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Vaucel JA, Larréché S, Paradis C, Courtois A, Pujo JM, Elenga N, Résière D, Caré W, de Haro L, Gallart JC, Torrents R, Schmitt C, Chevalier J, Labadie M, Kallel H. French Scorpionism (Mainland and Oversea Territories): Narrative Review of Scorpion Species, Scorpion Venom, and Envenoming Management. Toxins (Basel) 2022; 14:toxins14100719. [PMID: 36287987 PMCID: PMC9611377 DOI: 10.3390/toxins14100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Sixty-seven scorpion species have been described in France and its territories, where they have been found to be heterogeneously distributed. Indeed, only one species can be found on Réunion Island, while 38 species exist in French Guiana. The number of stings is also heterogenous, with up to 90 stings per 100,000 inhabitants occurring annually. Scorpion species can frequently be determined through simple visual factors, including species of medical importance (i.e., Buthus, Centruroides and Tityus). Scorpion venom is composed of local enzymes and peptides with a cysteine-stabilized α/β motif (NaTxs, Ktxs, Calcines), which allow for venom diffusion and the prey's incapacitation, respectively. Harmful scorpion species are limited to Centruroides pococki in the French West Indies, which can induce severe envenoming, and the Tityus obscurus and Tityus silvestris in French Guiana, which can cause fatalities in children and can induce severe envenoming, respectively. Envenomation by one of these scorpions requires hospital monitoring as long as systemic symptoms persist. Typical management includes the use of a lidocaine patch, pain killers, and local antiseptic. In the case of heart failure, the use of dobutamine can improve survival, and pregnant women must consult an obstetrician because of the elevated risk of preterm birth or stillbirth. France does not have scorpion antivenom, as scorpion stings are generally not fatal.
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Affiliation(s)
- Jules-Antoine Vaucel
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
- Correspondence: ; Tel.: +33-05-5679-8776
| | - Sébastien Larréché
- Medical Biology Department, Hôpital d’Instruction Des Armées Bégin, 94160 Saint-Mandé, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1144, Université de Paris, 75000 Paris, France
| | - Camille Paradis
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
| | - Arnaud Courtois
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
| | - Jean-Marc Pujo
- Emergency Department, Centre Hospitalier de Cayenne, 97300 Cayenne, France
| | - Narcisse Elenga
- Pediatric Unit, Centre Hospitalier de Cayenne, 97300 Cayenne, France
| | - Dabor Résière
- Intensive Care Unit, Centre Hospitalier et Universitaire Martinique, 97200 Fort de France, France
| | - Weniko Caré
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1144, Université de Paris, 75000 Paris, France
- Paris Poison Control Center, Fédération de Toxicologie (FeTox), Hôpital Fernand Widal, AP-HP, 75000 Paris, France
- Internal Medicine Department, Hôpital d’Instruction des Armées Bégin, 94160 Val-de-Marne, France
| | - Luc de Haro
- Marseille Poison Control Centre, Assistance Public des Hôpitaux de Marseille, 13000 Marseille, France
| | - Jean-Christophe Gallart
- Toulouse Poison Control Centre, Centre Hospitalier et Universitaire de Toulouse, 31000 Toulouse, France
| | - Romain Torrents
- Marseille Poison Control Centre, Assistance Public des Hôpitaux de Marseille, 13000 Marseille, France
| | - Corinne Schmitt
- Marseille Poison Control Centre, Assistance Public des Hôpitaux de Marseille, 13000 Marseille, France
| | | | - Magali Labadie
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
| | - Hatem Kallel
- Intensive Care Unit, Centre Hospitalier de Cayenne, 97300 Cayenne, France
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Sahyoun C, Krezel W, Mattei C, Sabatier JM, Legros C, Fajloun Z, Rima M. Neuro- and Cardiovascular Activities of Montivipera bornmuelleri Snake Venom. BIOLOGY 2022; 11:biology11060888. [PMID: 35741410 PMCID: PMC9219918 DOI: 10.3390/biology11060888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/04/2022] [Accepted: 06/06/2022] [Indexed: 12/31/2022]
Abstract
