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Rucavado A, Camacho E, Escalante T, Lomonte B, Fernández J, Solano D, Quirós-Gutiérrez I, Ramírez-Vargas G, Vargas K, Argüello I, Navarro A, Abarca C, Segura Á, Florentin J, Kallel H, Resiere D, Neviere R, Gutiérrez JM. A murine experimental model of the pulmonary thrombotic effect induced by the venom of the snake Bothrops lanceolatus. PLoS Negl Trop Dis 2024; 18:e0012335. [PMID: 39356725 DOI: 10.1371/journal.pntd.0012335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 09/24/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND The venom of Bothrops lanceolatus, a viperid species endemic to the Lesser Antillean Island of Martinique, induces thrombosis in a number of patients. Previous clinical observations indicate that thrombotic events are more common in patients bitten by juvenile specimens. There is a need to develop an experimental model of this effect in order to study the mechanisms involved. METHODOLOGY/PRINCIPAL FINDINGS The venoms of juvenile and adult specimens of B. lanceolatus were compared by (a) describing their proteome, (b) assessing their ability to induce thrombosis in a mouse model, and (c) evaluating their in vitro procoagulant activity and in vivo hemostasis alterations. Venom proteomes of juvenile and adult specimens were highly similar, albeit showing some differences. When injected by the intraperitoneal (i.p.) route, the venom of juvenile specimens induced the formation of abundant thrombi in the pulmonary vasculature, whereas this effect was less frequent in the case of adult venom. Thrombosis was not abrogated by the metalloproteinase inhibitor Batimastat. Both venoms showed a weak in vitro procoagulant effect on citrated mouse plasma and bovine fibrinogen. When administered intravenously (i.v.) venoms did not affect classical clotting tests (prothrombin time and activated partial thromboplastin time) but caused a partial drop in fibrinogen concentration. The venom of juvenile specimens induced partial alterations in some rotational thromboelastometry parameters after i.v. injection. When venoms were administered i.p., only minor alterations in classical clotting tests were observed with juvenile venom, and no changes occurred for either venom in rotational thromboelastometry parameters. Both juvenile and adult venoms induced a marked thrombocytopenia after i.p. injection. CONCLUSIONS/SIGNIFICANCE An experimental model of the thrombotic effect induced by B. lanceolatus venom was developed. This effect is more pronounced in the case of venom of juvenile specimens, despite the observation that juvenile and adult venom proteomes are similar. Adult and juvenile venoms do not induce a consumption coagulopathy characteristic of other Bothrops sp venoms. Both venoms induce a conspicuous thrombocytopenia. This experimental model reproduces the main clinical findings described in these envenomings and should be useful to understand the mechanisms of the thrombotic effect.
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Affiliation(s)
- Alexandra Rucavado
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Erika Camacho
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Teresa Escalante
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Bruno Lomonte
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Julián Fernández
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Daniela Solano
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Isabel Quirós-Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Gabriel Ramírez-Vargas
- Laboratorio de Hematología, Hospital Nacional de Niños 'Dr Carlos Sáenz Herrera', Caja Costarricense del Seguro Social, San José, Costa Rica
| | - Karol Vargas
- Laboratorio de Hematología, Hospital Nacional de Niños 'Dr Carlos Sáenz Herrera', Caja Costarricense del Seguro Social, San José, Costa Rica
| | - Ivette Argüello
- Laboratorio de Hematología, Hospital Nacional de Niños 'Dr Carlos Sáenz Herrera', Caja Costarricense del Seguro Social, San José, Costa Rica
| | - Alejandro Navarro
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Carlos Abarca
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Álvaro Segura
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Jonathan Florentin
- Department of Toxicology and Critical Care Medicine, University Hospital of Martinique (CHU Martinique), Fort-de-France, France
| | - Hatem Kallel
- Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana
- Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, Cayenne, French Guiana
| | - Dabor Resiere
- Department of Toxicology and Critical Care Medicine, University Hospital of Martinique (CHU Martinique), Fort-de-France, France
| | - Remi Neviere
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), Fort de France, France
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
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Zdenek CN, Cardoso FC, Robinson SD, Mercedes RS, Raidjõe ER, Hernandez-Vargas MJ, Jin J, Corzo G, Vetter I, King GF, Fry BG, Walker AA. Venom exaptation and adaptation during the trophic switch to blood-feeding by kissing bugs. iScience 2024; 27:110723. [PMID: 39280617 PMCID: PMC11402303 DOI: 10.1016/j.isci.2024.110723] [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: 04/25/2024] [Revised: 06/30/2024] [Accepted: 08/08/2024] [Indexed: 09/18/2024] Open
Abstract
Kissing bugs are known to produce anticoagulant venom that facilitates blood-feeding. However, it is unknown how this saliva evolved and if the venom produced by the entomophagous ancestors of kissing bugs would have helped or hindered the trophic shift. In this study, we show that venoms produced by extant predatory assassin bugs have strong anticoagulant properties mediated chiefly by proteolytic degradation of fibrinogen, and additionally contain anticoagulant disulfide-rich peptides. However, venom produced by predatory species also has pain-inducing and membrane-permeabilizing activities that would be maladaptive for blood-feeding, and which venom of the blood-feeding species lack. This study demonstrates that venom produced by the predatory ancestors of kissing bugs was exapted for the trophic switch to blood-feeding by virtue of its anticoagulant properties. Further adaptation to blood-feeding occurred by downregulation of venom toxins with proteolytic, cytolytic, and pain-inducing activities, and upregulation and neofunctionalization of toxins with anticoagulant activity independent of proteolysis.
