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Yusuf AJ, Bugaje AI, Sadiq M, Salihu M, Adamu HW, Abdulrahman M. Exploring the inhibitory potential of phytochemicals from Vernonia glaberrima leaves against snake venom toxins through computational simulation and experimental validation. Toxicon 2024; 247:107838. [PMID: 38971473 DOI: 10.1016/j.toxicon.2024.107838] [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: 04/24/2024] [Revised: 06/13/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024]
Abstract
Phospholipase A2 (PLA2) is an enzyme present in appreciable quantity in snake venoms which catalyze the hydrolysis of glycerophospholipids at sn-2 position and promote the release of lysophospholipids and fatty acids. 5-methylcoumarin-4-β-glucoside (5MC4BG) and lupeol were previously isolated from the leaves of V. glaberrima. The aim of this research was to evaluate effect of these compounds as potential inhibitors of snake venom toxins of Naja nigricollis using an in vitro and in silico studies. Antisnake venom studies was conducted using acidimetry while the molecular docking analysis against PLA2 enzyme from N. nigricollis was performed using Auto Dock Vina and ADME-Tox analysis was evaluated using swissADME and ProTox-II online servers. The two compounds (5MC4BG and Lupeol) were able to inhibit the hydrolytic actions of PLA2 enzyme with percentage inhibition ranging from 23.99 to 72.36 % and 21.97-24.82 % at 0.0625-1.00 mg/mL respectively while the standard ASV had 82.63 % at 1.00 mg/mL after 10 min incubation at 37 °C. Similar effects were observed after 30 min incubation, although there was significant increase in percentage inhibition of 5MC4BG and lupeol ranging from 66.51 to 83.73 % and 54.87-59.60 % at similar concentrations. Furthermore, the compounds were able to bind to the active site of PLA2 enzyme with high affinity (-7.7 to -6.3 kcal/mol); the standard ligand, Varespladib had a docking score of -6.9 kcal/mol and they exhibited favorable drug-likeness and pharmacokinetic properties and according to toxicity predictions, the two compounds are toxic. In conclusion, the leaf of V. glaberrima contains phytoconstituents with antisnake activity and thus, validates the hypothesis that, the phytoconstituents of V. glaberrima leaves has antisnake venom activity against N. nigricollis venom and thus, should be studied further for the development as antisnake venom agents.
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Affiliation(s)
- A J Yusuf
- Department of Pharmaceutical and Medicinal Chemistry, Usmanu Danfodiyo University, Sokoto, Nigeria.
| | - A I Bugaje
- Department of Pharmaceutical and Medicinal Chemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - M Sadiq
- Department of Pharmaceutical and Medicinal Chemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - M Salihu
- Department of Pharmaceutical and Medicinal Chemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - H W Adamu
- Department of Biology, Shehu Shagari College of Education, Sokoto, Nigeria
| | - M Abdulrahman
- Department of Pharmaceutical and Medicinal Chemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
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Rosales-García RA, Rautsaw RM, Hofmann EP, Grünwald CI, Franz-Chavez H, Ahumada-Carrillo IT, Ramirez-Chaparro R, de la Torre-Loranca MA, Strickland JL, Mason AJ, Holding ML, Borja M, Castañeda-Gaytan G, Myers EA, Sasa M, Rokyta DR, Parkinson CL. Sequence Divergence in Venom Genes Within and Between Montane Pitviper (Viperidae: Crotalinae: Cerrophidion) Species is Driven by Mutation-Drift Equilibrium. J Mol Evol 2023; 91:514-535. [PMID: 37269364 PMCID: PMC10995822 DOI: 10.1007/s00239-023-10115-2] [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: 10/14/2022] [Accepted: 05/03/2023] [Indexed: 06/05/2023]
Abstract
Snake venom can vary both among and within species. While some groups of New World pitvipers-such as rattlesnakes-have been well studied, very little is known about the venom of montane pitvipers (Cerrophidion) found across the Mesoamerican highlands. Compared to most well-studied rattlesnakes, which are widely distributed, the isolated montane populations of Cerrophidion may facilitate unique evolutionary trajectories and venom differentiation. Here, we describe the venom gland transcriptomes for populations of C. petlalcalensis, C. tzotzilorum, and C. godmani from Mexico, and a single individual of C. sasai from Costa Rica. We explore gene expression variation in Cerrophidion and sequence evolution of toxins within C. godmani specifically. Cerrophidion venom gland transcriptomes are composed primarily of snake venom metalloproteinases, phospholipase A[Formula: see text]s (PLA[Formula: see text]s), and snake venom serine proteases. Cerrophidion petlalcalensis shows little intraspecific variation; however, C. godmani and C. tzotzilorum differ significantly between geographically isolated populations. Interestingly, intraspecific variation was mostly attributed to expression variation as we did not detect signals of selection within C. godmani toxins. Additionally, we found PLA[Formula: see text]-like myotoxins in all species except C. petlalcalensis, and crotoxin-like PLA[Formula: see text]s in the southern population of C. godmani. Our results demonstrate significant intraspecific venom variation within C. godmani and C. tzotzilorum. The toxins of C. godmani show little evidence of directional selection where variation in toxin sequence is consistent with evolution under a model of mutation-drift equilibrium. Cerrophidion godmani individuals from the southern population may exhibit neurotoxic venom activity given the presence of crotoxin-like PLA[Formula: see text]s; however, further research is required to confirm this hypothesis.
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Affiliation(s)
| | - Rhett M Rautsaw
- Department of Biological Sciences, Clemson University, 190 Collings St., Clemson, SC, 29634, USA
| | - Erich P Hofmann
- Department of Biological Sciences, Clemson University, 190 Collings St., Clemson, SC, 29634, USA
- Science Department, Cape Fear Community College, Wilmington, NC, 28401, USA
| | | | - Hector Franz-Chavez
- Herp.mx A.C., Colima, Mexico
- Biodiversa A. C., Chapala, Jalisco, 45900, Mexico
| | | | | | | | - Jason L Strickland
- Department of Biological Sciences, Clemson University, 190 Collings St., Clemson, SC, 29634, USA
- Department of Biology, University of South Alabama, Mobile, AL, 36688, USA
| | - Andrew J Mason
- Department of Biological Sciences, Clemson University, 190 Collings St., Clemson, SC, 29634, USA
- Department of Evolution, Ecology, and Organismal Biology, The Ohio State University, Columbus, OH, 43210, USA
| | - Matthew L Holding
- Department of Biological Sciences, Clemson University, 190 Collings St., Clemson, SC, 29634, USA
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Miguel Borja
- Facultad de Ciencias Biológicas, Universdad Juárez del Estado de Durango, Gómez Palacio, Durango, 35010, Mexico
| | - Gamaliel Castañeda-Gaytan
- Facultad de Ciencias Biológicas, Universdad Juárez del Estado de Durango, Gómez Palacio, Durango, 35010, Mexico
| | - Edward A Myers
- Department of Biological Sciences, Clemson University, 190 Collings St., Clemson, SC, 29634, USA
| | - Mahmood Sasa
- Centro Investigaciones en Biodiversidad y Ecología Tropical and Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Costa Rica
| | - Darin R Rokyta
- Department of Biological Science, Florida State University, Tallahassee, FL, 32306, USA
| | - Christopher L Parkinson
- Department of Biological Sciences, Clemson University, 190 Collings St., Clemson, SC, 29634, USA.
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Altamimi I, Altamimi A, Alhumimidi AS, Altamimi A, Temsah MH. Snakebite Advice and Counseling From Artificial Intelligence: An Acute Venomous Snakebite Consultation With ChatGPT. Cureus 2023; 15:e40351. [PMID: 37456381 PMCID: PMC10339276 DOI: 10.7759/cureus.40351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Snakebites, particularly from venomous species, present a significant global public health challenge. Access to accurate and timely information regarding snakebite prevention, recognition, and management is crucial for minimizing morbidity and mortality. Artificial intelligence (AI) language models, such as ChatGPT (Chat Generative Pre-trained Transformer), have the potential to revolutionize the dissemination of medical information and improve patient education and satisfaction. METHODS This study aimed to explore the utility of ChatGPT, an advanced language model, in simulating acute venomous snakebite consultations. Nine hypothetical questions based on comprehensive snakebite management guidelines were posed to ChatGPT, and the responses were evaluated by clinical toxicologists and emergency medicine physicians. RESULTS ChatGPT provided accurate and informative responses related to the immediate management of snakebites, the urgency of seeking medical attention, symptoms, and health issues following venomous snakebites, the role of antivenom, misconceptions about snakebites, recovery, pain management, and prevention strategies. The model highlighted the importance of seeking professional medical care and adhering to healthcare practitioners' advice. However, some limitations were identified, including outdated knowledge, lack of personalization, and inability to consider regional variations and individual characteristics. CONCLUSION ChatGPT demonstrated proficiency in generating intelligible and well-informed responses related to venomous snakebites. It offers accessible and real-time advice, making it a valuable resource for preliminary information, education, and triage support in remote or underserved areas. While acknowledging its limitations, such as the need for up-to-date information and personalized advice, ChatGPT can serve as a supplementary source of information to complement professional medical consultation and enhance patient education. Future research should focus on addressing the identified limitations and establishing region-specific guidelines for snakebite management.
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Affiliation(s)
| | - Abdullah Altamimi
- Pediatric Emergency and Toxicology Department, King Fahd Medical City, Riyadh, SAU
| | | | - Abdulaziz Altamimi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Mohamad-Hani Temsah
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, SAU
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Recovery from the Neuroparalysis Caused by the Micrurus nigrocinctus Venom Is Accelerated by an Agonist of the CXCR4 Receptor. Toxins (Basel) 2022; 14:toxins14080531. [PMID: 36006193 PMCID: PMC9412299 DOI: 10.3390/toxins14080531] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/22/2022] [Accepted: 07/30/2022] [Indexed: 12/10/2022] Open
Abstract
Snake envenoming is a major but neglected human disease in tropical and subtropical regions. Among venomous snakes in the Americas, coral snakes of the genus Micrurus are particularly dangerous because they cause a peripheral neuroparalysis that can persist for many days or, in severe cases, progress to death. Ventilatory support and the use of snake species-specific antivenoms may prevent death from respiratory paralysis in most cases. However, there is a general consensus that additional and non-expensive treatments that can be delivered even long after the snake bite are needed. Neurotoxic degeneration of peripheral motor neurons activates pro-regenerative intercellular signaling programs, the greatest of which consist of the chemokine CXCL12α, produced by perisynaptic Schwann cells, which act on the CXCR4 receptor expressed on damaged neuronal axons. We recently found that the CXCR4 agonist NUCC-390 promotes axonal growth. Here, we show that the venom of the highly neurotoxic snake Micrurus nigrocinctus causes a complete degeneration of motor axon terminals of the soleus muscle, followed by functional regeneration whose time course is greatly accelerated by NUCC-390. These results suggest that NUCC-390 is a potential candidate for treating human patients envenomed by Micrurus nigrocinctus as well as other neurotoxic Micrurus spp. in order to improve the recovery of normal neuromuscular physiology, thus reducing the mortality and hospital costs of envenoming.
