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Li H, Gong J, Bian F, Yu F, Yuan H, Hu F. The role and mechanism of NLRP3 in wasp venom-induced acute kidney injury. Toxicon 2024; 238:107570. [PMID: 38103798 DOI: 10.1016/j.toxicon.2023.107570] [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: 10/08/2023] [Revised: 12/04/2023] [Accepted: 12/14/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Inflammation and pyroptosis have crucial impacts on the development of acute kidney injury (AKI) and have been validated in a variety of existing AKI animal models. However, the mechanisms underlying wasp venom-induced AKI are still unclear. The involvement of nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3) in some mouse models of AKI has been extensively documented, and its crucial function in controlling inflammation and pyroptosis has been highlighted. The objective of our study was to investigate the role and mechanism of NLRP3 in inflammation and pyroptosis associated with wasp venom-induced AKI. METHODS A mouse model of AKI induced by wasp venom pre-injected with an NLRP3 inhibitor was used to study the role and mechanism of NLRP3. To verify the importance of NLRP3, western blotting was performed to assess the expression of NLRP3, caspase-1 p20, and gasdermin D (GSDMD)-N. Additionally, quantitative real-time polymerase was used to determine the expression of NLRP3, caspase-1, and GSDMD. Furthermore, enzyme-linked immunosorbent assay was utilized to measure the levels of interleukin (IL)-1β and IL-18. RESULTS NLRP3 was found to be the downstream signal of the stimulator of interferon genes in the wasp sting venom-induced AKI model. The administration of wasp venom in mice significantly upregulated the expression of NLRP3, leading to renal dysfunction, inflammation, and pyroptosis. Treatment with an NLRP3 inhibitor reversed the renal damage induced by wasp venom and attenuated pathological injury, inflammatory response, and pyroptosis. CONCLUSION NLRP3 activation is associated with renal failure, inflammatory response and pyroptosis in the hyper early phase of wasp venom-induced AKI. The inhibition of NLRP3 significantly weakened this phenomenon. These findings could potentially offer a viable therapeutic approach for AKI triggered by wasp venom.
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Affiliation(s)
- Haoran Li
- School of Medicine, Wuhan University of Science and Technology, Wuhan, China; Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Jianhua Gong
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Fang Bian
- Department of Pharmacy, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Fanglin Yu
- School of Medicine, Wuhan University of Science and Technology, Wuhan, China; Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Hai Yuan
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
| | - Fengqi Hu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
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Zhang Y, Wu W, Zhang Z. The predictive value of the systemic inflammatory response index for the occurrence of multiple organ dysfunction syndrome in patients with wasp sting injury. Toxicon 2023; 234:107269. [PMID: 37678579 DOI: 10.1016/j.toxicon.2023.107269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/13/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
Wasp sting injuries pose a significant threat to public health, especially in areas with abundant trees. Mortality rates are alarmingly high, with reports indicating that up to 70% or more of cases result in multiple organ dysfunction syndrome (MODS). It is crucial for emergency and critical care physicians to promptly identify and implement effective measures to reduce the occurrence of MODS in patients who have been stung by wasps. Therefore, finding a reliable predictive indicator is of utmost importance. We conducted a retrospective study, and clinical data of 226 hospitalized patients with wasp sting from July 2013 to April 2023 in the First College of Clinical Medicine Science, China Three Gorges University were collected. The patients were divided into MODS group and non-MODS (NMODS) group, and the general data, clinical symptoms, laboratory indexes, and prognosis were compared between the two groups. The indicators with significant differences in univariate analysis were included in the multivariate Logistic regression analysis to analyze the independent risk factors for MODS. The value of systemic inflammatory response index (SIRI) in predicting the occurrence of MODS in wasp sting was analyzed by using the receiver operating characteristic curve (ROC curve). Of the 214 patients with wasp sting, 109 cases were in the NMODS group, and 105 cases were in the MODS group. The SIRI was 1.6 (0.7, 3.6) and 12.2 (5.2, 23.3) in the NMODS group and MODS group, respectively, with a significant difference between the two groups (P < 0.001). SIRI was an independent risk factor for MODS in patients with wasp sting; the AUC of SIRI in predicting MODS in wasp sting was 0.886 (P < 0.001), and the optimal cutoff value was 6.39, with a sensitivity of 71.43% and a specificity of 94.5%, which had prediction value. Allowing for early identification and enabling doctors to intervene and provide timely treatment. SIRI was defined as follows: SIRI = neutrophil count × monocyte count/lymphocyte count.
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Affiliation(s)
- Yupei Zhang
- Department of Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, 443000, Hubei, China
| | - Wen Wu
- Department of Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, 443000, Hubei, China.
| | - Zhaohui Zhang
- Department of Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, 443000, Hubei, China.
