1
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de Oliveira D, Luiz GP, Scussel R, Fagundes MI, Galvani NC, Abel JDS, Zaccaron RP, de Bem Silveira G, de Andrade TAM, Lock Silveira PC, Andrez Machado-de-Ávila R. The combined treatment of gold nanoparticles associated with photobiomodulation accelerate the healing of dermonecrotic lesion. J Drug Target 2024; 32:172-185. [PMID: 38155427 DOI: 10.1080/1061186x.2023.2298848] [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: 10/24/2023] [Accepted: 12/10/2023] [Indexed: 12/30/2023]
Abstract
Introduction: The search for fast and efficient treatment for dermonecrotic lesions caused by the venom of the spider from the Loxosceles simillis, is a demand in health. Prednisolone is one of the most used drugs, however it has side effects. In this context, addictionally gold nanoparticles (GNPs) have anti-inflammatory, antioxidant, and antibacterial properties. The use of photobiomodulation has show to be efficient in the process of tissue repair. Therefore, the purpose of this study was to investigate the anti-inflammatory effect of photobiomodulation and GNPs associated or not with a low concentration of prednisolone in animal models of dermonecrotic lesion.Methodology: For this, rabbits with venon-induced dermonecrotic lesion were subjected to topical treatment with prednisolone + laser or GNPs + laser or Pred-GNPs + laser. The area of edema, necrosis and erythema were measured. On the last day of treatment, the animals were euthanized to remove the organs for histopathological and biochemical analysis.Results: All treatments combinations were effective in promoting the reduction of necrotic tissue and erythema.Conclusion: With this results, we suggest that the use of laser and nanoparticles, associated or not with prednisolone, should be considered for the treatment of dermonecrotic injury.
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Affiliation(s)
- Daysiane de Oliveira
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Gabriel Paulino Luiz
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Rahisa Scussel
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Mirian Ivens Fagundes
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Nathália Coral Galvani
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Jessica da Silva Abel
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Rubya Pereira Zaccaron
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Gustavo de Bem Silveira
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Thiago Antônio Moretti de Andrade
- Postgraduate in Biomedical Sciences, University Center of Herminio Ometto Foundation, Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
| | - Paulo Cesar Lock Silveira
- Postgraduate in Health Sciences, Universidade do Extremo Sul de Catarinense, Criciúma, Santa Catarina, Brazil
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Moreno-Cordova EN, Alvarez-Armenta A, Garcia-Orozco KD, Arvizu-Flores AA, Islas-Osuna MA, Robles-Zepeda RE, Lopez-Zavala AA, Laino A, Sotelo-Mundo RR. Binding of green tea epigallocatechin gallate to the arginine kinase active site from the brown recluse spider ( Loxosceles laeta): A potential synergist to chemical pesticides. Heliyon 2024; 10:e34036. [PMID: 39071691 PMCID: PMC11282998 DOI: 10.1016/j.heliyon.2024.e34036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024] Open
Abstract
Loxosceles spp. spiders can cause serious public health issues. Chemical control is commonly used, leading to health and environmental problems. Identifying molecular targets and using them with natural compounds can help develop safer and eco-friendlier biopesticides. We studied the kinetics and predicted structural characteristics of arginine kinase (EC 2.7.3.3) from Loxosceles laeta (LlAK), a key enzyme in the energy metabolism of these organisms. Additionally, we explored (-)-epigallocatechin gallate (EGCG), a green tea flavonoid, as a potential lead compound for the LlAK active site through fluorescence and in silico analysis, such as molecular docking and molecular dynamics (MD) simulation and MM/PBSA analyses. The results indicate that LlAK is a highly efficient enzyme (K m Arg 0.14 mM, K m ATP 0.98 mM, k cat 93 s-1, k cat/K m Arg 630 s-1 mM-1, k cat/K m ATP 94 s-1 mM-1), which correlates with its structure similarity to others AKs (such as Litopenaeus vannamei, Polybetes pythagoricus, and Rhipicephalus sanguineus) and might be related to its important function in the spider's energetic metabolism. Furthermore, the MD and MM/PBSA analysis suggests that EGCG interacted with LlAK, specifically at ATP/ADP binding site (RMSD <1 nm) and its interaction is energetically favored for its binding stability (-40 to -15 kcal/mol). Moreover, these results are supported by fluorescence quenching analysis (K d 58.3 μM and K a 1.71 × 104 M-1). In this context, LlAK is a promising target for the chemical control of L. laeta, and EGCG could be used in combination with conventional pesticides to manage the population of Loxosceles species in urban areas.
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Affiliation(s)
- Elena N. Moreno-Cordova
- Laboratorio de Estructura Biomolecular, Centro de Investigación en Alimentación y Desarrollo, A. C., Hermosillo, Sonora, Mexico
| | - Andres Alvarez-Armenta
- Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Avenida Universidad 2001, Cuernavaca, Morelos, 62210, Mexico
| | - Karina D. Garcia-Orozco
- Laboratorio de Estructura Biomolecular, Centro de Investigación en Alimentación y Desarrollo, A. C., Hermosillo, Sonora, Mexico
| | - Aldo A. Arvizu-Flores
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Maria A. Islas-Osuna
- Laboratorio de Biología Molecular de Plantas, Centro de Investigación en Alimentación y Desarrollo, A. C., Hermosillo, Sonora, Mexico
| | - Ramon E. Robles-Zepeda
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Alonso A. Lopez-Zavala
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Aldana Laino
- Instituto de Investigaciones Bioquímicas de La Plata “Prof. Dr. Rodolfo R. Brenner” (INIBIOLP), Centro Científico Tecnológico – La Plata CONICET- Univerdad Nacional de La Plata, La Plata, Argentina
| | - Rogerio R. Sotelo-Mundo
- Laboratorio de Estructura Biomolecular, Centro de Investigación en Alimentación y Desarrollo, A. C., Hermosillo, Sonora, Mexico
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3
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Mai D, Muthukumarasamy N, Ford B, Sekar P. Systemic loxoscelism leading to autoimmune haemolytic anaemia in a healthy young adult. BMJ Case Rep 2024; 17:e260045. [PMID: 39002955 DOI: 10.1136/bcr-2024-260045] [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] [Indexed: 07/15/2024] Open
Abstract
The brown recluse spider (Loxosceles reclusa) is endemic to the southcentral Midwest and the Southern United States. A bite from a brown recluse spider may result in symptoms that range from local skin necrosis to systemic complications such as acute haemolytic anaemia, disseminated intravascular coagulopathy, rhabdomyolysis and death. Although rare, systemic loxoscelism is a clinical diagnosis of exclusion that should be considered in a patient with acute autoimmune haemolytic anaemia. We describe a case of a young man with autoimmune haemolytic anaemia secondary to systemic loxoscelism successfully treated with intravenous immunoglobulin and steroids.
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Affiliation(s)
- Daniel Mai
- Internal Medicine, University of Iowa Health Care, Iowa City, Iowa, USA
| | | | - Bradley Ford
- Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Poorani Sekar
- Infectious Disease, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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4
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Bisneto PF, Vilhena da Silva Neto A, Mota Cordeiro JS, Monteiro WM, de Almeida Gonçalves Sachett J. Does Covid-19 influence the dynamics of envenomation by animals in a country strongly affected by both conditions? Epidemiological data from Brazil. Toxicon 2024; 244:107776. [PMID: 38795850 DOI: 10.1016/j.toxicon.2024.107776] [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: 12/08/2023] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 05/28/2024]
Abstract
The impact of Covid-19 on envenomations by venomous animals in countries heavily affected by both conditions has not been quantified yet. Brazil shows high incidence of envenomations by scorpions, spiders and snakes and was heavily affected by waves of Covid-19. To determine how the pandemic impacted the epidemiology of envenomations by those three groups of venomous animals, we used online databases from two surveillance sources on number of cases and mortality. During the years before and during the pandemic, scorpion stings typically occurred in adults of both sexes in urban zones in the Southeast and Northeast regions. Spider bites occurred mainly in the South region, in adults of both sexes in urban zone. Snakebites affected mainly rural adult men in the Amazon. Between 2007 and 2021, overall incidence of cases by scorpions, spiders and snakes decreased after the beginning of the pandemic, snakebites did not show changes after the pandemic started in Brazil, but cases by scorpions and spiders decreased. No changes in the incidence of deaths were observed. On national level, Covid-19 affected some demographic, clinical and epidemiological aspects in cases by scorpions, spiders and snakes.
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Affiliation(s)
- Pedro Ferreira Bisneto
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil; Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil.
| | - Alexandre Vilhena da Silva Neto
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Jady Shayenne Mota Cordeiro
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil
| | - Wuelton Marcelo Monteiro
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil; Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Jacqueline de Almeida Gonçalves Sachett
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Programa de Pós-Graduação em Medicina Tropical, Manaus, Amazonas, Brazil; Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Diretoria de Ensino e Pesquisa, Manaus, Amazonas, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
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5
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Okamoto CK, van den Berg CW, Pohl PC, Tambourgi DV. Role of the complement system in kidney cell death induced by Loxosceles venom Sphingomyelinases D. Arch Toxicol 2024; 98:1561-1572. [PMID: 38498159 DOI: 10.1007/s00204-024-03711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/20/2024] [Indexed: 03/20/2024]
Abstract
Envenomation by Loxosceles spiders can result in local and systemic pathologies. Systemic loxoscelism, which can lead to death, is characterized by intravascular hemolysis, platelet aggregation, and acute kidney injury. Sphingomyelinase D (SMase D) in Loxosceles spider venom is responsible for both local and systemic pathologies, and has been shown to induce metalloprotease activity. As the complement system is involved in many renal pathologies and is involved in hemolysis in systemic loxoscelism, the aim of this study was to investigate its role and the role of complement regulators and metalloproteases in an in vitro model of Loxosceles venom induced renal pathology. We investigated the effects of the venom/SMase D and the complement system on the HK-2 kidney cell line. Using cell viability assays, western blotting, and flow cytometry, we show that human serum, as a source of complement, enhanced the venom/SMase D induced cell death and the deposition of complement components and properdin. Inhibitors for ADAM-10 and ADAM-17 prevented the venom induced release of the of the complement regulator MCP/CD46 and reduced the venom/SMase D induced cell death. Our results show that the complement system can contribute to Loxosceles venom induced renal pathology. We therefore suggest that patients experiencing systemic loxoscelism may benefit from treatment with metalloproteinase inhibitors and complement inhibitors, but this proposition should be further analyzed in future pre-clinical and clinical assays.