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Jones L, Youngman NJ, Neri-Castro E, Guadarrama-Martínez A, Lewin MR, Carter R, Frank N, Fry BG. Differential Antivenom and Small-Molecule Inhibition of Novel Coagulotoxic Variations in Atropoides, Cerrophidion, Metlapilcoatlus, and Porthidium American Viperid Snake Venoms. Toxins (Basel) 2022; 14:toxins14080511. [PMID: 35893753 PMCID: PMC9332056 DOI: 10.3390/toxins14080511] [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: 07/05/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023] Open
Abstract
Within Neotropical pit-vipers, the Mexican/Central-American clade consisting of Atropoides, Cerrophidion, Metlapilcoatlus, and Porthidium is a wide-ranging, morphologically and ecologically diverse group of snakes. Despite their prevalence, little is known of the functional aspects of their venoms. This study aimed to fill the knowledge gap regarding coagulotoxic effects and to examine the potential of different therapeutic approaches. As a general trait, the venoms were shown to be anticoagulant but were underpinned by diverse biochemical actions. Pseudo-procoagulant activity (i.e., thrombin-like), characterized by the direct cleavage of fibrinogen to form weak fibrin clots, was evident for Atropoides picadoi, Cerrophidiontzotzilorum, Metlapilcoatlus mexicanus, M. nummifer, M. occiduus, M. olmec, and Porthidium porrasi. In contrast, other venoms cleaved fibrinogen in a destructive (non-clotting) manner, with C. godmani and C. wilsoni being the most potent. In addition to actions on fibrinogen, clotting enzymes were also inhibited. FXa was only weakly inhibited by most species, but Cerrophidion godmani and C. wilsoni were extremely strong in their inhibitory action. Other clotting enzymes were more widely inhibited by diverse species spanning the full taxonomical range, but in each case, there were species that had these traits notably amplified relatively to the others. C. godmani and C. wilsoni were the most potent amongst those that inhibited the formation of the prothrombinase complex and were also amongst the most potent inhibitors of Factor XIa. While most species displayed only low levels of thrombin inhibition, Porthidium dunni potently inhibited this clotting factor. The regional polyvalent antivenom produced by Instituto Picado Clodomiro was tested and was shown to be effective against the diverse anticoagulant pathophysiological effects. In contrast to the anticoagulant activities of the other species, Porthidium volcanicum was uniquely procoagulant through the activation of Factor VII and Factor XII. This viperid species is the first snake outside of the Oxyuranus/Pseudonaja elapid snake clade to be shown to activate FVII and the first snake venom of any kind to activate FXII. Interestingly, while small-molecule metalloprotease inhibitors prinomastat and marimastat demonstrated the ability to prevent the procoagulant toxicity of P. volcanicum, neither ICP antivenom nor inhibitor DMPS showed this effect. The extreme variation among the snakes here studied underscores how venom is a dynamic trait and how this can shape clinical outcomes and influence evolving treatment strategies.
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Affiliation(s)
- Lee Jones
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia;
- Correspondence: (L.J.); (B.G.F.)
| | - Nicholas J. Youngman
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia;
| | - Edgar Neri-Castro
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnologia, Universidad Nacional Autónoma de México, Av. Universidad 2001, Cuernavaca 62210, Mexico; (E.N.-C.); (A.G.-M.)
| | - Alid Guadarrama-Martínez
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnologia, Universidad Nacional Autónoma de México, Av. Universidad 2001, Cuernavaca 62210, Mexico; (E.N.-C.); (A.G.-M.)
| | | | - Rebecca Carter
- Ophirex Inc., Corte Madera, CA 94925, USA; (M.R.L.); (R.C.)
| | | | - Bryan G. Fry
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia;
- Correspondence: (L.J.); (B.G.F.)
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Bourke LA, Zdenek CN, Tanaka-Azevedo AM, Silveira GPM, Sant’Anna SS, Grego KF, Rodrigues CFB, Fry BG. Clinical and Evolutionary Implications of Dynamic Coagulotoxicity Divergences in Bothrops (Lancehead Pit Viper) Venoms. Toxins (Basel) 2022; 14:toxins14050297. [PMID: 35622544 PMCID: PMC9148167 DOI: 10.3390/toxins14050297] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022] Open
Abstract
Despite coagulotoxicity being a primary weapon for prey capture by Bothrops species (lancehead pit vipers) and coagulopathy being a major lethal clinical effect, a genus-wide comparison has not been undertaken. To fill this knowledge gap, we used thromboelastography to compare 37 venoms, from across the full range of geography, taxonomy, and ecology, for their action upon whole plasma and isolated fibrinogen. Potent procoagulant toxicity was shown to be the main venom effect of most of the species tested. However, the most basal species (B. pictus) was strongly anticoagulant; this is consistent with procoagulant toxicity being a novel trait that evolved within Bothrops subsequent to their split from anticoagulant American pit vipers. Intriguingly, two of the arboreal species studied (B. bilineatus and B. taeniatus) lacked procoagulant venom, suggesting differential evolutionary selection pressures. Notably, some terrestrial species have secondarily lost the procoagulant venom trait: the Mogi Mirim, Brazil locality of B. alternatus; San Andres, Mexico locality of B. asper; B. diporus; and the São Roque of B. jararaca. Direct action on fibrinogen was extremely variable; this is consistent with previous hypotheses regarding it being evolutionary decoupled due to procoagulant toxicity being the primary prey-capture weapon. However, human patients live long enough for fibrinogen depletion to be clinically significant. The extreme variability may be reflective of antivenom variability, with these results thereby providing a foundation for such future work of clinical relevance. Similarly, the venom diversification trends relative to ecological niche will also be useful for integration with natural history data, to reconstruct the evolutionary pressures shaping the venoms of these fascinating snakes.
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Affiliation(s)
- Lachlan Allan Bourke
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St. Lucia, QLD 4072, Australia;
- Correspondence: (L.A.B.); (B.G.F.)
| | - Christina N. Zdenek
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St. Lucia, QLD 4072, Australia;
| | - Anita Mitico Tanaka-Azevedo
- Laboratrio de Herpetologia, Instituto Butantan, Sao Paulo 05503-900, Brazil; (A.M.T.-A.); (G.P.M.S.); (S.S.S.); (K.F.G.); (C.F.B.R.)
| | - Giovanni Perez Machado Silveira
- Laboratrio de Herpetologia, Instituto Butantan, Sao Paulo 05503-900, Brazil; (A.M.T.-A.); (G.P.M.S.); (S.S.S.); (K.F.G.); (C.F.B.R.)
| | - Sávio Stefanini Sant’Anna
- Laboratrio de Herpetologia, Instituto Butantan, Sao Paulo 05503-900, Brazil; (A.M.T.-A.); (G.P.M.S.); (S.S.S.); (K.F.G.); (C.F.B.R.)
| | - Kathleen Fernandes Grego
- Laboratrio de Herpetologia, Instituto Butantan, Sao Paulo 05503-900, Brazil; (A.M.T.-A.); (G.P.M.S.); (S.S.S.); (K.F.G.); (C.F.B.R.)
| | | | - Bryan Grieg Fry
- Venom Evolution Lab, School of Biological Sciences, University of Queensland, St. Lucia, QLD 4072, Australia;
- Correspondence: (L.A.B.); (B.G.F.)
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Saravia-Otten P, Hernández R, Marroquín N, Pereañez JA, Preciado LM, Vásquez A, García G, Nave F, Rochac L, Genovez V, Mérida M, Cruz SM, Orozco N, Cáceres A, Gutiérrez JM. Inhibition of enzymatic activities of Bothrops asper snake venom and docking analysis of compounds from plants used in Central America to treat snakebite envenoming. JOURNAL OF ETHNOPHARMACOLOGY 2022; 283:114710. [PMID: 34626780 DOI: 10.1016/j.jep.2021.114710] [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: 08/30/2021] [Revised: 09/28/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Snakebite envenoming is a public health problem of high impact in Central America. Bothrops asper, known as barba amarilla, terciopelo, and equis, is the snake species responsible for most snakebites in Central America. In this region, there is a long-standing tradition on the use of plants in the management of snakebites, especially in indigenous communities. Ethnomedical use of Eryngium foetidum L., Neurolaena lobata (L.) Cass. and Pimenta dioica (L.) Merr. to treat snakebite envenoming has been reported in Belice, Guatemala, Nicaragua, and Costa Rica. Extracts of the leaves of these plants have shown anti-venom activities in in vitro assays in previous studies. AIM OF THE STUDY To assess the ability of organic fractions from these three plants to inhibit enzymatic activities associated with toxicity of the venom of B. asper, and to study, by docking analysis, the interaction of metalloproteinase and phospholipases A2 (PLA2) from B. asper venom with secondary metabolites previously described in these plants. MATERIALS AND METHODS Organic fractions were obtained from these three plant species and their ability to neutralize proteolytic, PLA2 and in vitro coagulant activities of B. asper venom was assessed. A phytochemical analysis was carried out in these fractions. The interaction of secondary metabolites previously described in these plants with three toxins from B. asper venom (a metalloproteinase, a PLA2 and a PLA2 homologue) was investigated by docking analysis. RESULTS The inhibitory activity of plants was mainly concentrated in their polar fractions. Acetonic fraction from P. dioica was the most active against PLA2 activity, while the acetonic fraction of E. foetidum completely inhibited the proteolytic activity of the venom. Coagulant activity was partially inhibited only by the acetone and ethyl acetate fractions of P. dioica. Phytochemical analysis of the most bioactive fractions identified flavonoids, saponins, essential oils, coumarins, alkaloids, tannins and sesquiterpene lactones. Docking analysis revealed high affinity interactions of several secondary metabolites of these plants with residues in the vicinity of the catalytic site of these enzymes and, in the case of PLA2 homologue myotoxin II, in the hydrophobic channel. CONCLUSIONS Various fractions from these plants have inhibitory activity against enzymatic actions of B. asper venom which are directly associated with toxicological effects. Docking analysis showed structural evidence of the interaction of secondary metabolites with three toxins. These observations provide support to the potential of these plants to inhibit relevant toxic components of this snake venom.
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Affiliation(s)
- Patricia Saravia-Otten
- Departamento de Bioquímica, Escuela de Química Biológica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala.
| | - Rosario Hernández
- Departamento de Bioquímica, Escuela de Química Biológica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Nereida Marroquín
- Laboratorio de Investigación de Productos Naturales (Lipronat), Escuela de Química Farmacéutica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Jaime A Pereañez
- Toxinología, Alternativas Terapeúticas y Alimentarias, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellín, Colombia
| | - Lina M Preciado
- Toxinología, Alternativas Terapeúticas y Alimentarias, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellín, Colombia
| | - Allan Vásquez
- Facultad de Medicina, Universidad Francisco Marroquín, Guatemala
| | - Gabriela García
- Departamento de Bioquímica, Escuela de Química Biológica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Federico Nave
- Dirección General de Investigaciones (DIGI), Universidad de San Carlos de Guatemala, Guatemala
| | - Lorena Rochac
- Laboratorio de Investigación de Productos Naturales (Lipronat), Escuela de Química Farmacéutica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Vicente Genovez
- Departamento de Bioquímica, Escuela de Química Biológica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Max Mérida
- Laboratorio de Investigación de Productos Naturales (Lipronat), Escuela de Química Farmacéutica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Sully M Cruz
- Laboratorio de Investigación de Productos Naturales (Lipronat), Escuela de Química Farmacéutica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Nohemí Orozco
- Departamento de Química Orgánica, Escuela de Química, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | - Armando Cáceres
- Laboratorio de Investigación de Productos Naturales (Lipronat), Escuela de Química Farmacéutica, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala; Laboratorios de Productos Naturales Farmaya, Guatemala
| | - José M Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
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Affiliation(s)
- Ravikar Ralph
- Department of Internal Medicine, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | | | - Sanjib Kumar Sharma
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, 76500, Nepal
| | - Isabela Ribeiro
- Dynamic Portfolio, Drugs for Neglected Diseases initiative (DNDi), 15 Chemin Louis-Dunant, 1202, Geneva, Switzerland
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, Geneva, CH 1211, Switzerland
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Snakebites in Rural Areas of Brazil by Race: Indigenous the Most Exposed Group. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179365. [PMID: 34501955 PMCID: PMC8431164 DOI: 10.3390/ijerph18179365] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/28/2021] [Accepted: 09/03/2021] [Indexed: 01/02/2023]
Abstract
Animal stings are environmental hazards that threaten millions annually and cause a significant socioeconomic impact. Snakebite envenoming affects 2.7 million people globally every year, mostly the poorest and rural communities, with approximately 27,000 annual cases in Brazil. This study’s objective is to identify the most exposed racial group for snakebites in rural areas of Brazil and analyze possible differences in the outcome of an accident. A retrospective epidemiological study was conducted using a database of rural snakebite cases from Brazil’s Ministry of Health (2017). Descriptive analysis and a regression model were performed to examine the association of bad outcomes after a snakebite with several covariables. While mixed-race individuals presented the highest number of cases (61.79%), indigenous and white populations were the racial groups with the highest and lowest exposure rates (194.3 and 34.1 per 100,000 population, respectively). The fatality rate was 3.5 times higher in the indigenous population compared to the white population. In the multivariable model, the number of hours between the accident and health care received and the case classification suggested an association with a bad outcome. Snakebite is prominent in Brazil, particularly among indigenous groups. Antivenom is available in the Brazilian Health System; however, efforts need to be made for decentralization.
