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Ochola FO, Okumu MO, Gikunju JK, Mbaria JM, Muchemi GM, Nderitu JG. Neutralization of the lethality of the venom of Dendroaspis polylepis (black mamba) in mice by two polyvalent antivenoms used in Kenyan hospitals: Results of a 2009–2011 study. SCIENTIFIC AFRICAN 2019. [DOI: 10.1016/j.sciaf.2019.e00118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Salazar E, Salazar AM, Taylor P, Ibarra C, Rodríguez-Acosta A, Sánchez E, Pérez K, Brito B, Guerrero B. Pro-inflammatory response and hemostatic disorder induced by venom of the coral snake Micrurus tener tener IN C57BL/6 mice. Toxicon 2018; 150:212-219. [PMID: 29890232 DOI: 10.1016/j.toxicon.2018.06.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 12/20/2022]
Abstract
Micrurus venoms are known to induce mainly neurotoxicity in victims. However, other manifestations, including hemorrhage, edema, myotoxicity, complement activation, and hemostatic activity have been reported. In order to develop a more complete pharmacological profile of these venoms, inflammatory responses and hemostasis were evaluated in C57BL/6 mice treated with a sub-lethal dose of M. t. tener (Mtt) venom (8 μg/mouse), inoculated intraperitoneally. The venom induced moderate bleeding into the abdominal cavity and lungs, as well as infiltration of leukocytes into the liver. After 30 min, the release of pro-inflammatory mediators (TNF-α, IL-6, and NO) were observed, being most evident at 4 h. There was a decrease in hemoglobin and hematocrit levels at 72 h, a prolongation in coagulation times (PT and aPTT), a decrease in the fibrinogen concentration and an increase in fibrinolytic activity. In this animal model, it was proposed that Mtt venom induces inflammation with the release of mediators such as TNF-α, in response to the toxins. These mediators may activate hemostatic mechanisms, producing systemic fibrinolysis and hemorrhage. These findings suggest alternative treatments in Micrurus envenomations in which neurotoxic manifestations do not predominate.
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Affiliation(s)
- Emelyn Salazar
- Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Ana Maria Salazar
- Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Peter Taylor
- Laboratorio de Patología Celular y Molecular, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Carlos Ibarra
- Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Alexis Rodríguez-Acosta
- Laboratorio de Inmunoquímica y Ultraestructura, Instituto Anatómico de la Universidad Central de Venezuela, Caracas, Venezuela
| | - Elda Sánchez
- National Natural Toxins Research Center (NNTRC), Texas A&M University-Kingsville, MSC 158, Kingsville, TX 78363, USA
| | - Karin Pérez
- Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Beatriz Brito
- Laboratorio de Patología Celular y Molecular, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Belsy Guerrero
- Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela.
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Smiley-Walters SA, Farrell TM, Gibbs HL. Evaluating local adaptation of a complex phenotype: reciprocal tests of pigmy rattlesnake venoms on treefrog prey. Oecologia 2017; 184:739-748. [DOI: 10.1007/s00442-017-3882-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 05/08/2017] [Indexed: 11/24/2022]
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Gutiérrez JM, Solano G, Pla D, Herrera M, Segura Á, Vargas M, Villalta M, Sánchez A, Sanz L, Lomonte B, León G, Calvete JJ. Preclinical Evaluation of the Efficacy of Antivenoms for Snakebite Envenoming: State-of-the-Art and Challenges Ahead. Toxins (Basel) 2017; 9:toxins9050163. [PMID: 28505100 PMCID: PMC5450711 DOI: 10.3390/toxins9050163] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/17/2017] [Accepted: 05/10/2017] [Indexed: 01/09/2023] Open
Abstract
Animal-derived antivenoms constitute the mainstay in the therapy of snakebite envenoming. The efficacy of antivenoms to neutralize toxicity of medically-relevant snake venoms has to be demonstrated through meticulous preclinical testing before their introduction into the clinical setting. The gold standard in the preclinical assessment and quality control of antivenoms is the neutralization of venom-induced lethality. In addition, depending on the pathophysiological profile of snake venoms, the neutralization of other toxic activities has to be evaluated, such as hemorrhagic, myotoxic, edema-forming, dermonecrotic, in vitro coagulant, and defibrinogenating effects. There is a need to develop laboratory assays to evaluate neutralization of other relevant venom activities. The concept of the 3Rs (Replacement, Reduction, and Refinement) in Toxinology is of utmost importance, and some advances have been performed in their implementation. A significant leap forward in the study of the immunological reactivity of antivenoms against venoms has been the development of “antivenomics”, which brings the analytical power of mass spectrometry to the evaluation of antivenoms. International partnerships are required to assess the preclinical efficacy of antivenoms against snake venoms in different regions of the world in order to have a detailed knowledge on the neutralizing profile of these immunotherapeutics.