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Yu F, Wang L, Yuan H, Gao Z, He L, Hu F. Wasp venom-induced acute kidney injury: current progress and prospects. Ren Fail 2023; 45:2259230. [PMID: 38376456 PMCID: PMC10512847 DOI: 10.1080/0886022x.2023.2259230] [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: 07/04/2023] [Accepted: 09/11/2023] [Indexed: 02/21/2024] Open
Abstract
Wasp venom can trigger local and systemic reactions, with the kidneys being commonly affected, potentially causing acute kidney injury (AKI). Despite of the recent advances, our knowledge on the underlying mechanisms of toxicity and targeted therapies remain poor. AKI can result from direct nephrotoxic effects of the wasp venom or secondary rhabdomyolysis and intravascular hemolysis, which will release myoglobin and free hemoglobin. Inflammatory responses play a central role in these pathological mechanisms. Noteworthily, the successful establishment of a suitable experimental model can assist in basic research and clinical advancements related to wasp venom-induced AKI. The combination of therapeutic plasma exchange and continuous renal replacement therapy appears to be the preferred treatment for wasp venom-induced AKI. In addition, studies on cilastatin and varespladib for wasp venom-induced AKI treatment have shown their potential as therapeutic agents. This review summarizes the available evidence on the mechanisms and treatment of wasp venom-induced AKI, with a particular focus on the role of inflammatory responses and potential targets for therapeutic drugs, and, therefore, aiming to support the development of clinical treatment against wasp venom-induced AKI.
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Affiliation(s)
- Fanglin Yu
- School of Medicine, Wuhan University of Science and Technology, Wuhan, China
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Ling Wang
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Hai Yuan
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Zhao Gao
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Li He
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Fengqi Hu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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Wang M, Qin M, Wang AY, Zhao JW, Deng F, Han Y, Wang W. Clinical Manifestations and Risk Factors Associated with 14 Deaths following Swarm Wasp Stings in a Chinese Tertiary Grade A General Hospital: A Retrospective Database Analysis Study. J Clin Med 2023; 12:5789. [PMID: 37762730 PMCID: PMC10532120 DOI: 10.3390/jcm12185789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION The objective was to evaluate the poisoning severity score (PSS) as an early prognostic predictor in patients with wasp stings and identify associated clinical characteristics and risk factors for mortality. METHODS A total of 363 patients with wasp stings at Suining Central Hospital between January 2016 and December 2018 were enrolled. Within the first 24 h of admission, the poisoning severity score (PSS) and the Chinese expert consensus on standardized diagnosis and treatment of wasp stings (CECC) were utilized for severity classification, and their correlation was examined. Patients were then divided into survival and death groups based on discharge status. Logistic regression analysis was employed to analyze factors influencing patients' outcomes. RESULTS The mortality of wasp sting patients was 3.9%. The PSS and CECC were found to correlate for severity classification. Additionally, female gender, age, number of stings, and PSS were identified as independent risk factors for mortality in wasp sting patients. Combining these four factors yielded an AUC of 0.962 for predicting death. CONCLUSIONS PSS aids in early severity classification of wasp stings. Female gender, age, number of stings, and PSS were independent mortality risk factors in these patients.
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Affiliation(s)
- Maohe Wang
- Department of Nephrology, Suining Central Hospital, Suining 629000, China
| | - Mei Qin
- Department of Nephrology, Suining Central Hospital, Suining 629000, China
- Renal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Amanda Y. Wang
- Renal and Metabolic Division, The George Institute for Global Health, UNSW Australia, Sydney, NSW 2052, Australia
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord Clinical School, University of Sydney, Camperdown, NSW 2050, Australia
| | - Jia-Wei Zhao
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Fei Deng
- Renal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Yumei Han
- Department of Nephrology, Suining Central Hospital, Suining 629000, China
| | - Wei Wang
- Renal Department and Nephrology Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
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Lv Y, Lu L, Yu F, Gao Z, Yuan H, Hu F. STING deficiency protects against wasp venom-induced acute kidney injury. Inflamm Res 2023:10.1007/s00011-023-01749-5. [PMID: 37326694 DOI: 10.1007/s00011-023-01749-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/14/2023] [Accepted: 05/21/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE Recent evidence suggests a key role of the inflammatory responses in wasp venom-induced acute kidney injury (AKI). However, the potential regulatory mechanisms underlying the inflammatory responses in wasp venom-induced AKI remain unclear. STING reportedly plays a critical role in other AKI types and is associated with inflammatory responses and diseases. We aimed to investigate the involvement of STING in inflammatory responses associated with wasp venom-induced AKI. METHODS The role of the STING signaling pathway in wasp venom-induced AKI was studied in vivo using a mouse model of wasp venom-induced AKI with STING knockout or pharmacological inhibition and in vitro using human HK2 cells with STING knockdown. RESULTS STING deficiency or pharmacological inhibition markedly ameliorated renal dysfunction, inflammatory responses, necroptosis, and apoptosis in wasp venom-induced AKI in mice. Moreover, STING knockdown in cultured HK2 cells attenuated the inflammatory response, necroptosis, and apoptosis induced by myoglobin, the major pathogenic factor in wasp venom-induced AKI. Urinary mitochondrial DNA upregulation has also been observed in patients with wasp venom-induced AKI. CONCLUSIONS STING activation mediates the inflammatory response in wasp venom-induced AKI. This may offer a potential therapeutic target for the management of wasp venom-induced AKI.
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Affiliation(s)
- Ying Lv
- School of Medicine, Wuhan University of Science and Technology, Wuhan, 430065, China
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Li Lu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Fanglin Yu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Zhao Gao
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Hai Yuan
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China.
| | - Fengqi Hu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China.