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Abdalazim Dafallah M, Habour E, Ahmed Ragab E. Hemothorax after snake bite. Clin Case Rep 2021; 9:e04874. [PMID: 34584724 PMCID: PMC8457406 DOI: 10.1002/ccr3.4874] [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: 07/10/2021] [Revised: 08/10/2021] [Accepted: 09/09/2021] [Indexed: 11/11/2022] Open
Abstract
Hemothorax after snake bite is very rare and unusual presentation. Administration of antivenom with supportive measures and close monitoring can prevent further deterioration. Delays in the transportation of patients to health facilities where antivenom and other therapeutic resources are provided can lead to devastating consequences.
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Simões-Silva R, Alfonso JJ, Gómez AF, Sobrinho JC, Kayano AM, de Medeiros DSS, Teles CBG, Quintero A, Fuly AL, Gómez CV, Pereira SS, da Silva SL, Stábeli RG, Soares AM. Synergism of in vitro plasmodicidal activity of phospholipase A2 isoforms isolated from panamanian Bothrops asper venom. Chem Biol Interact 2021; 346:109581. [PMID: 34302801 DOI: 10.1016/j.cbi.2021.109581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/11/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
Bothrops asper is one of the most important snake species in Central America, mainly because of its medical importance in countries like Ecuador, Panama and Costa Rica, where this species causes a high number of snakebite accidents. Several basic phospholipases A2 (PLA2s) have been previously characterized from B. asper venom, but few studies have been carried out with its acidic isoforms. In addition, since snake venom is a rich source of bioactive substances, it is necessary to investigate the biotechnological potential of its components. In this context, this study aimed to carry out the biochemical characterization of PLA2 isoforms isolated from B. asper venom and to evaluate the antiparasitic potential of these toxins. The venom and key fractions were subjected to different chromatographic steps, obtaining nine PLA2s, four acidic ones (BaspAc-I, BaspAc-II, BaspAc-III and BaspAc-IV) and five basic ones (BaspB-I, BaspB-II, BaspB-III, BaspB-IV and BaspB-V). The isoelectric points of the acidic PLA2s were also determined, which presented values ranging between 4.5 and 5. The findings indicated the isolation of five unpublished isoforms, four Asp49-PLA, corresponding to the group of acidic isoforms, and one Lys49-PLA2-like. Acidic PLA2s catalyzed the degradation of all substrates evaluated; however, for the basic PLA2s, there was a preference for phosphatidylglycerol and phosphatidic acid. The antiparasitic potential of the toxins was evaluated, and the acidic PLA2s demonstrated action against the epimastigote forms of T. cruzi and promastigote forms of L. infantum, while the basic PLA2s BaspB-II and BaspB-IV showed activity against P. falciparum. The results indicated an increase of up to 10 times in antiplasmodial activity, when the Asp49-PLA2 and Lys49-PLA2 were associated with one another, denoting synergistic action between these PLA2 isoforms. These findings correspond to the first report of synergistic antiplasmodial action for svPLA2s, demonstrating that these molecules may be important targets in the search for new antiparasitic agents.
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Affiliation(s)
- Rodrigo Simões-Silva
- Centro de Estudos de Biomoléculas Aplicadas à Saúde, CEBio, Laboratório de Biotecnologia de Proteínas e Compostos Bioativos da Amazônia Ocidental, LaBioProt, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Instituto Federal de Educação, Ciência e Tecnologia de Rondônia, IFRO, Campus Vilhena, Vilhena, RO, Brazil
| | - Jorge Javier Alfonso
- Centro de Estudos de Biomoléculas Aplicadas à Saúde, CEBio, Laboratório de Biotecnologia de Proteínas e Compostos Bioativos da Amazônia Ocidental, LaBioProt, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Centro Para el Desarrollo de la Investigación Científica (CEDIC), Asunción, Paraguay
| | - Ana F Gómez
- Centro de Estudos de Biomoléculas Aplicadas à Saúde, CEBio, Laboratório de Biotecnologia de Proteínas e Compostos Bioativos da Amazônia Ocidental, LaBioProt, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Centro Para el Desarrollo de la Investigación Científica (CEDIC), Asunción, Paraguay
| | - Juliana C Sobrinho
- Centro de Estudos de Biomoléculas Aplicadas à Saúde, CEBio, Laboratório de Biotecnologia de Proteínas e Compostos Bioativos da Amazônia Ocidental, LaBioProt, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil
| | - Anderson M Kayano
- Centro de Estudos de Biomoléculas Aplicadas à Saúde, CEBio, Laboratório de Biotecnologia de Proteínas e Compostos Bioativos da Amazônia Ocidental, LaBioProt, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Centro de Pesquisa em Medicina Tropical, CEPEM-SESAU/RO, Porto Velho, RO, Brazil
| | - Daniel S S de Medeiros
- Plataforma de Bioensaios em Malária e Leishmanioses, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Programa de Pós-graduação em Biologia Experimental, Universidade Federal de Rondônia, Porto Velho, RO, Brazil
| | - Carolina B G Teles
- Plataforma de Bioensaios em Malária e Leishmanioses, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Programa de Pós-graduação em Biologia Experimental, Universidade Federal de Rondônia, Porto Velho, RO, Brazil; Instituto Nacional de Ciência e Tecnologia em Epidemiologia da Amazônia Ocidental (INCT-EpiAmO), Brazil
| | - Aristides Quintero
- Centro de Informaciones e Investigaciones Toxicológicas y Químicas Aplicadas (CEIITOXQUIA) and Departamento de Química, FCNYE, Universidad Autónoma de Chiriquí, UNACHI, David, Panama
| | - André L Fuly
- Universidade Federal Fluminense, UFF, Niteroi, RJ, Brazil
| | - Celeste Vega Gómez
- Centro Para el Desarrollo de la Investigación Científica (CEDIC), Asunción, Paraguay
| | - Soraya S Pereira
- Laboratório de Engenharia de Anticorpos, Fundação Oswaldo Cruz, FIOCRUZ, Fiocruz Rondônia, Porto Velho, RO, Brazil
| | - Saulo L da Silva
- Faculty of Chemical Sciences, University of Cuenca, Cuenca, Azuay, Ecuador; LAQV-REQUIMTE, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Rua do Campo Alegre s/n, Porto, Portugal
| | - Rodrigo G Stábeli
- Fundação Oswaldo Cruz, FIOCRUZ, Plataforma Bi-institucional de Medicina Translacional. Ribeirão Preto, SP, Brazil
| | - Andreimar M Soares
- Centro de Estudos de Biomoléculas Aplicadas à Saúde, CEBio, Laboratório de Biotecnologia de Proteínas e Compostos Bioativos da Amazônia Ocidental, LaBioProt, Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Programa de Pós-graduação em Biologia Experimental, Universidade Federal de Rondônia, Porto Velho, RO, Brazil; Instituto Nacional de Ciência e Tecnologia em Epidemiologia da Amazônia Ocidental (INCT-EpiAmO), Brazil; Centro Universitário São Lucas, UniSL, Porto Velho, RO, Brazil.
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12
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Knudsen C, Jürgensen JA, Føns S, Haack AM, Friis RUW, Dam SH, Bush SP, White J, Laustsen AH. Snakebite Envenoming Diagnosis and Diagnostics. Front Immunol 2021; 12:661457. [PMID: 33995385 PMCID: PMC8113877 DOI: 10.3389/fimmu.2021.661457] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Snakebite envenoming is predominantly an occupational disease of the rural tropics, causing death or permanent disability to hundreds of thousands of victims annually. The diagnosis of snakebite envenoming is commonly based on a combination of patient history and a syndromic approach. However, the availability of auxiliary diagnostic tests at the disposal of the clinicians vary from country to country, and the level of experience within snakebite diagnosis and intervention may be quite different for clinicians from different hospitals. As such, achieving timely diagnosis, and thus treatment, is a challenge faced by treating personnel around the globe. For years, much effort has gone into developing novel diagnostics to support diagnosis of snakebite victims, especially in rural areas of the tropics. Gaining access to affordable and rapid diagnostics could potentially facilitate more favorable patient outcomes due to early and appropriate treatment. This review aims to highlight regional differences in epidemiology and clinical snakebite management on a global scale, including an overview of the past and ongoing research efforts within snakebite diagnostics. Finally, the review is rounded off with a discussion on design considerations and potential benefits of novel snakebite diagnostics.
