriel Garca
Mrquez have used it in some of their stories. Onscreen, strychnine has appeared on
films such as Psycho (1960) or The Grand Budapest Hotel (2014).
The scope of this work is to analyse how strychnine has been used in literature and film;
focusing ourselves on some specific cases, we are going to discuss about how possible
they really are from a scientific point of view and whether the explanations given by the
author in each case are correct. Obviously, we will need to explain what exactly
strychnine is, where it comes from, and its effect on living organisms.
This highly toxic molecule is produced by some plants from the strychnos genus. Its
main source is the nux vomica tree (Strychnos nux-vomica), native to India and
Southeast Asia. Strychnine is majorly found on the seeds of the tree (Figure 2), together
with brucine and other alkaloids such as vomicine and igasurine. The seeds contain 2.63% total alkaloids, out of which 1.25-1.5% is strychnine and approximately 1.7%
brucine. The natural role for strychnine and the other
alkaloids is defence against herbivore.
The biosynthesis of strychnine (Figure 3) starts with the
condensation of tryptamine with secologanin following
a Pictet-Spengler type reaction catalysed by
strictosidine synthase [2] to obtain strictosidine.
Figure 2. Strychnos nux-vomica
seeds, the main source of
strychnine [1]
The toxic and medicinal effects of Strychnos nux-vomica have been well known from
the ancient times in India, although strychnine itself was not identified until 19th
century. The plant arrived to Europe near the 15th century as a rodenticide; there are
records of strychnine used to kill animals as back as 1640. It was first isolated on 1818
by Pelletier and Caventou and its elemental composition established 20 years later by
Regnault. The elucidation of strychnine constitutional structure and synthesis
represented one of the major achievements of classical organic chemistry. Degradative
work started in the 1880s and lasted until 1946 when Robin Robertson finally
determined it. The total synthesis of the molecule was achieved for the first time by
Robert B. Woodward in 1954. Both Robertson and Woodward became Nobel
Laureates in 1947 and 1965 respectively for their studies and synthesis.
As said before, the nux-vomica effects have been known since the times of ancient India
and its properties has been used for many ailments in the traditional Oriental medicine.
We can perfectly assume that the properties of the Strychnos nux-vomica are those of
the strychnine. The main historical application for the seeds have been the treatment of
dyspepsia, it is said that the bitter taste of strychnine increases appetite and the flow of
gastric juice, in addition to peristalsis stimulation [4]. These effects have not been
scientifically proven, but being this the main application for strychnine in medicine it
probably might be true. Another typical use for strychnine has been the preparation of
stimulant tonics, this part will be analysed in depth later. Modern studies have also
proven the effectiveness of strychnine in illnesses such as gastric carcinoma [5], diabetes
[6][7]
and allergy treatment [8]. However, the elevated toxicity of strychnine makes its
usage unviable as a recognised drug.
4
Thus, adding the latter excitatory action plus the inhibitory on the GlyR receptor,
glycine may cause a wide range of neuronal and motor activities. We may only focus in
the inhibitory activity of the neurotransmitter, as it is of interest for strychnine
interaction.
As we may know, neurotransmitters are a family of biomolecules, showing some
homologies (such as amino-acidic origin, but that bind to specific receptors after
secretion from the synaptic endosomes into the synaptic cleft. From now on, we will
refer to substances which bind neuronal receptors and activate them as agonist, and to
those which bind the receptor without any direct biological response, as antagonists.
Antagonists can be either competitive or non-competitive, if they share or not the
binding site with the natural agonist.
It is also important to introduce the membrane
rest potential, which is the electric potential
loosely defined as
(Figure 5,
A). Electrical impulse (action potential) is
transmitted as depolarization
created
+ +
2+
by positive ions entrance (Na /K /Ca ) to the
cytoplasm (B). This stimulus might cause
depolarization
in
other
regions
or
neurotransmitters secretion, when V rises above
a concrete threshold. Another interesting state is
hyperpolarization, where
, created
+
when excess K ions leave the cytoplasm or
negative ions (Cl-) enter the neuron. Here,
inhibition may be accomplished by making
neurons insensitive: depolarization from other
zones is muted due to the lower membrane
potential; the action potential threshold
rises(C).[14]
A
C
Glycine is synthesized from serine, and serine is in turn generated from 3phosphoglycerate [10]. They are, consequently, not essential amino acids, though glycine
is often referred as conditionally essential, in especial states such as severe
malnourishment. Our neurotransmitter binds the extracellular unit of the receptor GlyR,
which consists of a 48KDa subunit, called the subunit, and a 58KDa subunit,
subunit. This receptor might actually be a mutation from a single chloride ancestor
gene [20], as this is the function the transmembrane domain exerts: when glycine binds to
the -subunit, plasmatic membrane conductance of Cl- is increased (because they can
enter the cell through the gated channel).