Simple Summary Snake venoms are rich in molecules acting on different biological systems, and they are responsible for the complications following snake bite envenoming. These bioactive molecules are of interest in pharmaceutical industries as templates for drug design. Different biological activities of Montivipera bornmuelleri snake venom have been already studied; however, the venom’s activity on the nervous system has not yet been studied, and its effect on the cardiovascular system needs further investigation. Herein, we show that this venom induces toxicity on the nervous system and disrupts the cardiovascular system, highlighting a broad spectrum of biological activities. Abstract The complications following snake bite envenoming are due to the venom’s biological activities, which can act on different systems of the prey. These activities arise from the fact that snake venoms are rich in bioactive molecules, which are also of interest for designing drugs. The venom of Montivipera bornmuelleri, known as the Lebanon viper, has been shown to exert antibacterial, anticancer, and immunomodulatory effects. However, the venom’s activity on the nervous system has not yet been studied, and its effect on the cardiovascular system needs further investigation. Because zebrafish is a convenient model to study tissue alterations induced by toxic agents, we challenged it with the venom of Montivipera bornmuelleri. We show that this venom leads to developmental toxicity but not teratogenicity in zebrafish embryos. The venom also induces neurotoxic effects and disrupts the zebrafish cardiovascular system, leading to heartbeat rate reduction and hemorrhage. Our findings demonstrate the potential neurotoxicity and cardiotoxicity of M. bornmuelleri’s venom, suggesting a multitarget strategy during envenomation.
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Affiliation(s)
- Christina Sahyoun
- INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, University of Angers, 49000 Angers, France; (C.S.); (C.M.); (C.L.)
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
| | - Wojciech Krezel
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM, CNRS, Université de Strasbourg, 67400 Illkirch, France;
| | - César Mattei
- INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, University of Angers, 49000 Angers, France; (C.S.); (C.M.); (C.L.)
| | - Jean-Marc Sabatier
- CNRS, INP, Institute of Neurophysiopathology, Aix-Marseille University, 13385 Marseille, France
- Correspondence: (J.-M.S.); (Z.F.); (M.R.)
| | - Christian Legros
- INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, University of Angers, 49000 Angers, France; (C.S.); (C.M.); (C.L.)
| | - Ziad Fajloun
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
- Department of Biology, Faculty of Sciences 3, Campus Michel Slayman, Lebanese University, Tripoli 1352, Lebanon
- Correspondence: (J.-M.S.); (Z.F.); (M.R.)
| | - Mohamad Rima
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM, CNRS, Université de Strasbourg, 67400 Illkirch, France;
- Correspondence: (J.-M.S.); (Z.F.); (M.R.)
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Vásquez-Escobar J, Romero-Gutiérrez T, Morales JA, Clement HC, Corzo GA, Benjumea DM, Corrales-García LL. Transcriptomic Analysis of the Venom Gland and Enzymatic Characterization of the Venom of Phoneutria depilata (Ctenidae) from Colombia. Toxins (Basel) 2022; 14:toxins14050295. [PMID: 35622542 PMCID: PMC9144723 DOI: 10.3390/toxins14050295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/27/2022] [Accepted: 04/16/2022] [Indexed: 02/01/2023] Open
Abstract
The transcriptome of the venom glands of the Phoneutria depilata spider was analyzed using RNA-seq with an Illumina protocol, which yielded 86,424 assembled transcripts. A total of 682 transcripts were identified as potentially coding for venom components. Most of the transcripts found were neurotoxins (156) that commonly act on sodium and calcium channels. Nevertheless, transcripts coding for some enzymes (239), growth factors (48), clotting factors (6), and a diuretic hormone (1) were found, which have not been described in this spider genus. Furthermore, an enzymatic characterization of the venom of P. depilata was performed, and the proteomic analysis showed a correlation between active protein bands and protein sequences found in the transcriptome. The transcriptomic analysis of P. depilata venom glands show a deeper description of its protein components, allowing the identification of novel molecules that could lead to the treatment of human diseases, or could be models for developing bioinsecticides.
