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Pedro G, Brasileiro FCDS, Macedo JM, Soares AM, Mafra GC, Alves CEF, Laufer-Amorim R. Cytotoxic effects of crotoxin from Crotalus durissus terrificus snake in canine mammary tumor cell lines. J Venom Anim Toxins Incl Trop Dis 2024; 30:e20230062. [PMID: 38505509 PMCID: PMC10950368 DOI: 10.1590/1678-9199-jvatitd-2023-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024] Open
Abstract
Background Mammary gland tumors are the most prevalent neoplasm in intact female dogs, and they are good natural models to study comparative oncology. Most canine mammary malignancies, as in women, are commonly refractory to conventional therapies and demand continuous new therapeutic approaches. Crotalus durissus terrificus, also called rattlesnake, has more than 60 different proteins in its venom with multiple pharmaceutical uses, such as antitumor, antiviral, and antimicrobial action. Crotoxin, a potent β-neurotoxin formed by the junction of two subunits, a basic subunit (CB-PLA2) and an acidic subunit (crotapotin), has already been reported to have anticancer properties in different types of cancers. Methods In this work, we describe the cytotoxic potential of crotoxin and its subunits compared to doxorubicin (drug of choice) in two canine mammary carcinoma cell lines. Results Crotoxin, CB-PLA2, crotalic venom, and doxorubicin decreased cell viability and the ability to migrate in a dose-dependent manner, and crotapotin did not present an antitumoral effect. For all compounds, the predominant cell death mechanism was apoptosis. In addition, crotoxin did not show toxicity in normal canine mammary gland cells. Conclusion Therefore, this work showed that crotoxin and CB-PLA2 had cytotoxic activity, migration inhibition, and pro-apoptotic potential in canine mammary gland carcinoma cell lines, making their possible use in cancer research.
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Affiliation(s)
- Giovana Pedro
- School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | | | - Jamile Mariano Macedo
- Laboratory of Biotechnology and Education Applied to One Health (LABIOPROT), Oswaldo Cruz Foundation, Fiocruz - Porto Velho, RO, Brazil
- Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil
- São Lucas University Center - São Lucas PVH, Porto Velho, RO, Brazil
| | - Andreimar Martins Soares
- Laboratory of Biotechnology and Education Applied to One Health (LABIOPROT), Oswaldo Cruz Foundation, Fiocruz - Porto Velho, RO, Brazil
- Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil
- São Lucas University Center - São Lucas PVH, Porto Velho, RO, Brazil
- Western Amazon Research and Knowledge Network of Excellence (RED-CONEXAO), Porto Velho, RO, Brazil
- National Institute of Science and Technology of Epidemiology of the Western Amazon (INCT EpiAmO), Porto Velho, RO, Brazil
| | - Gabriel Caporale Mafra
- School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | | | - Renée Laufer-Amorim
- School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
- Western Amazon Research and Knowledge Network of Excellence (RED-CONEXAO), Porto Velho, RO, Brazil
- National Institute of Science and Technology of Epidemiology of the Western Amazon (INCT EpiAmO), Porto Velho, RO, Brazil
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Almeida TC, de Morais Ribeiro Silva L, de Oliveira AMB, Lopes FSR, Sant'Anna MB, Picolo G. Cytotoxic effect of crotoxin on cancer cells and its antitumoral effects correlated to tumor microenvironment: A review. Int J Biol Macromol 2023; 242:124892. [PMID: 37196721 DOI: 10.1016/j.ijbiomac.2023.124892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/19/2023]
Abstract
Cancer is the second leading cause of death worldwide, and despite the effort of standard treatments, the search for new tools against this disease is necessary. Importantly, it is known that the tumor microenvironment plays a crucial role in tumor initiation, progression, and response to therapies. Therefore, studies of potential drugs that act on these components are as critical as studies regarding antiproliferative substances. Through the years, studies of several natural products, including animal toxins, have been conducted to guide the development of medical compounds. In this review, we present the remarkable antitumor activities of crotoxin, a toxin from the rattlesnake Crotalus durissus terrificus, highlighting its effects on cancer cells and in the modulation of relevant elements in the tumor microenvironment as well as the clinical trials conducted with this compound. In summary, crotoxin acts through several mechanisms of action, such as activation of apoptosis, induction of cell cycle arrest, inhibition of metastasis, and decrease of tumor growth, in different tumor types. Crotoxin also modulates tumor-associated fibroblasts, endothelial cells, and immune cells, which contribute to its antitumoral effects. In addition, preliminary clinical studies confirm the promising results of crotoxin and support its potential future use as an anticancer drug.
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Affiliation(s)
| | | | | | | | | | - Gisele Picolo
- Laboratory of Pain and Signaling, Butantan Institute, 05503-900 São Paulo, Brazil.