A.
B.
Excitatory impulse
t(ms)
Hyperpolarization
Strychnine action
Figure 6 A) Scheme made with Chem-Bio Draw which summarize the antagonist action of strychnine. The
alkaloid binds to the 48KDa subunit and inhibits hyperpolarization, by competing with glycine. N impulses
provoke an action potential on the corticospinal neuron and depolarization is not muted; calcium voltagegated channels are activated and glutamate vesicles are secreted to the synaptic cleft. The signal is transmitted
through the motor neuron and acetylcholinergic excitation of muscles by the nicotinic acetylcholine receptor
leads to spasms and tetany.
B) The first two graphics show normal glycine inhibition through hyperpolarization of the corticospinal
neuron: excitatory depolarization and a low membrane potential induced by chloride ions, sum up. The result
(second graphic), doesnt surpass the threshold and so the rest potential (-65 mV) is almost instantly
achieved. In absence of inhibitory modulation, the membrane potential rises above the threshold and
generates an action potential (spike), that will be transmitted to the motor neuron.
8
By smiling muscle, we refer to the zygomaticus major muscle. This muscle extends
from each cheekbone to the corners of the mouth, where it connects with orbicularis
oris muscle (this muscle closes the mouth and puckers the lips when it contracts). The
zygomaticus muscle is activated by the brainstem through the VII cranial nerve, known
as facial nerve and its extracranial branches. Apart from directing facial expression, this
nerve is also implied in taste sensation and submandibular gland excitation by the
parasympathetic system [12]. There a many muscles implied in laughing and smiling, but
we focused on the zygomaticus muscle as it is often referred to cause natural smile
(similar to the grimace a patient makes when he is asked to close his eyes tightly).
On the other hand, local tetanus causing permanent contracture is the subject of some
studies. Tetanus, is an infection characterized by spasms and tetany, so severe that even
bone fracture may occur. It is caused by the anaerobic bacteria Clostriduium tetani,
which excretes among other substances, tetanospasmin or TeTN. TeTN is a potent
neurotoxin with clinical manifestations similar to those in strychnine poisoning, but
with a different mode of action: this 150KDa protein, enters into inhibitory neurons and
interferes with exocytosis vesicles pathways that carry glycine or GABA.[13] If, for
example, glycine is not secreted into the synaptic cleft, we may be in the strychninepoisoning-like state, where hyperpolarization cannot be reached and overexcitation
leads to spasms and tetany (here used to point the involuntary contraction of muscles, a
clinical manifestation shared by both pathologies). We consider this homology enough
to relate the medical condition observed under local tetanospasmin injection with a
hypothetic strychnine injection to the zygomaticus muscle.
10
Strychnine poisoning:
As we have seen, strychnine inhibits the action of glycine leading the neuron to
uncontrolled excitation due to the inability of the membrane to hyperpolarizate. This
leads to the characteristic symptoms of strychnine poisoning.
Once ingested, like the Colonel did,
the strychnine is rapidly adsorbed by
the gastrointestinal tract as the first
symptoms appear within the first ten
to twenty minutes after exposure.
The alteration of the muscular
neurons causes the muscles begin to
spasm. Convulsions, characterised
by risus sardonicus, opisthotonus,
flexor spasm of upper limbs, and
extensor spasm of lower limbs,
occurr with minimal sensory stimuli.
(Figure 8 ) [23]
11
These convulsions are very painful because of the strong contractions of muscles, they
lead to lactic acidosis, hyperthermia and rhabdomyolysis (muscular cell breakdown) due
to muscular cells stress.
The convulsions, increase in intensity and frequency until the backbone arches
continually. If not treated, death comes within 1 to 3 hours from asphyxiation caused by
paralysis of the neural pathways that control breathing, or by exhaustion from the
convulsions. [24]
Other clinical effects might be: tachycardia, vomit, pupil dilatation and hyperreflexia.
Analysis of the Colonel Aureliano Buenda case. Strychnine LD50 and treatment:
The first thing to analyze is the median lethal dose (LD50) of horses and humans. LD50
is the dose required to kill half the members of a tested population after specified test
durations. In horses, orally taken strychnine LD50 is 0.5 mg/Kg [25] and 1-2 mg/Kg in
humas [24]. As the average horse weights 500 Kg and the average male 80 Kg, it will
take 250 mg of strychnine to kill a horse and about 100 mg to kill a man.