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Affiliation(s)
- Cecilie Knudsen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
- BioPorto Diagnostics A/S, Hellerup, Denmark
| | - Jonas A. Jürgensen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Sofie Føns
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Aleksander M. Haack
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Rasmus U. W. Friis
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Søren H. Dam
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Sean P. Bush
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Julian White
- Toxinology Department, Women’s and Children’s Hospital, North Adelaide, SA, Australia
| | - Andreas H. Laustsen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
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Antivenomics and in vivo preclinical efficacy of six Latin American antivenoms towards south-western Colombian Bothrops asper lineage venoms. PLoS Negl Trop Dis 2021; 15:e0009073. [PMID: 33524033 PMCID: PMC7877754 DOI: 10.1371/journal.pntd.0009073] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/11/2021] [Accepted: 12/15/2020] [Indexed: 11/19/2022] Open
Abstract
Background Bothrops asper represents the clinically most important snake species in Central America and Northern South America, where it is responsible for an estimated 50–80% of snakebites. Compositional variability among the venom proteomes of B. asper lineages across its wide range mirrors clinical differences in their envenomings. Bothropic antivenoms generated in a number of Latin American countries commonly exhibit a certain degree of paraspecific effectiveness in the neutralization of congeneric venoms. Defining the phylogeographic boundaries of an antivenom's effectivity has implications for optimizing its clinical use. However, the molecular bases and impact of venom compositions on the immune recognition and neutralization of the toxic activities of across geographically disparate populations of B. asper lineages has not been comprehensively studied. Methodology/Principal findings Third-generation antivenomics was applied to quantify the cross-immunorecognizing capacity against the individual components of venoms of three B. asper lineages (B. asper (sensu stricto), B. ayerbei and B. rhombeatus) distributed in south-western (SW) Colombia, of six Latin American antivenoms, produced against homologous (Colombia, INS-COL and PROBIOL) and Costa Rica (ICP)), and heterologous (Argentina (BIOL), Perú (INS-PERU) and Venezuela (UCV)) bothropic venoms. In vivo neutralization assays of the lethal, hemorrhagic, coagulant, defibrinogenating, myotoxic, edematogenic, indirect hemolytic, and proteolytic activities of the three SW Colombian B. asper lineage venoms were carried to compare the preclinical efficacy of three (Colombian INS-COL and PROBIOL, and Costa Rican ICP) antivenoms frequently used in Colombia. Antivenomics showed that all the six antivenom affinity matrices efficiently immunoretained most of the B. asper lineages venom proteins and exhibited impaired binding towards the venoms' peptidomes. The neutralization profile of the INS-COL, PROBIOL and ICP antivenoms towards the biological activities of the venoms of SW Colombian B. asper (sensu stricto), B. ayerbei and B. rhombeatus lineages was coherent with the antivenomics outcome. In addition, the combination of in vitro (antivenomics) and in vivo neutralization results allowed us to determine their toxin-specific and venom neutralizing antibody content. Noteworthy, heterologous INS-PERU, BIOL, and UCV bothropic antivenoms had equal or higher binding capacity towards the venoms components of SW Colombian B. asper lineages that the homologous Colombian and Costa Rican antivenoms. Conclusions/Significance The combined in vitro and in vivo preclinical outcome showed that antivenoms manufactured in Colombia and Costa Rica effectively neutralize the major toxic activities of SW Colombian B. asper lineage venoms. The antivenomics profiles of the heterologous antivenoms manufactured in Argentina, Venezuela, and Perú strongly suggests their (pre)clinical adequacy for the treatment of B. asper lineage envenomings in SW Colombia. However, their recommendation in the clinical setting is pending on in vivo neutralization testing and clinical testing in humans. Bothrops asper is a highly adaptable snake species complex, which is considered the most dangerous snake throughout much of its distribution range from the Atlantic lowland of eastern México to northwestern Perú. Antivenoms are the only scientifically validated treatment of snakebite envenomings. Venom variation is particularly common in wide ranging species, such as B. asper, and may result in variable clinical presentations of envenomings, as is the case for the B. asper species complex, potentially undermining the efficacy of snakebite treatments depending on the immunization mixture used in the generation of the antivenom. Conversely, phylogenetic conservation of antigenic determinants confers an unpredictable degree of paraspecificity to homologous antivenoms produced for a geographic area, but also to heterologous congeneric antivenoms, towards the venom components of allopatric conspecific populations. This work aimed at comparing the preclinical profile of a panel of Latin American homologous and heterologous antivenoms against the venoms of B. asper lineages distributed in SW Colombia. The outcome of this study strongly suggests the suitability of considering the heterologous antivenoms BIOL (Argentina), UCV (Venezuela) and INS-PERU (Perú) as alternatives to homologous Colombian INS-COL and PROBIOL and Costa Rican ICP antivenoms for the treatment of envenomings by B. asper (sensu stricto) in W Colombia and Ecuador, B. ayerbei in Cauca and Nariño (Colombia), and B. rhombeatus in Cauca river valley, SW Colombia. Snakebite envenoming is an important occupational health problem, particularly in rural areas of developing countries. The timely administration of an effective antivenom remains the mainstay of snakebite management. However, the use of antivenoms is often limited by non-availability due to high cost or by lack of effectiveness. Antivenom shortage can be addressed through the generation of novel polyspecific antivenoms of wide clinical efficacy against the venoms of the medically-relevant snake species within the geographical range where these antivenoms are intended to be deployed, but also by optimizing the paraspecific use of current antivenoms. In Colombia, antivenoms are supplied by two manufacturers, one public, the Instituto Nacional de Salud (INS), and one private, Laboratorios Probiol (PROBIOL). However, the antivenom supply in Colombia has traditionally been insufficient, a circumstance that has led the Colombian Ministerio de Salud y Protección Social to issue several resolutions and decrees to announce this health emergency in the country, and to import antivenoms produced in México and Costa Rica. Contrary to these countries, where B. asper represents the only species of the genus, in SW Colombia three close phylogenetically related B. asper lineages, B. asper (sensu stricto), B. rhombeatus, and B. ayerbei, are responsible for most severe cases of snakebite accidents and exhibit remarkable differences in the physiopathological profile of their envenomings. This work aimed to assess the immunorecognition characteristics of a panel of antivenoms manufactured in Colombia, Costa Rica, Argentina, Perú and Venezuela towards the venoms of the three SW Colombian B. asper lineages. Additionally, combined quantitative in vitro and in vivo data show that the homologous antivenoms produced in Colombia (INS-COL, PROBIOL) and Costa Rica (ICP) effectively neutralize the lethality and the major toxic activities tested of the three SW Colombian B. asper lineage venoms. Heterologous Argentinian (BIOL), Venezuelan (UCV) and Peruvian (INS-PERU) antivenoms also showed comparable, even higher, effective immunocapturing ability towards the venom proteomes of SW Colombian B. asper (sensu stricto), B. rhombeatus, and B. ayerbei, than the Colombian and Costa Rican antivenoms. These results are in line with previous studies highlighting the notable conservation of paraspecific antigenic determinants across the phylogeny of genus Bothrops, and advocate for considering the heterologous Argentinian, Venezuelan and Peruvian antivenoms as further therapeutic alternatives for the treatment of B. asper spp. snakebites in Colombia.
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Pan-American Lancehead Pit-Vipers: Coagulotoxic Venom Effects and Antivenom Neutralisation of Bothrops asper and B. atrox Geographical Variants. Toxins (Basel) 2021; 13:toxins13020078. [PMID: 33499001 PMCID: PMC7911261 DOI: 10.3390/toxins13020078] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/10/2021] [Accepted: 01/17/2021] [Indexed: 11/17/2022] Open
Abstract
The toxin composition of snake venoms and, thus, their functional activity, can vary between and within species. Intraspecific venom variation across a species’ geographic range is a major concern for antivenom treatment of envenomations, particularly for countries like French Guiana that lack a locally produced antivenom. Bothrops asper and Bothrops atrox are the most medically significant species of snakes in Latin America, both producing a variety of clinical manifestations, including systemic bleeding. These pathophysiological actions are due to the activation by the venom of the blood clotting factors Factor X and prothrombin, thereby causing severe consumptive coagulopathy. Both species are extremely wide-ranging, and previous studies have shown their venoms to exhibit regional venom variation. In this study, we investigate the differential coagulotoxic effects on human plasma of six venoms (four B. asper and two B. atrox samples) from different geographic locations, spanning from Mexico to Peru. We assessed how the venom variation of these venom samples affects neutralisation by five regionally available antivenoms: Antivipmyn, Antivipmyn-Tri, PoliVal-ICP, Bothrofav, and Soro Antibotrópico (SAB). The results revealed both inter- and intraspecific variations in the clotting activity of the venoms. These variations in turn resulted in significant variation in antivenom efficacy against the coagulotoxic effects of these venoms. Due to variations in the venoms used in the antivenom production process, antivenoms differed in their species-specific or geographical neutralisation capacity. Some antivenoms (PoliVal-ICP, Bothrofav, and SAB) showed species-specific patterns of neutralisation, while another antivenom (Antivipmyn) showed geographic-specific patterns of neutralisation. This study adds to current knowledge of Bothrops venoms and also illustrates the importance of considering evolutionary biology when developing antivenoms. Therefore, these results have tangible, real-world implications by aiding evidence-based design of antivenoms for treatment of the envenomed patient. We stress that these in vitro studies must be backed by future in vivo studies and clinical trials before therapeutic guidelines are issued regarding specific antivenom use in a clinical setting.
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15
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Silva A, Hlusicka J, Siribaddana N, Waiddyanatha S, Pilapitiya S, Weerawansa P, Lokunarangoda N, Thalgaspitiya S, Siribaddana S, Isbister GK. Time delays in treatment of snakebite patients in rural Sri Lanka and the need for rapid diagnostic tests. PLoS Negl Trop Dis 2020; 14:e0008914. [PMID: 33253208 PMCID: PMC7728389 DOI: 10.1371/journal.pntd.0008914] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 12/10/2020] [Accepted: 10/23/2020] [Indexed: 02/07/2023] Open
Abstract
Delays in treatment seeking and antivenom administration remain problematic for snake envenoming. We aimed to describe the treatment seeking pattern and delays in admission to hospital and administration of antivenom in a cohort of authenticated snakebite patients. Adults (> 16 years), who presented with a confirmed snakebite from August 2013 to October 2014 were recruited from Anuradhapura Hospital. Demographic data, information on the circumstances of the bite, first aid, health-seeking behaviour, hospital admission, clinical features, outcomes and antivenom treatment were documented prospectively. There were 742 snakebite patients [median age: 40 years (IQR:27–51; males: 476 (64%)]. One hundred and five (14%) patients intentionally delayed treatment by a median of 45min (IQR:20-120min). Antivenom was administered a median of 230min (IQR:180–360min) post-bite, which didn’t differ between directly admitted and transferred patients; 21 (8%) receiving antivenom within 2h and 141 (55%) within 4h of the bite. However, transferred patients received antivenom sooner after admission to Anuradhapura hospital than those directly admitted (60min [IQR:30-120min] versus 120min [IQR:52-265min; p<0.0001]). A significantly greater proportion of transferred patients had features of systemic envenoming on admission compared to those directly admitted (166/212 [78%] versus 5/43 [12%]; p<0.0001), and had positive clotting tests on admission (123/212 [58%] versus 10/43 [23%]; p<0.0001). Sri Lankan snakebite patients present early to hospital, but there remains a delay until antivenom administration. This delay reflects a delay in the appearance of observable or measurable features of envenoming and a lack of reliable early diagnostic tests. Improved early antivenom treatment will require reliable, rapid diagnostics for systemic envenoming. Snakebite is a neglected tropical disease which is closely associated with underdevelopment. Poor accessibility to safe and effective antivenoms is a major issue in some regions highest-affected by snakebites. Antivenom can prevent severe effects of envenoming if given early. Therefore, educating communities and health care workers to improve treatment seeking after snakebite is a global priority. Many factors are associated with delayed presentation to hospital and early administration of antivenom. We found that most snakebite patients in Sri Lanka present to the first hospital within an hour of the bite. However, there remains a delay of about two more hours until the first dose of antivenom is administered. This delay is a reflection of a delay in the appearance of observable or measurable features of envenoming and a lack of reliable early diagnostic tests. We emphasise the need for reliable, rapid diagnostics for systemic envenoming.
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Affiliation(s)
- Anjana Silva
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Monash Venom Group, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- * E-mail:
| | - Jiri Hlusicka
- Charles University in Prague, 1st Faculty of Medicine, 4th Department of Internal Medicine, Prague, Czech Republic
| | - Nipuna Siribaddana
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Subodha Waiddyanatha
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Senaka Pilapitiya
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Prasanna Weerawansa
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Niroshan Lokunarangoda
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Sujeewa Thalgaspitiya
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Sisira Siribaddana
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Geoffrey K. Isbister
- Monash Venom Group, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Toxicology Research Group, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
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Gutiérrez JM, Castillo L, de Naves KMD, Masís J, Alape-Girón A. Epidemiology of snakebites in El Salvador (2014–2019). Toxicon 2020; 186:26-28. [DOI: 10.1016/j.toxicon.2020.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
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17
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Sasa M, Segura Cano SE. New insights into snakebite epidemiology in Costa Rica: A retrospective evaluation of medical records. Toxicon X 2020; 7:100055. [PMID: 32776004 PMCID: PMC7398977 DOI: 10.1016/j.toxcx.2020.100055] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 11/19/2022] Open
Abstract
Continuous monitoring of the snakebite envenoming allows elucidating factors that affect its incidence at spatial and temporal scales, and is a great tool to evaluate the proper management of snakebite in health centers. To determine if there have been changes over time in snakebite epidemiology in Costa Rica, we conducted a retrospective study using medical records from six hospitals for the years 2012-2013. A total of 475 snakebite patients were treated at the selected hospital during this period. Most bites occurred during the rainy season and primarily affected young men, mainly farm workers and schoolchildren. About 55% of bites occur in peri-domiciliary environments, although its prevalence varies geographically. Bothrops asper generates the vast majority of envenoming in the country, which is why the main local symptoms registered are edema, pain, and bleeding disorders. The time elapsed until treatment did not explain the degree of severity at admission. However, complications were observed more frequently in patients who took longer to receive treatment. The primary complications were bacterial infections, whereas kidney failure and compartment syndrome documented at very low frequencies. Only one death was recorded, reflecting the low fatality rate exhibited in the country. Hospital treatment included the rapid administration of antivenom and complementary treatment of antibiotics, analgesics, and antihistamines. The application of the latter as prophylactic does not seem to prevent the appearance of mild early adverse reactions, registered in 22.5% of the cases. Morbidity and mortality rates from snakebite have continued to decrease in the country, as a result of the efforts that Costa Rica has made to improve its public health system. Among those efforts, the creation of primary care centers (EBAIS) has reduced the time to treatment in many regions of the country. The Costa Rican experience of using antivenom in primary health care centers and maintaining good medical records could be considered for application in other countries where snakebite is a major health problem.