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Affiliation(s)
| | - Fernanda C Cardoso
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD 4072, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Samuel D Robinson
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Raine S Mercedes
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD 4072, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, St. Lucia, QLD 4072, Australia
| | | | - María José Hernandez-Vargas
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnologia, Universidad Nacional Autónoma de México, Apartado Postal 510-3, Cuernavaca 62210, Morelos, Mexico
| | - Jiayi Jin
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Gerardo Corzo
- Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnologia, Universidad Nacional Autónoma de México, Apartado Postal 510-3, Cuernavaca 62210, Morelos, Mexico
| | - Irina Vetter
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD 4072, Australia
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Glenn F King
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD 4072, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Bryan G Fry
- Venom Evolution Lab, School of the Environment, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Andrew A Walker
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD 4072, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, St. Lucia, QLD 4072, Australia
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3
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Radouani F, Jalta P, Rapon C, Lezin C, Branford C, Florentin J, Gutierrez JM, Resiere D, Neviere R, Pierre-Louis O. The Contrasting Effects of Bothrops lanceolatus and Bothrops atrox Venom on Procoagulant Activity and Thrombus Stability under Blood Flow Conditions. Toxins (Basel) 2024; 16:400. [PMID: 39330858 PMCID: PMC11435654 DOI: 10.3390/toxins16090400] [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: 08/22/2024] [Revised: 09/12/2024] [Accepted: 09/14/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Consumption coagulopathy and hemorrhagic syndrome are the typical features of Bothrops sp. snake envenoming. In contrast, B. lanceolatus envenoming can induce thrombotic complications. Our aim was to test whether crude B. lanceolatus and B. atrox venoms would display procoagulant activity and induce thrombus formation under flow conditions. METHODS AND PRINCIPAL FINDINGS Fibrin formation in human plasma was observed for B. lanceolatus venom at 250-1000 ng/mL concentrations, which also induced clot formation in purified human fibrinogen, indicating thrombin-like activity. The degradation of fibrinogen confirmed the fibrinogenolytic activity of B. lanceolatus venom. B. lanceolatus venom displayed consistent thrombin-like and kallikrein-like activity increases in plasma conditions. The well-known procoagulant B. atrox venom activated plasmatic coagulation factors in vitro and induced firm thrombus formation under high shear rate conditions. In contrast, B. lanceolatus venom induced the formation of fragile thrombi that could not resist shear stress. CONCLUSIONS Our results suggest that crude B. lanceolatus venom displays amidolytic activity and can activate the coagulation cascade, leading to prothrombin activation. B. lanceolatus venom induces the formation of an unstable thrombus under flow conditions, which can be prevented by the specific monovalent antivenom Bothrofav®.
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Affiliation(s)
- Fatima Radouani
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
- Department of Research, University Hospital of Martinique (CHU Martinique), 97261 Fort-de-France, France
| | - Prisca Jalta
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
- Department of Research, University Hospital of Martinique (CHU Martinique), 97261 Fort-de-France, France
| | - Caroline Rapon
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
| | - Chloe Lezin
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
- Department of Biology, Faculté des Sciences Exactes et Naturelles (SEN), Campus Fouillole, 97157 Pointe-à-Pitre, France
| | - Chelsea Branford
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
| | - Jonathan Florentin
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
- Department of Research, University Hospital of Martinique (CHU Martinique), 97261 Fort-de-France, France
| | - Jose Maria Gutierrez
- Clodomiro Picado Institute, School of Microbiology, University of Costa Rica, San José 11501, Costa Rica
| | - Dabor Resiere
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
- Department of Toxicology and Critical Care Medicine, University Hospital of Martinique (CHU Martinique), 97261 Fort-de-France, France
| | - Remi Neviere
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
- Department of Clinical Physiology, University Hospital of Martinique (CHU Martinique), 97261 Fort-de-France, France
| | - Olivier Pierre-Louis
- Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort-de-France, France; (F.R.); (P.J.); (C.R.); (C.L.); (J.F.); (D.R.); (O.P.-L.)