From this data we might conclude that the colonel must have died after its intake of
strychnine. However, we know from the novel that Colonel Aureliano Buenda was an
incredible and strong man so we will discuss if there is a reason why the Colonel could
have survived as the book says.
In order to survive, there isnt a specific antidote for strychnine but a medical treatment
can be applied. This treatment consists in trying to alleviate the symptoms and facilitate
the removal of the drug until its naturally metabolized or excreted.
Once the strychnine poisoning its confirmed, if symptoms are not showed, the first
thing to do is remove as much as the poison as its possible to prevent its absorption. It
can be done with activated charcoal or potassium permanganate solutions but it has to
be done quickly because of strychnine rapid absorption.
When the patient starts to show the symptoms it has to be taken to a quiet and dark
room since stimuli can produce convulsions. Then, the treatment is directed towards
control of convulsions and preventing of asphyxia by combination of anticonvulsants
like diazepam along with muscular relaxants and artificial ventilation [23]. If the patient
gets stable and remains free of convulsions during 6-10 hours it has a lot of chances to
survive as strychnine is rapidly metabolized and excreted from the body [26]. Total
excretion and normality is achieved in 48 hours. [23]
12
Another thing to bear in mind is the physical condition of the Colonel but even if he was
really robust, muscular and weighed about 180 Kg, the lethal dose of a horse would
have also killed him
A further analysis can be made taking into account the way the Colonel ingested the
strychnine. As the book says, the dose of strychnine was in its coffee and maybe other
alkaloids present there, such as caffeine, could have a positive effect alleviating
strychnine effects.
Caffeine (Figure 10) is also an alkaloid that acts as an
antagonist of brain cells adenosine receptors. With a
continued wakeful state, adenosine accumulates over time
in
the
neuronal synapse,
binding
to
and
activating adenosine receptors found on certain brain
neurons; when activated, these receptors produce a cellular
response that ultimately increases drowsiness. When
caffeine is consumed, it antagonizes adenosine receptors.
As a result, caffeine temporarily prevents or relieves
drowsiness, and thus maintains or restores alertness [27].
This increases the strychnine effect because the body is more sensible to stimuli and
remains in a awaken state. Also, recent studies [28] reveal that due to its structure,
caffeine could also attach to the glycine receptors like strychnine but obviously creating
a weaker interaction. Therefore, the fact that strychnine was in a coffee would decrease
the survival chances of the Colonel.
Finally, in order to survive strychnine poisoning, maybe the glycine receptors are
modified through a mutation that makes strychnine unable to bind them but dont affect
glycine binding, consequently the person is immune to strychnine without having other
major problems such as hiperekplexia. A study of the glycine receptor subunits [29]
showed that the R131A mutation in 1 GlyRs greatly reduces strychnine binding (330fold increase in the IC50 value) without compromising receptor sensitivity to glycine.
13
Only if the colonel had this mutation, he would have survived to the poisoning.
However, the possibilities of having this exact mutation are really low as it has been
created in vitro in order to study the receptors.
From everything that has been said, we can conclude that Colonel Aureliano must have
died if he took the dose of strychnine enough to kill a horse as the book says.
In this case, Mrs Inglethorp drunk the tonic as a medical treatment, to gain forces
since she was old.
Another reference to strychnine based tonics is found in The invisible man [31] by
H.G. Wells, when the protagonist ingests a strong dose of strychnine as tonic before
going to sleep. This can be seen in the following dialogue.
1 - Oskar Dirlewanger, the notorious leader of the SS Sturmbrigade Dirlewanger in the Second World
War, was known to have murdered several Jewish women by stripping them naked and having them
injected with strychnine. He and his officers then watched them convulse until death, just for their
entertainment.[34]
14
[] After a time I crawled home, took some food and a strong dose of
strychnine, and went to sleep in my clothes on my unmade bed. Strychnine is a
grand tonic, Kemp, to take the flabbiness out of a man.
It's the devil, said Kemp It's the paleolithic in a bottle.
I awoke vastly invigorated and rather irritable. You know?
I know the stuff.
From this text it can be understood that strychnine offers a better sleep and a recovery,
and it strengthens the body. This strychnine effects will be analyzed in the following
paragraphs.
Literature of the early 20th century [32]
show positive inotropic behavior
(which basically means a force
increment
of
the
muscular
contraction) of strychnine. This grants
a lengthen on the systolic period to
even the quadruple of the original
period. Also, the diastolic period is
shortened. In addition, a negative
cronotropic capacity has been listed
on strychnine (which means that
strychnine decreases heart's beating
speed) (Figure 12).