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Affiliation(s)
- Julieta Vásquez-Escobar
- Grupo de Toxinología y Alternativas Farmacéuticas y Alimentarias, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellin 1226, Colombia;
- Correspondence: (J.V.-E.); (L.L.C.-G.)
| | - Teresa Romero-Gutiérrez
- Traslational Bioengineering Department, Exact Sciences and Engineering University Center, Universidad de Guadalajara, Guadalajara 44430, Mexico; (T.R.-G.); (J.A.M.)
| | - José Alejandro Morales
- Traslational Bioengineering Department, Exact Sciences and Engineering University Center, Universidad de Guadalajara, Guadalajara 44430, Mexico; (T.R.-G.); (J.A.M.)
| | - Herlinda C. Clement
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico; (H.C.C.); (G.A.C.)
| | - Gerardo A. Corzo
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico; (H.C.C.); (G.A.C.)
| | - Dora M. Benjumea
- Grupo de Toxinología y Alternativas Farmacéuticas y Alimentarias, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellin 1226, Colombia;
| | - Ligia Luz Corrales-García
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico; (H.C.C.); (G.A.C.)
- Departamento de Alimentos, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellin 1226, Colombia
- Correspondence: (J.V.-E.); (L.L.C.-G.)
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Martínez-Villota VA, Mera-Martínez PF, Portillo-Miño JD. Massive acute ischemic stroke after Bothrops spp. envenomation in southwestern Colombia: Case report and literature review. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2022; 42:9-17. [PMID: 35471166 PMCID: PMC9045098 DOI: 10.7705/biomedica.6114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/20/2021] [Indexed: 06/14/2023]
Abstract
Bothrops spp. envenomation and its relationship with ischemic stroke has complex pathogenesis. Local effects such as edema, pain, redness, necrosis, and systemic manifestations like coagulation disorders, thrombosis, renal failure, and hemorrhage have been reported. Hemorrhagic stroke is a common neurological complication but ischemic stroke is poorly understood. We present here the case of a 50-year-old male with no comorbidities referred from a rural area in southwest Colombia with a Bothrops spp. snakebite on the left hand. On admission, the patient presented with a deterioration of consciousness and required mechanical ventilation assistance. The MRI showed multiple ischemic areas in the bilateral frontaltemporal and occipital regions. Two months later, the patient had a favorable resolution, although central paresis in the III and VI cranial nerves and positive Babinski's sign persisted. As already mentioned, the pathophysiology of ischemic stroke due to snakebite is complex but the procoagulant activity of the venom components, the hypovolemic shock, the endothelial damage, and the thromboinflammation can explain it, and although it rarely occurs, it should be considered as a complication of ophidian accidents caused by Bothrops spp.
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Affiliation(s)
- Viviana Alexandra Martínez-Villota
- Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Departamento de Neurología, Hospital Universitario Departamental de Nariño, Pasto, Colombia.
| | - Paulo Francisco Mera-Martínez
- Facultad de Ciencias de la Salud, Universidad de Nariño, Pasto, Colombia; Departamento de Emergencias, Hospital Universitario Departamental de Nariño, Pasto, Colombia.
| | - José Darío Portillo-Miño
- Facultad de Ciencias de la Salud, Grupo de Investigación RIZHOME GROUP II, Fundación Universitaria San Martín, Pasto, Colombia; Grupo de Investigación en Infecciosas y Cáncer, Fundación Hospital San Pedro, Pasto, Colombia.