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Qiao Z, Jones L, Bourke LA, Seneci L, Chowdhury A, Violette A, Fourmy R, Soria R, Aldridge M, Fry BG. Tiny but Mighty: Vipera ammodytes meridionalis (Eastern Long-Nosed Viper) Ontogenetic Venom Variations in Procoagulant Potency and the Impact on Antivenom Efficacies. Toxins (Basel) 2024; 16:396. [PMID: 39330854 PMCID: PMC11436208 DOI: 10.3390/toxins16090396] [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: 08/12/2024] [Revised: 09/01/2024] [Accepted: 09/12/2024] [Indexed: 09/28/2024] Open
Abstract
The Eastern Long-Nosed Viper (Vipera ammodytes meridionalis) is considered one of the most venomous snakes in Europe. However, it is unknown whether ontogenetic variation in venom effects occurs in this subspecies and how this may impact antivenom efficacy. In this study, we compared the procoagulant activities of V. a. meridionalis venom on human plasma between neonate and adult venom phenotypes. We also examined the efficacy of three antivenoms-Viperfav, ViperaTAb, and Inoserp Europe-across our neonate and adult venom samples. While both neonate and adult V. a. meridionalis venoms produced procoagulant effects, the effects produced by neonate venom were more potent. Consistent with this, neonate venom was a stronger activator of blood-clotting zymogens, converting them into their active forms, with a rank order of Factor X >> Factor VII > Factor XII. Conversely, the less potent adult venom had a rank order of FXII marginally more activated than Factor VII, and both much more so than Factor X. This adds to the growing body of evidence that activation of factors besides FII (prothrombin) and FX are significant variables in reptile venom-induced coagulopathy. Although all three examined antivenoms displayed effective neutralization of both neonate and adult V. a. meridionalis venoms, they generally showed higher efficacy on adult venom than on neonate venom. The ranking of antivenom efficacy against neonate venom, from the most effective to the least effective, were Viperfav, Inoserp Europe, ViperaTAb; for adult venom, the ranking was Inoserp Europe, Viperfav, ViperaTAb. Our data reveal ontogenetic variation in V. a meridionalis, but this difference may not be of clinical concern as antivenom was effective at neutralizing both adult and neonate venom phenotypes. Regardless, our results highlight a previously undocumented ontogenetic shift, likely driven by the documented difference in prey preference observed for this species across age classes.
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Affiliation(s)
- Zichen Qiao
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St. Lucia, QLD 4072, Australia; (Z.Q.); (L.J.); (L.A.B.); (L.S.); (A.C.)
| | - Lee Jones
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St. Lucia, QLD 4072, Australia; (Z.Q.); (L.J.); (L.A.B.); (L.S.); (A.C.)
| | - Lachlan A. Bourke
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St. Lucia, QLD 4072, Australia; (Z.Q.); (L.J.); (L.A.B.); (L.S.); (A.C.)
| | - Lorenzo Seneci
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St. Lucia, QLD 4072, Australia; (Z.Q.); (L.J.); (L.A.B.); (L.S.); (A.C.)
| | - Abhinandan Chowdhury
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St. Lucia, QLD 4072, Australia; (Z.Q.); (L.J.); (L.A.B.); (L.S.); (A.C.)
| | - Aude Violette
- Alphabiotoxine Laboratory Sprl, Barberie 15, 7911 Montroeul-au-Bois, Belgium; (A.V.); (R.F.)
| | - Rudy Fourmy
- Alphabiotoxine Laboratory Sprl, Barberie 15, 7911 Montroeul-au-Bois, Belgium; (A.V.); (R.F.)
| | - Raul Soria
- Inosan Biopharma, 28108 Alcobendas, Madrid, Spain;
| | | | - Bryan G. Fry
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St. Lucia, QLD 4072, Australia; (Z.Q.); (L.J.); (L.A.B.); (L.S.); (A.C.)
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5
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Chandrasekara U, Mancuso M, Seneci L, Bourke L, Trembath DF, Sumner J, Zdenek CN, Fry BG. A Russian Doll of Resistance: Nested Gains and Losses of Venom Immunity in Varanid Lizards. Int J Mol Sci 2024; 25:2628. [PMID: 38473875 DOI: 10.3390/ijms25052628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/18/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
The interplay between predator and prey has catalyzed the evolution of venom systems, with predators honing their venoms in response to the evolving resistance of prey. A previous study showed that the African varanid species Varanus exanthematicus has heightened resistance to snake venoms compared to the Australian species V. giganteus, V. komodoensis, and V. mertensi, likely due to increased predation by sympatric venomous snakes on V. exanthematicus. To understand venom resistance among varanid lizards, we analyzed the receptor site targeted by venoms in 27 varanid lizards, including 25 Australian varanids. The results indicate an active evolutionary arms race between Australian varanid lizards and sympatric neurotoxic elapid snakes. Large species preying on venomous snakes exhibit inherited neurotoxin resistance, a trait potentially linked to their predatory habits. Consistent with the 'use it or lose it' aspect of venom resistance, this trait was secondarily reduced in two lineages that had convergently evolved gigantism (V. giganteus and the V. komodoensis/V. varius clade), suggestive of increased predatory success accompanying extreme size and also increased mechanical protection against envenomation due to larger scale osteoderms. Resistance was completely lost in the mangrove monitor V. indicus, consistent with venomous snakes not being common in their arboreal and aquatic niche. Conversely, dwarf varanids demonstrate a secondary loss at the base of the clade, with resistance subsequently re-evolving in the burrowing V. acanthurus/V. storri clade, suggesting an ongoing battle with neurotoxic predators. Intriguingly, within the V. acanthurus/V. storri clade, resistance was lost again in V. kingorum, which is morphologically and ecologically distinct from other members of this clade. Resistance was also re-evolved in V. glebopalma which is terrestrial in contrast to the arboreal/cliff dwelling niches occupied by the other members of its clade (V. glebopalma, V. mitchelli, V. scalaris, V. tristis). This 'Russian doll' pattern of venom resistance underscores the dynamic interaction between dwarf varanids and Australian neurotoxic elapid snakes. Our research, which included testing Acanthophis (death adder) venoms against varanid receptors as models for alpha-neurotoxic interactions, uncovered a fascinating instance of the Red Queen Hypothesis: some death adders have developed more potent toxins specifically targeting resistant varanids, a clear sign of the relentless predator-prey arms race. These results offer new insight into the complex dynamics of venom resistance and highlight the intricate ecological interactions that shape the natural world.
