l-arginine enhances muscle regeneration after experimental envenomation by B. jararacussu: A future for nitric oxide-based therapy?

Development and evaluation of polymeric nanoparticles as a delivery system for snake envenoming prevention

Polymer-based nanoparticles have become an appealing carrier for improving vaccine delivery efficiency. In this study, we investigated an interesting approach based on PLGA nanoparticles encapsulating Cerastes cerastes venom as an intranasal vaccine delivery system for snake envenomation prevention. Particles were synthesized by double emulsion solvent evaporation method and characterized for their size, morphology, distribution, and venom-nanoparticles interactions. An immunization trial was performed in mice by the intranasal route to evaluate the immune response, the reactogenicity, and the protective effect of this nanovaccine. The physicochemical and structural characteristics of Cc-loaded PLGA NPs revealed that the particles exhibited a spherical shape with a diameter of 370 nm, and a negatively charged surface with a zeta potential value of 19,9 mV. The immunization with Cc-PLGA NPs can induce a systemic innate and humoral immune response and confers protection against Cerastes cerastes venom (Cc) over than 6 LD50 with a cross-protection against Vipera lebetina venom (Vl) over than 5 LD50. Nano-encapsulation of Cc venom reduced its toxicity and the induced tissue alterations. Our results confirm that the nano-formulation Cc-PLGA NPs is a potent adjuvant system that improve the humoral immune response and provide protection against high lethal doses of viper venoms.

Myotoxicity induced by Cerastes cerastes venom: Beneficial effect of heparin in skeletal muscle tissue regeneration

Myonecrosis is a relevant tissue damage induced by snakes of Viperidae family often leading to permanent tissue and function loss and even amputation. The aim of this study was to evaluate the effect of heparin on skeletal muscle tissue regeneration after Cerastes cerastes envenomation. Mice received either the venom (1 LD₅₀) by i.m. route, or the venom followed, by heparin administration by i.v. route at 15 min and 4 h. Obtained results showed that Cerastes cerastes venom induced deep tissue structure alterations, characterized mainly by edema, hemorrhage, myonecrosis and inflammation. Myotoxicity was correlated with increased CK levels in sera, concomitant with their decrease in muscle tissue homogenates. Muscle wet weight was restored within 2 weeks after heparin treatment and 28 days in the envenomed group. Heparin treatment significantly decreased MPO activity, suggesting an anti-inflammatory effect. NO, HGF, VEGF and G-CSF levels were increased after heparin administration. These mitogenic factors constitute potent stimuli for satellite and endothelial cells improving, thus, muscle regeneration. This study showed that muscle tissue recovery was significantly enhanced after heparin treatment. Heparin use seems to be a promising therapeutic approach after viper envenomation.

Why is Skeletal Muscle Regeneration Impaired after Myonecrosis Induced by Viperid Snake Venoms?

Skeletal muscle regeneration after myonecrosis involves the activation, proliferation and fusion of myogenic cells, and a coordinated inflammatory response encompassing phagocytosis of necrotic cell debris, and the concerted synthesis of cytokines and growth factors. Myonecrosis often occurs in snakebite envenomings. In the case of venoms that cause myotoxicity without affecting the vasculature, such as those of many elapid snakes, regeneration proceeds successfully. In contrast, in envenomings by most viperid snakes, which affect the vasculature and extracellular matrix in addition to muscle fibers, regeneration is largely impaired and, therefore, the muscle mass is reduced and replaced by fibro-adipose tissue. This review discusses possible causes for such poor regenerative outcome including: (a) damage to muscle microvasculature, which causes tissue hypoxia and affects the inflammatory response and the timely removal of necrotic tissue; (b) damage to intramuscular nerves, which results in atrophy of regenerating fibers; (c) degradation of muscle cell basement membrane, compromising the spatial niche for proliferating myoblasts; (d) widespread degradation of the extracellular matrix; and (e) persistence of venom components in the damaged tissue, which may affect myogenic cells at critical points in the regenerative process. Understanding the causes of poor muscle regeneration may pave the way for the development of novel therapeutic interventions aimed at fostering the regenerative process in envenomed patients.