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Les envenimations scorpioniques en France métropolitaine et d’Outremer : mise au point. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Florian IA, Lupan I, Sur L, Samasca G, Timiș TL. To be, or not to be… Guillain-Barré Syndrome. Autoimmun Rev 2021; 20:102983. [PMID: 34718164 DOI: 10.1016/j.autrev.2021.102983] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023]
Abstract
Guillain-Barré Syndrome (GBS) is currently the most frequent cause of acute flaccid paralysis on a global scale, being an autoimmune disorder wherein demyelination of the peripheral nerves occurs. Its main clinical features are a symmetrical ascending muscle weakness with reduced osteotendinous reflexes and variable sensory involvement. GBS most commonly occurs after an infection, especially viral (including COVID-19), but may also transpire after immunization with certain vaccines or in the development of specific malignancies. Immunoglobulins, plasmapheresis, and glucocorticoids represent the principal treatment modalities, however patients with severe disease progression may require supportive therapy in an intensive care unit. Due to its symptomology, which overlaps with numerous neurological and infectious illnesses, the diagnosis of GBS may often be misattributed to pathologies that are essentially different from this syndrome. Moreover, many of these require specific treatment methods distinct to those recommended for GBS, in lack of which the prognosis of the patient is drastically affected. Such diseases include exposure to toxins either environmental or foodborne, central nervous system infections, metabolic or serum ion alterations, demyelinating pathologies, or even conditions amenable to neurosurgical intervention. This extensive narrative review aims to systematically and comprehensively tackle the most notable and challenging differential diagnoses of GBS, emphasizing on the clinical discrepancies between the diseases, the appropriate paraclinical investigations, and suitable management indications.
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Affiliation(s)
- Ioan Alexandru Florian
- Department of Neurology, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania, Department of Neurosurgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Iulia Lupan
- Department of Molecular Biology, Babes Bolyai University, Cluj-Napoca, Romania.
| | - Lucia Sur
- Department of Pediatrics I, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Gabriel Samasca
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Teodora Larisa Timiș
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Zhou HJ, Xu K, Zheng PY, Gu W. Clinical characteristics of patients with black widow spider bites: A report of 59 patients and single-center experience. World J Emerg Med 2021; 12:317-320. [PMID: 34512830 DOI: 10.5847/wjem.j.1920-8642.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 04/18/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hai-Jiang Zhou
- Emergency Medicine Clinical Research Center, Beijing Chao-yang Hospital, Capital Medical University and Beijing Key
| | - Ke Xu
- Laboratory of Cardiopulmonary Resuscitation, Beijing 100020, China
| | - Ping-Yuan Zheng
- Department of Emergency Medicine, Xinjiang Bazhou People's Hospital, Bazhou 841000, China
| | - Wei Gu
- Department of Critical Care Medicine, Weihaiwei People's Hospital, Weihai 264200, China
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Sindelar M, Jilkova J, Kubala L, Velebny V, Turkova K. Hyaluronidases and hyaluronate lyases: From humans to bacteriophages. Colloids Surf B Biointerfaces 2021; 208:112095. [PMID: 34507069 DOI: 10.1016/j.colsurfb.2021.112095] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 12/26/2022]
Abstract
Hyaluronan is a non-sulfated negatively-charged linear polymer distributed in most parts of the human body, where it is located around cells in the extracellular matrix of connective tissues and plays an essential role in the organization of tissue architecture. Moreover, hyaluronan is involved in many biological processes and used in many clinical, cosmetic, pharmaceutic, and biotechnological applications worldwide. As interest in hyaluronan applications increases, so does interest in hyaluronidases and hyaluronate lyases, as these enzymes play a major part in hyaluronan degradation. Many hyaluronidases and hyaluronate lyases produced by eukaryotic cells, bacteria, and bacteriophages have so far been described and annotated, and their ability to cleave hyaluronan has been experimentally proven. These enzymes belong to several carbohydrate-active enzyme families, share very low sequence identity, and differ in their cleaving mechanisms and in their structural and functional properties. This review presents a summary of annotated and characterized hyaluronidases and hyaluronate lyases isolated from different sources belonging to distinct protein families, with a main focus on the binding and catalytic residues of the discussed enzymes in the context of their biochemical properties. In addition, the application potential of individual groups of hyaluronidases and hyaluronate lyases is evaluated.