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Affiliation(s)
| | - Carmen W van den Berg
- Department of Pharmacology, Therapeutics and Toxicology, School of Medicine, Cardiff University, Cardiff, UK
| | - Paula C Pohl
- Immunochemistry Laboratory, Instituto Butantan, São Paulo, Brazil
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6
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Sheta RV, Kolekar KK, Phulari YJ. Cutaneous Loxoscelism: A Potential Diagnosis. Indian J Dermatol 2024; 69:202. [PMID: 38841221 PMCID: PMC11149829 DOI: 10.4103/ijd.ijd_467_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Affiliation(s)
- Ruchi V Sheta
- From the Department of Dermatology, D.Y. Patil Medical College and Hospital, Kolhapur, Maharashtra, India E-mail:
| | - Ketan K Kolekar
- From the Department of Dermatology, D.Y. Patil Medical College and Hospital, Kolhapur, Maharashtra, India E-mail:
| | - Yoganand J Phulari
- From the Department of Dermatology, D.Y. Patil Medical College and Hospital, Kolhapur, Maharashtra, India E-mail:
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7
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Mani S, Katzman C, Liu V. Histopathology aiding diagnosis of viscerocutaneous loxoscelism in a nonendemic region. JAAD Case Rep 2024; 45:11-17. [PMID: 38333678 PMCID: PMC10847676 DOI: 10.1016/j.jdcr.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Affiliation(s)
- Smrithi Mani
- Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Charles Katzman
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Vincent Liu
- Departments of Dermatology and Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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8
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Martinez PA, Teixeira IBDF, Siqueira-Silva T, da Silva FFB, Lima LAG, Chaves-Silveira J, Olalla-Tárraga MÅ, Gutiérrez JM, Amado TF. Climate change-related distributional range shifts of venomous snakes: a predictive modelling study of effects on public health and biodiversity. Lancet Planet Health 2024; 8:e163-e171. [PMID: 38453382 DOI: 10.1016/s2542-5196(24)00005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/11/2023] [Accepted: 01/16/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Climate change is expected to have profound effects on the distribution of venomous snake species, including reductions in biodiversity and changes in patterns of envenomation of humans and domestic animals. We estimated the effect of future climate change on the distribution of venomous snake species and potential knock-on effects on biodiversity and public health. METHODS We built species distribution models based on the geographical distribution of 209 medically relevant venomous snake species (WHO categories 1 and 2) and present climatic variables, and used these models to project the potential distribution of species in 2070. We incorporated different future climatic scenarios into the model, which we used to estimate the loss and gain of areas potentially suitable for each species. We also assessed which countries were likely to gain new species in the future as a result of species crossing national borders. We integrated the species distribution models with different socioeconomic scenarios to estimate which countries would become more vulnerable to snakebites in 2070. FINDINGS Our results suggest that substantial losses of potentially suitable areas for the survival of most venomous snake species will occur by 2070. However, some species of high risk to public health could gain climatically suitable areas for habitation. Countries such as Niger, Namibia, China, Nepal, and Myanmar could potentially gain several venomous snake species from neighbouring countries. Furthermore, the combination of an increase in climatically suitable areas and socioeconomic factors (including low-income and high rural populations) means that southeast Asia and Africa (and countries including Uganda, Kenya, Bangladesh, India, and Thailand in particular) could have increased vulnerability to snakebites in the future, with potential effects on public human and veterinary health. INTERPRETATION Loss of venomous snake biodiversity in low-income countries will affect ecosystem functioning and result in the loss of valuable genetic resources. Additionally, climate change will create new challenges to public health in several low-income countries, particularly in southeast Asia and Africa. The international community needs to increase its efforts to counter the effects of climate change in the coming decades. FUNDING German Research Foundation, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, German Centre for Integrative Biodiversity Research, Ministerio de Ciencia e Innovación de España, European Regional Development Fund.
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Affiliation(s)
- Pablo Ariel Martinez
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil; Instituto de Cambio Global, Universidad Rey Juan Carlos, Madrid, Spain.
| | | | - Tuany Siqueira-Silva
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | | | - Luiz Antônio Gonzaga Lima
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Jonatas Chaves-Silveira
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | | | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Talita Ferreira Amado
- German Centre for Integrative Biodiversity Research, Leipzig, Germany; Institute of Biology, Leipzig University, Leipzig, Germany.
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Azuara-Antonio O, Isidoro Ortiz M, Jiménez-Oliver KD, Castillo-Cabrera M, Méndez-Salinas AK, Hernández-Ramírez L. Utilization of dapsone and hemoglobin in the epithelial skin regeneration therapy of cutaneous loxoscelism: A case report and integrative literature review. SAO PAULO MED J 2024; 142:e2023151. [PMID: 38422241 PMCID: PMC10885633 DOI: 10.1590/1516-3180.2023.0151.04012023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Loxosceles spp are arthropods found worldwide. Its bite may produce cutaneous loxoscelism (necrotic or edematous) or cutaneous-visceral loxoscelism. Depending on their severity and location, cutaneous forms are managed with local cold application and systemic administration of antihistamines, corticosteroids, antibiotics, polymorphonuclear inhibitors, and analgesics. OBJECTIVE This study aimed to report a case of cutaneous loxoscelism and to identify the main dermatological manifestations associated with the Loxosceles spp bite. DESIGN AND SETTING This case report and literature review was conducted in a Mexican university. METHODS A detailed report on the medical management of a patient with cutaneous loxoscelism treated at the emergency department of a public hospital was published. Scopus, PubMed, Web of Science, and Google Scholar databases were searched to identify articles reporting cutaneous loxoscelism. The following keywords were used during the database search: "loxoscelism" OR "spider bite," OR "loxosceles" OR "loxosceles species" OR "loxosceles venom" OR "loxoscelism case report" AND "cutaneous" OR "dermonecrotic arachnidism." RESULTS A 62-year-old female patient with cutaneous loxoscelism was treated with systemic dapsone and local heparin spray. Eighteen studies with 22 clinical cases were included in this systematic review. Of the 22 patients, 12 (54.5%) were men. L. rufescens was the predominant spider species. CONCLUSIONS The administration of dapsone and heparin for the management of cutaneous loxoscelism demonstrated success in this case, with no sequelae observed. In general, the literature review indicated favorable outcomes in patients treated with antimicrobials and corticosteroids, with continuous healing of skin lesions. SYSTEMATIC REVIEW REGISTRATION PROSPERO ID CRD42023422424 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023422424).
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Affiliation(s)
- Omar Azuara-Antonio
- MD. Physician, Medical staff, emergency department, general hospital de Pachuca. Pachuca, Hidalgo, Mexico; Subject teacher, Academic Field of Medicine, Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico
| | - Mario Isidoro Ortiz
- MD, PhD. Professor, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo. Pachuca, Hidalgo, Mexico
| | - Karla Daniela Jiménez-Oliver
- Medical student. Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo. Pachuca, Hidalgo, Mexico
| | - Marco Castillo-Cabrera
- MD. Physician, Medical staff, emergency department, general hospital de Pachuca. Pachuca, Hidalgo, Mexico
| | - Ana Karen Méndez-Salinas
- MD. Physician, Medical staff, emergency department, general hospital de Pachuca. Pachuca, Hidalgo, Mexico
| | - Luz Hernández-Ramírez
- MD. Physician, Medical staff, emergency department, general hospital de Pachuca. Pachuca, Hidalgo, Mexico
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10
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Fathallah N, Kenani Z, Mokni S, Gammoudi R, Slim R, Fetoui Ghariani N, Ghariani N, Ben Salem C, Ouni B, Denguezli M. Acute generalized exanthematous pustulosis: Analysis of cases managed in a Tunisian tertiary hospital. Therapie 2023:S0040-5957(23)00196-8. [PMID: 38142193 DOI: 10.1016/j.therap.2023.11.011] [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: 08/08/2023] [Revised: 11/01/2023] [Accepted: 11/28/2023] [Indexed: 12/25/2023]
Abstract
Acute generalized exanthematous pustulosis (AGEP) is a severe and life-threatening cutaneous adverse reaction. Drug-induced AGEP is mainly related to antibiotics. More recently, AGEP following spider bites has been increasingly described. Treatment includes withdrawal of the offending drug and supportive care. In Tunisia, data concerning severe cutaneous adverse reactions (SCARs) in general and especially AGEP is lacking. Herein, we conducted a retrospective study to investigate the epidemiological, clinical characteristics and etiologies of AGEP referred to the Dermatology department. Our study included 32 cases of AGEP. AGEP cases occurred in overall 8.9% of all SCARs referred to the department during the same period study. The majority were females (24 women and 7 men). The median age of the patients was 33 years. A history of psoriasis was reported in 16.1% of patients. All patients presented with an extensive erythematous rash with pinhead pustules. Neutrophil hyperleukocytosis (greater than 7000/mm3) was noted in 17 patients (63% of cases). It was associated with hypereosinophilia exceeding 500 elements/mm3 in 8 cases (29.6%). Drug-induced AGEP was reported in 53% of cases. Antibiotics were implicated in the majority of cases. Delay in onset ranged from 15hours to 7 days, with an average of 2.8 days. A non-drug-induced etiology was considered if the pharmacological investigation was negative, or if a clear non-drug trigger was found. It was retained in ten cases (48.4% of all observations). Spider bites were revealed in 8 cases. AGEP represents a severe, usually drug-related skin reaction. It is classified as a type IVd reaction mediating T cell-related sterile neutrophilic inflammatory response. It typically occurs within 24-48 h of ingestion of the offending drug. Antibiotics are the most common drug family to cause AGEP. Spider bites were involved in 25.8% of cases in our study, as important as antibiotic-induced AGEP. Analysis of the particularities of AGEP according to etiology, whether drug-induced or not, revealed the presence of an initial escarotic lesion (P=0.01) and the finding of blood hypereosinophilia (P=0.014) in the non-drug AGEP group were the distinguishing features. Blood hyperesoniophilia, more frequent in the non-drug AGEP group, suggests a pathophysiology probably different from that of the drug AGEP group. Clinicians should be aware of both etiologies. Our study focuses on the importance of AGEP associated with spider bite as a potential triggering factor in Tunisia.
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Affiliation(s)
- Neila Fathallah
- Faculty of Medicine of Sousse, Department of Pharmacology, University of Sousse, 4000 Sousse, Tunisia.
| | - Zied Kenani
- Department of Dermatology, Farhat Hached University Hospital, 4000 Sousse, Tunisia
| | - Sana Mokni
- Department of Dermatology, Farhat Hached University Hospital, 4000 Sousse, Tunisia
| | - Ryma Gammoudi
- Department of Dermatology, Farhat Hached University Hospital, 4000 Sousse, Tunisia
| | - Raoudha Slim
- Faculty of Medicine of Sousse, Department of Pharmacology, University of Sousse, 4000 Sousse, Tunisia
| | | | - Najet Ghariani
- Department of Dermatology, Farhat Hached University Hospital, 4000 Sousse, Tunisia
| | - Chaker Ben Salem
- Faculty of Medicine of Sousse, Department of Pharmacology, University of Sousse, 4000 Sousse, Tunisia
| | - Bouraoui Ouni
- Faculty of Medicine of Sousse, Department of Pharmacology, University of Sousse, 4000 Sousse, Tunisia
| | - Mohamed Denguezli
- Department of Dermatology, Farhat Hached University Hospital, 4000 Sousse, Tunisia
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11
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Caudill J, Chrisman T, Chen J, Zajac K, Simman R. Differential diagnosis of stage 2, 3 and 4 pressure injuries of the pelvis and lower extremity: a case series. J Wound Care 2023; 32:S22-S36. [PMID: 37682800 DOI: 10.12968/jowc.2023.32.sup9.s22] [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] [Indexed: 09/10/2023]
Abstract
Constant, unrelieved pressure of local tissue, particularly over bony prominences, may provoke damage that progresses to necrosis and pressure injury (PI). Differentiating PIs from conditions of similar appearance is imperative to minimising complications and implementing prompt treatment. This case series describes several conditions that may be mistaken for a PI. Outlined are the key differences in patient history, presentation and clinical cues that assist in correctly identifying the true pathology behind these conditions. Conditions reviewed included: pyoderma gangrenosum; necrotising fasciitis; genital herpes; Marjolin ulcer, Rosai-Dorfman disease; vascular disease; coagulopathies; calciphylaxis; trauma and surgical wounds; pilonidal cysts; graft-versus-host disease; hidradenitis suppurativa; Stevens-Johnson syndrome; epidermolysis bullosa; radiation wounds; spider bites; and end-of-life skin failure pressure ulcers (also known as Kennedy ulcers). Although commonly recognised and diagnosed, stage 2, 3 and 4 PIs occasionally prove to be difficult to pinpoint, with undefined characteristics and similarities in presentation to several other conditions. Therefore, it is clinically vital to be aware of their appearance, risk factors and aetiology in order to make an appropriate patient assessment and avoid misdiagnosis.