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Affiliation(s)
- José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Gabriela Solano
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Davinia Pla
- Instituto de Biomedicina de Valencia, CSIC, Valencia 46010, Spain.
| | - María Herrera
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
- Sección de Química Analítica, Escuela de Química, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Álvaro Segura
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Mariángela Vargas
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Mauren Villalta
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Andrés Sánchez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Libia Sanz
- Instituto de Biomedicina de Valencia, CSIC, Valencia 46010, Spain.
| | - Bruno Lomonte
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Guillermo León
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501-2060, Costa Rica.
| | - Juan J Calvete
- Instituto de Biomedicina de Valencia, CSIC, Valencia 46010, Spain.
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Barrios M, Rodríguez–Acosta A, Gil A, Salazar AM, Taylor P, Sánchez EE, Arocha–Piñango CL, Guerrero B. Comparative hemostatic parameters in BALB/c, C57BL/6 and C3H/He mice. Thromb Res 2009; 124:338-43. [DOI: 10.1016/j.thromres.2008.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Revised: 10/16/2008] [Accepted: 11/15/2008] [Indexed: 10/21/2022]
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Petricevich VL, Lebrun I. Immunomodulatory effects of the Tityus serrulatus venom on murine macrophage functions in vitro. Mediators Inflamm 2005; 2005:39-49. [PMID: 15770065 PMCID: PMC1513058 DOI: 10.1155/mi.2005.39] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Tityus serrulatus scorpion venom (TSV) consists of a very complex mixture of molecules and demonstrates significant immunomodulatory activities capable of stimulating immune functions in vivo. The purpose of this study was to compare the crude TSV with fractionated toxins extracted from this venom in order to determine which toxin(s) presented immunomodulatory effects on peritoneal macrophages. TSV was fractionated using gel filtration chromatography resulting in 5 heterogeneous fractions. The effects of these different fractions were analysed in vitro using detection by means of cytokines, oxygen intermediate metabolites (H2O2), and nitric oxide (NO) in supernatants of peritoneal macrophages. Several functional bioassays were employed: tumor necrosis factor (TNF) activity was assayed by measuring its cytotoxic activity in L929 cells, and other cytokines were assayed by enzyme-linked immunosorbent assay, whereas NO levels were detected by Griess colorimetric reactions in culture supernatant of macrophages exposed to different fractions. In vitro studies revealed that all fractions studied here presented an increment in H2O2, NO , and cytokines levels. The more pronounced increments were observed in macrophage cultures exposed to fraction FII which demonstrated that (a) the highest levels of IL-1alpha, IL-beta, and TNF were observed after 12 hours and that (b) the maximum levels of IFN-gamma and NO were observed after 72 hours. Taken together, these data indicate that fractions have a differential immunomodulating effect on macrophage secretion, and that FII is a potent activator of TNF production of macrophages.
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Affiliation(s)
- Vera L Petricevich
- Facultad de Medicina de la Universidad Autonoma del Estado de morelos, 62210 Cuernavaca, Mexico.