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Affiliation(s)
- Martin Sindelar
- Institute of Biophysics of the Czech Academy of Sciences, Kralovopolska 135, 61265, Brno, Czech Republic; Institute of Experimental Biology, Faculty of Science, Masaryk University, Kamenice 5, 62500, Brno, Czech Republic
| | - Jana Jilkova
- Contipro a.s., Dolní Dobrouč 401, 56102, Dolní Dobrouč, Czech Republic; Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 5, 62500, Brno, Czech Republic
| | - Lukas Kubala
- Institute of Biophysics of the Czech Academy of Sciences, Kralovopolska 135, 61265, Brno, Czech Republic; Institute of Experimental Biology, Faculty of Science, Masaryk University, Kamenice 5, 62500, Brno, Czech Republic; International Clinical Research Center, St. Anne's University Hospital Brno, Pekarska 53, 65691, Brno, Czech Republic
| | - Vladimir Velebny
- Contipro a.s., Dolní Dobrouč 401, 56102, Dolní Dobrouč, Czech Republic
| | - Kristyna Turkova
- Institute of Biophysics of the Czech Academy of Sciences, Kralovopolska 135, 61265, Brno, Czech Republic; International Clinical Research Center, St. Anne's University Hospital Brno, Pekarska 53, 65691, Brno, Czech Republic.
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Kadkhodazadeh M, Rajabibazl M, Motedayen M, Shahidi S, Veisi Malekshahi Z, Rahimpour A, Yarahmadi M. Isolation of Polyclonal Single-Chain Fragment Variable (scFv) Antibodies Against Venomous Snakes of Iran and Evaluation of Their Capability in Neutralizing the Venom. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2021; 19:288-296. [PMID: 33680030 PMCID: PMC7758004 DOI: 10.22037/ijpr.2019.14400.12358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Several species of dangerous snakes are found in Iran and, according to the Emergency Response Center of Iran from 2002 to 2011, 53,787 Iranians have suffered from snakebite. Although the mortalities caused by snakebite are very low, snakebite-related amputations are still a major concern. Currently, anti-venom polyclonal antibodies derived from animals, such as horses are used to treat snakebites; however, in some cases they can cause anaphylactic shock and serum sickness. In line with this premise, generation of recombinant anti-venom antibodies can be considered as an alternative strategy. Single-chain fragment variable (scFv) antibodies offer several advantages compared to the whole antibodies, including ease of production, high affinity and specificity. In the present study, scFv antibodies were selected against the venom of the most poisonous snakes in Iran using phage display technology. Phage particles harboring anti-venom specific scFv were separated and scFv antibodies were produced in bacteria. In-vitro assay showed that polyclonal scFvs specifically bind to the venom. Furthermore, in-vivo experiment in mice BALB/c indicated effective toxin neutralization using 20 µg of polyclonal scFv. Our study indicates the neutralizing capacity of anti-venom polyclonal scFvs, although further neutralization assays are needed to confirm their effectiveness.
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Affiliation(s)
- Maryam Kadkhodazadeh
- Department of Clinical Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Rajabibazl
- Department of Clinical Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Motedayen
- Department of Serotherapy, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Solmaz Shahidi
- Department of Clinical Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ziba Veisi Malekshahi
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University, Tehran, Iran
| | - Azam Rahimpour
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maral Yarahmadi
- Department of Clinical Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Huang TI, Hsieh CL. Effect of Traditional Chinese Medicine on Long-Term Outcomes of Snakebite in Taiwan. Toxins (Basel) 2020; 12:E132. [PMID: 32093388 PMCID: PMC7076781 DOI: 10.3390/toxins12020132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 11/16/2022] Open
Abstract
Herein, we review the characteristics of the six predominant venomous snakes in Taiwan and the effects of traditional Chinese medicine on the long-term outcomes of snakebite venom. We electronically searched databases, including PubMed, ClinicalKey, China National Knowledge Infrastructure, National Digital Library of Theses and Dissertations in Taiwan, and Airiti Library, from their inception to November 2019 by using the following Medical Subject Headings' keywords: snakebite, long-term, chronic, Chinese medicine, CAM, herb, and Taiwan. The most common long-term effects of snakebite envenomation include "migraine-like syndrome", brain injuries caused by hypoxia or intracranial hemorrhage, and chronic kidney disease. In addition, hypopituitarism is also worth mentioning. Traditional Chinese medicine can potentially be used in a complementary or alternative treatment for these effects, but additional studies are needed.