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Affiliation(s)
- Jennifer Caudill
- University of Toledo, College of Medicine and Life Science, Department of Surgery, Toledo, Ohio, US
| | - Tim Chrisman
- University of Toledo, College of Medicine and Life Science, Department of Surgery, Toledo, Ohio, US
| | - Joanna Chen
- University of Toledo, College of Medicine and Life Science, Department of Surgery, Toledo, Ohio, US
| | - Kelsee Zajac
- University of Toledo, College of Medicine and Life Science, Department of Surgery, Toledo, Ohio, US
| | - Richard Simman
- University of Toledo, College of Medicine and Life Science, Department of Surgery, Toledo, Ohio, US
- Jobst Vascular Institute, ProMedica Health Network, Toledo, Ohio, US
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12
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Ramesh R, Kanagasingam A, Anushanth U, Gunasinghe A, Suganthan N. A Case Report on Generalised Muscle Spasms After Ornamental Tarantula Bites That Responded Well to Intravenous Calcium Gluconate Treatment. Cureus 2023; 15:e43074. [PMID: 37692640 PMCID: PMC10483889 DOI: 10.7759/cureus.43074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/12/2023] Open
Abstract
Here, we present a case of a 55-year-old male, who was admitted with a spider bite, which caused swelling of the hand and painful muscle spasms along with palpitations. The patient made a complete recovery after the administration of intravenous calcium gluconate, followed by oral calcium supplements. Although no specific treatment exists in Sri Lanka for spider bites, calcium supplements can be beneficial for Sri Lankan ornamental tarantula (Poecilotheria fasciata) bites.
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13
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Rodríguez JA, Barredo-Vacchelli GR, Iglesias-García LC, Birocco AM, Blachman A, Calabrese GC, Acosta G, Albericio F, Camperi SA. Design and Synthesis of Peptides from Phoneutria nigriventer δ-Ctenitoxin-Pn2a for Antivenom Production. Int J Pept Res Ther 2023. [DOI: 10.1007/s10989-023-10491-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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14
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Cardoso FC, Walker AA, King GF, Gomez MV. Holistic profiling of the venom from the Brazilian wandering spider Phoneutria nigriventer by combining high-throughput ion channel screens with venomics. Front Mol Biosci 2023; 10:1069764. [PMID: 36865382 PMCID: PMC9972223 DOI: 10.3389/fmolb.2023.1069764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction: Spider venoms are a unique source of bioactive peptides, many of which display remarkable biological stability and neuroactivity. Phoneutria nigriventer, often referred to as the Brazilian wandering spider, banana spider or "armed" spider, is endemic to South America and amongst the most dangerous venomous spiders in the world. There are 4,000 envenomation accidents with P. nigriventer each year in Brazil, which can lead to symptoms including priapism, hypertension, blurred vision, sweating, and vomiting. In addition to its clinical relevance, P. nigriventer venom contains peptides that provide therapeutic effects in a range of disease models. Methods: In this study, we explored the neuroactivity and molecular diversity of P. nigriventer venom using fractionation-guided high-throughput cellular assays coupled to proteomics and multi-pharmacology activity to broaden the knowledge about this venom and its therapeutic potential and provide a proof-of-concept for an investigative pipeline to study spider-venom derived neuroactive peptides. We coupled proteomics with ion channel assays using a neuroblastoma cell line to identify venom compounds that modulate the activity of voltage-gated sodium and calcium channels, as well as the nicotinic acetylcholine receptor. Results: Our data revealed that P. nigriventer venom is highly complex compared to other neurotoxin-rich venoms and contains potent modulators of voltage-gated ion channels which were classified into four families of neuroactive peptides based on their activity and structures. In addition to the reported P. nigriventer neuroactive peptides, we identified at least 27 novel cysteine-rich venom peptides for which their activity and molecular target remains to be determined. Discussion: Our findings provide a platform for studying the bioactivity of known and novel neuroactive components in the venom of P. nigriventer and other spiders and suggest that our discovery pipeline can be used to identify ion channel-targeting venom peptides with potential as pharmacological tools and to drug leads.
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Affiliation(s)
- F. C. Cardoso
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia,Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, Brisbane, Australia,*Correspondence: F. C. Cardoso,
| | - A. A. Walker
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia,Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, Brisbane, Australia
| | - G. F. King
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia,Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, Brisbane, Australia
| | - M. V. Gomez
- Department of Neurotransmitters, Institute of Education and Research, Santa Casa, Belo Horizonte, Brazil
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15
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Chaves-Moreira D, Gremski LH, de Moraes FR, Vuitika L, Wille ACM, Hernández González JE, Chaim OM, Senff-Ribeiro A, Arni RK, Veiga SS. Brown Spider Venom Phospholipase-D Activity upon Different Lipid Substrates. Toxins (Basel) 2023; 15:toxins15020109. [PMID: 36828423 PMCID: PMC9965952 DOI: 10.3390/toxins15020109] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
Brown spider envenomation results in dermonecrosis, characterized by an intense inflammatory reaction. The principal toxins of brown spider venoms are phospholipase-D isoforms, which interact with different cellular membrane components, degrade phospholipids, and generate bioactive mediators leading to harmful effects. The Loxosceles intermedia phospholipase D, LiRecDT1, possesses a loop that modulates the accessibility to the active site and plays a crucial role in substrate. In vitro and in silico analyses were performed to determine aspects of this enzyme's substrate preference. Sphingomyelin d18:1/6:0 was the preferred substrate of LiRecDT1 compared to other Sphingomyelins. Lysophosphatidylcholine 16:0/0:0 was preferred among other lysophosphatidylcholines, but much less than Sphingomyelin d18:1/6:0. In contrast, phosphatidylcholine d18:1/16:0 was not cleaved. Thus, the number of carbon atoms in the substrate plays a vital role in determining the optimal activity of this phospholipase-D. The presence of an amide group at C2 plays a key role in recognition and activity. In silico analyses indicated that a subsite containing the aromatic residues Y228 and W230 appears essential for choline recognition by cation-π interactions. These findings may help to explain why different cells, with different phospholipid fatty acid compositions exhibit distinct susceptibilities to brown spider venoms.
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Affiliation(s)
- Daniele Chaves-Moreira
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | - Luiza Helena Gremski
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | - Fábio Rogério de Moraes
- Department of Physics, Multi-User Center for Biomolecular Innovation, State University of São Paulo (UNESP), São Paulo 05315-970, Brazil
| | - Larissa Vuitika
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | - Ana Carolina Martins Wille
- Department of Structural and Molecular Biology, State University of Ponta Grossa (UEPG), Ponta Grossa 84030-900, Brazil
| | - Jorge Enrique Hernández González
- Department of Physics, Multi-User Center for Biomolecular Innovation, State University of São Paulo (UNESP), São Paulo 05315-970, Brazil
| | - Olga Meiri Chaim
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
- Department of Pharmacology, University of California San Diego, La Jolla, CA 92093, USA
| | - Andrea Senff-Ribeiro
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | - Raghuvir Krishnaswamy Arni
- Department of Physics, Multi-User Center for Biomolecular Innovation, State University of São Paulo (UNESP), São Paulo 05315-970, Brazil
| | - Silvio Sanches Veiga
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
- Correspondence: ; Tel.: +55-41-3361-1776
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Production and Functional Evaluation of Anti- Loxosceles Sera Raised by Immunizations of Rabbits with Mutated Recombinant Phospholipases-D. Biomedicines 2022; 11:biomedicines11010079. [PMID: 36672587 PMCID: PMC9856178 DOI: 10.3390/biomedicines11010079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/11/2022] [Accepted: 10/27/2022] [Indexed: 12/30/2022] Open
Abstract
Loxoscelism is the clinical condition triggered after the bite of spiders of the genus Loxosceles. The main species involved in accidents in South America are L. intermedia, L. laeta, and L. gaucho. The only specific treatment is the anti-Loxosceles serum produced with crude venoms. As phospholipases D (PLDs) trigger most of the effects observed in accidents, we developed and evaluated second-generation sera using mutated PLDs as antigens. Three isoforms of PLDs with site-directed mutations without biological activities were used for rabbit immunizations: D32A-E34A (L. gaucho), W230A (L. intermedia), and H12A-H47A (L. laeta). Sera were produced using crude venoms of three species of Loxosceles enriched with mutated recombinant PLDs (MIX) or using only mutated PLDs (REC). Immunizations stimulated the immune system from the second immunization with higher antibody production in the REC group. In vivo neutralization assays demonstrated that both sera reduced edema and dermonecrosis caused by Loxosceles intermedia crude venom. Follow-up of animals during the immunization protocols and in the neutralization assays demonstrated that the mutated proteins and the sera are safe. Results demonstrate the potential of using mutated recombinant PLDs in total or partial replacement of Loxosceles venoms in animal immunizations to produce anti-Loxosceles sera for treatments of Loxoscelism.
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17
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Gremski LH, da Justa HC, Polli NLC, Schluga PHDC, Theodoro JL, Wille ACM, Senff-Ribeiro A, Veiga SS. Systemic Loxoscelism, Less Frequent but More Deadly: The Involvement of Phospholipases D in the Pathophysiology of Envenomation. Toxins (Basel) 2022; 15:17. [PMID: 36668837 PMCID: PMC9864854 DOI: 10.3390/toxins15010017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 12/29/2022] Open
Abstract
Bites of Loxosceles spiders can lead to a set of clinical manifestations called loxoscelism, and are considered a public health problem in many regions. The signs and symptoms of loxoscelism are divided into cutaneous and systemic forms. The former is more frequent and includes signs of envenoming at the bite site or neighboring regions. Systemic loxoscelism, although much less frequent, is associated with complications, and can even lead to death. It may include intravascular hemolysis, acute renal failure, and thrombocytopenia. Loxosceles venoms are enriched with phospholipases D (PLDs), which are a family of isoforms found at intra-species and inter-species levels. Under experimental conditions, these enzymes reproduce the main clinical signs of loxoscelism, including an exacerbated inflammatory response at the bite site and dermonecrosis, as well as thrombocytopenia, intravascular hemolysis, and acute renal failure. The role of PLDs in cutaneous loxoscelism was described over forty years ago, when studies identified and purified toxins featured as sphingomyelinase D. More recently, the production of recombinant PLDs and discoveries about their structure and mechanism has enabled a deeper characterization of these enzymes. In this review, we describe these biochemical and functional features of Loxosceles PLDs that determine their involvement in systemic loxoscelism.