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Affiliation(s)
- Mahmood Sasa
- Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Costa Rica
- Museo de Zoología, Escuela de Biología, Universidad de Costa Rica, San José, Costa Rica
| | - Sofía E. Segura Cano
- Departamento de Farmacología y Toxicología, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
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18
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Nascimento da Costa T, Mota-da-Silva A, Colombini M, Moura-da-Silva AM, Medeiros de Souza R, Monteiro WM, Bernarde PS. Relationship between snake size and clinical, epidemiological and laboratory aspects of Bothrops atrox snakebites in the Western Brazilian Amazon. Toxicon 2020; 186:160-167. [PMID: 32822734 DOI: 10.1016/j.toxicon.2020.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/07/2020] [Accepted: 08/12/2020] [Indexed: 01/19/2023]
Abstract
In the Brazilian Amazon, snakebites are a significant problem, especially for populations in rural areas, particularly in forests, where victims are a considerable distance from hospital care. Several factors are associated with the severity of the accident, such as the size and age of the snake. This study aims to compare the clinical, epidemiological and laboratory aspects of envenomation to the size of Bothrops atrox snakes. Clinical, epidemiological and laboratory variables were collected from patients bitten by B. atrox and who were admitted to a hospital in the city of Cruzeiro do Sul (western Brazilian Amazon). When the two punctures of the teeth were present in the bite sign, the distance between these was measured. When taken to the hospital, the snake was measured; otherwise, its size was estimated via interviews with patients. In 92 cases, the size of the snake was estimated, and most of these were caused by small snakes. Bites of small snakes occur mainly on the feet, while larger specimens reach the legs or higher regions. Small snakes were associated primarily with mild and moderate snakebites, with more presence of hemorrhagic manifestations, while larger snakes were responsible for severe cases and characterized by local effects (necrosis, edema, flictena, compartment syndrome, and infection) and patients were treated with a higher amount of antivenom and for a longer period of hospitalization. The distance of the punctures was related to the size of the snake and the severity of the local envenomation. The observation of the distance between puncture marks when present, which is correlated with the length of the specimen, as well as the estimation of the snake size by the patient, may provide more support for the health professional on the prognosis of envenomation. The use of boots in activities in rural areas and forests could contribute to a lower rate of cases of snakebites, and health education on preventive measures and first aid for populations is fundamental.
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Affiliation(s)
- Tamires Nascimento da Costa
- Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brazil; Universidade Federal do Acre, Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde na Amazônia Ocidental, Rio Branco, AC, Brazil
| | - Ageane Mota-da-Silva
- Instituto Federal do Acre, Campus de Cruzeiro do Sul, Cruzeiro do Sul. Acre, Brazil
| | - Mônica Colombini
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo, Brazil
| | | | - Rodrigo Medeiros de Souza
- Laboratório de Microbiologia, Imunologia e Parasitologia, Centro Multidisciplinar, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brazil
| | - Wuelton Marcelo Monteiro
- Universidade do Estado do Amazonas, Manaus, AM, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
| | - Paulo Sérgio Bernarde
- Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brazil; Universidade Federal do Acre, Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde na Amazônia Ocidental, Rio Branco, AC, Brazil.
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Bhaumik S, Norton R, Jagnoor J. Burden and risk factors for snakebite in India: protocol for a systematic review. F1000Res 2020; 9:25. [PMID: 32399199 PMCID: PMC7194469 DOI: 10.12688/f1000research.21924.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2020] [Indexed: 03/29/2024] Open
Abstract
Introduction: Snakebites are a neglected tropical disease with a high burden in South and South-East Asia and sub-Saharan Africa. In 2019, the World Health Organization (WHO) released a roadmap which aims for a 50% reduction in death and disability due to snakebite globally by 2030. It is estimated that India has the highest number of snakebite deaths in the world. Objective: To synthesize evidence on the burden (incidence/ prevalence, mortality, morbidity, health facility and economic), and risk factors for snakebite in India. Methods: We will search for peer-reviewed literature and grey literature in six electronic databases (MEDLINE, EMBASE, Global Health, PsychInfo, CENTRAL, SafetyLit) and hand-search IndMed, conference abstracts, relevant websites and citation tracking. Two reviewers will screen and extract data independently with a third reviewer acting as an arbiter for any inconsistencies. Quality of the included studies will be assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. For burden, data from facility based and community-based studies will be synthesised and reported separately, except in the case of studies conducted concurrently. We will conduct narrative analyses with the aim of understanding patterns in data through tabulation for both burden and risk factors evidence synthesis. The PROGRESS Plus lens will be used to explore equity pertaining to burden of snakebites. Analyses for each individual risk factor-outcome pair will be conducted and reported separately. If appropriate, meta-analyses will be conducted as per JBI guidelines, assessing heterogeneity using Tau-squared, Cochran's Q test and Chi-squared (p > 0.05) tests. We plan to conduct sub-group analyses based on setting, study design, sex/gender, age-groups, tribal people and occupation. A funnel plot will be generated if there are more than nine studies included in a specific meta-analysis, to assess publication bias. Asymmetry of the funnel plot will be adjudged using the Egger, Begg and Harbord tests.
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Affiliation(s)
- Soumyadeep Bhaumik
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, New Delhi, India
| | - Robyn Norton
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, New Delhi, India
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Bhaumik S, Norton R, Jagnoor J. Burden and risk factors for snakebite in India: protocol for a systematic review. F1000Res 2020; 9:25. [PMID: 32399199 PMCID: PMC7194469 DOI: 10.12688/f1000research.21924.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: Snakebite is a neglected tropical disease with a high burden in South and South-East Asia and sub-Saharan Africa. In 2019, the World Health Organization (WHO) released a roadmap which aims for a 50% reduction in death and disability due to snakebite globally by 2030. It is estimated that India has the highest number of snakebite deaths in the world. Objective: To synthesize evidence on the burden (incidence/ prevalence, mortality, morbidity, health facility and economic), and risk factors for snakebite in India. Methods: We will search for peer-reviewed literature and grey literature in six electronic databases (MEDLINE, EMBASE, Global Health, PsychInfo, CENTRAL, SafetyLit) and hand-search IndMed, conference abstracts, relevant websites and citation tracking. Two reviewers will screen and extract data independently with a third reviewer acting as an arbiter for any inconsistencies. Quality of the included studies will be assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. For burden, data from facility based and community-based studies will be synthesised and reported separately, except for studies conducted concurrently. We will conduct meta-analysis for community-based studies at state-level for incidence/prevalence, mortality and morbidity , if appropriate. The PROGRESS Plus lens will be used to explore equity . Analyses for each individual risk factor-outcome pair will be conducted and reported separately. If appropriate, meta-analyses will be conducted as per JBI guidelines, assessing heterogeneity using Tau-squared, Cochran's Q test and Chi-squared (p > 0.05) tests. We plan to conduct sub-group analyses based on pre-specific parameters. A funnel plot will be generated if there are more than nine studies included in a specific meta-analysis, to assess publication bias When meta-analysis is not appropriate, structured tabulation of results across studies and/or by vote counting based on the direction of effect as per guidelines in the Cochrane Handbook.
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Affiliation(s)
- Soumyadeep Bhaumik
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, New Delhi, India
| | - Robyn Norton
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, New Delhi, India
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Rodríguez-Abarca S, Corrales G, Chacón D, Guevara M, Esquivel C, Arroyo C, Gómez A. Morphological alterations caused by manual venom extraction on the main venom gland of Bothrops asper and Crotalus simus snakes (Serpentes: Viperidae): Long-term implications for antivenom production. Toxicon 2019; 172:23-32. [PMID: 31689424 DOI: 10.1016/j.toxicon.2019.10.242] [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: 07/03/2019] [Revised: 10/21/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
The only scientifically validated treatment for snakebite envenomation is the administration of antivenoms. For their production, small quantities of snake venom are injected in animals to elicit a specific antibody response. Snakes are kept in captivity, and their venom is regularly extracted to assure antivenom access. It has already been reported that the pressure exerted upon the venom gland during this extraction can cause tissue damage and fibrosis, leading to a decrease in the venom yield. We described the histopathology of venom glands for B. asper and C. simus snakes used for antivenom production. Based on these reported tissue abnormalities, we quantify the tissue injury by a generated damage-SCORE and fibrosis. A variety of histopathological damages were found such as fibrosis, edema, necrosis, hemorrhage, and formation of anomalous structures, especially in C. simus, which is more prone to suffer severe damage. The level and severity of the damage depend on the frequency and the number of venom extractions. Furthermore, we design an experimental intensive venom extraction scheme with which we could confirm the causality of these effects. In addition to the histopathological damages, the LD50 and biochemical venom composition were also affected giving experimental evidence that the venom extraction not only causes tissue damage but also affects the composition stability and toxicity of the venom. In order to produce quality and effective antivenoms, an improvement of the management of snake collections could be established, such as rotation groups to assure the quality of the venom yielded.
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Affiliation(s)
- Sylvia Rodríguez-Abarca
- Serpentario, Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Apto: 11501-2060, Costa Rica; Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Universidad Nacional, Heredia, Apto: 86-3000, Costa Rica.
| | - Greivin Corrales
- Serpentario, Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Apto: 11501-2060, Costa Rica.
| | - Danilo Chacón
- Serpentario, Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Apto: 11501-2060, Costa Rica.
| | - Maricruz Guevara
- Facultad de Medicina Veterinaria, Universidad Técnica Nacional, Alajuela, Costa Rica.
| | - Carolina Esquivel
- Escuela de Ciencias Biológicas, Laboratoria de Biología Tropical, Facultad de Ciencias Exactas y Naturales, Universidad Nacional, Apto: 86-3000, Heredia, Costa Rica.
| | - Cynthia Arroyo
- Departamento de Análisis Clínicos, Facultad de Microbiología, Universidad de Costa Rica, San José, Apto: 11501-2060, Costa Rica.
| | - Aarón Gómez
- Serpentario, Instituto Clodomiro Picado, Universidad de Costa Rica, San José, Apto: 11501-2060, Costa Rica.
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Pinto LJ, Lee Fernández L, Gutiérrez JM, Simón DS, Ceballos Z, Aguilar LF, Sierra M. Case Report: Hemothorax in Envenomation by the Viperid Snake Bothrops asper. Am J Trop Med Hyg 2019; 100:714-716. [PMID: 30594282 PMCID: PMC6402921 DOI: 10.4269/ajtmh.18-0826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/26/2018] [Indexed: 11/07/2022] Open
Abstract
Bothrops asper, a highly venomous pit viper distributed from Colombia and northwestern Peru in South America to southern Mexico, is responsible for most snake bites in Central America, affecting especially young agricultural workers. A 17-year-old male from a rural area in northern Honduras was admitted at San Francisco Hospital after a B. asper bite that had occurred 3 days earlier. The puncture wounds were located on the first toe of the right foot. On the second day of admission, the patient developed dyspnea. A physical examination revealed hypoventilation of the left lung with dullness on 75% of the left lung. Left pleural effusion, approximately 90%, was observed on the chest X-ray. The patient was diagnosed with hemothorax, and a thoracostomy drained 1,350 mL of serosanguineous fluid, followed by the installation of a wet suction control system (Pleur-evac®). After 10 days, the patient was discharged. This case illustrates the diversity of hemorrhagic manifestations in envenomations by B. asper.