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Tang X, Wei T, Guan M, Li P, Pu Y, Cheng L, Zhou Z, Fu P, Zhang L. Phospholipase A 2 induces acute kidney injury by complement mediated mitochondrial apoptosis via TNF-α/NF-κB signaling pathway. Food Chem Toxicol 2023; 172:113591. [PMID: 36581091 DOI: 10.1016/j.fct.2022.113591] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Acute kidney injury (AKI) is one of common complications of wasp/bee stings. Phospholipase A2 (PLA2) is a vital pathogenic composition of wasp/bee venom. We aimed to investigate the role of complement mediated mitochondrial apoptosis in PLA2 induced AKI. MATERIALS AND METHODS PLA2 induced AKI model was established by injecting PLA2 into via tail vein on mice. The pathological changes and the microstructural changes of kidney, complement activation, inflammation and apoptosis were detected in vitro and in vivo respectively. RESULTS The results showed that PLA2 induced AKI models were successfully established in vivo and vitro. Compared with control, serum creatinine and urea nitrogen levels were elevated. Complement system activation and mitochondrial damage were observed. Expressions of IL-6, TNF-α, cleaved caspase-3 and cleaved caspase-9, and Bax/Bcl-2 increased in PLA2 induced AKI models. TNF-α/NF-κB signaling pathway activation in AKI models. CONCLUSION In the present study, PLA2 induced AKI model was first successfully established to our knowledge. The role of complement mediated mitochondrial apoptosis pathway in renal tubular epithelial cells in PLA2 induced AKI were verified in vitro and vivo.
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Affiliation(s)
- Xin Tang
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Tiantian Wei
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Mingjing Guan
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Peiyun Li
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Yajun Pu
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Lixin Cheng
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Zhifeng Zhou
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Fu
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Zhang
- Department of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China.
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Han J, Cui L, Yu F, Wang R, Yuan H, Hu F. Megalin blockade with cilastatin ameliorates multiple wasp sting-induced acute kidney injury in rats. Toxicon 2022; 220:106960. [DOI: 10.1016/j.toxicon.2022.106960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
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Sedighi G, Dehghani R, Varzandeh M. Toxic reaction of a 3-year-old boy due to Hornet multiple stings in Kerman-Iran province: A case report. Toxicon 2022; 221:106976. [DOI: 10.1016/j.toxicon.2022.106976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
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Nwaji AR, Arieri O, Anyang AS, Nguedia K, Abiade EB, Forcados GE, Oladipo OO, Makama S, Elisha IL, Ozele N, Gotep JG. Natural toxins and One Health: a review. SCIENCE IN ONE HEALTH 2022; 1:100013. [PMID: 39076609 PMCID: PMC11262277 DOI: 10.1016/j.soh.2023.100013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/28/2023] [Indexed: 07/31/2024]
Abstract
Background The One Health concept considers the interconnectivity, interactions and interdependence of humans, animals and the environment. Humans, animals and other organisms are constantly exposed to a wide range of natural toxins present in the environment. Thus, there is growing concern about the potential detrimental effects that natural toxins could pose to achieve One Health. Interestingly, alkaloids, steroids and bioactive peptides obtained from natural toxins could be used for the development of therapeutic agents. Methodology Our literature search focused on the following keywords; toxins, One Health, microbial toxins, mycotoxins, phytotoxins, phycotoxins, insect toxins and toxin effects. Google Scholar, Science Direct, PubMed and Web of Science were the search engines used to obtain primary databases. We chose relevant full-text articles and review papers published in English language only. The research was done between July 2022 and January 2023. Results Natural toxins are poisonous substances comprising bioactive compounds produced by microorganisms, invertebrates, plants and animals. These compounds possess diverse structures and differ in biological function and toxicity, posing risks to human and animal health through the contamination of the environment, causing disease or death in certain cases. Findings from the articles reviewed revealed that effects of natural toxins on animals and humans gained more attention than the impact of natural toxins on the environment and lower organisms, irrespective of the significant roles that lower organisms play to maintain ecosystem balance. Also, systematic approaches for toxin control in the environment and utilization for beneficial purposes are inadequate in many regions. Remarkably, bioactive compounds present in natural toxins have potential for the development of therapeutic agents. These findings suggest that global, comprehensive and coordinated efforts are required for improved management of natural toxins through an interdisciplinary, One Health approach. Conclusion Adopting a One Health approach is critical to addressing the effects of natural toxins on the health of humans, animals and the environment.
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Affiliation(s)
- Azubuike Raphael Nwaji
- Department of Physiology, Faculty of Basic Medical Sciences, Alex Ekwueme Federal University, Ndufu-Alike, Ebonyi State, Nigeria
| | - Onikisateinba Arieri
- Department of Industrial Chemistry and Petrochemical Technology, Faculty of Science Laboratory, University of Portharcourt, Nigeria
| | | | - Kaze Nguedia
- Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | | | | | | | - Sunday Makama
- Biochemistry Division, National Veterinary Research Institute, Vom, Plateau State, Nigeria
| | - Ishaku Leo Elisha
- Drug Development Division, National Veterinary Research Institute, Vom, Plateau State, Nigeria
| | - Nonyelim Ozele
- Biochemistry Division, National Veterinary Research Institute, Vom, Plateau State, Nigeria
| | - Jurbe Gofwan Gotep
- Drug Development Division, National Veterinary Research Institute, Vom, Plateau State, Nigeria
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Ruwanpathirana P, Priyankara D. Clinical manifestations of wasp stings: a case report and a review of literature. Trop Med Health 2022; 50:82. [PMID: 36307881 PMCID: PMC9615201 DOI: 10.1186/s41182-022-00475-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Wasp stinging, a neglected tropical entity can have a myriad of local and systemic effects. We present a case of multi-organ injury following multiple wasp stings and a review of literature on the systemic manifestations of wasp stings.