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Affiliation(s)
- Luiza Helena Gremski
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | - Hanna Câmara da Justa
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | | | | | - João Lucas Theodoro
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | - Ana Carolina Martins Wille
- Department of Structural, Molecular Biology and Genetics, State University of Ponta Grossa (UEPG), Ponta Grossa 84030-900, Brazil
| | - Andrea Senff-Ribeiro
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
| | - Silvio Sanches Veiga
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
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18
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Duggal J, Rao SS, Reddy SK. Acute necrotic arachnidism with necrotising fasciitis and recurrent pneumothorax. BMJ Case Rep 2022; 15:e253018. [PMID: 36423946 PMCID: PMC9693886 DOI: 10.1136/bcr-2022-253018] [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] [Indexed: 11/26/2022] Open
Abstract
A male infant presented with swelling of the left leg and fever. Over the next 2 days, the area developed fasciitis extending to the left thigh, abdomen, and lower chest. Meanwhile, the parents found a giant brown spider within the infant's cot belonging to the genus Loxosceles, otherwise called the brown recluse spider. The dermo-myonecrosis progressed to deeper tissues involving the lung parenchyma requiring invasive ventilation. CT of the thorax showed multiple pneumatoceles, and lung biopsy showed alveolar necrosis. The infant was treated with intravenous antibiotics and corticosteroids. We drained the pneumothoraces by thoracostomy and insertion of intercostal drainage tubes. The infant required respiratory support initially by conventional ventilation, which was escalated to high-frequency oscillatory ventilation. He had refractory hypoxaemia and died. This is the first fatal case of acute spider envenomation described in India. Spider envenomation must be considered in patients with sudden onset, rapidly progressive necrotising fasciitis unresponsive to antibiotic therapy.
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Affiliation(s)
- Jasleen Duggal
- Paediatrics, Nitte(Deemed to be University), KS Hegde Medical Academy, Mangalore, Karnataka, India
| | - Swathi Sunil Rao
- Pediatrics, Nitte(Deemed to be University), KS Hegde Medical Academy, Mangalore, Karnataka, India
| | - Shiva Kumar Reddy
- Paediatrics, Nitte(Deemed to be University), KS Hegde Medical Academy, Mangalore, Karnataka, India
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19
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Malaque CMS, Novaes CTG, Piorelli RO, Risk JY, Murad JC, Lara AN, Virgulino CC, Miyaji KT, Santoro ML. Impact of antivenom administration on the evolution of cutaneous lesions in loxoscelism: A prospective observational study. PLoS Negl Trop Dis 2022; 16:e0010842. [PMID: 36240248 PMCID: PMC9604982 DOI: 10.1371/journal.pntd.0010842] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 10/26/2022] [Accepted: 09/23/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Spiders of the genus Loxosceles are distributed throughout tropical and temperate regions worldwide. Loxosceles spp. bites may evolve to necrosis, with or without intravascular hemolysis. There is no consensus regarding the best treatment to prevent necrosis. The objective of this study was to evaluate the factors associated with the development of necrosis and the impact that antivenom administration has on the evolution of cutaneous loxoscelism. METHODOLOGY/PRINCIPAL FINDINGS This was a prospective observational study carried out at a referral center for envenoming. Over a 6-year period, we included 146 patients with a presumptive or definitive diagnosis of loxoscelism. Depending on the symptom severity, a polyvalent anti-arachnid antivenom was administered or not-in 74 cases (50.7%) and 72 cases (49.3%), respectively. Cutaneous and systemic manifestations were assessed at admission and weekly thereafter. Adverse reactions to the antivenom were also evaluated. Cutaneous loxoscelism was observed in 141 cases (96.6%), and the spider was identified in 29 (19.9%). The mean time from bite to antivenom administration was 41.6 ± 27.4 h. After discharge, 130 patients (90.9%) were treated with corticosteroids, antihistamines and analgesics being prescribed as needed. The probability of developing necrosis was significantly lower among the patients who were admitted earlier, as well as among those who received antivenom (p = 0.0245). Among the 74 patients receiving antivenom, early and delayed adverse reactions occurred in seven (9.5%) and four (5.4%), respectively. Local infection was observed only in three (2.3%) of the 128 patients for whom that information was available. CONCLUSIONS/SIGNIFICANCE Necrosis after a Loxosceles sp. bite appears to more common when hospital admission is delayed or when antivenom is not administered. In addition, the administration of a polyvalent anti-arachnid antivenom appears to be safe, with a relatively low rate of adverse reactions.
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Affiliation(s)
| | | | | | - Jose Y. Risk
- Hospital Vital Brazil, Instituto Butantan, São Paulo, Brazil
| | | | - Amanda N. Lara
- Hospital Vital Brazil, Instituto Butantan, São Paulo, Brazil
| | | | - Karina T. Miyaji
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo L. Santoro
- Laboratório de Fisiopatologia, Instituto Butantan, São Paulo, Brazil
- Escola Superior do Instituto Butantan (ESIB), Instituto Butantan, São Paulo, Brazil
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20
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Gómez-Muñoz E, Pérez-Úbeda MJ, Garríguez-Pérez D, Echevarría-Marín M, Gimeno MD, Marco F. Suspected Brown Recluse Spider Envenomation: Missed Diagnosis and Delayed Treatment of Loxoscelism: A Case Report. JBJS Case Connect 2022; 12:01709767-202212000-00025. [PMID: 36820835 DOI: 10.2106/jbjs.cc.22.00344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 09/14/2022] [Indexed: 02/24/2023]
Abstract
CASE We report the case of a previously healthy 51-year-old man who presented to our hospital after worsening clinical appearance of his left ring finger, despite antibiotics and previous surgical drainage for suspected abscess at an outside institution 3 weeks ago. He was admitted to our hospital for surgical debridement and decompression. After suspicion of cutaneous loxoscelism based on the clinical record and corticosteroid administration, the patient presented a favorable evolution. CONCLUSION Cutaneous loxoscelism caused by a spider bite is present in Europe, mainly in the Mediterranean area, and should be considered in cases of skin infections which do not respond to antibiotics.
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Affiliation(s)
- Eduardo Gómez-Muñoz
- Department of Orthopaedic Surgery and Traumatology, Clínico San Carlos Hospital, Madrid, Spain
| | - María José Pérez-Úbeda
- Department of Orthopaedic Surgery and Traumatology, Clínico San Carlos Hospital, Madrid, Spain
| | - Daniel Garríguez-Pérez
- Department of Orthopaedic Surgery and Traumatology, Clínico San Carlos Hospital, Madrid, Spain
| | - Marta Echevarría-Marín
- Department of Orthopaedic Surgery and Traumatology, Clínico San Carlos Hospital, Madrid, Spain
| | - María Dolores Gimeno
- Department of Orthopaedic Surgery and Traumatology, Clínico San Carlos Hospital, Madrid, Spain
| | - Fernando Marco
- Department of Orthopaedic Surgery and Traumatology, Clínico San Carlos Hospital, Madrid, Spain.,Department of Surgery, Complutense University, Madrid, Spain
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21
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Recker A, Patel S, Baus C, Wittler R, Jefferson M, Teran P, McClure A. A 14-Year-Old Boy With Neck Pain, Fevers, and Diffuse Erythematous Rash. Pediatrics 2022; 150:189552. [PMID: 36137984 DOI: 10.1542/peds.2022-056508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 11/24/2022] Open
Abstract
A previously healthy 14-year-old boy developed right-sided neck pain, tachycardia, a diffuse erythematous rash, and subjective fevers over 2 days. He sought medical attention in a local urgent care clinic, where he had a negative Sars-CoV-2 antigen test and was referred to the local emergency department (ED) for persistent tachycardia and further workup. After fluid resuscitation, his tachycardia was not improved, so he was admitted to the Pediatric Hospital Medicine Service. Physical examination showed large areas of erythema and erythroderma of multiple body sites, perioral sparing, increased erythema in flexor skin folds, posterior soft palate petechiae, and a white strawberry tongue. There was a small, tender lesion with surrounding erythema without discharge on his right neck thought to be a possible entry point for infection. Laboratory results showed thrombocytopenia, normal white blood cell count, normal hemoglobin concentration, absolute lymphopenia, and an elevated C-reactive protein (CRP) to 130 mg/L. He was started on intravenous fluids and antibiotics for a presumed infectious cause of the rash and laboratory findings. The next morning, an expanded diagnostic workup was undertaken including electrocardiogram, echocardiogram, ferritin, triglycerides, liver enzymes, lactate dehydrogenase (LDH), brain natriuretic peptide, coagulation studies, and fibrinogen. With treatment and supportive care, his tachycardia and energy improved, so he was discharged with oral antibiotics and follow-up with the Infectious Disease Clinic in 2 days. When seen in follow-up, he was immediately admitted to the hospital for worsening fatigue, tachycardia, and new findings that prompted multiple consultations, and transfer to pediatric critical care services.
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Affiliation(s)
- Anne Recker
- University of Kansas School of Medicine - Wichita, Wichita, Kansas
| | - Shivani Patel
- University of Kansas School of Medicine - Wichita, Wichita, Kansas
| | - Conner Baus
- University of Kansas School of Medicine - Wichita, Wichita, Kansas.,Wesley Children's Hospital, Wichita, Kansas
| | - Robert Wittler
- University of Kansas School of Medicine - Wichita, Wichita, Kansas.,Wesley Children's Hospital, Wichita, Kansas
| | - Melissa Jefferson
- University of Kansas School of Medicine - Wichita, Wichita, Kansas.,Wesley Children's Hospital, Wichita, Kansas
| | - Paul Teran
- University of Kansas School of Medicine - Wichita, Wichita, Kansas.,Wesley Children's Hospital, Wichita, Kansas
| | - Adam McClure
- University of Kansas School of Medicine - Wichita, Wichita, Kansas.,Wesley Children's Hospital, Wichita, Kansas
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22
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Thill VL, Moniz HA, Teglas MB, Wasley MJ, Feldman CR. Preying dangerously: black widow spider venom resistance in sympatric lizards. ROYAL SOCIETY OPEN SCIENCE 2022; 9:221012. [PMID: 36277837 PMCID: PMC9579766 DOI: 10.1098/rsos.221012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Lizards and spiders are natural adversaries, yet little is known of adaptations that lizards might possess for dealing with the venomous defences of spider prey. In the Western USA, two lizard species (Elgaria multicarinata and Sceloporus occidentalis) are sympatric with and predate western black widow spiders (Latrodectus hesperus). The consequences of black widow spider venom (BWSV) can be severe, and are well understood for mammals but unknown for reptiles. We evaluated potential resistance to BWSV in the lizards that consume black widows, and a potentially susceptible species (Uta stansburiana) known as prey of widows. We investigated BWSV effects on whole-animal performance (sprint) and muscle tissue at two venom doses compared with control injections. Sprint speed was not significantly decreased in E. multicarinata or S. occidentalis in any treatment, while U. stansburiana suffered significant performance reductions in response to BWSV. Furthermore, E. multicarinata showed minimal tissue damage and immune response, while S. occidentalis and U. stansburiana exhibited increased muscle damage and immune system infiltration in response to BWSV. Our data suggest predator-prey relationships between lizards and spiders are complex, possibly leading to physiological and molecular adaptations that allow some lizards to tolerate or overcome the dangerous defences of their arachnid prey.