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Affiliation(s)
- Teng-I Huang
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan;
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan;
- Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
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Iserson KV, Jagit Ramcharran SD. Black Scorpion (Tityus obscurus) Fatalities in Guyana and a Literature Review. J Emerg Med 2019; 57:554-559. [DOI: 10.1016/j.jemermed.2019.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 07/04/2019] [Accepted: 07/18/2019] [Indexed: 10/25/2022]
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Al-Sadawi M, Mohamadpour M, Zhyvotovska A, Ahmad T, Schechter J, Soliman Y, McFarlane SI. Cerebrovascular Accident and Snake Envenomation: A Scoping Study. INTERNATIONAL JOURNAL OF CLINICAL RESEARCH & TRIALS 2019; 4:133. [PMID: 31528777 PMCID: PMC6746409 DOI: 10.15344/2456-8007/2019/133] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Snake envenomation is associated with serious complications including infections, bleeding and, in rare occasions, thrombosis. Previous work by our group examined the association of snakebite and acute myocardial infarction. In this systematic review we aim to assess the clinical characteristics and outcomes of acute cerebrovascular accidents that are reported to be extremely rare complications of snake envenomation. METHODS We performed a literature search for reports on stroke associated with snake envenomation between Jan 1995 to Oct 2018, and summarized their characteristics. RESULTS Eighty-three published cases were reviewed. 66.3% of the cases were younger than 50 years of age. The mean time for the onset of the symptoms is 23.8±10.9 hours after exposure. 77.1% of the cases found to have ischemic stroke, 20.5% with intra-cranial hemorrhage and both infarction and hemorrhage in 2.4%. Mortality was reported in 16.9% with mean time between onset of the symptoms and death is 4.2 days. CONCLUSION Stroke secondary to snake envenomation is a rare but serious complication. Once stroke is suspected, initiating appropriate management is crucial in reducing morbidity and mortality associated with this potentially fatal complication of snake envenomation.
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Affiliation(s)
- Mohammed Al-Sadawi
- Department of Internal Medicine, Division of Cardiovascular
Disease, State University of New York, Downstate Medical Center, Brooklyn, NY 11203,
USA
| | - Maliheh Mohamadpour
- Department of Internal Medicine, Division of Cardiovascular
Disease, State University of New York, Downstate Medical Center, Brooklyn, NY 11203,
USA
| | - Angelina Zhyvotovska
- Department of Internal Medicine, Division of Cardiovascular
Disease, State University of New York, Downstate Medical Center, Brooklyn, NY 11203,
USA
| | - Tahir Ahmad
- Department of Internal Medicine, Division of Cardiovascular
Disease, State University of New York, Downstate Medical Center, Brooklyn, NY 11203,
USA,Department of Emergency Medicine State University of New
York, Downstate Medical Center, Brooklyn, New York, USA
| | - Joshua Schechter
- Department of Emergency Medicine State University of New
York, Downstate Medical Center, Brooklyn, New York, USA
| | - Yasmin Soliman
- Department of Internal Medicine, Division of Cardiovascular
Disease, State University of New York, Downstate Medical Center, Brooklyn, NY 11203,
USA
| | - Samy I. McFarlane
- Department of Internal Medicine, Division of Cardiovascular
Disease, State University of New York, Downstate Medical Center, Brooklyn, NY 11203,
USA,Corresponding Author: Prof. Samy I.
McFarlane, Divisions of Cardiovascular Disease,and Endocrinology, Department of
Internal Medicine, State University of New York, Downstate Medical Center,
Brooklyn, New York,11203, USA, Tel: 718-270-6707, Fax: 718-270-4488;
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Reis J. Environmental Risk Factors for Stroke and Cardiovascular Disease. ENCYCLOPEDIA OF CARDIOVASCULAR RESEARCH AND MEDICINE 2018. [PMCID: PMC7150018 DOI: 10.1016/b978-0-12-809657-4.64111-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Besides the classical individual stroke risk factors a new class has appeared, the environmental risk factors. After a review of the evidences demonstrating that air pollution is a potent risk factor (Part 1), we propose an update of other physical, chemical, and biological factors, now considered as risk factors (Part 2). One of the challenges is to precise their specific roles as they can be combined in their noxious impacts (traffic air pollution + noise + weather + infections). This knowledge has practical consequences; From now on, medical advices cannot be limited to individual recommendations but must also deal with environmental public health issues.