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Affiliation(s)
| | | | | | | | | | | | - Manuel Sierra
- Universidad Tecnológica Centroamericana, Tegucigalpa, Honduras
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24
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Alger J, Boza-Oviedo EE, Mejía RE, Navas F, Simons-Morales P, Velázquez RT, Gutiérrez JM. A multi-sectorial approach for addressing the problem of snakebite envenoming in Honduras. Toxicon 2019; 159:61-62. [PMID: 30677415 DOI: 10.1016/j.toxicon.2019.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/13/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Jackeline Alger
- Hospital Escuela Universitario, Tegucigalpa, Honduras; Unidad de Investigación Científica, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras.
| | | | - Rosa Elena Mejía
- Organización Panamericana de la Salud, Organización Mundial de la Salud, Tegucigalpa, Honduras
| | - Fanny Navas
- Secretaría de Asuntos Educativos y Culturales, Colegio Médico de Honduras, Tegucigalpa, Honduras
| | - Perla Simons-Morales
- Unidad de Investigación Científica, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras
| | - Reina Teresa Velázquez
- Unidad de Vigilancia de Zoonosis y Enfermedades Infecciosas Desatendidas, Secretaría de Salud de Honduras, Tegucigalpa, Honduras.
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, Costa Rica
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Tianyi FL, Agbor VN, Tochie JN, Kadia BM, Nkwescheu AS. Community-based audits of snake envenomations in a resource-challenged setting of Cameroon: case series. BMC Res Notes 2018; 11:317. [PMID: 29776445 PMCID: PMC5960191 DOI: 10.1186/s13104-018-3409-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/07/2018] [Indexed: 11/24/2022] Open
Abstract
Background Snakebites are a major cause of mortality and morbidity worldwide with the highest mortality burden in poor rural areas of sub-Saharan Africa. Inadequate surveillance systems result in loss of morbidity and mortality data in these settings. Although rarely reported in these resource-constraint environments, community-based audits are recognised pivotal tools which could help update existing data and indicate key public health interventions to curb snakebite-related mortality. Herein, we present two cases of snakebite-related deaths in a rural Cameroonian community. Case presentations The first case was a 3-year-old female who presented at a primary care health centre and was later referred due to absence of antivenom serum (AVS). However, she had an early fatal outcome before getting to the referral hospital. The second case was an 80-year-old traditional healer who got bitten while attempting to kill a snake. He died before hospital presentation. Conclusion Community-based audits help identify key intervention points to curb snakebite mortality in high-risk rural areas like ours. From our audits, we note a remarkable absence of affordable AVS in rural health facilities in Cameroon. We recommend frequent community health education sessions on preventing snakebites; continuous training modules for health personnel from high-risk areas; training traditional healers on the importance of AVS in managing cases of snakebite envenoming, and the need for timely hospital presentation; and setting up context-specific approaches to rapidly transport snakebite victims to hospitals.
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Affiliation(s)
| | | | - Joel Noutakdie Tochie
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Benjamin Momo Kadia
- Foumbot District Hospital, Foumbot, Cameroon.,Grace Community Health and Development Association, Kumba, Cameroon
| | - Armand Seraphin Nkwescheu
- Cameroon Society of Epidemiology-CaSE, P.O. Box 1411, Yaoundé, Cameroon.,Laboratory of Public Health Biotechnology and Research, Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon.,Research Foundation for Tropical Diseases and Environment-REFOTDE, Buea, Cameroon
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26
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Julve Parreño JM, Huet E, Fernández‐del‐Carmen A, Segura A, Venturi M, Gandía A, Pan W, Albaladejo I, Forment J, Pla D, Wigdorovitz A, Calvete JJ, Gutiérrez C, Gutiérrez JM, Granell A, Orzáez D. A synthetic biology approach for consistent production of plant-made recombinant polyclonal antibodies against snake venom toxins. PLANT BIOTECHNOLOGY JOURNAL 2018; 16:727-736. [PMID: 28850773 PMCID: PMC5814581 DOI: 10.1111/pbi.12823] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/03/2017] [Accepted: 08/23/2017] [Indexed: 05/26/2023]
Abstract
Antivenoms developed from the plasma of hyperimmunized animals are the only effective treatment available against snakebite envenomation but shortage of supply contributes to the high morbidity and mortality toll of this tropical disease. We describe a synthetic biology approach to affordable and cost-effective antivenom production based on plant-made recombinant polyclonal antibodies (termed pluribodies). The strategy takes advantage of virus superinfection exclusion to induce the formation of somatic expression mosaics in agroinfiltrated plants, which enables the expression of complex antibody repertoires in a highly reproducible manner. Pluribodies developed using toxin-binding genetic information captured from peripheral blood lymphocytes of hyperimmunized camels recapitulated the overall binding activity of the immune response. Furthermore, an improved plant-made antivenom (plantivenom) was formulated using an in vitro selected pluribody against Bothrops asper snake venom toxins and has been shown to neutralize a wide range of toxin activities and provide protection against lethal venom doses in mice.
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Affiliation(s)
- Jose Manuel Julve Parreño
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Estefanía Huet
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Asun Fernández‐del‐Carmen
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Alvaro Segura
- Instituto Clodomiro PicadoFacultad de MicrobiologíaUniversidad de Costa RicaSan JoséCosta Rica
| | - Micol Venturi
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Antoni Gandía
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Wei‐song Pan
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Irene Albaladejo
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Javier Forment
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Davinia Pla
- Instituto de Biomedicina de ValenciaAgencia Estatal Consejo Superior de Investigaciones CientíficasValenciaSpain
| | | | - Juan J. Calvete
- Instituto de Biomedicina de ValenciaAgencia Estatal Consejo Superior de Investigaciones CientíficasValenciaSpain
| | - Carlos Gutiérrez
- Research Institute of Biomedical and Health SciencesUniversity of Las Palmas de Gran CanariaArucasLas PalmasCanary IslandsSpain
| | - José María Gutiérrez
- Instituto Clodomiro PicadoFacultad de MicrobiologíaUniversidad de Costa RicaSan JoséCosta Rica
| | - Antonio Granell
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
| | - Diego Orzáez
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)Agencia Estatal Consejo Superior de Investigaciones CientíficasUniversidad Politécnica de ValenciaValenciaSpain
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27
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Solano G, Gómez A, Corrales G, Chacón D, Estrada R, León G. Contributions of the snake venoms of Bothrops asper, Crotalus simus and Lachesis stenophrys to the paraspecificity of the Central American polyspecific antivenom (PoliVal-ICP). Toxicon 2018; 144:1-6. [DOI: 10.1016/j.toxicon.2018.01.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
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Wang Y, Zhang J, Zhang D, Xiao H, Xiong S, Huang C. Exploration of the Inhibitory Potential of Varespladib for Snakebite Envenomation. Molecules 2018; 23:molecules23020391. [PMID: 29439513 PMCID: PMC6017252 DOI: 10.3390/molecules23020391] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 11/22/2022] Open
Abstract
Phospholipase A2s (PLA2) is a major component of snake venom with diverse pathologic toxicities and, therefore, a potential target for antivenom therapy. Varespladib was initially designed as an inhibitor of mammal PLA2s, and was recently repurposed to a broad-spectrum inhibitor of PLA2 in snake venom. To evaluate the protective abilities of varespladib to hemorrhage, myonecrosis, and systemic toxicities that are inflicted by different crude snake venoms, subcutaneous ecchymosis, muscle damage, and biochemical variation in serum enzymes derived from the envenomed mice were determined, respectively. Varespladib treatment showed a significant inhibitory effect to snake venom PLA2, which was estimated by IC50 in vitro and ED50 in vivo. In animal models, the severely hemorrhagic toxicity of D. acutus and A. halys venom was almost fully inhibited after administration of varespladib. Moreover, signs of edema in gastrocnemius muscle were remarkably attenuated by administration of varespladib, with a reduced loss of myonecrosis and desmin. Serum levels of creatine kinase, lactate dehydrogenase isoenzyme 1, aspartate transaminase, and alanine transaminase were down-regulated after treatment with varespladib, which indicated the protection to viscera injury. In conclusion, varespladib may be a potential first-line drug candidate in snakebite envenomation first aid or clinical therapy.
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Affiliation(s)
- Yiding Wang
- School of Basic Medical Sciences, Nanchang University, Nanchang 330006, China.
| | - Jing Zhang
- School of Basic Medical Sciences, Nanchang University, Nanchang 330006, China.
| | - Denghong Zhang
- School of Basic Medical Sciences, Nanchang University, Nanchang 330006, China.
| | - Huixiang Xiao
- School of Basic Medical Sciences, Nanchang University, Nanchang 330006, China.
| | - Shengwei Xiong
- School of Basic Medical Sciences, Nanchang University, Nanchang 330006, China.
| | - Chunhong Huang
- School of Basic Medical Sciences, Nanchang University, Nanchang 330006, China.
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29
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Madrigal M, Alape-Girón A, Barboza-Arguedas E, Aguilar-Ulloa W, Flores-Díaz M. Identification of B cell recognized linear epitopes in a snake venom serine proteinase from the central American bushmaster Lachesis stenophrys. Toxicon 2017; 140:72-82. [PMID: 29111117 DOI: 10.1016/j.toxicon.2017.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 10/19/2017] [Accepted: 10/22/2017] [Indexed: 10/18/2022]
Abstract
Snake venom serine proteinases are toxins that perturb hemostasis acting on proteins from the blood coagulation cascade, the fibrinolytic or the kallikrein-kinin system. Despite the relevance of these enzymes in envenomations by viper bites, the characterization of the antibody response to these toxins at the molecular level has not been previously addressed. In this work surface-located B cell recognized linear epitopes from a Lachesis stenophrys venom serine proteinase (UniProt accession number Q072L7) were predicted using an artificial neuronal network at the ABCpred server, the corresponding peptides were synthesized and their immunoreactivity was analyzed against a panel of experimental and therapeutic antivenoms. A molecular model of the L. stenophrys enzyme was built using as a template the structure of the D. acutus Dav-PA serine proteinase (Q9I8X1), which displays the highest degree of sequence similarity to the L. stenophrys enzyme among proteins of known 3D structure, and the surface-located epitopes were identified in the protein model using iCn3D. A total of 13 peptides corresponding to the surface exposed predicted epitopes from L. stenophrys serine proteinase were synthesized and, their reactivity with a rabbit antiserum against the recombinant enzyme and a panel of antivenoms was evaluated by a capture ELISA. Some of the epitopes recognized by monospecific and polyspecific antivenoms comprise sequences overlapping motifs conserved in viper venom serine proteinases. The identification and characterization of relevant epitopes recognized by B cells in snake venom toxins may provide valuable information for the preparation of immunogens that help in the production of improved therapeutic antivenoms.