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Affiliation(s)
- Uthpala Chandrasekara
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St Lucia, QLD 4072, Australia
| | - Marco Mancuso
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St Lucia, QLD 4072, Australia
| | - Lorenzo Seneci
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St Lucia, QLD 4072, Australia
| | - Lachlan Bourke
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St Lucia, QLD 4072, Australia
| | - Dane F Trembath
- Herpetology Department, Australian Museum Research Institute, Australian Museum, Sydney, NSW 2010, Australia
| | - Joanna Sumner
- Museums Victoria Research Institute, Melbourne, VIC 3001, Australia
| | - Christina N Zdenek
- School of the Environment, University of Queensland, St Lucia, QLD 4072, Australia
| | - Bryan G Fry
- Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St Lucia, QLD 4072, Australia
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6
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Freitas-de-Sousa LA, Colombini M, Souza VC, Silva JPC, Mota-da-Silva A, Almeida MRN, Machado RA, Fonseca WL, Sartim MA, Sachett J, Serrano SMT, Junqueira-de-Azevedo ILM, Grazziotin FG, Monteiro WM, Bernarde PS, Moura-da-Silva AM. Venom Composition of Neglected Bothropoid Snakes from the Amazon Rainforest: Ecological and Toxinological Implications. Toxins (Basel) 2024; 16:83. [PMID: 38393161 PMCID: PMC10891915 DOI: 10.3390/toxins16020083] [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: 12/11/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Snake venoms have evolved in several families of Caenophidae, and their toxins have been assumed to be biochemical weapons with a role as a trophic adaptation. However, it remains unclear how venom contributes to the success of venomous species for adaptation to different environments. Here we compared the venoms from Bothrocophias hyoprora, Bothrops taeniatus, Bothrops bilineatus smaragdinus, Bothrops brazili, and Bothrops atrox collected in the Amazon Rainforest, aiming to understand the ecological and toxinological consequences of venom composition. Transcriptomic and proteomic analyses indicated that the venoms presented the same toxin groups characteristic from bothropoids, but with distinct isoforms with variable qualitative and quantitative abundances, contributing to distinct enzymatic and toxic effects. Despite the particularities of each venom, commercial Bothrops antivenom recognized the venom components and neutralized the lethality of all species. No clear features could be observed between venoms from arboreal and terrestrial habitats, nor in the dispersion of the species throughout the Amazon habitats, supporting the notion that venom composition may not shape the ecological or toxinological characteristics of these snake species and that other factors influence their foraging or dispersal in different ecological niches.
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Affiliation(s)
| | - Mônica Colombini
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (L.A.F.-d.-S.); (M.C.)
| | - Vinicius C. Souza
- Laboratório de Toxinologia Aplicada, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (V.C.S.); (J.P.C.S.); (S.M.T.S.); (I.L.M.J.-d.-A.)
| | - Joanderson P. C. Silva
- Laboratório de Toxinologia Aplicada, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (V.C.S.); (J.P.C.S.); (S.M.T.S.); (I.L.M.J.-d.-A.)
| | - Ageane Mota-da-Silva
- Instituto Federal do Acre, Campus de Cruzeiro do Sul, Cruzeiro do Sul 69980-000, AC, Brazil;
| | - Marllus R. N. Almeida
- Laboratório de Herpetologia, Universidade Federal do Acre, Campus Floresta, Cruzeiro do Sul 69895-000, AC, Brazil; (M.R.N.A.); (R.A.M.); (W.L.F.); (P.S.B.)
| | - Reginaldo A. Machado
- Laboratório de Herpetologia, Universidade Federal do Acre, Campus Floresta, Cruzeiro do Sul 69895-000, AC, Brazil; (M.R.N.A.); (R.A.M.); (W.L.F.); (P.S.B.)
