Toxicologic study of snake venoms from Costa Rica

Lys49 myotoxins, secreted phospholipase A2-like proteins of viperid venoms: A comprehensive review

Muscle necrosis is a potential clinical complication of snakebite envenomings, which in severe cases can lead to functional or physical sequelae such as disability or amputation. Snake venom proteins with the ability to directly damage skeletal muscle fibers are collectively referred to as myotoxins, and include three main types: cytolysins of the "three-finger toxin" protein family expressed in many elapid venoms, the so-called "small" myotoxins found in a number of rattlesnake venoms, and the widespread secreted phospholipase A₂ (sPLA₂) molecules. Among the latter, protein variants that conserve the sPLA₂ structure, but lack such enzymatic activity, have been increasingly found in the venoms of many viperid species. Intriguingly, these sPLA₂-like proteins are able to induce muscle necrosis by a mechanism independent of phospholipid hydrolysis. They are commonly referred to as "Lys49 myotoxins" since they most often present, among other substitutions, the replacement of the otherwise invariant residue Asp49 of sPLA₂s by Lys. This work comprehensively reviews the historical developments and current knowledge towards deciphering the mechanism of action of Lys49 sPLA₂-like myotoxins, and points out main gaps to be filled for a better understanding of these multifaceted snake venom proteins, to hopefully lead to improved treatments for snakebites.

The dielectric properties of neutron irradiated snake venom and its pathological impact

The changes in the dielectric properties of a saline solution of Cerastes cerastes snake venom after irradiation with low-level doses of fast neutrons from a Cf-252 source, were investigated. The pathological changes in the internal organs such as liver, kidney spleen, lung and heart of the rats injected with unirradiated and irradiated venom were also studied. The changes in the molecular structure of a diluted saline solution of snake venom were measured through dielectric relaxation studies in the frequency range 0.1-10 MHz at 4 +/- 0.5 degrees C. The absorption spectra of the venom solution were measured in the wavelength range 200 to 600 nm. The results indicated remarkable changes in the molecular radii, shape, relaxation time and dielectric increment of the venom molecules as a result of irradiation. Also, the intensities of the absorption bands of the venom solution decreased as a result of the irradiation process. Furthermore, the pathological examination results indicated that the toxicity of the irradiated venom decreased as compared with that of unirradiated venom, hence increasing the chance of repair of the affected organs.

Isolation and characterization of a myotoxic phospholipase A2 from the venom of the arboreal snake Bothriechis (Bothrops) schlegelii from Costa Rica

A new myotoxic phospholipase A2 was isolated from the venom of the arboreal snake Bothriechis schlegelii (formerly Bothrops schlegelii) from Costa Rica, by ion-exchange chromatography on CM-Sephadex. B. schlegelii myotoxin I is a basic protein (pI > 9.3) with a subunit molecular weight of 15 kDa, which migrates as a dimer in sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing conditions. This myotoxin is recognized by antibodies generated against Bothrops asper myotoxin II (a lysine-49 phospholipase A2), by both enzyme-immunoassay and gel immunodiffusion, in the latter case with a pattern of partial identity. The toxin induces rapid myonecrosis upon intramuscular injection in mice, as evidenced by the early increase in plasma creatine kinase activity and by direct intravital microscopic observation. B. schlegelii myotoxin I also induces edema in the mouse footpad assay and exerts lethal activity (LD50 approximately 2.5 microg/g) upon intravenous injection. The toxin has a low phospholipase A2 activity (4.2 microEq.mg-1.min-1) using egg yolk phospholipids as substrate. It also shows a weak anticoagulant effect in vitro. Its N-terminal sequence, SMYELGKMILLETGKNAATSYIAYG, shows 93% homology with both Bothrops asper myotoxin II and B. jararacussu bothropstoxin I, suggesting that B. schlegelii myotoxin I may be a new lysine-49 variant of this family of myotoxic phospholipases A2.

Muscle necrosis caused by snake venoms and toxins

Snake bite is often associated with localised soft tissue necrosis. Less frequently victims may suffer extensive muscle damage leading to rhabdomyolysis and the loss of muscle-specific protein. This review describes the organisation and structure of mammalian skeletal muscle, and its response to myotoxic venoms and to isolated pure myotoxic venom fractions. The clinical reports of muscle damage in man following snake bite are discussed, and the various classes of myotoxic toxins are introduced. Muscle damage caused by the toxins is next described, particular emphasis being placed on the correlation between muscle pathology seen at the light level and the morphological changes seen at the level of the electron microscope. Where known, those subcellular components of the muscle fibre that are especially sensitive to assault, and those components that appear to be spared, are identified. The relevance of the selective sparing of some components to the regenerative capacity of the skeletal muscle is considered.