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Affiliation(s)
- M Madrigal
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica; Departamento de Bioquímica, Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - A Alape-Girón
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica; Departamento de Bioquímica, Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica.
| | - E Barboza-Arguedas
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - W Aguilar-Ulloa
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - M Flores-Díaz
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
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Li J, Xiong Y, Sun S, Yu L, Huang C. Preparation of monoclonal antibodies against gamma-type phospholipase A 2 inhibitors and immunodetection of these proteins in snake blood. J Venom Anim Toxins Incl Trop Dis 2017; 23:37. [PMID: 28785278 PMCID: PMC5543733 DOI: 10.1186/s40409-017-0128-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/25/2017] [Indexed: 12/04/2022] Open
Abstract
Background The gamma-type phospholipase A2 inhibitor (PLIγ) is a natural protein commonly found in snake serum, which can neutralize pathophysiological effects of snake venom phospholipases A2. Therefore, this protein is a potential candidate to the development of a novel antivenom. To the best of our knowledge, there is no antibody currently available for PLIγ identification and characterization. Methods Bioinformatics prediction of epitope using DNAStar software was performed based on the sequence of Sinonatrix annularis PLIγ (SaPLIγ). The best epitope 151CPVLRLSNRTHEANRNDLIKVA172 was chosen and synthesized, and then conjugated to keyhole limpet hemocyanin and bovine serum albumin for use as an immunogen and plate-coating antigen, respectively. Results Eighteen IgG anti-PLIγ mAb hybridoma cell strains were obtained, and all the mAbs had positive interaction with recombinant His6-PLIγ and natural SaPLIγ. Moreover, the mAb from 10E9 strain was also successfully used for the immunodetection of other snake serum PLIγs. cDNA sequence alignment of those PLIγs from different snake species showed that their epitope segments were highly homologous. Conclusions The successful preparation of anti-PLIγmAb is significant for further investigation on the relationship between the structure and function of PLIγs, as well as the interaction between PLIγs and PLA2s.
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Affiliation(s)
- Jingjing Li
- Department of Biochemistry, College of Basic Medical Science, Nanchang University, Nanchang, 330006 China
| | - Ying Xiong
- Second Affiliated Hospital to Nanchang University, Nanchang University, Nanchang, 330006 China
| | - Shimin Sun
- Department of Biochemistry, College of Basic Medical Science, Nanchang University, Nanchang, 330006 China
| | - Lehan Yu
- Department of Biochemistry, College of Basic Medical Science, Nanchang University, Nanchang, 330006 China
| | - Chunhong Huang
- Jiangxi Province Key Laboratory of Tumor Pathogens and Molecular Pathology, Nanchang University, 461 Bayi Avenue, Nanchang, 330006 China
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Oliveira FDR, Noronha MDDN, Lozano JLL. Biological and molecular properties of yellow venom of the Amazonian coral snake Micrurus surinamensis. Rev Soc Bras Med Trop 2017; 50:365-373. [DOI: 10.1590/0037-8682-0408-2016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/11/2017] [Indexed: 11/22/2022] Open
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Sartim MA, Cezarette GN, Jacob-Ferreira AL, Frantz FG, Faccioli LH, Sampaio SV. Disseminated intravascular coagulation caused by moojenactivase, a procoagulant snake venom metalloprotease. Int J Biol Macromol 2017; 103:1077-1086. [PMID: 28552727 DOI: 10.1016/j.ijbiomac.2017.05.146] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/27/2017] [Accepted: 05/18/2017] [Indexed: 02/07/2023]
Abstract
Snake venom toxins that activate coagulation factors are key players in the process of venom-induced coagulopathy, and account for severe clinical manifestations. The present study applies a variety of biochemical, hematological, and histopathological approaches to broadly investigate the intravascular and systemic effects of moojenactivase (MooA), the first described PIIId subclass metalloprotease isolated from Bothrops sp. venom that activates coagulation factors. MooA induced consumption coagulopathy with high toxic potency, characterized by prolongation of prothrombin and activated partial thromboplastin time, consumption of fibrinogen and the plasma coagulation factors X and II, and thrombocytopenia. MooA promoted leukocytosis and expression of the proinflammatory cytokines interleukin-6 and tumor necrosis factor-α, accompanied by tissue factor-dependent procoagulant activity in peripheral blood mononuclear cells. This metalloprotease also caused intravascular hemolysis, elevated plasma levels of creatine kinase-MB, aspartate transaminase, and urea/creatinine, and induced morphopathological alterations in erythrocytes, heart, kidney, and lungs associated with thrombosis and hemorrhage. Diagnosis of MooA-induced disseminated intravascular coagulation represents an important approach to better understand the pathophysiology of Bothrops envenomation and develop novel therapeutic strategies targeting hemostatic disturbances.
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Affiliation(s)
- Marco A Sartim
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Gabriel N Cezarette
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Anna L Jacob-Ferreira
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Fabiani G Frantz
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Lucia H Faccioli
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Suely V Sampaio
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil.
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Meléndez-Martínez D, Muñoz JM, Barraza-Garza G, Cruz-Peréz MS, Gatica-Colima A, Alvarez-Parrilla E, Plenge-Tellechea LF. Rattlesnake Crotalus molossus nigrescens venom induces oxidative stress on human erythrocytes. J Venom Anim Toxins Incl Trop Dis 2017; 23:24. [PMID: 28439287 PMCID: PMC5399391 DOI: 10.1186/s40409-017-0114-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 04/12/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Globally, snake envenomation is a well-known cause of death and morbidity. In many cases of snakebite, myonecrosis, dermonecrosis, hemorrhage and neurotoxicity are present. Some of these symptoms may be provoked by the envenomation itself, but others are secondary effects of the produced oxidative stress that enhances the damage produced by the venom toxins. The only oxidative stress effect known in blood is the change in oxidation number of Fe (from ferrous to ferric) in hemoglobin, generating methemoglobin but not in other macromolecules. Currently, the effects of the overproduction of methemoglobin derived from snake venom are not extensively recorded. Therefore, the present study aims to describe the oxidative stress induced by Crotalus molossus nigrescens venom using erythrocytes. METHODS Human erythrocytes were washed and incubated with different Crotalus molossus nigrescens venom concentrations (0-640 μg/mL). After 24 h, the hemolytic activity was measured followed by attenuated total reflectance-Fourier transform infrared spectroscopy, non-denaturing PAGE, conjugated diene and thiobarbituric acid reactive substances determination. RESULTS Low concentrations of venom (<10 μg/mL) generates oxyhemoglobin release by hemolysis, whereas higher concentrations produced a hemoglobin shift of valence, producing methemoglobin (>40 μg/mL). This substance is not degraded by proteases present in the venom. By infrared spectroscopy, starting in 80 μg/mL, we observed changes in bands that are associated with protein damage (1660 and 1540 cm-1) and lipid peroxidation (2960, 2920 and 1740 cm-1). Lipid peroxidation was confirmed by conjugated diene and thiobarbituric acid reactive substance determination, in which differences were observed between the control and erythrocytes treated with venom. CONCLUSIONS Crotalus molossus nigrescens venom provokes hemolysis and oxidative stress, which induces methemoglobin formation, loss of protein structure and lipid peroxidation.
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Affiliation(s)
- David Meléndez-Martínez
- Departamento de Ciencias Químico Biológicas, Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Estocolmo s/n, C. P. 32310. A. P. 1595-D Ciudad Juárez, Chihuahua Mexico
| | - Juan Manuel Muñoz
- Departamento de Ciencias Químico Biológicas, Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Estocolmo s/n, C. P. 32310. A. P. 1595-D Ciudad Juárez, Chihuahua Mexico
| | - Guillermo Barraza-Garza
- Departamento de Ciencias Químico Biológicas, Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Estocolmo s/n, C. P. 32310. A. P. 1595-D Ciudad Juárez, Chihuahua Mexico
| | - Martha Sandra Cruz-Peréz
- Herpetario de la Universidad Autónoma de Querétaro, Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Juriquilla, Querétaro, Mexico
| | - Ana Gatica-Colima
- Departamento de Ciencias Químico Biológicas, Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Estocolmo s/n, C. P. 32310. A. P. 1595-D Ciudad Juárez, Chihuahua Mexico
| | - Emilio Alvarez-Parrilla
- Departamento de Ciencias Químico Biológicas, Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Estocolmo s/n, C. P. 32310. A. P. 1595-D Ciudad Juárez, Chihuahua Mexico
| | - Luis Fernando Plenge-Tellechea
- Departamento de Ciencias Químico Biológicas, Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Estocolmo s/n, C. P. 32310. A. P. 1595-D Ciudad Juárez, Chihuahua Mexico
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Nery NM, Luna KP, Fernandes CFC, Zuliani JP. An overview of Bothrops erythromelas venom. Rev Soc Bras Med Trop 2017; 49:680-686. [PMID: 28001213 DOI: 10.1590/0037-8682-0195-2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 10/14/2016] [Indexed: 11/22/2022] Open
Abstract
This review discusses studies on the venom of Bothrops erythromelas published over the past 36 years. During this period, many contributions have been made to understand the venomous snake, its venom, and its experimental and clinical effects better. The following chronological overview is based on 29 articles that were published between 1979 and 2015, with emphasis on diverse areas. The complexity of this task demands an integration of multidisciplinary research tools to study toxinology. This science is in need of renewed conceptual and experimental platforms aimed at obtaining a profound understanding of the highly complex pathophysiology of snakebite envenoming and toxins isolated from snakes.
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Affiliation(s)
- Neriane Monteiro Nery
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, Rondônia, Porto Velho, Brazil
| | - Karla Patrícia Luna
- Departamento de Biologia, Universidade Estadual da Paraíba, Campina Grande, Paraíba, Brazil
| | - Carla Freire Celedônio Fernandes
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, Rondônia, Porto Velho, Brazil.,Centro de Pesquisa em Medicina Tropical, Porto Velho, Rondônia, Brazil
| | - Juliana Pavan Zuliani
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, Rondônia, Porto Velho, Brazil.,Departamento de Medicina, Universidade Federal de Rondônia, Porto Velho, Rondônia, Brazil
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Quan D, Zurcher K. Reversible atrial fibrillation following Crotalinae envenomation. J Venom Anim Toxins Incl Trop Dis 2017; 23:16. [PMID: 28331489 PMCID: PMC5359800 DOI: 10.1186/s40409-017-0108-9] [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: 08/08/2016] [Accepted: 03/13/2017] [Indexed: 11/25/2022] Open
Abstract
Background Cardiotoxicity is a documented complication of Crotalinae envenomation. Reported cardiac complications following snake envenomation have included acute myocardial infarction, electrocardiogram abnormalities and arrhythmias. Few reports exist describing arrhythmia induced by viper envenomation and to our knowledge none describe arrhythmia induced by Crotalinae envenomation. This report concerns the first known case of atrial fibrillation precipitated by rattlesnake bite. Case presentation A 73-year-old Caucasian man with a past medical history of hypertension, hyperlipidemia, type 1 diabetes mellitus, and a baseline first-degree atrioventricular block presented to the emergency department following a rattlesnake bite to his left lower leg. He developed pain and swelling in his left leg two-hour post-envenomation and subsequently received four vials of Crotalidae polyvalent immune fab (ovine). At three-hour post-envenomation following transfer to the intensive care unit, an electrocardiogram revealed new-onset atrial fibrillation. An amiodarone drip was started and the patient successfully converted to normal sinus rhythm approximately six hours after he was found to be in atrial fibrillation. A transthoracic echocardiogram revealed mild concentric left ventricular hypertrophy and an ejection fraction of 72%. He was discharged the following day with no hematological abnormalities and a baseline first-degree atrioventricular block. Conclusion This is the first documented case of reversible atrial fibrillation precipitated by Crotalinae envenomation. In patients with pertinent risk factors for developing atrial fibrillation, physicians should be aware of the potential for this arrhythmia. Direct toxic effects of venom or structural and electrophysiological cardiovascular abnormalities may predispose snakebite patients to arrhythmia, warranting extended and attentive cardiac monitoring.