| | - Wirven L. Fonseca
- Laboratório de Herpetologia, Universidade Federal do Acre, Campus Floresta, Cruzeiro do Sul 69895-000, AC, Brazil; (M.R.N.A.); (R.A.M.); (W.L.F.); (P.S.B.)
| | - Marco A. Sartim
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil; (M.A.S.); (J.S.); (W.M.M.)
| | - Jacqueline Sachett
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil; (M.A.S.); (J.S.); (W.M.M.)
| | - Solange M. T. Serrano
- Laboratório de Toxinologia Aplicada, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (V.C.S.); (J.P.C.S.); (S.M.T.S.); (I.L.M.J.-d.-A.)
| | - Inácio L. M. Junqueira-de-Azevedo
- Laboratório de Toxinologia Aplicada, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (V.C.S.); (J.P.C.S.); (S.M.T.S.); (I.L.M.J.-d.-A.)
| | - Felipe G. Grazziotin
- Laboratório de Coleções Zoológicas, Instituto Butantan, São Paulo 05503-900, SP, Brazil;
| | - Wuelton M. Monteiro
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil; (M.A.S.); (J.S.); (W.M.M.)
| | - Paulo S. Bernarde
- Laboratório de Herpetologia, Universidade Federal do Acre, Campus Floresta, Cruzeiro do Sul 69895-000, AC, Brazil; (M.R.N.A.); (R.A.M.); (W.L.F.); (P.S.B.)
| | - Ana M. Moura-da-Silva
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (L.A.F.-d.-S.); (M.C.)
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Abad Ribeiro AB, Santoro ML, Duarte MR, Virgulino CC, de Oliveira GSS, França FODS. Hemoperitoneum after a Bothrops snakebite: Case report. Toxicon 2024; 237:107350. [PMID: 38016581 DOI: 10.1016/j.toxicon.2023.107350] [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: 08/09/2023] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023]
Abstract
Snakebites are frequent in tropical countries. Brazil has an average of 27,000 cases per year, with a fatality rate of 0.5%, and the Bothrops genus is the most common causative agent, accounting for about 70-90% of the accidents. This report describes a case of human envenomation by a juvenile Bothrops jararaca snake in São Paulo, Brazil, in a 71 years-old man, previously healthy. He presented a life-threatening envenomation, which developed to severe hypotension, acute kidney injury and extensive peritoneal hemorrhage. The hemoperitoneum was diagnosed due to persistent hypotension associated with anemia, pain and gastrointestinal complaints. Abdominal Computed Tomography scans showed a moderate to large amount of presumable hematic material inside the abdominal cavity, predominantly in the perihepatic and perisplenic spaces. The intra-abdominal hemorrhage was not surgically addressed, and the patient was discharged 5 days after hospitalization, with the progressive absorption of the hemoperitoneum. Systemic bleeding is one of the complications and main causes of death in Bothrops envenomations. Acute peritoneal hemorrhage is one of these serious complications that must be carefully addressed since its management must take into account the risk of bleeding caused by toxins that affect hemostasis. The case described highlights the importance of early diagnosis and adequate management of this potentially fatal complication in snakebites.
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Affiliation(s)
| | - Marcelo Larami Santoro
- Biotério Central and Escola Superior do Instituto Butantan (ESIB), Secretaria de Saúde do Estado de São Paulo, São Paulo, Brazil
| | - Marcelo Ribeiro Duarte
- Laboratório de Coleções Zoológicas, Instituto Butantan, Secretaria de Saúde do Estado de São Paulo, São Paulo, Brazil
| | - Cristiana Cruz Virgulino
- Hospital Vital Brazil, Instituto Butantan, Secretaria de Saúde do Estado de São Paulo, São Paulo, Brazil
| | - Gerson Sobrinho Salvador de Oliveira
- Divisão de Clínica Médica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil; Comissão de Controle de Infecção Hospitalar, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Francisco Oscar de Siqueira França
- Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Laboratório de Imunologia (LIM48), Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
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8
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Larréché S, Chevillard L, Jourdi G, Mathé S, Servonnet A, Joly BS, Siguret V, Chippaux JP, Mégarbane B. Bothrops venom-induced hemostasis disorders in the rat: Between Scylla and Charybdis. PLoS Negl Trop Dis 2023; 17:e0011786. [PMID: 38011218 PMCID: PMC10703418 DOI: 10.1371/journal.pntd.0011786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/07/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
Hemostasis impairment represents the most threatening consequence of Viperidae envenoming, notably with Bothrops genus. In the French departments of America, B. atrox envenomation in French Guiana may lead to bleeding while B. lanceolatus envenomation in Martinique to thrombosis. Bleeding related to B. atrox envenomation is attributed to vascular damage mediated by venom metalloproteinases and blood uncoagulable state resulting from thrombocytopenia and consumptive coagulopathy. Thrombosis related to B. lanceolatus envenomation are poorly understood. We aimed to compare the effects of B. atrox and B. lanceolatus venoms in the rat to identify the determinants of the hemorrhagic versus thrombotic complications. Viscoelastometry (ROTEM), platelet count, plasma fibrinogen, thrombin generation assay, fibrinography, endothelial (von Willebrand factor, ADAMTS13 activity, ICAM-1, and soluble E-selectin), and inflammatory biomarkers (IL-1β, IL-6, TNF-α, MCP-1, and PAI-1) were determined in blood samples obtained at H3, H6, and H24 after the subcutaneous venom versus saline injection. In comparison to the control, initial fibrinogen consumption was observed with the two venoms while thrombocytopenia and reduction in the clot amplitude only with B. atrox venom. Moreover, we showed an increase in thrombin generation at H3 with the two venoms, an increase in fibrin generation accompanied with hyperfibrinogenemia at H24 and an increase in inflammatory biomarkers with B. lanceolatus venom. No endothelial damage was found with the two venoms. To conclude, our data support two-sided hemostasis complications in Bothrops envenoming with an initial risk of hemorrhage related to platelet consumption and hypocoagulability followed by an increased risk of thrombosis promoted by the activated inflammatory response and rapid-onset fibrinogen restoration.