Case presentation A 48-year-old Sri Lankan male who suffered multiple wasp stings, developed an anaphylactic shock with respiratory failure, which was treated with adrenaline and mechanical ventilation. Within the next 2 days the patient developed acute fulminant hepatitis, stage III acute kidney injury, rhabdomyolysis, haemolysis and thrombocytopenia. The patient was treated in the intensive care unit with ionopressors and continuous renal replacement therapy (CRRT). Haemoadsorbant therapy was used in adjunct with CRRT. There was a gradual recovery of the organ functions over the 1st week. However, the patient succumbed to fungal sepsis on the 16th day despite treatment. We conducted a literature review to identify the various clinical manifestations of wasp stinging. Wasp venom contains enzymes, amines, peptides and other compounds. These proteins can cause type 1 hypersensitive reactions ranging from local skin irritation to anaphylactic shock. Furthermore, the toxins can cause direct organ injury or delayed hypersensitivity reactions. The commonly affected organs are the kidneys, liver, and muscles. The effect on the haematological system manifests as coagulopathy and/or cytopenia. The heart, nervous system, lungs, intestines and skin can be affected rarely. Treatment is mainly supportive. Conclusion In conclusion, wasp envenomation can result in multi-organ injury and attention should be paid in doing further research and establishing evidence-based treatment practices.
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Affiliation(s)
- Pramith Ruwanpathirana
- Medical Intensive Unit, National Hospital Sri Lanka, 435/11, Thimbirigasyaya Road, Colombo 05, Sri Lanka.
| | - Dilshan Priyankara
- Medical Intensive Unit, National Hospital Sri Lanka, 435/11, Thimbirigasyaya Road, Colombo 05, Sri Lanka
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A rat model of acute kidney injury caused by multiple subcutaneous injections of Asian giant hornet (Vespa mandarina Smith) venom. Toxicon 2022; 213:23-26. [DOI: 10.1016/j.toxicon.2022.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/12/2022] [Accepted: 04/11/2022] [Indexed: 12/20/2022]
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Wang R, Gao D, Yu F, Han J, Yuan H, Hu F. Phospholipase A 2 inhibitor varespladib prevents wasp sting-induced nephrotoxicity in rats. Toxicon 2022; 215:69-76. [PMID: 35724947 DOI: 10.1016/j.toxicon.2022.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 02/07/2023]
Abstract
This study aimed to clarify whether varespladib, a phospholipase A2 (PLA2) inhibitor, can be used as a therapeutic agent for wasp sting-induced acute kidney injury (AKI). Rats were divided into control, AKI, and AKI + varespladib groups. The AKI model was established by subcutaneously injecting wasp venom at five different sites in rats. Varespladib treatment showed a significant inhibitory effect on wasp venom PLA2in vitro and in vivo. Moreover, we observed that varespladib decreased the levels of rhabdomyolysis and hemolysis markers compared with that in the AKI group. Histopathological changes in the kidney decreased significantly, and rat serum creatinine levels were reduced after varespladib administration. The significantly regulated genes in the kidney of the AKI group were mostly involved in inflammatory response pathway, and the administration of varespladib remarkably attenuated the expression of these genes. Therefore, varespladib inhibited wasp sting-induced functional and pathological damage to the kidneys. We propose that the PLA2 inhibitor varespladib protects the kidney tissue in a wasp sting-induced AKI model by inhibiting PLA2 activity.
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Affiliation(s)
- Rui Wang
- School of Medicine, Wuhan University of Science and Technology, Wuhan, 430065, China; Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Dan Gao
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Fanglin Yu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Jiamin Han
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China
| | - Hai Yuan
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China.
| | - Fengqi Hu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China.