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Affiliation(s)
- Vicki L. Thill
- Department of Biology, University of Nevada, Reno, NV 89557, USA
- Program in Ecology, Evolution and Conservation Biology, University of Nevada, Reno, NV 89557, USA
| | - Haley A. Moniz
- Department of Biology, University of Nevada, Reno, NV 89557, USA
- Program in Ecology, Evolution and Conservation Biology, University of Nevada, Reno, NV 89557, USA
| | - Mike B. Teglas
- Program in Ecology, Evolution and Conservation Biology, University of Nevada, Reno, NV 89557, USA
- Department of Agriculture, Veterinary and Rangeland Sciences, University of Nevada, Reno, NV 89557, USA
| | - McKenzie J. Wasley
- Department of Biology, University of Nevada, Reno, NV 89557, USA
- United States Fish and Wildlife Service, Klamath Falls Fish and Wildlife Office, Klamath Falls, OR 97602, USA
| | - Chris R. Feldman
- Department of Biology, University of Nevada, Reno, NV 89557, USA
- Program in Ecology, Evolution and Conservation Biology, University of Nevada, Reno, NV 89557, USA
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23
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Talib U, Abdelfattah AH, Talib M, Dawoud HA, Ayub N, Ayub S, Talib A. Brown Recluse Spider Bite Resulting in Coombs Negative Hemolytic Anemia in a Young Male Requiring Blood Transfusion. Cureus 2022; 14:e26574. [PMID: 35936160 PMCID: PMC9351826 DOI: 10.7759/cureus.26574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
Spider bites, including the bites of recluse spiders (Loxosceles, also known as brown spiders), usually lead to local symptoms; however, severe systemic symptoms have also been reported in the literature. Management of spider bites is based on symptoms. In severe cases involving the development of angioedema, hemolytic anemia, skin necrosis with superimposed bacterial infection or disseminated intravascular coagulation, antibiotics, steroids, blood transfusions, and plasma exchange may also play a role. We present a case of a brown recluse spider bite resulting in symptomatic hemolytic anemia and jaundice requiring blood transfusion.
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Le Roux G, Richard V, Larcher G, Sinno-Tellier S, Labadie M, de Haro L, Descatha A. Spider bites in France: Epidaemiology of cases occurring in 10 years in metropolitan France. MEDICAL AND VETERINARY ENTOMOLOGY 2022; 36:159-167. [PMID: 34910823 DOI: 10.1111/mve.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/18/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
Spiders are often wrongly designated as responsible for cutaneous eruptions. We aim to describe spider bites and the spider species implicated in metropolitan France. A retrospective observational study was conducted for all reported cases of spider bites from 2007 to 2018 extracted from the French Poison Control Centers (PCCs) information system, after exclusion of non-native spiders. We described identification of the spider, level of certainty of the bite, symptoms and severity of cases. 1194 cases of spider bites met the inclusion criteria. The average age of the patients was 36.9 ± 19.8 years. Identification of the species or at least that a spider was implicated was only possible in 346 cases (29.0%). Loxosceles were involved in 53 cases (4.4%), Latrodectus in 46 cases (3.9%) and Cheiracanthium in 35 cases (2.9%). In one third of cases, the involved spider was not known to be present where the bite occurred. Where most of the patients (n = 1111, 93%) reported at least one cutaneous symptom, most of the symptoms were neurological. The bite was considered proven in only 242 cases (20%). Despite the efforts of arachnologists to educate the public, the fear of spiders is still alive in France, where spider bite is rare with low severity and often unproven.
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Affiliation(s)
- Gaël Le Roux
- Centre Antipoison et Toxicovigilance Grand Ouest, Centre Hospitalier Universitaire, Angers, France
- Institut de Recherche en Santé, Environnement, Travail (IRSET, Inserm UMR_S 1085), Université d'Angers-Équipe ESTER, Angers, France
| | - Virginie Richard
- Centre Antipoison et Toxicovigilance Grand Ouest, Centre Hospitalier Universitaire, Angers, France
| | - Gérald Larcher
- Département d'Enseignements Pharmacie, Faculté de Santé, Université d'Angers, Angers, France
| | - Sandra Sinno-Tellier
- Direction des Alertes et des Vigilances Sanitaires, Agence Nationale de Sécurité Sanitaire de L'alimentation, de L'environnement et du Travail, Maisons-Alfort, France
| | - Magali Labadie
- Centre Antipoison et Toxicovigilance, Centre Hospitalier Universitaire, Bordeaux, France
| | - Luc de Haro
- Centre Antipoison et Toxicovigilance, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Alexis Descatha
- Centre Antipoison et Toxicovigilance Grand Ouest, Centre Hospitalier Universitaire, Angers, France
- Institut de Recherche en Santé, Environnement, Travail (IRSET, Inserm UMR_S 1085), Université d'Angers-Équipe ESTER, Angers, France
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Oranges T, Veraldi S, Granieri G, Fidanzi C, Janowska A, Dini V, Romanelli M. Parasites causing cutaneous wounds: Theory and practice from a dermatological point of view. Acta Trop 2022; 228:106332. [PMID: 35092728 DOI: 10.1016/j.actatropica.2022.106332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/27/2022]
Abstract
A wide range of parasites can infest open wounds, or cause wounds due to the effects of the infestation. Parasitic infestations can involve the skin and subcutaneous tissues, with various clinical manifestations. In case of cutaneous wounds related to infestations, protozoa, helminths and arthropods are the main groups of parasites involved and emerging new aspects have been recently reported. Treating the wound correctly is fundamental in these patients in order to reduce the development of pathological scars and prevent complications. In particular, a gentle debridement for devitalized/infested tissue removal, the appropriate use of topical antiseptics and dressings such as hydrogel, hydrocolloids and antimicrobial dressings can be useful to control superinfections, moisture balance, inflammation and to promote edge proliferation.
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Affiliation(s)
- Teresa Oranges
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy; Department of Pediatrics, Dermatology Unit, Meyer Children's University Hospital, Florence, Italy
| | - Stefano Veraldi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giammarco Granieri
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Cristian Fidanzi
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Valentina Dini
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Marco Romanelli
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy.
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Ferreira MD, Veiga SS, Dos Santos FA. Brown spider (Loxosceles sp.) bite and COVID-19: A case report. Toxicon 2022; 212:1-7. [PMID: 35346694 PMCID: PMC8957330 DOI: 10.1016/j.toxicon.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 01/03/2023]
Abstract
We present the case of a 32-year-old male patient hospitalized during the COVID-19 pandemic because of a Brown spider bite on his lower lip. The Brown spider accident occurred in southern Brazil; at hospital admission, the patient presented on his lip: edema, pustules, necrotic regions, and ulcerations. The patient complained of lower back pain, fever and dyspnea. Laboratory tests showed monocytosis, leukocytosis, neutrophilia, increased D-dimer levels, C-reactive protein, glutamate-pyruvate transaminase, delta bilirubin, creatine phosphokinase, procalcitonin, and fibrinogen. The patient was hospitalized and a multi-professional team carried out the treatment. The medical team diagnosed loxoscelism with moderate changes. The dentist treated the oral cavity. The patient began to develop nausea, vomiting, and desaturation episodes during hospitalization. A computed tomography of the chest was performed, which showed signs of viral infection. The RT-PCR test for COVID-19 was positive. The systemic conditions worsened (renal dysfunction, systemic inflammatory response, pulmonary complications). This condition may have resulted from the association of the two diseases (loxoscelism and COVID-19), leading to the patient's death. This case illustrates the difficulties and risks in treating patients with venomous animal accidents during the pandemic, and the importance of a multi-professional team in treating such cases.
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Affiliation(s)
- Marceli Dias Ferreira
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | | | - Fábio André Dos Santos
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil.
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Multitarget nociceptor sensitization by a promiscuous peptide from the venom of the King Baboon spider. Proc Natl Acad Sci U S A 2022; 119:2110932119. [PMID: 35074873 PMCID: PMC8812547 DOI: 10.1073/pnas.2110932119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 12/15/2022] Open
Abstract
The King Baboon spider, Pelinobius muticus, is a burrowing African tarantula. Its impressive size and appealing coloration are tempered by reports describing severe localized pain, swelling, itchiness, and muscle cramping after accidental envenomation. Hyperalgesia is the most prominent symptom after bites from P. muticus, but the molecular basis by which the venom induces pain is unknown. Proteotranscriptomic analysis of P. muticus venom uncovered a cysteine-rich peptide, δ/κ-theraphotoxin-Pm1a (δ/κ-TRTX-Pm1a), that elicited nocifensive behavior when injected into mice. In small dorsal root ganglion neurons, synthetic δ/κ-TRTX-Pm1a (sPm1a) induced hyperexcitability by enhancing tetrodotoxin-resistant sodium currents, impairing repolarization and lowering the threshold of action potential firing, consistent with the severe pain associated with envenomation. The molecular mechanism of nociceptor sensitization by sPm1a involves multimodal actions over several ion channel targets, including NaV1.8, KV2.1, and tetrodotoxin-sensitive NaV channels. The promiscuous targeting of peptides like δ/κ-TRTX-Pm1a may be an evolutionary adaptation in pain-inducing defensive venoms.
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Marchi FC, Mendes-Silva E, Rodrigues-Ribeiro L, Bolais-Ramos LG, Verano-Braga T. Toxinology in the proteomics era: a review on arachnid venom proteomics. J Venom Anim Toxins Incl Trop Dis 2022; 28:20210034. [PMID: 35291269 PMCID: PMC8893269 DOI: 10.1590/1678-9199-jvatitd-2021-0034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/01/2021] [Indexed: 11/22/2022] Open
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Venomous Snake and Spider Bites in Pregnancy. Obstet Gynecol Surv 2021; 76:760-767. [PMID: 34942652 DOI: 10.1097/ogx.0000000000000959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Importance Venomous snake and spider bites are relatively rare in the Unites States and even more so in the pregnant population. However, the impact of a venomous bite, also known as an envenomation, can be serious in a pregnant patient. Thus, providers in endemic and high-risk areas must be familiar with the management of envenomation in the pregnant population. Objective The purpose of this article is to review the current literature on the most common snake and spider envenomations in the United States, the effects of envenomation on maternal and fetal health, and the management of envenomation in pregnancy. Evidence Acquisition Original research articles, review articles, and guidelines on snake and spider envenomation were reviewed. Results Snake envenomation carries higher risks of maternal morbidity and fetal morbidity and mortality than spider envenomation. Although the data are limited, current literature suggests that both snake and spider antivenom can be used in the pregnant population without significant adverse outcomes. However, the risks of an adverse hypersensitivity reaction with antivenom administration should be weighed carefully with the benefits. Conclusions and Relevance The use of antivenom therapy in the symptomatic envenomated pregnant population is likely safe with the appropriate monitoring and follow-up. Knowledge of the indications for antivenom therapy and proper escalation of care are vital to optimizing maternal and fetal outcomes. More research is needed to determine the effects of both envenomation and antivenom therapy on the pregnant patient and their fetus.