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Affiliation(s)
- Sébastien Larréché
- Université Paris Cité, Inserm UMRS-1144, Paris, France
- Department of Medical Biology, Bégin Military Teaching Hospital, Saint-Mandé, France
| | | | - Georges Jourdi
- Université Paris Cité, Inserm UMRS-1140, Innovative Therapies in Hemostasis, Paris, France
- Department of Biological Hematology, Lariboisière Hospital, APHP, Paris, France
| | - Simon Mathé
- Université Paris Cité, Inserm UMRS-1144, Paris, France
| | - Aurélie Servonnet
- Unité analyses biologiques, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Bérangère S. Joly
- Université Paris Cité, Inserm UMRS-1140, Innovative Therapies in Hemostasis, Paris, France
- Université Paris Cité, EA3518, Institut de Recherche Saint-Louis, Paris, France
| | - Virginie Siguret
- Université Paris Cité, Inserm UMRS-1140, Innovative Therapies in Hemostasis, Paris, France
- Department of Biological Hematology, Lariboisière Hospital, APHP, Paris, France
| | - Jean-Philippe Chippaux
- Université Paris Cité, Research Institute for Development, Mother, and Child in Tropical Environment: Pathogens, Health system and Epidemiological transition, Paris, France
| | - Bruno Mégarbane
- Université Paris Cité, Inserm UMRS-1144, Paris, France
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Federation of Toxicology, APHP, Paris, France
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9
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Larréché S, Bousquet A, Chevillard L, Gahoual R, Jourdi G, Dupart AL, Bachelot-Loza C, Gaussem P, Siguret V, Chippaux JP, Mégarbane B. Bothrops atrox and Bothrops lanceolatus Venoms In Vitro Investigation: Composition, Procoagulant Effects, Co-Factor Dependency, and Correction Using Antivenoms. Toxins (Basel) 2023; 15:614. [PMID: 37888645 PMCID: PMC10611193 DOI: 10.3390/toxins15100614] [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: 09/13/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Bothrops venoms are rich in enzymes acting on platelets and coagulation. This action is dependent on two major co-factors, i.e., calcium and phospholipids, while antivenoms variably neutralize venom-related coagulopathy effects. Our aims were (i) to describe the composition of B. atrox and B. lanceolatus venoms; (ii) to study their activity on the whole blood using rotational thromboelastometry (ROTEM); (iii) to evaluate the contribution of calcium and phospholipids in their activity; and (iv) to compare the effectiveness of four antivenoms (Bothrofav™, Inoserp™ South America, Antivipmyn™ TRI, and PoliVal-ICP™) on the procoagulant activity of these two venoms. Venom composition was comparable. Both venoms exhibited hypercoagulant effects. B. lanceolatus venom was completely dependent on calcium but less dependent on phospholipids than B. atrox venom to induce in vitro coagulation. The four antivenoms neutralized the procoagulant activity of the two venoms; however, with quantitative differences. Bothrofav™ was more effective against both venoms than the three other antivenoms. The relatively similar venom-induced effects in vitro were unexpected considering the opposite clinical manifestations resulting from envenomation (i.e., systemic bleeding with B. atrox and thrombosis with B. lanceolatus). In vivo studies are warranted to better understand the pathophysiology of systemic bleeding and thrombosis associated with Bothrops bites.