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Kowalski K, Marciniak P, Rychlik L. A new, widespread venomous mammal species: hemolytic activity of Sorex araneus venom is similar to that of Neomys fodiens venom. ZOOLOGICAL LETTERS 2022; 8:7. [PMID: 35672837 PMCID: PMC9172195 DOI: 10.1186/s40851-022-00191-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Venom production has evolved independently many times in the animal kingdom, although it is rare among mammals. Venomous shrews produce toxins in their salivary glands and use their venoms to hunt and store prey. Thus far, the toxicity and composition of shrew venoms have been studied only in two shrew species: the northern short-tailed shrew, Blarina brevicauda, and the Eurasian water shrew, Neomys fodiens. Venom of N. fodiens has potent paralytic activity which enables hunting and storing prey in a comatose state. Here, we assayed the hemolytic effects of extracts from salivary glands of N. fodiens and the common shrew, Sorex araneus, in erythrocytes of Pelophylax sp. frogs. We identified toxins in shrew venom by high-performance liquid chromatography coupled to tandem mass spectrometry. RESULTS Our results prove, confirming a suggestion made four centuries ago, that S. araneus is venomous. We also provide the first experimental evidence that shrew venoms produce potent hemolysis in frog erythrocytes. We found significant concentration-dependent effects of venoms of N. fodiens and S. araneus on hemolysis of red blood cells evaluated as hemoglobin release. Treatment of erythrocytes with N. fodiens venom at concentrations of 1.0 and 0.5 mg/ml and with S. araneus venom at concentration of 1.0 mg/ml caused an increased release of hemoglobin. Our findings confirm that hemolytic effects of N. fodiens venom are stronger than those produced by S. araneus venom. We identified four toxins in the venom of N. fodiens: proenkephalin, phospholipase A2 (PLA2), a disintegrin and metalloproteinase domain-containing protein (ADAM) and lysozyme C, as well as a non-toxic hyaluronidase. In the venom of S. araneus we found five toxins: proenkephalin, kallikrein 1-related peptidase, beta-defensin, ADAM and lysozyme C. PLA2 and ADAMs are likely to produce hemolysis in frog erythrocytes. CONCLUSIONS Our results clearly show that shrew venoms possess hemolytic action that may allow them to hunt larger prey. Since a member of the numerous genus Sorex is venomous, it is likely that venom production among shrews and other eulipotyphlans may be more widespread than it has previously been assumed.
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Affiliation(s)
- Krzysztof Kowalski
- Department of Vertebrate Zoology and Ecology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Toruń, Poland
| | - Paweł Marciniak
- Department of Animal Physiology and Developmental Biology, Institute of Experimental Biology, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland
| | - Leszek Rychlik
- Department of Systematic Zoology, Institute of Environmental Biology, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland
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Wang M, Prince S, Tang Y, Zhong X, Chen S, Li G, Wang L, Wang W. Macroscopic hematuria in wasp sting patients: a retrospective study. Ren Fail 2021; 43:500-509. [PMID: 33706645 PMCID: PMC7971319 DOI: 10.1080/0886022x.2021.1896547] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Macroscopic hematuria after wasp sting has been reported in Asia to occur before acute kidney injury (AKI), and is often used by clinicians as a sign indicating the need for intensive care and blood purification therapy. However, there is no study on the clinical characteristics and prognosis of this symptom. METHODS The clinical data of 363 patients with wasp sting admitted to Suining Central Hospital from January 2016 to December 2018 were retrospectively analyzed. At admission, the poisoning severity score (PSS) was used as the criterion for severity classification. According to the presence of macroscopic hematuria, the patients were divided into macroscopic hematuria and non-macroscopic hematuria group. RESULTS Of the 363 wasp sting patients, 219 were male and 144 were female, with a mean age of 55.9 ± 16.3 years. Fifty-one (14%) had macroscopic hematuria, 39 (10.7%) had AKI, 105 (28.9%) had rhabdomyolysis, 61 (16.8%) had hemolysis, 45 (12.4%) went on to received hemodialysis, and 14 (3.9%) died. The incidence of AKI in macroscopic hematuria group was 70.6%, and oliguric renal failure accounted for 72.2%. Patients with macroscopic hematuria had significantly higher PSS (2.2 ± 0.5 vs. 1.1 ± 0.3, p < .001). CONCLUSION Macroscopic hematuria can be regarded as a surrogate marker of deteriorating clinical outcome following wasp stings. In wasp sting patients with symptoms of macroscopic hematuria or serum LDH higher than 463.5 u/L upon admission, the risk of AKI increases significantly, therefore hemodialysis should be considered. The PSS is helpful in early assessment of the severity of wasp sting patients.
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Affiliation(s)
- Maohe Wang
- Zunyi Medical University, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Nephrology & Institute of Nephrology, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, China
- Suining central hospital, Suining, China
| | - Singh Prince
- Division of Nephrology & Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Yong Tang
- Suining central hospital, Suining, China
| | - Xiang Zhong
- Department of Nephrology & Institute of Nephrology, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, China
| | - Shasha Chen
- Department of Nephrology & Institute of Nephrology, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, China
| | - Guisen Li
- Department of Nephrology & Institute of Nephrology, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, China
| | - Li Wang
- Department of Nephrology & Institute of Nephrology, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, China
| | - Wei Wang
- Zunyi Medical University, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Nephrology & Institute of Nephrology, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, China
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Yuan H, Gao Z, Chen G, Peng C, Sun Y, Jiang B, Zhou H, Cheng Y, Hu F, Zhang Q. An integrative proteomics metabolomics based strategy reveals the mechanisms involved in wasp sting induced acute kidney injury. Toxicon 2021; 205:1-10. [PMID: 34773816 DOI: 10.1016/j.toxicon.2021.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 01/06/2023]
Abstract
The pathophysiological mechanisms involved in wasp-sting-induced acute kidney injury (AKI) remain largely unknown. Here, we combined proteomics and metabolomics to investigate the mechanisms behind multiple wasp sting-induced AKI. Interestingly, we found many differentially abundant proteins in the serum of AKI group compared with that of the non-AKI and control groups, involved in several metabolic pathways and the regulation of cellular processes. In addition, we also detected differentially abundant metabolites in the AKI group; among them many were involved in the glycerophospholipid metabolic pathway (the key pathway in the context of AKI): 50 metabolites, all downregulated in the AKI group. Importantly, the convergent analysis of metabolomics and proteomics data revealed that biomarkers of rhabdomyolysis (CA 3, MYL3, and LDH) and hemolysis (ALT and LDH) were integrated into a regulatory network with phospholipid metabolism products in the AKI group, indicating that wasp sting-induced AKI is secondary to rhabdomyolysis and intravascular hemolysis. Of note, such a phenotype suggests the disruption of the membrane of skeletal muscle cells and red blood cells mediated by the phospholipase A1 (PLA1), PLA2, and mastoparan in the wasp venom, via the disruption of membrane glycerophospholipids. Overall, our results highlight a potential new mechanism behind wasp sting-induced AKI and suggest that PLA inhibitors may be potential agents for the treatment of this condition.
