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Teixeira-Cruz JM, Martins-Ferreira J, Monteiro-Machado M, Strauch MA, de Moraes JA, Amaral LS, Valente RC, Melo PA, Quintas LEM. Heparin prevents the cytotoxic activity of Bothrops jararacussu and Apis mellifera venoms in renal cells. Toxicon 2023; 223:107011. [PMID: 36584790 DOI: 10.1016/j.toxicon.2022.107011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022]
Abstract
Envenomation by Bothrops snakes and Apis mellifera bee may imply systemic disorders which affect well-perfused organs such as kidneys, a process that can lead to acute renal failure. Nevertheless, there is scarce information regarding a direct renal cell effect and the putative antagonism by antivenoms. Here the cytotoxic effect of B. jararacussu and A. mellifera venoms was evaluated in the renal proximal tubule cell line LLC-PK1, as well as the antagonism of this effect by heparin. B. jararacussu venom showed significant cytotoxicity as assessed by LDH release and MTT reduction, with a sharp decline of the cell number after 180 min (>90% at 50 μg/mL). A. mellifera venom produced a much faster and potent cytotoxic activity, conferring almost no viable cells after 15 min at 25 μg/mL. Phase contrast microscopy revealed that while B. jararacussu venom induced a progressive loss of cell adhesion and detachment, A. mellifera venom promoted a rapid plasma membrane disruption and nuclear condensation suggestive of necrotic cell death. Pre-incubation of both venoms with heparin for 30 min significantly reduced cytotoxicity. Our results demonstrate direct toxicity of B. jararacussu and A. mellifera venoms toward renal cells but with distinct kinetics and cell pattern, suggesting different mechanisms of action. In addition, the antagonistic, cytoprotective effect of heparin ascribes such compound as a promising drug for preventing renal failure from envenomation.
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Affiliation(s)
- Jhonatha M Teixeira-Cruz
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jainne Martins-Ferreira
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcos Monteiro-Machado
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcelo A Strauch
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Instituto Vital Brazil, Niterói, RJ, Brazil
| | - João Alfredo de Moraes
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana S Amaral
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Raphael C Valente
- Núcleo Multidisciplinar de Pesquisa Em Biologia, Universidade Federal do Rio de Janeiro - Campus Duque de Caxias Professor Geraldo Cidade, Rio de Janeiro, Brazil
| | - Paulo A Melo
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luis Eduardo M Quintas
- Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Acehan S, Satar S, Gulen M, Yucel C, Segmen MS. Angina and Arrhythmia Symptoms Following Multiple Bee Stings: Kounis Syndrome. Wilderness Environ Med 2022; 33:417-421. [PMID: 36109267 DOI: 10.1016/j.wem.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
Kounis syndrome (KS) is an acute coronary syndrome including coronary spasm, acute myocardial infarction, and stent thrombosis preceded by an anaphylactic, anaphylactoid, allergic, or hypersensitivity injury. In this case presentation, we discussed Type I and Type II KS. Case 1 was a 72-y-old man who presented to the emergency department with allergic symptoms and chest pain that developed after multiple bee stings. Electrocardiography showed ST depression in the lateral leads. Case 2 was a 42-y-old woman who presented to the emergency department with complaints of chest pain, dizziness, and presyncope that developed after multiple bee stings. Mobitz Type II Block with right bundle branch block was observed in 42 beats·min-1 in the electrocardiography. Both patients were first treated for allergic reaction. Although early percutaneous coronary intervention was performed for graft thrombosis in Case 1, a permanent pacemaker was inserted in Case 2. The patients were discharged without any complications. Increasing physician awareness towards the existence of KS can prevent fatal outcomes with early diagnosis and treatment.