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Affiliation(s)
- Sébastien Larréché
- Inserm, UMRS-1144, Université Paris Cité, F-75006 Paris, France;
- Department of Medical Biology, Bégin Military Teaching Hospital, F-94160 Saint-Mandé, France; (A.B.); (A.-L.D.)
| | - Aurore Bousquet
- Department of Medical Biology, Bégin Military Teaching Hospital, F-94160 Saint-Mandé, France; (A.B.); (A.-L.D.)
| | - Lucie Chevillard
- Inserm, UMRS-1144, Université Paris Cité, F-75006 Paris, France;
| | - Rabah Gahoual
- Chemical and Biological Technologies for Health Unit, CNRS UMR 8258, Inserm, Université Paris Cité, F-75006 Paris, France;
| | - Georges Jourdi
- Innovative Therapies in Hemostasis, Inserm, Université Paris Cité, F-75006 Paris, France; (G.J.); (C.B.-L.); (P.G.); (V.S.)
- Department of Biological Hematology, Lariboisière Hospital, Assistance Publique–Hôpitaux de Paris, F-75010 Paris, France
| | - Anne-Laure Dupart
- Department of Medical Biology, Bégin Military Teaching Hospital, F-94160 Saint-Mandé, France; (A.B.); (A.-L.D.)
| | - Christilla Bachelot-Loza
- Innovative Therapies in Hemostasis, Inserm, Université Paris Cité, F-75006 Paris, France; (G.J.); (C.B.-L.); (P.G.); (V.S.)
| | - Pascale Gaussem
- Innovative Therapies in Hemostasis, Inserm, Université Paris Cité, F-75006 Paris, France; (G.J.); (C.B.-L.); (P.G.); (V.S.)
- Department of Hematology, Georges Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris, F-75015 Paris, France
| | - Virginie Siguret
- Innovative Therapies in Hemostasis, Inserm, Université Paris Cité, F-75006 Paris, France; (G.J.); (C.B.-L.); (P.G.); (V.S.)
- Department of Biological Hematology, Lariboisière Hospital, Assistance Publique–Hôpitaux de Paris, F-75010 Paris, France
| | - Jean-Philippe Chippaux
- French National Research Institute for Sustainable Development, Université Paris Cité, F-75006 Paris, France;
| | - Bruno Mégarbane
- Inserm, UMRS-1144, Université Paris Cité, F-75006 Paris, France;
- Department of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, Assistance Publique–Hôpitaux de Paris, F-75010 Paris, France
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Zdenek CN, Rodrigues CFB, Bourke LA, Tanaka-Azevedo AM, Monagle P, Fry BG. Children and Snakebite: Snake Venom Effects on Adult and Paediatric Plasma. Toxins (Basel) 2023; 15:158. [PMID: 36828472 PMCID: PMC9961128 DOI: 10.3390/toxins15020158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/26/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
Snakebite is a globally neglected tropical disease, with coagulation disturbances being the primary pathology of many deadly snake venoms. Age-related differences in human plasma have been abundantly reported, yet the effect that these differences pose regarding snakebite is largely unknown. We tested for differences in coagulotoxic effects (via clotting time) of multiple snake venoms upon healthy human adult (18+) and paediatric (median 3.3 years old) plasma in vivo and compared these effects to the time it takes the plasmas to clot without the addition of venom (the spontaneous clotting time). We tested venoms from 15 medically significant snake species (from 13 genera) from around the world with various mechanisms of coagulotoxic actions, across the three broad categories of procoagulant, pseudo-procoagulant, and anticoagulant, to identify any differences between the two plasmas in their relative pathophysiological vulnerability to snakebite. One procoagulant venom (Daboia russelii, Russell's Viper) produced significantly greater potency on paediatric plasma compared with adult plasma. In contrast, the two anticoagulant venoms (Pseudechis australis, Mulga Snake; and Bitis cornuta, Many-horned Adder) were significantly more potent on adult plasma. All other procoagulant venoms and all pseudo-procoagulant venoms displayed similar potency across both plasmas. Our preliminary results may inform future studies on the effect of snake venoms upon plasmas from different age demographics and hope to reduce the burden of snakebite upon society.