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Affiliation(s)
- Hai Yuan
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
| | - Zhao Gao
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
| | - Guang Chen
- Department of Clinical Laboratory, People's Hospital of Weifang, Weifang, 261000, Shandong, China.
| | - Changkun Peng
- Department of Nephrology, People's Hospital of Baokang, Xiangyang, 441000, Hubei, China.
| | - Yujun Sun
- Department of Nephrology, Nanzhang Hospital of Traditional Chinese Medicine, Xiangyang, 441000, Hubei, China.
| | - Binbin Jiang
- Department of Nephrology, Baokang Hospital of Traditional Chinese Medicine, Xiangyang, 441000, Hubei, China.
| | - Hongyu Zhou
- Department of Nephrology, People's Hospital of Gucheng, Xiangyang, 441000, Hubei, China.
| | - Yong Cheng
- Department of Nephrology, People's Hospital of Nanzhang, Xiangyang, 441000, Hubei, China.
| | - Fengqi Hu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
| | - Qi Zhang
- Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
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Li F, Liu L, Chen D, Zhang Y, Wang M, Zhou D, Peng L, Lin W. Efficacy of Three Renal Replacement Therapy Modalities for the Treatment of Acute Kidney Injury Caused by Wasp Sting. Blood Purif 2021; 51:365-375. [PMID: 34710874 DOI: 10.1159/000514284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/08/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM This study mainly aimed to explore the therapeutic effects of 3 renal replacement therapy (RRT) modalities on acute kidney injury (AKI) caused by wasp stings. METHODS A retrospective study from September 2016 to December 2019 was conducted. Thirty-one patients with AKIs caused by wasp sting were selected and divided into 3 groups according to the initial RRT modality received, namely, (1) the intermittent hemodialysis combined with hemoperfusion (IHD + HP) group, (2) the continuous veno-venous hemodiafiltration (CVVHDF) group, and (3) the CVVHDF combined with HP (CVVHDF + HP) group. The laboratory results were measured and analyzed before treatment on the 3rd, 7th, and 14th days of treatment. The renal function outcomes and survival of the patients were investigated at 3 months follow-up. RESULTS The laboratory results of enzyme measures and inflammatory indicators in wasp sting patients increased significantly in the early stage and 3 RRT modalities were effective in reducing these indicators. In addition, continuous RRT modality (CVVHDF and CVVHDF + HP) showed better clearance of myoglobin than IHD + HP. The serum creatinine levels of patients in the 3 groups did not recover to baseline within 14 days after beginning treatment. Nevertheless, the CVVHDF + HP group was better than the CVVHDF group, and CVVHDF was better than the IHD + HP group on the 3rd day. The interleukin (IL)-6 and IL-10 levels in CVVHDF + HP and IHD + HP groups were obviously lower than those in the CVVHDF group on the 3rd day. In the follow-up study, the recovery rate of renal function in CVVHDF and CVVHDF + HP groups was significantly better than that in the IHD + HP group. CONCLUSION Early RRT was effective in the treatment of patients with A KI caused by wasp sting. CVVHDF + HP and CVVHDF modalities were better than the IHD + HP group in venom clearance and renal function recovery.
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Affiliation(s)
- Fugang Li
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China.,Central Laboratory, People's Hospital of Jianyang, Jianyang, China
| | - Li Liu
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China
| | - Dezheng Chen
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China
| | - Yong Zhang
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China
| | - Mingli Wang
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China
| | - Dongmei Zhou
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China
| | - Li Peng
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China
| | - Wujun Lin
- Department of Nephrology, People's Hospital of Jianyang, Jianyang, China
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Wasp Venom Biochemical Components and Their Potential in Biological Applications and Nanotechnological Interventions. Toxins (Basel) 2021; 13:toxins13030206. [PMID: 33809401 PMCID: PMC8000949 DOI: 10.3390/toxins13030206] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/26/2021] [Accepted: 03/08/2021] [Indexed: 12/23/2022] Open
Abstract
Wasps, members of the order Hymenoptera, are distributed in different parts of the world, including Brazil, Thailand, Japan, Korea, and Argentina. The lifestyles of the wasps are solitary and social. Social wasps use venom as a defensive measure to protect their colonies, whereas solitary wasps use their venom to capture prey. Chemically, wasp venom possesses a wide variety of enzymes, proteins, peptides, volatile compounds, and bioactive constituents, which include phospholipase A2, antigen 5, mastoparan, and decoralin. The bioactive constituents have anticancer, antimicrobial, and anti-inflammatory effects. However, the limited quantities of wasp venom and the scarcity of advanced strategies for the synthesis of wasp venom’s bioactive compounds remain a challenge facing the effective usage of wasp venom. Solid-phase peptide synthesis is currently used to prepare wasp venom peptides and their analogs such as mastoparan, anoplin, decoralin, polybia-CP, and polydim-I. The goal of the current review is to highlight the medicinal value of the wasp venom compounds, as well as limitations and possibilities. Wasp venom could be a potential and novel natural source to develop innovative pharmaceuticals and new agents for drug discovery.