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Carneiro AS, Ribeiro OG, De Franco M, Cabrera WHK, Vorraro F, Siqueira M, Ibañez OM, Starobinas N. Local inflammatory reaction induced by Bothrops jararaca venom differs in mice selected for acute inflammatory response. Toxicon 2002; 40:1571-9. [PMID: 12419508 DOI: 10.1016/s0041-0101(02)00174-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bothrops jararaca venom (BjV) causes severe systemic and local reactions, characterized by an acute inflammatory reaction with accumulation of leukocytes and release of endogenous mediators. The systemic and local effects of BjV were compared in lines of mice genetically selected for maximal (AIR(max)) or minimal (AIR(min)) acute inflammatory reactivity (AIR). The systemic reaction was evaluated by LD(50) and the local reaction by edema formation, cellular influx, release of PGE(2), NO and H(2)O(2) and the production of the pro-inflammatory cytokines IL-6, Tumor necrosis factor-alpha (TNF-alpha) and IFN-gamma. Both mouse lines were equally susceptible to the lethal effects of the venom showing similar LD(50) but differed significantly in terms of the local inflammatory reaction. Footpad edema and leukocyte influx in the peritoneum after BjV inoculation was higher in AIR(max) compared to AIR(min), BALB/c or outbred Swiss mice. Coincidently, higher levels of the soluble mediators PGE(2), IFN-gamma and TNF-alpha were detected in the inflammatory exudate induced by BjV in AIR(max) mice. Cytokines levels were correlated to in vitro NO and H(2)O(2) production. The results demonstrate that the genetic factors selected in AIR(max) and AIR(min) lines of mice interfere in the control of the acute local reaction triggered by BjV venom.
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Affiliation(s)
- Adriana S Carneiro
- Laboratório de Imunogenética, Instituto Butantan, Av Vital Brasil 1500-cep 05503-900 São Paulo, SP, Brazil
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Petricevich VL, Peña CF. The dynamics of cytokine d nitric oxide secretion in mice injected with Tityus serrulatus scorpion venom. Mediators Inflamm 2002; 11:173-80. [PMID: 12137246 PMCID: PMC1781655 DOI: 10.1080/09622935020138811] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AIMS The effects of Tityus serrulatus venom (TSV) were analysed with respect to the susceptibility of four isogenic mouse, the symptoms following injection of venom and the inflammatory mediators in an experimental model of severe envenomation induced in mice. METHODS The susceptibility was analysed by lethal dose (LD50) determination, including the symptoms observed during envenomating and glucose levels. The detection of cytokines in serum from mice were analysed using enzyme-linked immunosorbent assay, and nitric oxide (NO) was analysed using nitrite determination. RESULTS The estimated LD50 values were in micrograms per 100 microliters, and the susceptibility of mice to TSV varies with: (a) mouse strain and route of injection (A/J < BALB/c < C57Bl/6 = DBA); (b) mouse strain and sex (A/J female and male < BALB/c female and male); and (c) body weight (all groups of A/J < BALB/c groups). Among the mouse strains studied, BALB/c mice presented moderate sensibility to TSV, with changes in specific signs and serum levels of glucose, several cytokines and NO, when injected intraperitoneally (i.p.) with 1 LD50 of venom. Sweating, salivation and tremor were the specific signs that preceded death. The maximum levels of glucose in sera from mice injected i.p. with 1 LD50 of TSV were observed 60-90 min post-injection. Significant differences were observed in the time-course of cytokine levels, and the venom induced marked elevations of interleukin (IL)-1alpha, IL-1beta, IL-6, IL-10 and interferon gamma (IFN-gamma). The maximum levels of IL-1alpha and IL-1beta were observed 2 h post-injection. The more pronounced levels of IL-6 were observed 4 h post-injection. There was an early increase in IFN-gamma followed by an even higher level after 4 h. IL-10 levels peaked between 6 and 8 h, and this cytokine probably modulates the secretion of IFN-gamma. Tumor necrosis factor release was not detected in BALB/c mice injected with TSV. NO levels attained maximal release after 2 h, following venom injection, while a second peak for NO was at 6 h. CONCLUSIONS These findings indicate that the susceptibility to the systemic effects of the venom varies among mice of different haplotypes, and that the cytokines such as IL-1, IL-6, IFN-gamma and NO are strongly involved in the pathogenesis caused by this venom and are correlated with the severity of envenomation.
