Palytoxin is a complex marine natural product containing 71 asymmetric centers. Palytoxin, isolated from soft coral, is considered to be one of the most toxic non-peptide substances known, second only to maitotoxin. Palytoxin was originally isolated in 1971 in Hawaii from the seaweed-like coral, "Limu make o hana (Seaweed of Death from Hana)"[1]. Later, in 1982 its full chemical structure was published by Prof. Daisuke Uemura and coworkers at Nagoya University[2][3][4]. Professor Yoshito Kishi's group at Harvard University first synthesized palytoxin in 1994[5][6]. This feat is still considered today by many to be the greatest synthetic accomplishment ever, due to its complexity in structure.
Palytoxin targets the sodium-potassium pump protein by binding to the molecule such that the molecule is locked in a position where it allows passive transport of both the sodium and potassium ions, thereby destroying the ion gradient that is essential for most cells.
Typical symptoms of palytoxin poisoning are angina-like chest pains, asthma-like breathing difficulties, tachycardia, unstable blood pressure, hemolysis (destruction of red blood cells), and an electrocardiogram showing an exaggerated T wave. The onset of symptoms is rapid, and death usually follows just minutes after.
Animal studies have shown that vasodilators, such as papverine and isosorbide nitrate, can be used as antidotes. The animal experiments only showed benefit if the antidotes were injected into the heart immediately following exposure.[7] Treatment in humans is symptomatic and supportive.
A case of human poisoning by palytoxin after contact with zoanthid corals (Parazoanthus sp.) in an aquarium through skin injuries on fingers is reported. The clinical symptoms include swelling, paraesthesia and numbness around the site of the injury spreading over the arm, but also signs of systemic poisoning such as dizziness, general weakness and myalgia, irregularities in the ECG and indications of rhabdomyolysis. Symptomatic treatment consisted of infusion of physiological fluids. The patient recovered within 3 days. Analysis of the zoanthid coral involved revealed extremely high concentrations of palytoxin (between 2 and 3 mg/g).