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Ou WF, Huang WH, Chiu HF, Mao YC, Wen MC, Chen CH, Hung SJ, Wu MJ, Wu CL, Chao WC. Clinical manifestation of multiple wasp stings with details of whole transcriptome analysis: Two case reports. Medicine (Baltimore) 2021; 100:e24492. [PMID: 33530269 PMCID: PMC7850695 DOI: 10.1097/md.0000000000024492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/28/2020] [Accepted: 01/07/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Multiple wasp stings is an emergency result from systemic reactions to the toxin with a wide range of manifestations, and we presented 2 patients with distinct clinical and transcriptomic findings. PATIENT CONCERNS Two patients without systemic disease presented with nearly 90 painful papules after attacked by a swarm of wasps (Vespa basalis). DIAGNOSIS Patient 1 was a 44-year-old healthy male whose clinical manifestations mainly comprised hemolysis, hepatic injury, rhabdomyolysis, and acute kidney injury. Patient 2 was a 49-year-old healthy female who presented with severe acute respiratory distress syndrome (ARDS) in addition to certain clinical manifestations that were also found in patient 1. We used ribo- nucleic acid sequencing (RNA-Seq) to characterize the inflammatory responses of 2 patients with distinct clinical manifestations after multiple wasp stings. INTERVENTIONS Both 2 patients received 5 sessions of plasmapheresis, and patient-1 further received mechanical ventilation for 8 days as well as 8 sessions of hemodialysis until day 17. OUTCOMES Both patients recovered uneventfully after the aforementioned management. We used RNA-Seq to demonstrate a largely regulated neutrophil-predominated immune response in patient 1. In patient 2, we found a profound neutrophilc response on week 1 and a robust neutrophilic as well as pro-inflammatory responses on week 2. Furthermore, we found increased expression of signals that were associated with renal system process on week 2. CONCLUSION In conclusion, we report 2 patients who manifested with shared and distinct presentations after an attack by the same swarm of wasps. Both patients had hemolysis, rhabdomyolysis, hepatic injury and acute kidney injury, and 1 patient had ARDS. The whole transcriptomic analyses were consistent with the distinct clinical manifestation, and these results suggest the potential of RNA-Sequencing to disentangle complex inflammatory responses in patients with multiple wasp stings. Plasmapheresis and corticosteroid were administered to both patients and case 2 also underwent 8 sessions of hemodialysis.
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Affiliation(s)
| | | | - Hsien-Fu Chiu
- Division of Nephrology, Department of Internal Medicine
| | - Yan-Chiao Mao
- Division of Clinical Toxicology, Department of Emergency Medicine
| | - Mei-Chin Wen
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital
| | - Cheng-Hsu Chen
- Division of Nephrology, Department of Internal Medicine
- Department of Life Science, Tunghai University
| | - Sheng-Jou Hung
- Department of Medical Research, Taichung Veterans General Hospital
| | - Ming-Ju Wu
- Division of Nephrology, Department of Internal Medicine
- School of Medicine, Chung Shan Medical University
- Rong Hsing Research Center for Translational Medicine, Institute of Biomedical Science, College of Life Science, National Chung Hsing University
- Graduate Institute of Clinical Medical Science, School of Medicine, China Medical University
| | - Chieh-Liang Wu
- Department of Critical Care Medicine, Taichung Veterans General Hospital
- Department of Industrial Engineering and Enterprise Information
| | - Wen-Cheng Chao
- Department of Critical Care Medicine, Taichung Veterans General Hospital
- Department of Computer Science, Tunghai University, Taichung, Taiwan
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Risk factors of acute kidney injury induced by multiple wasp stings. Toxicon 2020; 182:1-6. [PMID: 32387349 DOI: 10.1016/j.toxicon.2020.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/27/2020] [Accepted: 05/05/2020] [Indexed: 12/22/2022]
Abstract
In Asia, acute kidney injury (AKI) induced by wasp stings is common; however, the pathophysiological mechanisms involved remain unclear. To evaluate the mechanisms associated with AKI induced by wasp stings, we conducted a retrospective cohort study that assessed blood and urinary samples from 112 patients with hospital admissions resulting from wasp stings. These samples were divided into those with AKI and without AKI as described in the Kidney Disease Improving Global Outcomes (KDIGO) database. Of the patients, 48.2% presented with an elevated number of leukocytes (median 19.9 vs. 15.8 × 109/L), serum creatinine (median 122.0 vs. 66.0 μmol/L), alanine aminotransferase (ALT) (median 176 vs. 32 U/L), aspartate aminotransferase (AST) (median 402 vs. 37 U/L), lactate dehydrogenase (LDH) (median 3076.0 vs. 300.0 U/L), creatine kinase (CK) (median 9990.0 vs. 261.0 U/L), creatine kinase myocardial band (CK-mb) (median 200.0 vs. 29.5 U/L), activated partial thromboplastin time (APTT) (median 70.0 vs. 42.5s), prothrombin time (PT) (median 15.0 vs. 12.5s), myoglobin (median 2200.0 vs. 78.0 ng/mL), proteinuria (51.9% vs. 17.2% ≥ 1+), and urinary monocyte chemotactic protein-1 (MCP-1) (median 432.0 vs. 177.0 pg/mL), and subsequently developed AKI. As determined by multivariate logistic regression analysis, elevated leukocytes (>10 × 109/L) [OR 1.12 (95% CI 1.02-1.23)], high myoglobin (>1200 ng/mL) [OR 18.51 (95% CI 1.51-132.27)], and high urinary MCP-1 (>200 pg/mL) [OR 5.42 (95% CI 1.27-30.39)] on admission were independent risk factors for AKI. At admission, baseline values for ALT, aspartate aminotransferase (AST), LDH, CK-mb, APTT, PT, and proteinuria were higher for those who later died as well as for those who developed end-stage renal disease (ESRD). No patients without AKI died or developed ESRD. The present study explored the pathophysiology of AKI induced by wasp stings based on the findings of risk factors as well as factors related to outcomes. An understanding of AKI induced by wasp stings allows better treatment options and clinical management for wasp stings patients.