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Petricevich VL. Effect of Tityus serrulatus venom on cytokine production and the activity of murine macrophages. Mediators Inflamm 2002; 11:23-31. [PMID: 11926592 PMCID: PMC1781641 DOI: 10.1080/09629350210308] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
THE purpose of this study was to investigate the effects of Tityus serrulatus venom (TSV) on murine peritoneal macrophages evaluated in terms of activation. The effects of crude TSV were analysed by detection of cytokines, oxygen intermediate metabolites (H2O2) and nitric oxide (NO) in supernatants of peritoneal macrophages. Several functional bioassays were employed including an in vitro model for envenomating: cytotoxicity of TSV was assessed using the lyses percentage. Tumor necrosis factor (TNF) activity was assayed by measuring its cytotoxic activity on L-929 cells, and interleukin-6 (IL-6) and interferon-gamma (IFN-gamma) were assayed by enzyme-linked immunosorbent assay, whereas NO levels were detected by Griess colorimetric reactions in culture supernatant of macrophages incubated with TSV and subsequently exposed to either lipopolysaccharide or IFN-gamma. Incubation of macrophages with TSV increased production of IL-6 and IFN-gamma in a dose-dependent manner. TNF production was not detected in supernatants treated with TSV at any concentration. The increase in IL-6 secretion was not associated with concentration-dependent cytoxicity of TSV on these cells. These data suggest that the cytotoxicity does not appear to be the main cause of an increased cytokine production by these cells. Although NO is an important effector molecule in macrophage microbicidal activity, the inducing potential of the test compounds for its release was found to be very moderate, ranging from 125 to 800 mM. Interestingly, NO levels of peritoneal macrophages were increased after IFN-gamma. Moreover, NO production had an apparent effect on macrophage activity. The results obtained here also shown that the TSV induces an important elevation in H2O2 release. These results combined with NO production suggest that TSV possesses significant immunomodulatory activities capable of stimulating immune functions in vitro.
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Bogarín G, Morais JF, Yamaguchi IK, Stephano MA, Marcelino JR, Nishikawa AK, Guidolin R, Rojas G, Higashi HG, Gutiérrez JM. Neutralization of crotaline snake venoms from Central and South America by antivenoms produced in Brazil and Costa Rica. Toxicon 2000; 38:1429-41. [PMID: 10758277 DOI: 10.1016/s0041-0101(99)00236-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A study was performed on the ability of antivenoms, produced in Brazil and Costa Rica, to neutralize lethal, hemorrhagic and coagulant activities of the venoms of 16 species of Central and South American snakes of the subfamily Crotalinae. Neutralization of lethality was studied by two different methods routinely used in the quality control of antivenoms at Instituto Butantan (IB) and Instituto Clodomiro Picado (ICP). Both antivenoms neutralized the majority of the venoms studied, but the values of effective doses 50% (ED(50)) differed markedly depending on the method used. In general, higher potencies were obtained with the method of ICP, where a challenge dose corresponding to 4 LD(50)s is used, than with the method of IB, where a challenge dose of 5 LD(50)s is employed. All venoms induced hemorrhagic activity in the mouse skin test, which was effectively neutralized by the two antivenoms. All venoms, except those of Porthidium nasutum and Bothriechis lateralis, induced coagulation of human plasma in vitro and both antivenoms were effective in the neutralization of this activity. In conclusion, our results provide evidence of an extensive cross reactivity between these antivenoms and Central and South American crotaline snake venoms.