Histopathological and biochemical alterations induced by intramuscular injection of Bothrops asper (terciopelo) venom in mice

The local and systemic pathological changes induced by an i.m. injection of 100 micrograms of Bothrops asper venom in mice were studied histologically and by following the changes in serum levels of enzymes, proteins, ATP and lactate, as well as alterations in hematocrit and clotting time. B. asper venom induced a rapid and marked increase in serum levels of creatine kinase, aspartate aminotransferase and lactate dehydrogenase, but not alanine aminotransferase or alkaline phosphatase. A local myonecrosis and hemorrhage was observed, with the lungs collapsing by 24 hr and the kidneys showing glomerular congestion and vacuolar degeneration of tubular cells. Only minor histopathological changes were observed in cardiac muscle and liver. Both ATP and lactate blood levels decreased after venom injection, whereas there were no changes in serum protein concentration. Blood incoagulability was observed 1 and 3 hr after envenomation. Antivenom neutralized venom-induced increases in serum enzyme levels following preincubation with venom, indicating that antivenom contains antibodies against tissue-damaging toxins. However, when antivenom was administered i.v. at different time intervals after venom injection, neutralization was only partial, with the exception of defibrinating activity, which was totally neutralized even after a delay of 1 hr in administering antivenom.

Electric shock does not save snakebitten rats

A team of missionary doctors from Ecuador recently described striking success in the treatment of venomous snakebites with a series of brief, high-voltage, low-current electric shocks applied to the bit site. We designed a randomized, controlled, blinded test of their methods in laboratory rats. Venom of the fer-de-lance, Bothrops atrox, was injected subcutaneously into rats in a series of increasing doses. Half of each dose group then was shocked with a device used by the Ecuadoran group. Envenomated animals developed hemorrhagic ulcers at the injection sites, the size of which was strongly related to venom dose. Electric shock did not influence the development of morbidity or the eventual ulcer size in sublethally envenomated animals, nor did shocks reduce mortality in lethally envenomated animals. We conclude that shocks are without effect on snakebitten rats, and we discuss implications of our findings for the treatment of snakebitten human beings.

Isolation and partial characterization of a myotoxin from the venom of the snake Bothrops nummifer

A myotoxin from the venom of the snake Bothrops nummifer was purified to homogeneity by ion-exchange chromatography on CM-Sephadex. The toxin is a basic dimer with a subunit molecular weight of 16,000, as estimated by SDS-polyacrylamide gel electrophoresis. The toxin lacks phospholipase A2 activity when tested on egg yolk lecithin and skeletal muscle homogenates. It induces skeletal muscle damage both in vivo and in vitro. When injected i.m. it promotes a drastic increase in serum creatine kinase levels; the isozyme CK-MM is responsible for this increment. A rapid release of creatine kinase was observed when mouse gastrocnemius muscle was incubated with the toxin, suggesting that it induces the formation of relatively large 'lesions' in the plasma membrane of muscle cells. Moreover, analysis of the dose-response data indicated that the myotoxin affects muscle sarcolemma by a 'one hit' mechanism. Skeletal muscle cells are affected by the toxin when calcium is eliminated from the medium. The myotoxin has an i.v. LD50 of 3.9 mg/kg body weight in mice, and induces edema when injected in the foot pad. On the other hand, it is not directly hemolytic, anticoagulant, hemorrhagic nor cytotoxic for lymphocytes. The myotoxin shows partial immunologic identity with a myotoxic phospholipase A2 isolated from Bothrops asper venom. The polyvalent antivenom produced in Costa Rica forms a precipitation arc against B. nummifer myotoxin on immunoelectrophoresis.