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Simões GCS, Paladino Júnior JR, Simões AGS. Loxoscelism leading to penile necrosis. Rev Soc Bras Med Trop 2021; 54:e05162021. [PMID: 34932769 PMCID: PMC8687494 DOI: 10.1590/0037-8682-0516-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Gabriel Chahade Sibanto Simões
- Universidade Estadual de Campinas, Departamento de Cirurgia, Programa de Residência Médica em Área Básica Cirúrgica, Campinas, SP, Brasil
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Diochot S. Pain-related toxins in scorpion and spider venoms: a face to face with ion channels. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210026. [PMID: 34925480 PMCID: PMC8667759 DOI: 10.1590/1678-9199-jvatitd-2021-0026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
Pain is a common symptom induced during envenomation by spiders and scorpions.
Toxins isolated from their venom have become essential tools for studying the
functioning and physiopathological role of ion channels, as they modulate their
activity. In particular, toxins that induce pain relief effects can serve as a
molecular basis for the development of future analgesics in humans. This review
provides a summary of the different scorpion and spider toxins that directly
interact with pain-related ion channels, with inhibitory or stimulatory effects.
Some of these toxins were shown to affect pain modalities in different animal
models providing information on the role played by these channels in the pain
process. The close interaction of certain gating-modifier toxins with membrane
phospholipids close to ion channels is examined along with molecular approaches
to improve selectivity, affinity or bioavailability in vivo for
therapeutic purposes.
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Affiliation(s)
- Sylvie Diochot
- Institut de Pharmacologie Moléculaire et Cellulaire (IPMC), Centre National de la Recherche Scientifique (CNRS) UMR 7275 et Université Côte d'Azur (UCA), 06560 Valbonne, France. Institut de Pharmacologie Moléculaire et Cellulaire Centre National de la Recherche Scientifique Université Côte d'Azur Valbonne France
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A protective vaccine against the toxic activities following Brown spider accidents based on recombinant mutated phospholipases D as antigens. Int J Biol Macromol 2021; 192:757-770. [PMID: 34634338 DOI: 10.1016/j.ijbiomac.2021.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 11/24/2022]
Abstract
Accidents involving Brown spiders are reported throughout the world. In the venom, the major toxins involved in the deleterious effects are phospholipases D (PLDs). In this work, recombinant mutated phospholipases D from three endemic species medically relevant in South America (Loxosceles intermedia, L. laeta and L. gaucho) were tested as antigens in a vaccination protocol. In such isoforms, key amino acid residues involved in catalysis, magnesium-ion coordination, and binding to substrates were replaced by Alanine (H12A-H47A, E32A-D34A and W230A). These mutations eliminated the phospholipase activity and reduced the generation of skin necrosis and edema to residual levels. Molecular modeling of mutated isoforms indicated that the three-dimensional structures, topologies, and surface charges did not undergo significant changes. Mutated isoforms were recognized by sera against the crude venoms. Vaccination protocols in rabbits using mutated isoforms generated a serum that recognized the native PLDs of crude venoms and neutralized dermonecrosis and edema induced by L. intermedia venom. Vaccination of mice prevented the lethal effects of L. intermedia crude venom. Furthermore, vaccination of rabbits prevented the cutaneous lesion triggered by the three venoms. These results indicate a great potential for mutated recombinant PLDs to be employed as antigens in developing protective vaccines for Loxoscelism.
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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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Saavedra-Langer R, Costa TGF, Lima SA, Costal-Oliveira F, Martins CA, Machado-de-Ávila RA, Minozzo JC, Soccol VT, Guerra-Duarte C, Kalapothakis E, Chávez-Olórtegui C. A prokaryote system optimization for rMEPLox expression: A promising non-toxic antigen for Loxosceles antivenom production. Int J Biol Macromol 2021; 187:66-75. [PMID: 34246677 DOI: 10.1016/j.ijbiomac.2021.07.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Loxoscelism is the most dangerous araneism form in Brazil and antivenom therapy is the recommended treatment. Antivenom is produced by horse immunization with Loxosceles spider venom, which is toxic for the producer animal. Moreover, due to the high amount of venom required for horse hyperimmunization, new strategies for antigens obtention have been proposed. In this sense, our research group has previously produced a non-toxic recombinant multiepitopic protein derived from Loxosceles toxins (rMEPLox). rMEPLox was a successful immunogen, being able to induce the production of neutralizing antibodies, which could be used in the Loxoscelism treatment. However, rMEPLox obtention procedure requires optimization, as its production needs to be scaled up to suit antivenom manufacture. Therefore, an effective protocol development for rMEPlox production would be advantageous. To achieve this objective, we evaluated the influence of different cultivation conditions for rMEPLox optimum expression. The optimum conditions to obtain large amounts of rMEPlox were defined as the use of C43(DE3)pLysS as a host strain, 2xTY medium, 0.6 mM IPTG, biomass pre induction of OD600nm = 0.4 and incubation at 30 °C for 16 h. Following the optimized protocol, 39.84 mg/L of soluble rMEPLox was obtained and tested as immunogen. The results show that the obtained rMEPLox preserved the previously described immunogenicity, and it was able to generate antibodies that recognize different epitopes of the main Loxosceles venom toxins, which makes it a promising candidate for the antivenom production for loxoscelism treatment.
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Affiliation(s)
- Rafael Saavedra-Langer
- Departamentos de Bioquímica e Imunologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tamara G F Costa
- Departamentos de Bioquímica e Imunologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sabrina A Lima
- Departamentos de Bioquímica e Imunologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Costal-Oliveira
- Departamentos de Bioquímica e Imunologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Christina A Martins
- Departamentos de Bioquímica e Imunologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - João C Minozzo
- Centro de Pesquisa e Produção de Imunobiologicos of Paraná State (CPPI), Brazil
| | | | - Clara Guerra-Duarte
- Diretoria de Pesquisa e Desenvolvimento, Fundação Ezequiel Dias, 30510-010 Belo Horizonte, MG, Brazil
| | - Evanguedes Kalapothakis
- Genética, Ecologia e Evolução, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carlos Chávez-Olórtegui
- Departamentos de Bioquímica e Imunologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Cocks J, Chu S, Gamage L, Rossaye S, Schutz J, Soon AWC. Redback spider bites in children in South Australia: A 10-year review of antivenom effectiveness. Emerg Med Australas 2021; 34:230-236. [PMID: 34558205 DOI: 10.1111/1742-6723.13869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the South Australian paediatric redback spider bite experience and to examine the hypothesis that redback antivenom (RBAV) treatment in children is clinically effective. METHODS Retrospective chart review of all children under 18 years of age presenting to the EDs of the three major paediatric or mixed hospitals in Adelaide, South Australia, with a discharge diagnosis of redback spider envenomation between 1 January 2010 and 31 March 2020. The main outcome measures include: patient and bite demographics; presenting symptoms and signs; treatment provided; clinical effects at 2 h post RBAV administration on pain, diaphoresis, blood pressure, heart rate and systemic features; overall clinical impression of RBAV effectiveness and resolution of symptoms prior to discharge. RESULTS There were 256 patient encounters involving 235 patients. Latrodectism was described in one-third (34%) of the cases. Sixty-one patients received RBAV and in 57 (93%) patients the RBAV had good clinical effect. Two hours post RBAV administration, pain resolved in 71%, hypertension resolved in 62%, diaphoresis resolved in 43% and tachycardia resolved in 82%. There were no cases of urticaria or anaphylaxis and one case of serum sickness. CONCLUSIONS This retrospective review of redback spider envenomation in South Australian children over a 10-year period has demonstrated clinical effectiveness of RBAV in paediatric patients across all age groups, observed in both clinician perceived results and measurable outcomes. RBAV remains an effective treatment for redback envenomation in children.
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Affiliation(s)
- Jane Cocks
- Paediatric Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Simon Chu
- Emergency Department, Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - Lalith Gamage
- Paediatric Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Sasha Rossaye
- Paediatric Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Jacquie Schutz
- Paediatric Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Aun Woon Cindy Soon
- Paediatric Emergency Department, Flinders Medical Centre, Adelaide, South Australia, Australia
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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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Combi F, Papi S, Marchesini D, Andreotti A, Gambini A, Palma E, Tazzioli G. Uncommon differential diagnosis of a breast ulcer: a case study. J Wound Care 2021; 30:XIIi-XIIiv. [PMID: 34597171 DOI: 10.12968/jowc.2021.30.sup9a.xii] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Spider bites are common worldwide. Frequently symptoms resolve without any adverse outcome, but in rare cases the bite can cause severe morbidity. The most typical presentation of Mediterranean recluse spider (Loxosceles Rufescens) bite is a dermatonecrotic lesion of the skin (skin loxoscelism). When the only manifestation of a spider bite is an ulcerated skin lesion, clinical suspicion and differential diagnosis strongly depend on its site. We present the case of an ulcerated wound of the breast, diagnosed as a Mediterranean recluse spider bite. CASE PRESENTATION A 79-year-old woman presented a 10cm-wide soft tissue ulceration of her left breast. At first, the diagnostic hypothesis of an ulcerated cancer was ruled out. Two family members revealed a recent history of Mediterranean recluse spider bite and the same clinical diagnosis was made for our patient. A wide excision was performed, with complete resolution of symptoms. DISCUSSION No specific diagnostic criteria for spider bites are available. Diagnosis is usually clinical. Skin loxoscelism could be easily mistaken for cellulitis, various types of skin infections, cutaneous anthrax, vasculitis, scorpion sting, pyoderma gangrenosum, erythema migrans of Lyme disease or prurigo nodularis. A thorough anamnestic interview is fundamental to raise the diagnostic hypothesis. When possible, a biopsy is recommended and it is extremely important when the ulcer can mimic a cancer, as is the case in breast tissue. CONCLUSION We recommend a wide excision of the wound after failure of conservative treatment, in order to obtain local control and to perform histological examination on a more representative specimen.