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Affiliation(s)
- Christina N. Zdenek
- Venom Evolution Lab, School of Biological Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | | | - Lachlan A. Bourke
- Venom Evolution Lab, School of Biological Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Anita Mitico Tanaka-Azevedo
- Laboratório de Herpetologia, Instituto Butantan, São Paulo 05508-040, SP, Brazil
- Programa de Pós-Graduação Interunidades Em Biotecnologia, USP, IPT e Instituto Butantan, São Paulo 05508-040, SP, Brazil
| | - Paul Monagle
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3010, Australia
- Haematology Research, Murdoch children’s Research Institute, Flemington Rd., Parkville, VIC 3052, Australia
- Department of Clinical Haematology, Royal Children’s Hospital, Flemington Rd., Parkville, VIC 3052, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, High St., Randwick, NSW 2031, Australia
| | - Bryan G. Fry
- Venom Evolution Lab, School of Biological Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
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Resiere D, Kallel H, Florentin J, Houcke S, Mehdaoui H, Gutiérrez JM, Neviere R. Bothrops (Fer-de-lance) snakebites in the French departments of the Americas (Martinique and Guyana): Clinical and experimental studies and treatment by immunotherapy. PLoS Negl Trop Dis 2023; 17:e0011083. [PMID: 36854042 PMCID: PMC9974124 DOI: 10.1371/journal.pntd.0011083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Snakebite envenomation is a relevant medical hazard in French Guiana and Martinique, two French territories in the Americas. All snakebite envenomations in Martinique are inflicted by the endemic viperid species Bothrops lanceolatus, whereas Bothrops atrox is responsible for the majority of snakebites in French Guiana, although other venomous snake species also occur in this South American territory. This review summarizes some of the key aspects of the natural history of these species, as well as of their venom composition, the main clinical manifestations of envenomations, and their treatment by antivenoms. B. atrox venom induces the typical set of clinical manifestations characteristic of Bothrops sp. venoms, i.e., local tissue damage and systemic alterations associated with coagulopathies, hemorrhage, hemodynamic alterations, and acute kidney injury. In the case of B. lanceolatus venom, in addition to some typical features of bothropic envenomation, a unique and severe thrombotic effect occurs in some patients. The pathogenesis of this effect remains unknown but may be related to the action of venom components and inflammatory mediators on endothelial cells in the vasculature. A monospecific antivenom has been successfully used in Martinique to treat envenomations by B. lanceolatus. In the case of French Guiana, a polyvalent antivenom has been used for some years, but it is necessary to assess the preclinical and clinical efficacy against viperid venoms in this country of other antivenoms manufactured in the Americas.
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Affiliation(s)
- Dabor Resiere
- Cardiovascular Research Team EA7525, Université des Antilles, Fort de France, France
- Department of Critical Care Medicine, Toxicology and Emergency, CHU Martinique (University Hospital of Martinique), Fort-de-France, France
| | - Hatem Kallel
- Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Jonathan Florentin
- Cardiovascular Research Team EA7525, Université des Antilles, Fort de France, France
- Department of Critical Care Medicine, Toxicology and Emergency, CHU Martinique (University Hospital of Martinique), Fort-de-France, France
| | - Stephanie Houcke
- Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Hossein Mehdaoui
- Cardiovascular Research Team EA7525, Université des Antilles, Fort de France, France
- Department of Critical Care Medicine, Toxicology and Emergency, CHU Martinique (University Hospital of Martinique), Fort-de-France, France
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Remi Neviere
- Cardiovascular Research Team EA7525, Université des Antilles, Fort de France, France
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Alsolaiss J, Alomran N, Hawkins L, Casewell NR. Commercial Antivenoms Exert Broad Paraspecific Immunological Binding and In Vitro Inhibition of Medically Important Bothrops Pit Viper Venoms. Toxins (Basel) 2022; 15:1. [PMID: 36668821 PMCID: PMC9862972 DOI: 10.3390/toxins15010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/13/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Snakebite envenoming is a life threatening neglected tropical disease that represents a considerable public health concern in the tropics. Viperid snakes of the genus Bothrops are among those of greatest medical importance in Latin America, and they frequently cause severe systemic haemotoxicity and local tissue destructive effects in human victims. Although snakebite antivenoms can be effective therapeutics, their efficacy is undermined by venom toxin variation among snake species. In this study we investigated the extent of paraspecific venom cross-reactivity exhibited by three distinct anti-Bothrops antivenoms (Soro antibotrópico-crotálico, BothroFav and PoliVal-ICP) against seven different Bothrops pit viper venoms from across Latin America. We applied a range of in vitro assays to assess the immunological binding and recognition of venom toxins by the antivenoms and their inhibitory activities against specific venom functionalities. Our findings demonstrated that, despite some variations, the monovalent antivenom BothroFav and the polyvalent antivenoms Soro antibotrópico-crotálico and PoliVap-ICP exhibited extensive immunological recognition of the distinct toxins found in the different Bothrops venoms, with Soro antibotrópico-crotálico generally outperformed by the other two products. In vitro functional assays revealed outcomes largely consistent with the immunological binding data, with PoliVap-ICP and BothroFav exhibiting the greatest inhibitory potencies against procoagulant and fibrinogen-depleting venom activities, though Soro antibotrópico-crotálico exhibited potent inhibition of venom metalloproteinase activities. Overall, our findings demonstrate broad levels of antivenom paraspecificity, with in vitro immunological binding and functional inhibition often highly comparable between venoms used to manufacture the antivenoms and those from related species, even in the case of the monovalent antivenom BothroFav. Our findings suggest that the current clinical utility of these antivenoms could possibly be expanded to other parts of Latin America that currently suffer from a lack of specific snakebite therapies.
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Affiliation(s)
- Jaffer Alsolaiss
- Centre for Snakebite Research & Interventions, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
- Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Nessrin Alomran
- Centre for Snakebite Research & Interventions, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
- Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Laura Hawkins
- Centre for Snakebite Research & Interventions, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
- Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Nicholas R. Casewell
- Centre for Snakebite Research & Interventions, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
- Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
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