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Dehghani R, Monzavi SM, Mehrpour O, Shirazi FM, Hassanian-Moghaddam H, Keyler DE, Wüster W, Westerström A, Warrell DA. Medically important snakes and snakebite envenoming in Iran. Toxicon 2023; 230:107149. [PMID: 37187227 DOI: 10.1016/j.toxicon.2023.107149] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
Snakebite is a common health condition in Iran with a diverse snake fauna, especially in tropical southern and mountainous western areas of the country with plethora of snake species. The list of medically important snakes, circumstances and effects of their bite, and necessary medical care require critical appraisal and should be updated regularly. This study aims to review and map the distributions of medically important snake species of Iran, re-evaluate their taxonomy, review their venomics, describe the clinical effects of envenoming, and discuss medical management and treatment, including the use of antivenom. Nearly 350 published articles and 26 textbooks with information on venomous and mildly venomous snake species and snakebites of Iran, were reviewed, many in Persian (Farsi) language, making them relatively inaccessible to an international readership. This has resulted in a revised updated list of Iran's medically important snake species, with taxonomic revisions of some, compilation of their morphological features, remapping of their geographical distributions, and description of species-specific clinical effects of envenoming. Moreover, the antivenom manufactured in Iran is discussed, together with treatment protocols that have been developed for the hospital management of envenomed patients.
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Affiliation(s)
- Ruhollah Dehghani
- Department of Environmental Health, Kashan University of Medical Sciences, Kashan, Iran; Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Seyed Mostafa Monzavi
- Medical Toxicology Center, Mashhad University of Medical Sciences, Mashhad, Iran; Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Mehrpour
- Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran; Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA.
| | - Farshad M Shirazi
- Arizona Poison and Drug Information Center, University of Arizona, Tucson, AZ, USA
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Daniel E Keyler
- Department of Experimental & Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Wolfgang Wüster
- Molecular Ecology and Evolution at Bangor, School of Natural Sciences, Bangor University, Bangor, UK
| | | | - David A Warrell
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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A case of envenoming by a Persian false-horned viper Pseudocerastes persicus (Duméril, Bibron & Duméril, 1854) (Serpentes: Viperidae) in Southeastern Iran. Toxicon 2023; 223:107009. [PMID: 36586490 DOI: 10.1016/j.toxicon.2022.107009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
Despite the wide distribution of the Persian false-horned viper (Pseudocerastes persicus) in the Middle East, few identified bites have been reported. A 33-year-old herpetologist bitten on the hand by Pseudocerastes persicus in Kerman Province, Southeastern Iran, developed local pain and extensive swelling with mild non-specific systemic symptoms and minimal laboratory evidence of systemic envenoming.
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op den Brouw B, Coimbra FCP, Bourke LA, Huynh TM, Vlecken DHW, Ghezellou P, Visser JC, Dobson JS, Fernandez-Rojo MA, Ikonomopoulou MP, Casewell NR, Ali SA, Fathinia B, Hodgson WC, Fry BG. Extensive Variation in the Activities of Pseudocerastes and Eristicophis Viper Venoms Suggests Divergent Envenoming Strategies Are Used for Prey Capture. Toxins (Basel) 2021; 13:112. [PMID: 33540884 PMCID: PMC7913145 DOI: 10.3390/toxins13020112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 11/28/2022] Open
Abstract
Snakes of the genera Pseudocerastes and Eristicophis (Viperidae: Viperinae) are known as the desert vipers due to their association with the arid environments of the Middle East. These species have received limited research attention and little is known about their venom or ecology. In this study, a comprehensive analysis of desert viper venoms was conducted by visualising the venom proteomes via gel electrophoresis and assessing the crude venoms for their cytotoxic, haemotoxic, and neurotoxic properties. Plasmas sourced from human, toad, and chicken were used as models to assess possible prey-linked venom activity. The venoms demonstrated substantial divergence in composition and bioactivity across all experiments. Pseudocerastes urarachnoides venom activated human coagulation factors X and prothrombin and demonstrated potent procoagulant activity in human, toad, and chicken plasmas, in stark contrast to the potent neurotoxic venom of P. fieldi. The venom of E. macmahonii also induced coagulation, though this did not appear to be via the activation of factor X or prothrombin. The coagulant properties of P. fieldi and P. persicus venoms varied among plasmas, demonstrating strong anticoagulant activity in the amphibian and human plasmas but no significant effect in that of bird. This is conjectured to reflect prey-specific toxin activity, though further ecological studies are required to confirm any dietary associations. This study reinforces the notion that phylogenetic relatedness of snakes cannot readily predict venom protein composition or function. The significant venom variation between these species raises serious concerns regarding antivenom paraspecificity. Future assessment of antivenom is crucial.