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Affiliation(s)
- Dan Quan
- Department of Emergency Medicine, Maricopa Integrated Health System, 2601 East Roosevelt Road, Phoenix, AZ 85008 USA.,Department of Emergency Medicine, University of Arizona College of Medicine - Phoenix, 550 East Van Buren Street, Phoenix, AZ 85004 USA
| | - Kenneth Zurcher
- University of Arizona College of Medicine - Phoenix, 550 East Van Buren Street, Phoenix, AZ 85004 USA
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Santos-Filho NA, Santos CT. Alpha-type phospholipase A 2 inhibitors from snake blood. J Venom Anim Toxins Incl Trop Dis 2017; 23:19. [PMID: 28344595 PMCID: PMC5364564 DOI: 10.1186/s40409-017-0110-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/16/2017] [Indexed: 01/22/2023] Open
Abstract
It is of popular and scientific knowledge that toxins from snake venom (among them the PLA2 and myotoxins) are neutralized by various compounds, such as antibodies and proteins purified from animal blood. Venomous and nonvenomous snakes have PLA2 inhibitory proteins, called PLIs, in their blood serum. One hypothesis that could explain the presence of these PLIs in the serum of venomous snakes would be self-protection against the enzymes of their own venom, which eventually could reach the circulatory system. However, the presence of PLIs in non-venomous snakes suggests that their physiological role might not be restricted to protection against PLA2 toxins, but could be extended to other functions, as in the innate immune system and local regulation of PLA2s. The present study aimed to review the currently available literature on PLA2 and myotoxin alpha inhibitors present in snake plasma, thus helping to improve the research on these molecules. Furthermore, this review includes current information regarding the mechanism of action of these inhibitors in an attempt to better understand their application, and proposes the use of these molecules as new models in snakebite therapy. These molecules may help in the neutralization of different types of phospholipases A2 and myotoxins, complementing the conventional serum therapy.
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Affiliation(s)
- Norival A. Santos-Filho
- Institute of Chemistry, São Paulo State University (UNESP – Univ Estadual Paulista), Araraquara, SP Brazil
| | - Claudia T. Santos
- School of Pharmaceutical Sciences, São Paulo State University (UNESP – Univ Estadual Paulista), Araraquara, SP Brazil
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Isolation and characterization of a novel metalloprotease inhibitor from Bothrops alternatus snake serum. Int J Biol Macromol 2017; 98:436-446. [PMID: 28163123 DOI: 10.1016/j.ijbiomac.2017.01.131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/08/2017] [Accepted: 01/30/2017] [Indexed: 02/05/2023]
Abstract
Resistance of snakes and some other animals to snake envenomation has been attributed to soluble factors present in their tissues. Here we report the isolation of a novel metalloprotease inhibitor from Bothrops alternatus snake serum (named BaltMPI) with high purity, using a four-step chromatographic method. BaltMPI has molecular weights of 60.5 and 42.4kDa, as determined by SDS-PAGE and mass spectrometry, respectively, and pI=5.27. The first 60 amino acids from the N-terminal region of BaltMPI, determined by Edman's degradation, showed high homology (97%) with the snake venom metalloprotease inhibitor (SVMPI) BJ46a and other SVMPIs (78-82%). The chromatographic fractions and purified BaltMPI exhibited anti-hemorrhagic activity against Batroxase and BjussuMP-I. BaltMPI was stable over wide ranges of pH (1, 5, 8, and 9) and temperature (-80, -20, 4, 60, and 100°C), and suppressed the fibrinogenolytic, fibrinolytic, and azocaseinolytic activities of Batroxase. BaltMPI specifically inhibited the activity of metalloproteases, without affecting the activity of serine proteases. Together, our results suggest that BaltMPI and other SVMPIs are promising molecules for the treatment of snake envenomation, in particular that caused by Bothrops sp.
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rBaltMIP, a recombinant alpha-type myotoxin inhibitor from Bothrops alternatus (Rhinocerophis alternatus) snake, as a potential candidate to complement the antivenom therapy. Toxicon 2016; 124:53-62. [PMID: 28327300 DOI: 10.1016/j.toxicon.2016.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 02/04/2023]
Abstract
Phospholipase A2 inhibitors (PLIs) are important targets in the search and development of new drugs. This study aimed at evaluating the potential of an alpha-type phospholipase A2 inhibitor from Bothrops alternatus (Rhinocerophis alternatus) snake in its recombinant form (rBaltMIP) to complement the conventional antivenom therapy. Biochemical experiments showed that rBaltMIP presented pI 5.8 and molecular masses of ∼21 kDa by SDS-PAGE and 19.57 kDa by MALDI/TOF MS. After tryptic peptides sequencing, the results were compared with other PLIs available in databases, showing 100% identity between rBaltMIP and its native inhibitor BaltMIP and from 92% to 96% identity with other inhibitors. Myotoxic activities of BthTX-I and BthTX-II toxins were measured via plasma CK levels, showing myotoxic effective concentrations (EC50) of 0.1256 μg/μL and 0.6183 μg/μL, respectively. rBaltMIP neutralized the myotoxicity caused by these two toxins up to 65%, without promoting primary antibody response against itself. Nevertheless, this recombinant PLI was immunogenic when standard immunization protocol with Freud's adjuvant was used. In paw edema assays, EC50 of 0.02581 μg/μL and 0.02810 μg/μL, respectively, were observed with edema reductions of up to 40% by rBaltMIP, suggesting its use as an additional antivenom. In addition, myotoxicity neutralization experiments with the myotoxin BthTX-I showed that rBaltMIP was more effective in inhibiting muscle damage than the conventional antivenom. Thus, considering the severity of envenomations due to Bothrops alternatus (Rhinocerophis alternatus) and the low neutralization of their local effects (such as myotoxicity) by the current antivenoms, rBaltMIP is a promising molecule for the development of novel therapeutic strategies for clinical applications.
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Hossain J, Biswas A, Rahman F, Mashreky SR, Dalal K, Rahman A. Snakebite Epidemiology in Bangladesh—A National Community Based Health and Injury Survey. Health (London) 2016. [DOI: 10.4236/health.2016.85051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hemorrhagic stroke in children caused by Bothrops marajoensis envenoming: a case report. J Venom Anim Toxins Incl Trop Dis 2015; 21:53. [PMID: 26672486 PMCID: PMC4678637 DOI: 10.1186/s40409-015-0052-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/21/2015] [Indexed: 11/10/2022] Open
Abstract
According to the World Health Organization, snakebites are considered neglected diseases. Bothrops, the genus most frequently implicated in envenomations in Brazil, includes the species B. marajoensis Hoge, 1966, part of the complex B. atrox, which is found in the savannas of Marajó Island, Pará state, Brazil, a region that presents scarce epidemiological data. This work reports the first case of hemorrhagic stroke in a child, attributed to delayed medical care after snakebite envenoming by Bothrops marajoensis in Anajás city, Marajó Island, Pará, Brazil, which led to permanent hemiplegia as a sequela.
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Snakes and snakebite envenoming in Northern Tanzania: a neglected tropical health problem. J Venom Anim Toxins Incl Trop Dis 2015; 21:32. [PMID: 26309444 PMCID: PMC4548540 DOI: 10.1186/s40409-015-0033-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 08/13/2015] [Indexed: 12/02/2022] Open
Abstract
Background Snakebites cause considerable human and livestock injuries as well as deaths worldwide, and particularly have a high impact in sub-Saharan Africa. Generating a basic platform of information on the characteristics of snakes and snakebites in various countries is relevant for designing and implementing public health interventions. Methods This study was performed to identify types of snakes and some of the characteristics of snakebite cases in two communities, an agricultural and a pastoralist, in Arusha region, northern Tanzania. A total of 30 field visits were carried out in areas considered by local inhabitants to be potential microhabitats for snakes. Direct observation of snake types based on morphological features and a structured questionnaire were employed for data collection. Results A total of 25 live and 14 dead snakes were encountered. Among the dead ones, the following species were identified: two black-necked spitting cobras (Naja nigricollis); five puff adders (Bitis arietans), one common egg-eater (Dasypeltis scabra); two rufous-beaked snakes (Ramphiophis rostratus); two brown house snakes (Lamprophis fuliginosus); one Kenyan sand boa (Eryx colubrinus), and one black mamba (Dendroaspis polylepis). The frequency of snake encounters was significantly higher (χ2 = 4.6; p = 0.03) in the pastoral than in the agricultural area; there were more snakebite cases in the former, but the differences were not statistically significant (p = 0.7). A total of 242 snakebite victims attended at the Meserani Clinic, located in the study area, between the years 2007 to 2012. Of all cases, 146 (61.6 %) and 96 (38.4 %) were male and female patients, respectively. As for age distribution, 59.1 % of snakebite victims were from the economically active age groups between 15 and 55 years. Conclusion Snakebites are a threat to rural communities and public health in general. The burden of snakebites in Tanzania presents an epidemiologically similar picture to other tropical countries. Livestock keeping and agriculture are the major economic activities associated with snakebites. Community-based public education is required to create awareness on venomous snakes and predisposing factors to snakebites. These tasks demand integration of diverse stakeholders to achieve a common goal of reducing the impact of human suffering from these envenomings in Tanzania.
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Menaldo DL, Jacob-Ferreira AL, Bernardes CP, Cintra ACO, Sampaio SV. Purification procedure for the isolation of a P-I metalloprotease and an acidic phospholipase A2 from Bothrops atrox snake venom. J Venom Anim Toxins Incl Trop Dis 2015; 21:28. [PMID: 26273288 PMCID: PMC4535780 DOI: 10.1186/s40409-015-0027-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 07/21/2015] [Indexed: 11/25/2022] Open
Abstract
Background Snake venoms are complex mixtures of inorganic and organic components, mainly proteins and peptides. Standardization of methods for isolating bioactive molecules from snake venoms is extremely difficult due to the complex and highly variable composition of venoms, which can be influenced by factors such as age and geographic location of the specimen. Therefore, this study aimed to standardize a simple purification methodology for obtaining a P-I class metalloprotease (MP) and an acidic phospholipase A2 (PLA2) from Bothrops atrox venom, and biochemically characterize these molecules to enable future functional studies. Methods To obtain the toxins of interest, a method has been standardized using consecutive isolation steps. The purity level of the molecules was confirmed by RP-HPLC and SDS-PAGE. The enzymes were characterized by determining their molecular masses, isoelectric points, specific functional activity and partial amino acid sequencing. Results The metalloprotease presented molecular mass of 22.9 kDa and pI 7.4, with hemorrhagic and fibrin(ogen)olytic activities, and its partial amino acid sequence revealed high similarity with other P-I class metalloproteases. These results suggest that the isolated metalloprotease is Batroxase, a P-I metalloprotease previously described by our research group. The phospholipase A2 showed molecular mass of 13.7 kDa and pI 6.5, with high phospholipase activity and similarity to other acidic PLA2s from snake venoms. These data suggest that the acidic PLA2 is a novel enzyme from B. atrox venom, being denominated BatroxPLA2. Conclusions The present study successfully standardized a simple methodology to isolate the metalloprotease Batroxase and the acidic PLA2 BatroxPLA2 from the venom of B. atrox, consisting mainly of classical chromatographic processes. These two enzymes will be used in future studies to evaluate their effects on the complement system and the inflammatory process, in addition to the thrombolytic potential of the metalloprotease.
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Affiliation(s)
- Danilo L Menaldo
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, (USP), Avenida do Café, s/n, Ribeirão Preto, SP, CEP 14040-903 Brasil
| | - Anna L Jacob-Ferreira
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, (USP), Avenida do Café, s/n, Ribeirão Preto, SP, CEP 14040-903 Brasil
| | - Carolina P Bernardes
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, (USP), Avenida do Café, s/n, Ribeirão Preto, SP, CEP 14040-903 Brasil
| | - Adélia C O Cintra
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, (USP), Avenida do Café, s/n, Ribeirão Preto, SP, CEP 14040-903 Brasil
| | - Suely V Sampaio
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, (USP), Avenida do Café, s/n, Ribeirão Preto, SP, CEP 14040-903 Brasil
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