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Affiliation(s)
- Francesca Combi
- hD Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Italy.,Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Italy
| | - Simona Papi
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Italy
| | - Denise Marchesini
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Italy.,General Surgery Residency Program, University of Modena and Reggio Emilia, Italy
| | - Alessia Andreotti
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Italy
| | - Anna Gambini
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Italy
| | - Enza Palma
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Italy
| | - Giovanni Tazzioli
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Italy
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Lüddecke T, Herzig V, von Reumont BM, Vilcinskas A. The biology and evolution of spider venoms. Biol Rev Camb Philos Soc 2021; 97:163-178. [PMID: 34453398 DOI: 10.1111/brv.12793] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/24/2022]
Abstract
Spiders are diverse, predatory arthropods that have inhabited Earth for around 400 million years. They are well known for their complex venom systems that are used to overpower their prey. Spider venoms contain many proteins and peptides with highly specific and potent activities suitable for biomedical or agrochemical applications, but the key role of venoms as an evolutionary innovation is often overlooked, even though this has enabled spiders to emerge as one of the most successful animal lineages. In this review, we discuss these neglected biological aspects of spider venoms. We focus on the morphology of spider venom systems, their major components, biochemical and chemical plasticity, as well as ecological and evolutionary trends. We argue that the effectiveness of spider venoms is due to their unprecedented complexity, with diverse components working synergistically to increase the overall potency. The analysis of spider venoms is difficult to standardize because they are dynamic systems, fine-tuned and modified by factors such as sex, life-history stage and biological role. Finally, we summarize the mechanisms that drive spider venom evolution and highlight the need for genome-based studies to reconstruct the evolutionary history and physiological networks of spider venom compounds with more certainty.
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Affiliation(s)
- Tim Lüddecke
- Department for Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Ohlebergsweg 12, Gießen, 35392, Germany.,LOEWE Centre for Translational Biodiversity Genomics (TBG), Senckenberganlage 25, Frankfurt am Main, 60325, Germany
| | - Volker Herzig
- GeneCology Research Centre, University of the Sunshine Coast, Sippy Downs, QLD, 4556, Australia.,School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, 4556, Australia
| | - Björn M von Reumont
- LOEWE Centre for Translational Biodiversity Genomics (TBG), Senckenberganlage 25, Frankfurt am Main, 60325, Germany.,Institute for Insect Biotechnology, Justus-Liebig University Giessen, Heinrich-Buff-Ring 26-32, Gießen, 35392, Germany
| | - Andreas Vilcinskas
- Department for Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Ohlebergsweg 12, Gießen, 35392, Germany.,LOEWE Centre for Translational Biodiversity Genomics (TBG), Senckenberganlage 25, Frankfurt am Main, 60325, Germany.,Institute for Insect Biotechnology, Justus-Liebig University Giessen, Heinrich-Buff-Ring 26-32, Gießen, 35392, Germany
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Gremski LH, Matsubara FH, da Justa HC, Schemczssen-Graeff Z, Baldissera AB, Schluga PHDC, Leite IDO, Boia-Ferreira M, Wille ACM, Senff-Ribeiro A, Veiga SS. Brown spider venom toxins: what are the functions of astacins, serine proteases, hyaluronidases, allergens, TCTP, serpins and knottins? J Venom Anim Toxins Incl Trop Dis 2021; 27:e20200188. [PMID: 34377142 PMCID: PMC8314928 DOI: 10.1590/1678-9199-jvatitd-2020-0188] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/09/2021] [Indexed: 12/27/2022] Open
Abstract
Accidents caused by the bites of brown spiders (Loxosceles) generate a clinical condition that often includes a threatening necrotic skin lesion near the bite site along with a remarkable inflammatory response. Systemic disorders such as hemolysis, thrombocytopenia, and acute renal failure may occur, but are much less frequent than the local damage. It is already known that phospholipases D, highly expressed toxins in Loxosceles venom, can induce most of these injuries. However, this spider venom has a great range of toxins that probably act synergistically to enhance toxicity. The other protein classes remain poorly explored due to the difficulty in obtaining sufficient amounts of them for a thorough investigation. They include astacins (metalloproteases), serine proteases, knottins, translationally controlled tumor proteins (TCTP), hyaluronidases, allergens and serpins. It has already been shown that some of them, according to their characteristics, may participate to some extent in the development of loxoscelism. In addition, all of these toxins present potential application in several areas. The present review article summarizes information regarding some functional aspects of the protein classes listed above, discusses the directions that could be taken to materialize a comprehensive investigation on each of these toxins as well as highlights the importance of exploring the full venom repertoire.
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Affiliation(s)
- Luiza Helena Gremski
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba, PR, Brazil
| | | | - Hanna Câmara da Justa
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba, PR, Brazil
| | | | | | | | | | | | - Ana Carolina Martins Wille
- Department of Molecular Structural Biology and Genetics, State University of Ponta Grossa (UEPG), Ponta Grossa, PR, Brazil
| | - Andrea Senff-Ribeiro
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba, PR, Brazil
| | - Silvio Sanches Veiga
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba, PR, Brazil
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40
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Gremski LH, Matsubara FH, Polli NLC, Antunes BC, Schluga PHDC, da Justa HC, Minozzo JC, Wille ACM, Senff-Ribeiro A, Veiga SS. Prospective Use of Brown Spider Venom Toxins as Therapeutic and Biotechnological Inputs. Front Mol Biosci 2021; 8:706704. [PMID: 34222343 PMCID: PMC8247472 DOI: 10.3389/fmolb.2021.706704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/04/2021] [Indexed: 11/20/2022] Open
Abstract
Brown spider (genus Loxosceles) venoms are mainly composed of protein toxins used for predation and defense. Bites of these spiders most commonly produce a local dermonecrotic lesion with gravitational spread, edema and hemorrhage, which together are defined as cutaneous loxoscelism. Systemic loxoscelism, such as hematological abnormalities and renal injury, are less frequent but more lethal. Some Loxosceles venom toxins have already been isolated and extensively studied, such as phospholipases D (PLDs), which have been recombinantly expressed and were proven to reproduce toxic activities associated to the whole venom. PLDs have a notable potential to be engineered and converted in non-toxic antigens to produce a new generation of antivenoms or vaccines. PLDs also can serve as tools to discover inhibitors to be used as therapeutic agents. Other Loxosceles toxins have been identified and functionally characterized, such as hyaluronidases, allergen factor, serpin, TCTP and knottins (ICK peptides). All these toxins were produced as recombinant molecules and are biologically active molecules that can be used as tools for the potential development of chemical candidates to tackle many medical and biological threats, acting, for instance, as antitumoral, insecticides, analgesic, antigens for allergy tests and biochemical reagents for cell studies. In addition, these recombinant toxins may be useful to develop a rational therapy for loxoscelism. This review summarizes the main candidates for the development of drugs and biotechnological inputs that have been described in Brown spider venoms.
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Affiliation(s)
| | | | | | - Bruno Cesar Antunes
- Department of Cell Biology, Federal University of Paraná, Curitiba, Brazil.,Production and Research Center of Immunobiological Products, State Department of Health, Piraquara, Brazil
| | | | | | - João Carlos Minozzo
- Production and Research Center of Immunobiological Products, State Department of Health, Piraquara, Brazil
| | - Ana Carolina Martins Wille
- Department of Structural, Molecular Biology and Genetics, State University of Ponta Grossa, Ponta Grossa, Brazil
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41
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Gutiérrez JM, Chippaux JP, Isbister GK. PLOS Neglected Tropical Diseases broadens its coverage of envenomings caused by animal bites and stings. PLoS Negl Trop Dis 2021; 15:e0009481. [PMID: 34138869 PMCID: PMC8211284 DOI: 10.1371/journal.pntd.0009481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- José María Gutiérrez
- Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Costa Rica
- * E-mail:
| | | | - Geoffrey K. Isbister
- Clinical Toxicology Research Group, University of Newcastle, Newcastle, New South Wales, Australia
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Dunbar JP, Vitkauskaite A, O'Keeffe DT, Fort A, Sulpice R, Dugon MM. Bites by the noble false widow spider Steatoda nobilis can induce Latrodectus-like symptoms and vector-borne bacterial infections with implications for public health: a case series. Clin Toxicol (Phila) 2021; 60:59-70. [PMID: 34039122 DOI: 10.1080/15563650.2021.1928165] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
CONTEXT In recent years, the Noble false widow spider Steatoda nobilis (Thorell, 1875) has expanded its range globally and may represent a potential threat to native ecosystems and public health. Increasing numbers in synanthropic habitats have led to more human encounters and envenomations. Steatoda nobilis bites were previously classed as medically significant with similarities to bites from true black widows of the genus Latrodectus but deemed milder in onset, with symptoms generally ranging from mild to moderate. CASE DETAILS In this manuscript we present 16 new cases of S. nobilis envenomations bringing the total number of confirmed cases reported in the literature to 24. We report new symptoms and provide discussion on the contributing factors to pathology following bites by S. nobilis. DISCUSSION We report a range of pathologies including necrosis, Latrodectus-like envenomation symptoms that include debilitating pain, tremors, fatigue, nausea, hypotension, and vectored bacterial infections including cellulitis and dermatitis. Symptoms ranged from mild to severe, requiring hospitalisation in some cases.
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Affiliation(s)
- John P Dunbar
- Venom Systems & Proteomics Lab, School of Natural Sciences, Ryan Institute, National University of Ireland Galway, Galway, Ireland
| | - Aiste Vitkauskaite
- Venom Systems & Proteomics Lab, School of Natural Sciences, Ryan Institute, National University of Ireland Galway, Galway, Ireland
| | - Derek T O'Keeffe
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Antoine Fort
- Plant Systems Biology Lab, School of Natural Sciences, Ryan Institute & MaREI Centre for Marine, Climate and Energy, National University of Ireland Galway, Galway, Ireland
| | - Ronan Sulpice
- Plant Systems Biology Lab, School of Natural Sciences, Ryan Institute & MaREI Centre for Marine, Climate and Energy, National University of Ireland Galway, Galway, Ireland
| | - Michel M Dugon
- Venom Systems & Proteomics Lab, School of Natural Sciences, Ryan Institute, National University of Ireland Galway, Galway, Ireland
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Schemczssen-Graeff Z, Justa HCD, Nowatzki J, Baldissera AB, Polli NLC, De-Bona E, Rossi IV, Ramirez MI, Minozzo JC, Matsubara FH, Senff-Ribeiro A, Gremski LH, Veiga SS. Description of a serpin toxin in Loxosceles (Brown spider) venoms: Cloning, expression in baculovirus-infected insect cells and functional characterization. Int J Biol Macromol 2021; 183:1607-1620. [PMID: 34029585 DOI: 10.1016/j.ijbiomac.2021.05.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022]
Abstract
Several classes of toxins are present in the venom of Brown spiders (Loxosceles genus), some of them are highly expressed and others are less expressed. In this work, we aimed to clone the sequence of a little expressed novel toxin from Loxosceles venom identified as a serine protease inhibitor (serpin), as well as to express and characterize its biochemical and biological properties. It was named LSPILT, derived from Loxoscelesserine protease inhibitor-like toxin. Multiple alignment analysis revealed high identity between LSPILT and other serpin molecules from spiders and crab. LSPILT was produced in baculovirus-infected insect cells, resulting in a 46-kDa protein fused to a His-tag. Immunological assays showed epitopes in LSPILT that resemble native venom toxins of Loxosceles spiders. The inhibitory activity of LSPILT on trypsin was found both by reverse zymography and fluorescent gelatin-degradation assay. Additionally, LSPILT inhibited the complement-dependent lysis of Trypanosoma cruzi epimastigotes, reduced thrombin-dependent clotting and suppressed B16-F10 melanoma cells migration. Results described herein prove the existence of conserved serpin-like toxins in Loxosceles venoms. The availability of a recombinant serpin enabled the determination of its biological and biochemical properties and indicates potential applications in future studies regarding the pathophysiology of the envenoming or for biotechnological purposes.