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Affiliation(s)
- Bianca op den Brouw
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia; (F.C.P.C.); (L.A.B.); (J.C.V.); (J.S.D.)
| | - Francisco C. P. Coimbra
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia; (F.C.P.C.); (L.A.B.); (J.C.V.); (J.S.D.)
| | - Lachlan A. Bourke
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia; (F.C.P.C.); (L.A.B.); (J.C.V.); (J.S.D.)
| | - Tam Minh Huynh
- Monash Venom Group, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, VIC 3800, Australia; (T.M.H.); (W.C.H.)
| | - Danielle H. W. Vlecken
- Department of Animal Science and Health, Institute of Biology Leiden, 2333 BE Leiden, The Netherlands;
| | - Parviz Ghezellou
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, 1983969411 Tehran, Iran;
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Jeroen C. Visser
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia; (F.C.P.C.); (L.A.B.); (J.C.V.); (J.S.D.)
| | - James S. Dobson
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia; (F.C.P.C.); (L.A.B.); (J.C.V.); (J.S.D.)
| | - Manuel A. Fernandez-Rojo
- Madrid Institute for Advanced Studies in Food, E28049 Madrid, Spain; (M.A.F.-R.); (M.P.I.)
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Maria P. Ikonomopoulou
- Madrid Institute for Advanced Studies in Food, E28049 Madrid, Spain; (M.A.F.-R.); (M.P.I.)
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Nicholas R. Casewell
- Centre for Snakebite Research & Interventions, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
| | - Syed A. Ali
- HEJ Research Institute of Chemistry, International Centre for Chemical and Biological Sciences (ICCBS), University of Karachi, Karachi 75270, Pakistan;
| | - Behzad Fathinia
- Department of Biology, Faculty of Science, Yasouj University, 75914 Yasouj, Iran;
| | - Wayne C. Hodgson
- Monash Venom Group, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, VIC 3800, Australia; (T.M.H.); (W.C.H.)
| | - Bryan G. Fry
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia; (F.C.P.C.); (L.A.B.); (J.C.V.); (J.S.D.)
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Yousefi M, Kafash A, Khani A, Nabati N. Applying species distribution models in public health research by predicting snakebite risk using venomous snakes' habitat suitability as an indicating factor. Sci Rep 2020; 10:18073. [PMID: 33093515 PMCID: PMC7582189 DOI: 10.1038/s41598-020-74682-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/05/2020] [Indexed: 12/29/2022] Open
Abstract
Snakebite envenoming is an important public health problem in Iran, despite its risk not being quantified. This study aims to use venomous snakes' habitat suitability as an indicator of snakebite risk, to identify high-priority areas for snakebite management across the country. Thus, an ensemble approach using five distribution modelling methods: Generalized Boosted Models, Generalized Additive Models, Maximum Entropy Modelling, Generalized Linear Models, and Random Forest was applied to produce a spatial snakebite risk model for Iran. To achieve this, four venomous snakes' habitat suitability (Macrovipera lebetinus, Echis carinatus, Pseudocerastes persicus and Naja oxiana) were modelled and then multiplied. These medically important snakes are responsible for the most snakebite incidents in Iran. Multiplying habitat suitability models of the four snakes showed that the northeast of Iran (west of Khorasan-e-Razavi province) has the highest snakebite risk in the country. In addition, villages that were at risk of envenoming from the four snakes were identified. Results revealed that 51,112 villages are at risk of envenoming from M. lebetinus, 30,339 from E. carinatus, 51,657 from P. persicus and 12,124 from N. oxiana. Precipitation seasonality was identified as the most important variable influencing distribution of the P. persicus, E. carinatus and M. lebetinus in Iran. Precipitation of the driest quarter was the most important predictor of suitable habitats of the N. oxiana. Since climatic variables play an important role in shaping the distribution of the four venomous snakes in Iran, thus their distribution may alter with changing climate. This paper demonstrates application of species distribution modelling in public health research and identified potential snakebite risk areas in Iran by using venomous snakes' habitat suitability models as an indicating factor. Results of this study can be used in snakebite and human-snake conflict management in Iran. We recommend increasing public awareness of snakebite envenoming and education of local people in areas which identified with the highest snakebite risk.
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Affiliation(s)
- Masoud Yousefi
- Department of Environmental Science, Faculty of Natural Resources, University of Tehran, Karaj, Iran
| | - Anooshe Kafash
- Department of Environmental Science, Faculty of Natural Resources, University of Tehran, Karaj, Iran.
| | - Ali Khani
- Khorasan-e-Razavi Provincial Office of the Department of the Environment, Mashhad, Iran
| | - Nima Nabati
- Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Carné A, Fathinia B, Rastegar-Pouyani E. Molecular phylogeny of the Arabian Horned Viper, Cerastes gasperettii (Serpentes: Viperidae) in the Middle East. ZOOLOGY IN THE MIDDLE EAST 2020. [DOI: 10.1080/09397140.2020.1711622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Behzad Fathinia
- Department of Biology, Faculty of Science, Yasouj University, Yasouj, Iran
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