Beneficial effects of Heparin and l Arginine on dermonecrosis effect induced by Vipera lebetina venom: Involvement of NO in skin regeneration

It is well known that snake venoms such as Viperidae caused severe local effects such as hemorrhage, myonecrosis and dermonecrosis which can lead to permanent tissue loss or the disability. The aim of this study is to evaluate the skin regeneration using heparin and l-arginine as well as the dermonecrotic effects induced by Vipera lebetina venom (VLV). To better understand the toxic effects induced by VLV and to prevent or treat these effects, we evaluate the local effects and the skin regeneration with or without drugs. The evaluation of NO as a marker of angiogenesis was also undertaken to understand its involvement in tissue wound healing and skin regeneration after envenomation. Obtained results showed that this venom is able to induce severe necrosis characterized by hemorrhage, hair follicles' destruction, glandular structure and increased of the thickness (acanthosis) in the epidermo-dermic junction. Inflammatory cells were also observed in the dermis. Pretreatment with heparin or L arginine seemed to decrease the induced dermonecrotic after one and two weeks improving the skin regeneration. The high level of NO could be involved in this regeneration, since it participates in the skin homeostatic functions' regulation and the maintenance of the skin protective barrier integrity against microorgansims. Nitric oxide plays also a key role in wound healing; it acts as a potent mitogenic stimulus to keratinocytes during skin repair and enhances the hair follicles and sebaceous gland structure that appeared after two weeks of treatment. Thus, these drugs could be used in therapeutic approach for dermonecrotic skin repair.

Ibuprofen suppresses depressive like behavior induced by BCG inoculation in mice: role of nitric oxide and prostaglandin

Prostaglandins (PGs) and nitric oxide (NO) may be involved in the pathophysiology of depression. Since NSAIDs decrease PGs and NO production, they may have an antidepressant effect. The aim of the present work was to explore a possible antidepressant action of ibuprofen in the new model of Bacillus Calmette-Guerin (BCG) induced depression. Mice injected with BCG (10(7) CFU/mouse intraperitoneally) showed an increase in the total immobility time during the forced swim test (FST) and the tail suspension test (TST) and an increase in cerebral PGE2 and NO levels. Fluoxetine administered in drinking water at a dose of 80 mg/l, 5 days before BCG and for 2 more weeks resulted in significant decrease in total immobility time during FST and TST and in cerebral PGE2 and NO levels. Both ibuprofen (200 mg/l) and L-NAME (1 g/l) administered in drinking water 24 h before BCG and for 2 more weeks resulted in decrease in the total immobility time during FST and TST and in cerebral PGE2 and NO levels, which was comparable to fluoxetine's effect. On the other hand, l-arginine administered at a dose of 6 g/l in drinking water together with ibuprofen or fluoxetine reversed their effect on FST, TST and cerebral PGE2 and NO levels. Immunohistochemistry showed a decrease in COX-1 and i-NOS immunoreactivity in the CA1 and CA3 areas of the hippocampus following ibuprofen treatment. These results suggest that ibuprofen may have an antidepressant effect through inhibition of PGE2 and NO production, especially in depression secondary to chronic inflammation.

Myocardial fibrosis is unaltered by long-term administration of L-arginine in dystrophin deficient mdx mice: a histomorphometric analysis

Cardiac failure secondary to myocardial fibrosis (MF) significantly contributes to death in Duchenne muscular dystrophy (DMD), a fatal form of muscle disease. In aging, the mdx mice, an animal model of DMD, MF is similar to that observed in humans. Nitric oxide-based therapy has been proposed to retard MF in DMD and a candidate is L-arginine (L-arg). In this study we evaluated the effects of long-term therapy with L-arg in the MF of mdx mice. mdx mice (6 months old) were treated with L-arg in drinking water. Control mdx mice received water only. After 15 months of treatment, hearts were stained with Masson's trichrome for analysis of MF and with hematoxilyn and eosin for analysis of inflammation and cardiomyocyte damage. We observed that MF was not affected (29.5 +/- 2.5% of MF area for control vs 31.4 +/- 2% for L-arginine-treated animals; P > 0.05). The density of inflammatory cells was reduced (169 +/- 12 cells/mm 2 in control vs 102 +/- 9 cells/mm 2 in L-arg-treated; P < 0.05). The present study shows that long-term administration of L-arg is not effective in retarding MF in mdx dystrophinopathy.