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Reddy C R, Bompelli N, Khardenavis V, Deshpande A. Scorpion bite-induced ischaemic stroke. BMJ Case Rep 2017; 2017:bcr-2017-221606. [PMID: 29025779 DOI: 10.1136/bcr-2017-221606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report a 54-year-old woman with scorpion bite. After 3 hours of admission, the patient developed sudden onset tachycardia with hypotension. Cardiac evaluation showed raised creatine kinase MB isoenzyme was elevated; ECG and two-dimensional echocardiography findings were suggestive of myocarditis. Subsequently, she developed transient ventricular tachycardia before developing abrupt onset, right hemiplegia, global aphasia and progressive worsening of sensorium 12 hours after the bite. MRI of brain revealed massive left middle cerebral artery (MCA) territory infarct. The magnetic resonance angiography showed non-visualisation of left internal carotid artery (ICA) and MCA. Coagulation parameters were normal. Sudden complete occlusion of left ICA was probably secondary to cardioembolic phenomenon leading to massive infarct. Despite aggressive medical and supportive measures, she clinically worsened rapidly to Glasgow Coma Scale of 3/15 over next 6 hours and succumbed to her illness the next day.
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Affiliation(s)
- Rakesh Reddy C
- Department of Internal Medicine, Aditya Hospital, Warangal, Telangana, India
| | | | - Vikram Khardenavis
- Department of Medicine, Miraj Medical College, Miraj, Maharashtra, India
| | - Anirudda Deshpande
- Department of Neurology, Vinayaka Neuro Multispecialty Clinic, Warangal, India
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Jin NZ, Gopinath SC. Potential blood clotting factors and anticoagulants. Biomed Pharmacother 2016; 84:356-365. [DOI: 10.1016/j.biopha.2016.09.057] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/06/2016] [Accepted: 09/15/2016] [Indexed: 12/20/2022] Open
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Osnaya-Romero N, Acosta-Saavedra LC, Goytia-Acevedo R, Lares-Asseff I, Basurto-Celaya G, Perez-Guille G, Possani LD, Calderón-Aranda ES. Serum level of scorpion toxins, electrolytes and electrocardiogram alterations in Mexican children envenomed by scorpion sting. Toxicon 2016; 122:103-108. [PMID: 27693586 DOI: 10.1016/j.toxicon.2016.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/19/2016] [Accepted: 09/28/2016] [Indexed: 11/22/2022]
Abstract
The scorpion Centruroides limpidus limpidus (C.l.l.) is endemic in México, producing hundreds of accidents in humans; children being one of the most susceptible targets. Few studies reported that severe envenoming by scorpion venom induces cardiac damage and electrolytes abnormalities in children, but the relationship of envenoming severity and toxic blood levels is unknown. The aim of this study was to determine the relationship among clinical status of envenoming, serum electrolyte, electrocardiographic abnormalities, and serum toxin levels in 44 children stung by scorpion over a period of 6 months in the State of Morelos, Mexico. The patients were said to be asymptomatic, when they presented just local symptoms, and were said to be symptomatic when showing local symptoms and at least one systemic symptom. The clinical status was evaluated at the admission at the emergency room of the Hospital, and 30 min after the administration of polyspecific F(ab')2 anti-scorpion therapy to symptomatic children. Forty-one percent of the children were asymptomatic and 59% symptomatic. Potassium and sodium imbalance and an elongation of the QT interval were detected; the rate of hypokalemia was higher in symptomatic than on asymptomatic children (50% and 6%, respectively). Hypokalemia persisted in 19% in symptomatic patients, whereas sodium reached normal levels 30 min after anti-venom therapy. The hypokalemia statistically correlated with elongation of the QT interval. The concentration of the toxic components of C.l.l in serum was significantly higher in symptomatic than asymptomatic children, and the serum levels of the toxic component significantly decreased to undetectable levels after the application of anti-venom therapy. Despite the small size of the sample, this study establishes that severity of envenoming was statistically related to potassium imbalance in serum, QT interval and the concentration of toxic components in serum, which decreased at undetectable levels after specific treatment with the anti-scorpion venom, correlating with clinical disappearance or greatly reduction of symptoms of envenomation.