Comparative study of three proteinases from the venom of the Chinese habu snake (Trimeresurus mucrosquamatus)

Three immunochemically distinct proteinases (P-1, 2 and 3) devoid of hemorrhagic activity were isolated from the lyophilized venom of Trimeresurus mucrosquamatus using column chromatography on Sephadex G-100, CM-Sephadex C-50, DEAE-Sephacel, CM-Cellulose and Bio-Rex 70. By these procedures, about 7.6, 7.3 and 8.2 mg of purified P-1, 2 and 3 may be obtained from 1 g of crude venom, respectively. The purified proteinases 1-3 were homogeneous by disc electrophoresis on polyacrylamide gel at pH 4.3, isoelectric focusing and by the presence of one precipitin line on immunodiffusion. The isoelectric point of P-1 was 8.1; P-2, 9.2; P-3, 9.8. The molecular weights of proteinases 1-3 were determined to be 23,000, 23,500 and 23,000, by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis, respectively. The purified proteinases 1-3 possessed caseinolytic and fibrinogenolytic activities. These activities were inhibited when the proteinases were incubated with the metal chelators ethylenediaminetetraacetic acid (EDTA), 1,10-phenanthroline or cysteine, but not with egg white trypsin inhibitor (EWTI) or soybean trypsin inhibitor (SBTI). P-1 cleaved the B beta-chain of fibrinogen first and then the A alpha-chain, whereas P-2 and 3 cleaved the A alpha-chain first and then the B beta-chain. However, these three proteinases did not hydrolyze the gamma-chain.

Muscle necrosis and regeneration after envenomation by Bothrops jararacussu snake venom

The lesions caused by sublethal doses of Bothrops jararacussu venom injected into tibialis anterior (tib. ant.) muscles of mice were studied with paraffin sections. Doses of 5 and 20 micrograms produced a large area of necrosis in tib. ant., but hardly affected neighbouring muscles. Phagocytosis of necrotic remnants was followed by marked regeneration of the muscle fibres. Within two weeks of the 5 micrograms dose there was recovery to near normal appearance and slight fibrosis. With 20 micrograms, a circumscribed scar and stronger interstitial fibrosis developed in the tib. ant. Most regenerated muscle fibres were small, but varied in diameter, retained central nuclei for three months (the longest survival) and were surrounded by collagen. Doses of 80 and 200 micrograms produced widespread coagulative necrosis of tib. ant., though neighbouring leg muscles were relatively spared. Myonecrosis was evident microscopically at 10 min, and over the next week the necrotic muscle remained acellular and devoid of inflammatory reaction except at the very edge. Blood vessels within and outside tib. ant. often became hyalinized and thrombosed. Phagocytosis of debris proceeded from the periphery, and after two weeks the muscle was replaced by fibro-adipose tissue. There was little if any muscle fibre regeneration. Abscesses developed in the vicinity of the injection site in several mice receiving high venom doses, but never after low doses or saline. Muscle necrosis after B. jararacussu venom seems due primarily to direct action of the venom, though vascular thrombosis and ischaemia may contribute. The venom can cause fibrosis of muscle and hinder or prevent muscle fibre regeneration.

Isolation of a myotoxin from Bothrops asper venom: partial characterization and action on skeletal muscle

A myotoxic phospholipase has been isolated from Bothrops asper venom by ion-exchange chromatography on CM-Sephadex followed by gel filtration on Sephadex G-75. The toxin is a basic polypeptide with an estimated molecular weight of 10,700. It has both phospholipase A and indirect hemolytic activities, but is devoid of proteolytic, direct hemolytic and hemorrhagic effects. When injected i.m. into mice the toxin induces a rapid increase in plasma creatine kinase levels and a series of degenerative events in skeletal muscle which lead to myonecrosis. The toxin induces an increase in intracellular calcium levels and is able to hydrolyze muscle phospholipids in vivo. Pretreatment with the calcium antagonist verapamil failed to prevent the myotoxic activity. It is proposed that B. asper myotoxin causes cell injury by disrupting the integrity of skeletal muscle plasma membrane and that myotoxicity is at least partially due to the phospholipase A activity of the toxin.

[Neutralization of local effects of Bothrops asper venom by polyvalent antivenin]

Neutralization of lethality, myonecrosis, hemorrhage and edema induced by Bothrops asper venom in mice was studied using the polyvalent antivenom produced in the Instituto Clodomiro Picado. The neutralizing effect (ED50) on each of these toxic activities varied; the neutralization of lethal and hemorrhagic effects being more effective than the neutralization of myonecrosis and edema. With independent inoculation of venom and antivenom, antivenom was not effective in neutralizing edema-forming activity. The myonecrotic effect was only partially neutralized when serum was given i.v. immediately after envenomation; however, antivenin effectively neutralized the hemorrhagic activity. The ineffectiveness of antivenom in neutralizing edema and myonecrosis could be partially explained by the rapid development of these effects. Hence, the time interval between envenomation and antivenom administration and the route of serum administration both play an important role in the neutralization of local effects.