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Affiliation(s)
| | | | | | - Ceyhun Yucel
- Department of Cardiology, Adana City Training and Research Hospital, Adana, Turkey
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Bee Products as Interesting Natural Agents for the Prevention and Treatment of Common Cardiovascular Diseases. Nutrients 2022; 14:nu14112267. [PMID: 35684067 PMCID: PMC9182958 DOI: 10.3390/nu14112267] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 02/02/2023] Open
Abstract
Apitherapy is a form of alternative therapy that relies on the use of bee products, i.e., honey, royal jelly, propolis, pollen, and bee venom (known as apitoxin), for the prevention and treatment of various diseases. Various in vitro and in vivo studies suggest that these products may be effective in the prophylaxis and treatment of cardiovascular diseases (CVDs). This mini-review of papers identified in various electronic databases describes new aspects of the bioactivity of certain bee products, viz. bee pollen, royal jelly, bee venom, propolis, and bee bread, as natural interesting products for the prevention and treatment of common CVDs.
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Franco-Lugo D, Uribe-Vallarta DA, Bernal-Contreras KD, Vargas-Abonce VP, Soto-Pérez-De-Celis E, Rivera-Figueroa J, Cuevas-Ramos D, Gómez-Pérez FJ, Gómez-Sámano MÁ. Idioventricular rhythm and shock after a honeybee sting. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:186-189. [PMID: 33887752 PMCID: PMC8295876 DOI: 10.24875/acm.20000035] [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] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The objective of this study was to describe the case of a 19-year-old male presenting with bradycardia and hypotension after a honeybee sting making a review of the literature and pathophysiology of the cardiovascular and electrocardiogram (EKG) changes after a bee sting. METHODS The patient's airway was inspected and secured. Electrocardiogram with an idioventricular rhythm at 41' bpm. Oxygen was administered, an intravenous access was established, and the transcutaneous pacemaker leads were placed on the chest of the patient, then published guidelines management was induced. RESULTS The EKG showed idioventricular rhythm at a rate of 41 beats/min that resolved to a normal sinus rhythm after treatment. CONCLUSIONS A full and prompt cardiovascular evaluation should be performed in all patients presenting to the emergency department after a bee sting, and published guidelines regarding the management of bradycardia and anaphylaxis should be followed to achieve successful outcomes.
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Affiliation(s)
| | | | | | | | - Enrique Soto-Pérez-De-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Jaime Rivera-Figueroa
- Department of Cardiology and Electrophysiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Daniel Cuevas-Ramos
- Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Francisco J Gómez-Pérez
- Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Miguel Á Gómez-Sámano
- Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
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[Mortal poisoning by bee stings in a child: Study of a case observed in the regional hospital of Maradi (Niger)]. ACTA ACUST UNITED AC 2016; 109:325-328. [PMID: 27738911 DOI: 10.1007/s13149-016-0506-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 05/03/2016] [Indexed: 11/26/2022]
Abstract
We report a fatal case due to a massive attack by a swarm of bees in a nine-year-old child. The accident was fatal because of two aggravating factors: the cephalic location and the large number of stings (about 300). Complications were coagulopathy, anemia, hemorrhage, coma, and oligoanuria. Support was symptomatic at a facility second level. The outcome was fatal within 14 days. In view of the encountered difficulties, we recommend to build written protocols for the management of envenomation in any health training reference.
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Caldas SA, Graça FAS, de Barros JSM, Rolim MF, Peixoto TDC, Peixoto PV. Lesions caused by Africanized honeybee stings in three cattle in Brazil. J Venom Anim Toxins Incl Trop Dis 2013; 19:18. [PMID: 23968247 PMCID: PMC3765377 DOI: 10.1186/1678-9199-19-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 08/12/2013] [Indexed: 11/24/2022] Open
Abstract
We report three cases of stings by Africanized bees in cattle in the state of Rio de Janeiro, Brazil. Erythema, subcutaneous edema, necrosis accompanied by skin detachment, and subsequent skin regeneration were observed, especially on the head and dewlap. Histopathological examinations performed 45 days later revealed complete skin reepithelialization with moderate dermal fibrosis. The clinical picture and differential diagnosis are discussed in the present manuscript, with a focus on photosensitization, which causes cutaneous lesions on the head (sequela) with cicatricial curving of the ears and can be very similar to what is observed in cattle attacked by swarms of bees. The distinction between photosensitization and bee sting lesions can be made with a focus on history and clinical and pathological aspects.