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Affiliation(s)
| | - Hanna Câmara da Justa
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81530-900, PR, Brazil
| | - Jenifer Nowatzki
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81530-900, PR, Brazil
| | | | | | - Elidiana De-Bona
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81530-900, PR, Brazil
| | - Izadora Volpato Rossi
- Department of Biochemistry, Federal University of Paraná, (UFPR), Curitiba 81530-900, PR, Brazil
| | - Marcel Ivan Ramirez
- Department of Biochemistry, Federal University of Paraná, (UFPR), Curitiba 81530-900, PR, Brazil; Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, RJ, Brazil
| | - João Carlos Minozzo
- Center for Production and Research of Immunobiological Products (CPPI), State Department of Health, Piraquara 83302-200, PR, Brazil
| | | | - Andrea Senff-Ribeiro
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81530-900, PR, Brazil
| | - Luiza Helena Gremski
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81530-900, PR, Brazil
| | - Silvio Sanches Veiga
- Department of Cell Biology, Federal University of Paraná (UFPR), Curitiba 81530-900, PR, Brazil.
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Brown Spiders' Phospholipases-D with Potential Therapeutic Applications: Functional Assessment of Mutant Isoforms. Biomedicines 2021; 9:biomedicines9030320. [PMID: 33801128 PMCID: PMC8004160 DOI: 10.3390/biomedicines9030320] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 12/18/2022] Open
Abstract
Phospholipases-D (PLDs) found in Loxosceles spiders' venoms are responsible for the dermonecrosis triggered by envenomation. PLDs can also induce other local and systemic effects, such as massive inflammatory response, edema, and hemolysis. Recombinant PLDs reproduce all of the deleterious effects induced by Loxosceles whole venoms. Herein, wild type and mutant PLDs of two species involved in accidents-L. gaucho and L. laeta-were recombinantly expressed and characterized. The mutations are related to amino acid residues relevant for catalysis (H12-H47), magnesium ion coordination (E32-D34) and binding to phospholipid substrates (Y228 and Y228-Y229-W230). Circular dichroism and structural data demonstrated that the mutant isoforms did not undergo significant structural changes. Immunoassays showed that mutant PLDs exhibit conserved epitopes and kept their antigenic properties despite the mutations. Both in vitro (sphingomyelinase activity and hemolysis) and in vivo (capillary permeability, dermonecrotic activity, and histopathological analysis) assays showed that the PLDs with mutations H12-H47, E32-D34, and Y228-Y229-W230 displayed only residual activities. Results indicate that these mutant toxins are suitable for use as antigens to obtain neutralizing antisera with enhanced properties since they will be based on the most deleterious toxins in the venom and without causing severe harmful effects to the animals in which these sera are produced.
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45
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BİLDİK F, ÇOMRUK B, YÜKSEK B, ASLANER MA, TÜRKEŞ T. Mediterranean black widow spider (Latrodectus tredecimguttatus) poisoning in a metropolitan city in Turkey. JOURNAL OF EMERGENCY MEDICINE CASE REPORTS 2021. [DOI: 10.33706/jemcr.837733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lopes PH, Fukushima CS, Shoji R, Bertani R, Tambourgi DV. Searching for the toxic potential of Loxosceles amazonica and Loxosceles willianilsoni spiders' venoms. Toxicon 2020; 191:1-8. [PMID: 33347860 DOI: 10.1016/j.toxicon.2020.12.006] [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: 09/26/2020] [Revised: 11/25/2020] [Accepted: 12/13/2020] [Indexed: 11/16/2022]
Abstract
The Loxosceles genus belongs to the Sicariidae family and it comprises species whose venom can cause accidents with potentially fatal consequences. We have previously shown that SMase D is the enzyme responsible for the main pathological effects of Loxosceles venom. Despite the severity of accidents with Loxosceles, few species are considered to be of medical importance. Little is known about the venom of non-synanthropic species that live in natural environments. To contribute to a better understanding about the venom's toxicity of Loxosceles genus, the aim of this study was to (i) characterize the toxic properties of Loxosceles amazonica from two different localities and a recent described cave species Loxosceles willianilsoni and (ii) compare these venoms with that from Loxosceles laeta, which is among the most toxic ones. We show here that both L. amazonica venoms (from the two studied locations) and L. willianilsoni presented SMase D activity similar to that exhibited by L. laeta venom. Although L. amazonica and L. willianilsoni venoms were able to induce complement dependent human erythrocytes lysis, they were not able to induce cell death of human keratinocytes, as promoted by L. laeta venom, in the concentrations tested. These results indicate that other species of Loxosceles, in addition to those classified as medically important, have toxic potential to cause accidents in humans, despite interspecific variations that denote possible less toxicity.
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Affiliation(s)
| | - Caroline Sayuri Fukushima
- Special Laboratory of Ecology and Evolution, Butantan Institute, São Paulo, Brazil; Finnish Museum of Natural History, University of Helsinki, Helsinki, Finland
| | - Rosana Shoji
- Immunochemistry Laboratory, Butantan Institute, São Paulo, Brazil
| | - Rogério Bertani
- Special Laboratory of Ecology and Evolution, Butantan Institute, São Paulo, Brazil
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Hauke TJ, Herzig V. Love bites - Do venomous arachnids make safe pets? Toxicon 2020; 190:65-72. [PMID: 33307110 DOI: 10.1016/j.toxicon.2020.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/30/2020] [Accepted: 12/06/2020] [Indexed: 12/21/2022]
Abstract
With a global estimate of tens of thousands of arachnid enthusiasts, spiders and scorpions are gaining increasing popularity as pets in industrialised countries in Europe, Northern America and Asia. As most spiders and all scorpions are venomous and due to their mostly negative image in the public media, several governments are already considering introducing legislation to regulate the domestic care of potentially dangerous captive animals. We aimed to investigate the circumstances and effects of exposure to arachnids kept in captivity. Thus, we collected and analysed data from 354 self-reported bites and stings attributed to pet arachnids. Our data revealed that on average there were less than 20 recorded envenomations per year with ~90% preventable by due care. We also categorized the severity of the resulting symptoms and found that the vast majority of symptoms were either local (60.7%) or minor (32.8%), 5.4% were asymptomatic, only 1.1% were severe and no fatalities were recorded. Based on our database of bite and sting reports, we performed a risk assessment for arachnid pet ownership and concluded that, with the proper care, arachnids can be safely kept as pets and pose a lower risk than many other recreational activities.
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Affiliation(s)
| | - Volker Herzig
- GeneCology Research Centre, School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, 4556, Australia.
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48
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Piscopo A, Massari F, Scicchitano P, Sanasi M, De Palo M, Caldarola P, Liccese M, Calculli G. Acute Myocarditis After Black Widow Spider Bite: A Case Report. Cardiol Ther 2020; 9:569-575. [PMID: 32462634 PMCID: PMC7584717 DOI: 10.1007/s40119-020-00178-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Indexed: 01/21/2023] Open
Abstract
The black widow spider (BWS) is a venomous spider whose bite can cause various clinical conditions that range from local damage to serious systemic complications, including death. Cases of myocarditis following a BWS bite are rare but they can be fatal on occasion. However, the prognostic significance of the bite and presentation of myocarditis is unknown. Our case involved a 50-year-old man who presented with myocarditis after being bitten by a BWS and subsequently admitted to the intensive care unit for cardiac monitoring. During the hospital stay, he showed worsening signs on both the electrocardiographic and echocardiographic evaluations despite therapeutic success. Subsequent cardiac magnetic resonance and coronary angiography investigations showed no significant alterations; blood and instrumental test results slowly improved, and the patient was discharged home after 12 days of hospitalization without complications. This case illustrates that acute myocarditis, although an infrequent complication of BWS bite, has the potential to be lethal. The correct diagnosis, which is not always easy to formulate, is important to identify those patients who can benefit from careful monitoring and specific therapies aimed at reducing the risk of life.
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Affiliation(s)
- A Piscopo
- Cardiology Unit, Hospital "F. Perinei", Bari Local Health Authority (ASL Bari), Altamura, Bari, BA, Italy
| | - F Massari
- Cardiology Unit, Hospital "F. Perinei", Bari Local Health Authority (ASL Bari), Altamura, Bari, BA, Italy
| | - P Scicchitano
- Cardiology Unit, Hospital "F. Perinei", Bari Local Health Authority (ASL Bari), Altamura, Bari, BA, Italy.
| | - M Sanasi
- Cardiology Unit, Hospital "F. Perinei", Bari Local Health Authority (ASL Bari), Altamura, Bari, BA, Italy
| | - M De Palo
- Cardiac Surgery Department, University of Bari, Bari, BA, Italy
| | - P Caldarola
- Cardiology Unit, Hospital "San Paolo, Bari Local Health Authority (ASL Bari), Bari, BA, Italy
| | - M Liccese
- Cardiology Unit, Hospital "Madonna Delle Grazie", Matera Local Health Authority (ASL Matera), Matera, MT, Italy
| | - G Calculli
- Cardiology Unit, Hospital "Madonna Delle Grazie", Matera Local Health Authority (ASL Matera), Matera, MT, Italy
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Molecular cloning and functional characterization of recombinant Loxtox from Loxosceles similis venom. Int J Biol Macromol 2020; 164:1112-1123. [PMID: 32702423 DOI: 10.1016/j.ijbiomac.2020.07.190] [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: 04/04/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 11/23/2022]
Abstract
Loxoscelism is a recognized public health problem in Brazil, but the venom from Loxosceles similis, which is widespread in Brazil due to its adaptability to the urban environment, remains poorly characterized. Loxtox is a family of phospholipase D enzymes (PLDs), which are the major components of Loxosceles venom and are responsible for the clinical effects of loxoscelism. Loxtox toxins correspond to 15% of L. similis venom gland transcripts, but the Loxtox family of L. similis has yet to be fully described. In this study, we cloned and functionally characterized recLoxtox s1A and recLoxtox s11A. These recombinant toxins exhibited different in vitro activities depending on pH, and recLoxtox s1A had more intense effects on rabbit skin than did recLoxtox s11A in vivo. Both recombinant toxins were used in immunization protocols, and mapping of their epitopes revealed different immunological reactions for the produced immune serums. Additionally, polyclonal antibodies raised against recLoxtox s1A had greater capacity to significantly reduce the in vitro and in vivo effects of L. similis venom. In summary, we obtained and characterized two novel Loxtox isoforms from L. similis venom, which may be valuable biotechnological and immunological tools against loxoscelism.
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50
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Justa HCD, Matsubara FH, de-Bona E, Schemczssen-Graeff Z, Polli NLC, de Mari TL, Boia-Ferreira M, Minozzo JC, Wille ACM, Senff-Ribeiro A, Gremski LH, Veiga SS. LALLT (Loxosceles Allergen-Like Toxin) from the venom of Loxosceles intermedia: Recombinant expression in insect cells and characterization as a molecule with allergenic properties. Int J Biol Macromol 2020; 164:3984-3999. [DOI: 10.1016/j.ijbiomac.2020.08.212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022]
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