Assessment of the effectiveness of intravenous lipid emulsion as a new treatment method in grayanotoxin (Mad honey) intoxication

Mad honey poisoning, resulting from the consumption of honey containing grayanotoxin (GTX) from Rhododendron species plants, has been reported in several countries. Current treatment approaches involve using atropine, but it can have life-threatening side effects. Intravenous lipid emulsion (ILE) therapy, known for treating lipid-soluble substance poisoning, has been used in poisoning cases involving various drugs. This study aimed to evaluate the efficacy of ILE treatment as an alternative to atropine in grayanotoxin intoxication, focusing on its haemodynamic effects in Wistar albino rats and its potential to increase survival. Haemodynamic parameters, oxidative stress markers, and biochemical levels were monitored and analyzed. The results indicated that ILE treatment improved survival rates of rats, and reduced some oxidative stress parameters in the heart and liver tissues of rats intoxicated with grayanotoxin. However, no significant differences were observed in cardiac malondialdehyde and catalase levels. Additionally, liver malondialdehyde levels were significantly lower in the lipid group compared to the toxin and treatment groups. Liver catalase levels were higher in the treatment group compared to the lipid group. The findings suggest that ILE treatment shows promise as an alternative therapeutic approach for grayanotoxin intoxication, with potential benefits in improving survival and reducing oxidative stress. Further research is warranted to fully understand the mechanism of action and optimize the treatment protocol. Keywords: Grayanotoxin, Intravenous Lipid, Survival, Rat model