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Affiliation(s)
- Saulo Andrade Caldas
- Department of Veterinary Surgery and Medicine, Institute of Veterinary Medicine, Federal Rural University of Rio de Janeiro (UFRRJ), Seropédica, Rio de Janeiro, Brazil
| | - Flávio Augusto Soares Graça
- Center of Agricultural Sciences and Technology, State University of Norte Fluminense, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Márcia Farias Rolim
- Graduate Program in Veterinary Medicine, State University of Norte Fluminense, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tiago da Cunha Peixoto
- Department of Pathology and Clinical Medicine, School of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Paulo Vargas Peixoto
- Department of Animal Nutrition and Pastures, Institute of Animal Husbrandry, Federal Rural University of Rio de Janeiro (UFRRJ), Seropédica, Rio de Janeiro, Brazil
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Santhosh M SR, Viswanathan S, Kumar S. The bee sting related wolff-Parkinson-white syndrome. J Clin Diagn Res 2013; 6:1541-3. [PMID: 23285451 DOI: 10.7860/jcdr/2012/4604.2554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 09/17/2012] [Indexed: 01/20/2023]
Abstract
Hymenoptera stings are common reasons for emergency visits. The admissions for the hymenoptera stings occur for systemic or unusual reactions. We are reporting a man with multiple bee stings, who presented with dizziness and palpitations and was found to have ECG findings of the Wolff-Parkinson-White syndrome. He had no worsening of symptoms or new ECG changes during his hospitalization. The hymenoptera related cardiac effects have also been reviewed and summarized.
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Affiliation(s)
- Shanmuga Ravi Santhosh M
- Intern, Department of Internal Medicine Pondicherry Institute of Medical Sciences, Pondicherry, India
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Almeida RAMDB, Olivo TET, Mendes RP, Barraviera SRCS, Souza LDR, Martins JG, Hashimoto M, Fabris VE, Ferreira Junior RS, Barraviera B. Africanized honeybee stings: how to treat them. Rev Soc Bras Med Trop 2012; 44:755-61. [PMID: 22231250 DOI: 10.1590/s0037-86822011000600020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 06/16/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In 1956, Africanized honeybees (AHB) migrated from Brazil to other regions of the Western Hemisphere, including South, Central, and North America, except for Canada. Despite being productive, they are highly aggressive and cause fatal accidents. This study aimed to evaluate patients at the Clinical Hospital of Botucatu Medical School (HC-FMB) and to propose treatment guidelines. METHODS From 2005 to 2006, the clinical and laboratorial aspects of 11 patients (7 male and 4 female) and the anatomopathological aspects of one patient who had died in 2003 were analyzed. RESULTS The age of the surviving patients varied from 5 to 87 years, with a mean of 42.5 years. The majority of accidents occurred in the afternoon, and the number of stings ranged from 20 to 500. The principal signs and symptoms were pain and local inflammatory signs, nausea, tachycardia, and vomiting. Biochemical findings presented increased levels of creatine phosphokinase, lactate dehydrogenase, and aspartate/alanine aminotransferase. An 11-year-old male patient died upon entering the attic of a two-story building where he was attacked by a swarm, receiving more than 1,000 stings. He was sent to HC-FMB where he was treated, but he died 24h later. Observed at the autopsy were erythematous-purpuric skin lesions besides necrosis at the sting locations, rhabdomyolysis, focal myocardial necrosis, tubular hydropic degeneration and focal tubular acute necrosis of the kidneys, myoglobinuria, and centrolobular necrosis in the liver. CONCLUSIONS Accidents caused by multiple AHB stings always constitute a medical emergency. As there is no specific antivenom, we have developed guidelines, including first aid, drugs, and the proper removal of stingers.
