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Mathis S, Carla L, Duval F, Nadal L, Solé G, Le Masson G. Acute peripheral neuropathy following animal envenomation: A case report and systematic review. J Neurol Sci 2022; 442:120448. [PMID: 36244096 DOI: 10.1016/j.jns.2022.120448] [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: 01/18/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 10/31/2022]
Abstract
Animal envenomation in humans is usually accidental or for defensive purposes. Depending on the venom composition and administration, different reactions can be observed. After reporting the first case of acute polyradiculitis in a 57-year-old healthy male after red lionfish envenomation, we propose to analyze rare similar cases of acute neuritis after animal envenomation published in the medical literature. Including our case, we found 54 patients who developed acute peripheral neuropathy after having been stung or bitten by various animals, mainly hymenoptera (in half of the cases) but also jellyfishes, snakes, corals or nonhooked arthropods. We observed two distinct patterns of peripheral neuropathy: more than half of them were polyneuropathy while the others were focal neuropathy. The prognosis was favorable in most cases. The pathophysiological mechanism associated with these rare complications remain unknown, although some hypotheses may be proposed. A direct action of certain components of the venom, such as phospholipase-A2, could explain the focal forms of peripheral neuropathy trough toxic reactions and/or vasculitis processes. The more diffuse clinical situations could be due to an allergy-triggered immune-mediated reaction (possibly linked to a molecular mimicry mechanism between venom proteins and some myelin proteins of the peripheral nervous system), or to the action of some venom components on membrane ionic channels particularly at the node of Ranvier. Even if acute peripheral neuropathies are rare after envenomation, they may occur after envenomation from various animals, and their usually favorable prognoses should be known by neurologists.
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Affiliation(s)
- Stéphane Mathis
- Department of Neurology, Nerve-Muscle Unit, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France; ALS Center, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France; AOC Neuromuscular Reference Center, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France.
| | - Louis Carla
- Department of Neurology, Nerve-Muscle Unit, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France
| | - Fanny Duval
- Department of Neurology, Nerve-Muscle Unit, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France; AOC Neuromuscular Reference Center, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France
| | - Louis Nadal
- Department of Neurology, Nerve-Muscle Unit, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France
| | - Guilhem Solé
- Department of Neurology, Nerve-Muscle Unit, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France; AOC Neuromuscular Reference Center, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France
| | - Gwendal Le Masson
- Department of Neurology, Nerve-Muscle Unit, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France; ALS Center, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France; AOC Neuromuscular Reference Center, University Hospital (CHU) of Bordeaux (Pellegrin Hospital), 2 place Amélie Raba-Léon, 33000 Bordeaux, France
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Shi D, Feng C, Xie J, Zhang X, Dai H, Yan L. Recent Progress of Nanomedicine on Secreted Phospholipase A2 as a Potential Therapeutic Target. J Mater Chem B 2022; 10:7349-7360. [DOI: 10.1039/d2tb00608a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Overexpressed secretory phospholipase A2 (sPLA2) is found in many inflammatory diseases and various types of cancer. sPLA2 can catalyze the hydrolysis of phospholipid sn-2 ester bond to lysophosphatidylcholine and free...
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Trotter A, Anstadt E, Clark RB, Nichols F, Dwivedi A, Aung K, Cervantes JL. The role of phospholipase A2 in multiple Sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2018; 27:206-213. [PMID: 30412818 DOI: 10.1016/j.msard.2018.10.115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 01/25/2023]
Abstract
Phospholipases A2 (PLA2) are a diverse group of enzymes that cleave the fatty acids of membrane phospholipids. They play critical roles in pathogenesis of neurodegenerative diseases such as multiple sclerosis by enhancing oxidative stress and initiating inflammation. The levels of PLA2 activity in MS patients compared to controls and role of inhibiting PLA2 activity on severity scores in different experimental models are not comprehensively assessed in the light of varying evidence from published studies. The objective of this systematic review is to determine the association between PLA2 activity and multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE). We performed a systematic review of six studies that assessed PLA2 activity in MS patients compared to controls and nine studies that assessed PLA2 activity in EAE. sPLA2 nor Lp-PLA2 activity were not increased in MS compared to controls in five of those six studies. A difference in sPLA2 activity was only found in a study that measured the enzyme activity in urine. However, inhibiting cPLA2 or sPLA2 led to lower clinical severity or no signs of EAE in mice, and a lower incidence of EAE lesions compared to animals without cPLA2 inhibition. These findings indicate that PLA2 appears to play a role in the pathogenesis of EAE.
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Affiliation(s)
- Austin Trotter
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Emily Anstadt
- Department of Immunology, and Department of Medicine, Farmington, CT, USA
| | - Robert B Clark
- Department of Immunology, and Department of Medicine, Farmington, CT, USA; University of Connecticut School of Medicine, Farmington, CT, USA
| | - Frank Nichols
- Department of Oral Health and Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Alok Dwivedi
- Department of Biomedical Sciences, Division of Biostatistics and Epidemiology, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Koko Aung
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Jorge L Cervantes
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA; Department of Medical Education, Texas Tech University Health Sciences Center, El Paso, TX, USA.
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Unresolved issues in the understanding of the pathogenesis of local tissue damage induced by snake venoms. Toxicon 2018; 148:123-131. [PMID: 29698755 DOI: 10.1016/j.toxicon.2018.04.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/04/2018] [Accepted: 04/22/2018] [Indexed: 12/20/2022]
Abstract
Snakebite envenoming by viperid species, and by some elapids, is characterized by a complex pattern of tissue damage at the anatomical site of venom injection. In severe cases, tissue destruction may be so extensive as to lead to permanent sequelae, with serious pathophysiological, social and psychological consequences. Significant advances have been performed in the study of venom-induced tissue damage, including identification and characterization of the toxins involved, insights into the mechanisms of action of venoms and toxins, and study of tissue responses to venom-induced injury. Nevertheless, much remains to be known and understood on the pathogenesis of these alterations. This review focuses on some of the pending issues in the topic of snake venom-induced local tissue damage. The traditional 'reductionist' approach, which has predominated in the study of snake venoms and their actions, needs to be complemented by more integrative and holistic perspectives aimed at capturing the complexity of these pathological alterations. Future advances in the study of these topics will certainly pave the way for innovative therapeutic interventions, with the goal of reducing the impact of this aspect of snakebite envenoming.
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