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Affiliation(s)
- G Bogarín
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José
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Tambourgi DV, Petricevich VL, Magnoli FC, Assaf SL, Jancar S, Dias Da Silva W. Endotoxemic-like shock induced by Loxosceles spider venoms: pathological changes and putative cytokine mediators. Toxicon 1998; 36:391-403. [PMID: 9620587 DOI: 10.1016/s0041-0101(97)00063-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The systemic symptoms, tissue lesions and release of cytokines were analysed in four isogenic mouse strains with distinct haplotypes injected with various doses of Loxosceles intermedia spider venom. The estimated LD50 were 24.5 microg for C57Bl/6, 17.6 microg for BALB/c, 6.3 microg for C3H/HeJ and 4.6 microg for A/Sn mice. Prostration, acute cachexia, hypothermia, neurological disorders and hemoglobinuria were the signals preceding death. Accumulation of eosinophilic material inside the proximal and distal renal tubules and acute tubular necrosis were the most common histopathological findings. Death was prevented by previous treatment of venom with specific antivenom serum. The protein F35 purified from the whole venom retained the ability to induce the symptoms of the whole venom. The cytokines tumor necrosis factor (TNF), interleukins IL-6 and IL-10 and the radical nitric oxide were detected in serum at different levels after venom injection. These findings indicate that the state of shock produced in mice by whole endotoxin-free L. intermedia venom or by its purified fraction, protein F35, mimics the endotoxemic shock, that susceptibility to the systemic effects of the venom varies among mice of different haplotypes and that the pattern of in vivo cytokine release resembles that of endotoxemic shock.
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Affiliation(s)
- D V Tambourgi
- Laboratory of Immunochemistry, Instituto Butantan, São Paulo, SP, Brazil
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Barros SF, Friedlanskaia I, Petricevich VL, Kipnis TL. Local inflammation, lethality and cytokine release in mice injected with Bothrops atrox venom. Mediators Inflamm 1998; 7:339-46. [PMID: 9883969 PMCID: PMC1781860 DOI: 10.1080/09629359890866] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
We have provided evidence that: (a) lethality of mice to crude Bothrops venom varies according the isogenic strain (A/J > C57Bl/6 > A/Sn > BALB/c > C3H/HePas > DBA/2 > C3H/He); (b)BALB/c mice (LD50=100.0 microg) were injected i.p. with 50 microg of venom produced IL-6, IL-10, INF-gamma, TNF-alpha and NO in the serum. In vitro the cells from the mice injected and challenged with the venom only released IL-10 while peritoneal macrophages released IL-10, INF-gamma and less amounts of IL-6; (c) establishment of local inflammation and necrosis induced by the venom, coincides with the peaks of TNF-alpha, IFN-gamma and NO and the damage was neutralized when the venom was incubated with a monoclonal antibody against a 60 kDa haemorrhagic factor. These results suggest that susceptibility to Bothrops atrox venom is genetically dependent but MHC independent; that IL-6, IL-10, TNF-alpha, IFN-gamma and NO can be involved in the mediation of tissue damage; and that the major venom component inducers of the lesions are haemorrhagins.
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Affiliation(s)
- S F Barros
- Laboratório de Imunoparasitologia, Instituto Butantan São Paulo, SP, Brazil
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Barros AC, Fernandes DP, Ferreira LC, Dos Santos MC. Local effects induced by venoms from five species of genus Micrurus sp. (coral snakes). Toxicon 1994; 32:445-52. [PMID: 8052999 DOI: 10.1016/0041-0101(94)90296-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Venoms from five species of Micrurus (coral snakes) from Brazil (Amazonas State) were tested for the following effects: edematogenic, myotoxic, coagulant, hemorrhagic and phospholipase A2 (PLA2) detection. None of the venoms tested presented coagulant activity. The presence of PLA2 was detected by ELISA in the venoms of M. spixii, M. averyi and M. lemniscatus. The myotoxicity was estimated by the increase in the serum creatine kinase level and by histological analysis. All venoms, except that from M. surinamensis, induced intense edematogenic and myotoxic effects. The venom of M. averyi showed hemorrhagic activity which was confirmed by histopathological analysis. This is the first evidence of such an effect by coral snake venom.
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Affiliation(s)
- A C Barros
- Convênio Conselho Nacional de Pesquisa, Universidade do Amazonas, Manaus, Brazil
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