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Affiliation(s)
- N Osnaya-Romero
- Instituto Nacional de Pediatría, Ciudad de México, Mexico; Hospital Del Niño Morelense, Cuernavaca, Morelos, Mexico
| | - L C Acosta-Saavedra
- Departamento de Toxicología, Centro de Investigación y Estudios Avanzados, IPN, Ciudad de México, Mexico
| | - R Goytia-Acevedo
- Facultad de Medicina, Universidad Juárez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - I Lares-Asseff
- Instituto Politécnico Nacional (IPN), Centro Interdisciplinario de Investigación para el Desarrollo Integral Regional, Unidad Durango, Durango, Mexico
| | | | - G Perez-Guille
- Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - L D Possani
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, Mexico
| | - E S Calderón-Aranda
- Departamento de Toxicología, Centro de Investigación y Estudios Avanzados, IPN, Ciudad de México, Mexico.
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Kuiper M, Hendrikx S, Koehler PJ. Headache and Tremor: Co-occurrences and Possible Associations. Tremor Other Hyperkinet Mov (N Y) 2015; 5:285. [PMID: 26175954 PMCID: PMC4472994 DOI: 10.7916/d8p55mkx] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 05/12/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Tremor and headache are two of the most prevalent neurological conditions. This review addresses possible associations between various types of tremor and headache, and provides a differential diagnosis for patients presenting with both tremor and headache. METHODS Data were identified by searching MEDLINE in February 2015, with the terms "tremor" and terms representing the primary headache syndromes. RESULTS Evidence for an association between migraine and essential tremor is conflicting. Other primary headaches are not associated with tremor. Conditions that may present with both tremor and headache include cervical dystonia, infectious diseases, hydrocephalus, spontaneous cerebrospinal fluid leaks, space-occupying lesions, and metabolic disease. Furthermore, both can be seen as a side effect of medication and in the use of recreational drugs. DISCUSSION No clear association between primary headaches and tremor has been found. Many conditions may feature both headache and tremor, but rarely as core clinical symptoms at presentation.
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Kaushik JS, Chakrabarty B, Gulati S, Patel H, Lodha R, Pai G, Kumar A. Unusual late neurological complication in a child after an Indian krait bite. Pediatr Neurol 2014; 51:130-2. [PMID: 24814058 DOI: 10.1016/j.pediatrneurol.2014.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 02/15/2014] [Accepted: 02/19/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Neurological manifestations of elapid snakebites include neuromuscular paralysis and cerebrovascular complications. Autonomic manifestations are observed in almost two third of patients following moderate to severe envenomation. PATIENT SUMMARY A 10-year-old boy presented with acute onset flaccid quadriparesis with encephalopathy, cranial neuropathy, and respiratory failure after bite of a common Indian krait. He also had features of autonomic instability in the form of hypertension and variable heart rate. Within 10 days, he was weaned from the ventilator and discharged on multiple oral antihypertensives. Within a week, he returned with focal status epilepticus. MRI of the brain suggested posterior reversible leukoencephalopathy. He recovered completely within 2 days with visual impairments while recovering. Within next 1 month, his antihypertensives were tapered completely. MRI of the brain, repeated after 3 months, confirmed complete resolution. CONCLUSIONS This patient highlights the fact that posterior reversible leukoencephalopathy can be a late complication of Indian krait bite secondary to autonomic instability with systemic hypertension.
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Affiliation(s)
- Jaya Shankar Kaushik
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sheffali Gulati
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Harsh Patel
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Gautham Pai
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Atin Kumar
- Department of Radio-Diagnosis, JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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