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Anti-Thrombotic, Anti-Oxidant and Haemolysis Activities of Six Edible Insect Species. Foods 2020; 9:foods9040401. [PMID: 32244589 PMCID: PMC7231258 DOI: 10.3390/foods9040401] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/29/2022] Open
Abstract
In Korea, various insect species such as crickets and grasshoppers, as well as honey bee and silkworm pupae, have been consumed as food and used in oriental medicine. In this study to evaluate useful the bioactivities and potentially adverse effects of edible insects, ethanol extracts of Allomyrina dichotoma (AD), Tenebrio molitor (TM), Protaetia brevitarsis (PB), Gryllus bimaculatus (GB), Teleogryllusemma (TE), and Apis mellifera (AM) were prepared and evaluated with regard to their anti-thrombosis, anti-oxidant and haemolysis activities against human red blood cells. AD and TE extracts showed strong anti-oxidant activities, which were not related to polyphenol content. All ethanol extracts, except AM extract, showed strong platelet aggregation activities. The platelet aggregation ratios of the extracts were 194%–246% of those of the solvent controls. The effects of the AD, TM, PB, GM, and AM extracts on thrombin, prothrombin and various coagulation factors were negligible. Only the extract of TM showed concentration-dependent anti-coagulation activities, with a 1.75-fold aPTT (activated Partial Thromboplastin Time) extension at 5 mg/mL. Of the six insect extracts, TM and AM extracts exhibited potent haemolytic activity. Our results on the insect extracts’ functional properties suggest that edible insects have considerable potential not just as a food source but as a novel bio-resource as well.
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Li L, Bo W, Chen H, XiaoWei L, Hongbao L, Peng Z. Hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings. Int J Artif Organs 2019; 43:143-149. [PMID: 31621466 DOI: 10.1177/0391398819881459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE This study aimed to evaluate the clinical effects of hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings and investigate its impacts on cytokines. METHODS A total of 12 patients with multiple organ failure after wasp stings admitted to Xijing Hospital were included in the present study between January 2017 and January 2019. All patients received hemoperfusion plus continuous veno-venous hemofiltration treatment in addition to conventional treatment after admission. Procedure of treatment was conducted as the following: hemoperfusion (2 h/day) and followed by continuous veno-venous hemofiltration (22 h/day) for at least 5 days. Patients' clinical features, serum laboratory tests, and hemodynamic variables were monitored. The blood samples were taken to measure the changes of plasma cytokines. RESULTS All 12 patients survived in the observation period. After hemoperfusion plus continuous veno-venous hemofiltration treatment, there were significant improvements in indicators of liver function, renal function, state of consciousness, and mediators in blood circulation, including alanine transaminase, aspartate transaminase, creatine kinase, blood urea nitrogen, serum creatinine, myoglobin, C-reactive protein, and so on. In these patients, acid-base metabolism returned to normal levels; Acute Physiology and Chronic Health Evaluation II score, Simplified Acute Physiology Score II score, and Sequential Organ Failure Assessment score lowered markedly. Furthermore, the plasma levels of interleukin 1β, interleukin 4, interleukin 6, interleukin 8, and interleukin 10 in these patients were significantly decreased; no significant change was shown in the level of tumor necrosis factor α. CONCLUSION Our results revealed that hemoperfusion plus continuous veno-venous hemofiltration was effective in the management of patients with multiple organ failure after wasp sting via the non-specific removal of the wasp venom and inflammatory cytokines.
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Affiliation(s)
- Li Li
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wang Bo
- Department of Clinical Epidemiology, Fourth Military Medical University, Xi'an, China
| | - Huang Chen
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Liu XiaoWei
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Liu Hongbao
- Department of Nephrology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhang Peng
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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