Since strychnine strengthens the heart's beat, it can be accepted that it gives forces.
For that reason, and because no accumulative effect has been detected (that is due to its
easy renal excretion), strychnine could be used has cardiac tonic. Its effect as good sleep
provider are not explained, though.
Dr Watson in Arthur Conan Doyle's The sign of four [33], when narrating some
successes that took place the night before, makes funny about his mental state at the
moment because he recommended Mr Holmes to intake grant doses of strychnine
before sleeping as muscular relaxant.
The idea of strychnine as muscular relaxant seems absurd to Dr. Watson, but it was used
as something likely by H.G.Wells. In the following paragraphs, strychnine's efficiency
as sedan or as recovering sleep provider will be studied by comparing its action
mechanism with nowadays sleep powders action mechanisms.
15
During the human's history, many sleep powders or sedans have been used. Some of
them are barbiturates, benzodiazapines and opioids. Since almost all of those relaxing
drugs share the same action mechanism, only benzodiazepines's will be explained. From
those, diazepam is also administrated in strychnine poisoning patients in order to
combat it, so his action mechanisms will be the most interesting to be explained.
Diazepam (first marketed as Valium) (Figure 13) is used
in patients that suffer from anxiety, muscle spams, panic
attacks, insomnia and epilepsy. That is because of its
hypnotic, anxiolytic, sedative and anticonvulsant effects.
Its molecular formula is 1,4-benzodiazepine.
As well as other benzodiazepines, diazepam is very
addictive and, especially if mixed with alcohol, it might
cause or deepen depressions. Its dependance is not only
physical but psychical, and it is not easy to be cured from.
What basically gives benzodiazepines their effects is their
interaction with the GABAA receptor. When attached to
benzodiazepines, GABAA experiments a transformation
in its space disposition. This is because benzodiazepines
are GABAA's allosteric modulators. As benzodiazepines
are positive allosteric modulators, they increase GABAA's
efficiency [35].
An allosteric modulator gets attached to the target protein by a specific point 2. The
difference between barbiturics's and benzodiazepines's action mechanism is this specific
point. Moreover, in grant doses, barbiturics can provide the same effect even without
GABA, which makes barbiturics more dangerous than benzodiazepines. (Figure 14)
3 attaching points have been discoverd for benzodiazepines in GABAA receptors [35]
16
The inhibitory action of GABAA receptor is very similar to glycine receptors. That
might be explained since glycine receptors and GABAA receptors are members of the
same family of receptors, the cys-loop ligand-gated ion channels [37]. (Figure 16)
17
The difference between diazepam and other sedans and strychnine, is that the first ones
increase its receptor's activity, which leads to the relaxation of the musculature (and the
other effects of the compounds), while strychnine inhibits its receptors, that results on
the non-inhibition of the stimulus transmission and the subsequent spams and
excitement.
For this reason, the intake of strychnine before sleeping would be contraindicated, since
it would cause nothing else than excitation and tension.
Also, that explains the successful treatment of poisoned patients with diazepam, because
it compensates the inhibition of the cys-loop ligand-gated ion channels with its
stimulation and effectiveness increase.
In conclusion, it seems to be that Dr Watson's is not only doctor by tittle but by
knowledge and formation. The ingest of strychnine before sleeping is as illogical as
drinking several cups of coffee before going bed.
Conclusion
After all the research work done in order to achieve the objectives that we initially
proposed we have been able to analyse how strychnine has been used in literature in
some specific cases. Strychnine has captivated us in the same way it attracted all authors
who have written about it and all the readers who have enjoyed their work.
We have noticed how some authors are more concerned about the scientific accuracy of
their stories than others. For instance Agatha Christie or Sherlock Holmes have proven
to write well documented stories when it comes to the substances their characters use to
commit murder.
On the other hand, we have the graphic novel Gotham by Gaslight, where can see that
even the author knew which the effects of strychnine are, he went one step further and
made strychnine the cause for Jokers grin. Another example would be the
misunderstanding from The invisible man, where the author seems to give strychnine
sleep-inducing properties, while is well known that the properties of the substance are
opposite. The last case of strychnines wrong use would be the Colonel Aureliano
Buenda and its horse-lethal dose.
Its curious to see how strychnine properties are well used on the crime novels, where
the reader really appreciates realism of stories; whereas these properties are not
correctly applied on superhero stories and science fiction novels. When reading the
latter, people dont expect scientific accuracy, just an interesting plot which can take
their mind to unexpected places. Who cares about authenticity when you have a
masterpiece on your hands?
18
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