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Silva TC, De Paula Moura S, Ramos HR, De Araujo PS, Bueno Da Costa MH. Design of a Modern Liposome and Bee Venom Formulation for the Traditional VIT-Venom Immunotherapy. J Liposome Res 2008; 18:353-68. [DOI: 10.1080/08982100802518046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tatiana C. Silva
- Laboratório de Microesferas e Lipossomas
- Departamento de Medicina, Disciplina de Clínica Médica-UNIFESP, São Paulo, Brasil
| | | | - Henrique R. Ramos
- Laboratório de Biotecnologia Molecular, (Centro de Biotecnologia), Instituto Butantan, São Paulo, Brasil
- Departamento de Bioquímica-Instituto de Química-USP, São Paulo, Brasil
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Sitprija V. Animal toxins and the kidney. ACTA ACUST UNITED AC 2008; 4:616-27. [DOI: 10.1038/ncpneph0941] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Accepted: 07/30/2008] [Indexed: 01/15/2023]
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Kang HS, Kim SJ, Lee MY, Jeon SH, Kim SZ, Kim JS. The cardiovascular depression caused by bee venom in Sprague-Dawley rats associated with a decrease of developed pressure in the left ventricular and the ratio of ionized calcium/ionized magnesium. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2008; 36:505-16. [PMID: 18543385 DOI: 10.1142/s0192415x08005941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bee venom (BV) has been used in Oriental medicine to treat inflammatory diseases, such as tendonitis, bursitis, and rheumatoid arthritis, despite the sensitivity of the victims and toxicity of the venom. This study examined the mechanisms for the effects of BV on the cardiovascular system in rats. The arterial pressure and heart rate (HR) were measured in anesthetized rats. In addition, the left ventricular development pressure (LVDP) and total magnesium efflux ([Mg]e) in isolated perfused hearts, the vascular tonic responses in the isolated aorta, and the blood ionic and biochemical changes were determined simultaneously. In the anesthetized rats, the mean arterial pressure, systolic pressure, and pulse pressure were reduced by BV in a dose-dependent manner, even though the HR was increased. BV had no effects on the relaxation of phenylephrine- or KCl-induced contraction of the aortic rings. In the isolated hearts, BV generated a reversible decrease in the LVDP and velocity with changes in pressure, which were accompanied by increases in the HR and [Mg]e. BV increased the plasma ionized and total magnesium concentrations, and decreased the total magnesium level in the red blood cells. The ratio of ionized calcium/ionized magnesium was also decreased by the BV treatment. BV caused a detectable increase in blood creatine kinase, glutamic oxaloacetic transaminase, and lactic dehydrogenase, as well as a decrease in the blood total protein albumin and globulin levels. These results suggest that BV induces cardiovascular depression by decreasing the cardiac pressure and increasing the ionized magnesium concentration in the blood.
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Affiliation(s)
- Hyung-Sub Kang
- Department of Pharmacology and Toxicology, College of Veterinary Medicine, Bio-Safety Research Institute, Chonbuk National University, Center for the Healthcare Technology Development, Jeonju 561-756, Republic of Korea
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Abdulkader RC, Barbaro KC, Barros EJG, Burdmann EA. Nephrotoxicity of Insect and Spider Venoms in Latin America. Semin Nephrol 2008; 28:373-382. [DOI: 10.1016/j.semnephrol.2008.04.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Oliveira EC, Pedroso PMO, Meirelles AEWB, Pescador CA, Gouvêa AS, Driemeier D. Pathological findings in dogs after multiple Africanized bee stings. Toxicon 2007; 49:1214-8. [PMID: 17383705 DOI: 10.1016/j.toxicon.2007.01.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Revised: 01/30/2007] [Accepted: 01/31/2007] [Indexed: 11/22/2022]
Abstract
This retrospective study included 19 dogs that died by intoxication due to multiple Africanized bee stings. Bee accidents occurred in rural and urban areas of the Rio Grande do Sul state, southern Brazil. Although bee stings were associated with edema and hyperemia in several regions of the body, head and neck were the most commonly and massively affected areas. Stingers and bees were also observed in the digestive tract. Dark-colored kidneys, dark-red urine, splenomegaly, and dark red lungs were the main gross changes. Histologically, all the dogs had kidney tubular degeneration and necrosis, which were associated with tubular pigment accumulation in most cases. Other lesions included muscular necrosis, hemorrhage in different organs, marked congestion of the spleen and pulmonary edema and congestion.
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Affiliation(s)
- Eduardo C Oliveira
- Department of Veterinary Clinical Pathology, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), Avenida Bento Gonçalves 9090, CEP 91540-000, Brazil
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