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Osipov A, Utkin Y. What Are the Neurotoxins in Hemotoxic Snake Venoms? Int J Mol Sci 2023; 24:ijms24032919. [PMID: 36769242 PMCID: PMC9917609 DOI: 10.3390/ijms24032919] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/10/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Snake venoms as tools for hunting are primarily aimed at the most vital systems of the prey, especially the nervous and circulatory systems. In general, snakes of the Elapidae family produce neurotoxic venoms comprising of toxins targeting the nervous system, while snakes of the Viperidae family and most rear-fanged snakes produce hemotoxic venoms directed mainly on blood coagulation. However, it is not all so clear. Some bites by viperids results in neurotoxic signs and it is now known that hemotoxic venoms do contain neurotoxic components. For example, viperid phospholipases A2 may manifest pre- or/and postsynaptic activity and be involved in pain and analgesia. There are other neurotoxins belonging to diverse families ranging from large multi-subunit proteins (e.g., C-type lectin-like proteins) to short peptide neurotoxins (e.g., waglerins and azemiopsin), which are found in hemotoxic venoms. Other neurotoxins from hemotoxic venoms include baptides, crotamine, cysteine-rich secretory proteins, Kunitz-type protease inhibitors, sarafotoxins and three-finger toxins. Some of these toxins exhibit postsynaptic activity, while others affect the functioning of voltage-dependent ion channels. This review represents the first attempt to systematize data on the neurotoxins from "non-neurotoxic" snake venom. The structural and functional characteristic of these neurotoxins affecting diverse targets in the nervous system are considered.
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Hayashi MAF, Campeiro JD, Yonamine CM. Revisiting the potential of South American rattlesnake Crotalus durissus terrificus toxins as therapeutic, theranostic and/or biotechnological agents. Toxicon 2021; 206:1-13. [PMID: 34896407 DOI: 10.1016/j.toxicon.2021.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/10/2021] [Accepted: 12/08/2021] [Indexed: 02/07/2023]
Abstract
The potential biotechnological and biomedical applications of the animal venom components are widely recognized. Indeed, many components have been used either as drugs or as templates/prototypes for the development of innovative pharmaceutical drugs, among which many are still used for the treatment of human diseases. A specific South American rattlesnake, named Crotalus durissus terrificus, shows a venom composition relatively simpler compared to any viper or other snake species belonging to the Crotalus genus, although presenting a set of toxins with high potential for the treatment of several still unmet human therapeutic needs, as reviewed in this work. In addition to the main toxin named crotoxin, which is under clinical trials studies for antitumoral therapy and which has also anti-inflammatory and immunosuppressive activities, other toxins from the C. d. terrificus venom are also being studied, aiming for a wide variety of therapeutic applications, including as antinociceptive, anti-inflammatory, antimicrobial, antifungal, antitumoral or antiparasitic agent, or as modulator of animal metabolism, fibrin sealant (fibrin glue), gene carrier or theranostic agent. Among these rattlesnake toxins, the most relevant, considering the potential clinical applications, are crotamine, crotalphine and gyroxin. In this narrative revision, we propose to organize and present briefly the updates in the accumulated knowledge on potential therapeutic applications of toxins collectively found exclusively in the venom of this specific South American rattlesnake, with the objective of contributing to increase the chances of success in the discovery of drugs based on toxins.
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Affiliation(s)
- Mirian A F Hayashi
- Department of Pharmacology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), SP, Brazil.
| | - Joana D Campeiro
- Department of Pharmacology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), SP, Brazil
| | - Camila M Yonamine
- Department of Microbiology, Immunology and Parasitology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), SP, Brazil.
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Crotoxin-Induced Mice Lung Impairment: Role of Nicotinic Acetylcholine Receptors and COX-Derived Prostanoids. Biomolecules 2020; 10:biom10050794. [PMID: 32443924 PMCID: PMC7277605 DOI: 10.3390/biom10050794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 12/12/2022] Open
Abstract
Respiratory compromise in Crotalus durissus terrificus (C.d.t.) snakebite is an important pathological condition. Considering that crotoxin (CTX), a phospholipase A2 from C.d.t. venom, is the main component of the venom, the present work investigated the toxin effects on respiratory failure. Lung mechanics, morphology and soluble markers were evaluated from Swiss male mice, and mechanism determined using drugs/inhibitors of eicosanoids biosynthesis pathway and autonomic nervous system. Acute respiratory failure was observed, with an early phase (within 2 h) characterized by enhanced presence of eicosanoids, including prostaglandin E2, that accounted for the increased vascular permeability in the lung. The alterations of early phase were inhibited by indomethacin. The late phase (peaked 12 h) was marked by neutrophil infiltration, presence of pro-inflammatory cytokines/chemokines, and morphological alterations characterized by alveolar septal thickening and bronchoconstriction. In addition, lung mechanical function was impaired, with decreased lung compliance and inspiratory capacity. Hexamethonium, a nicotinic acetylcholine receptor antagonist, hampered late phase damages indicating that CTX-induced lung impairment could be associated with cholinergic transmission. The findings reported herein highlight the impact of CTX on respiratory compromise, and introduce the use of nicotinic blockers and prostanoids biosynthesis inhibitors as possible symptomatic therapy to Crotalus durissus terrificus snakebite.
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Teixeira NB, Sant'Anna MB, Giardini AC, Araujo LP, Fonseca LA, Basso AS, Cury Y, Picolo G. Crotoxin down-modulates pro-inflammatory cells and alleviates pain on the MOG 35-55-induced experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Brain Behav Immun 2020; 84:253-268. [PMID: 31843645 DOI: 10.1016/j.bbi.2019.12.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 02/07/2023] Open
Abstract
Multiple sclerosis (MS) is a Central Nervous System inflammatory demyelinating disease that has as primary symptoms losses of sensory and motor functions, including chronic pain. To date, however, few studies have investigated the mechanisms of chronic pain in animal models of MS since locomotor impairments render difficult its evaluation. It was previously demonstrated that in the MOG35-55-induced EAE, an animal model of MS, the hypernociception appears before the onset of motor disability, allowing for the study of these two phenomena separately. Here, we evaluated the effect of crotoxin (CTX), a neurotoxin isolated from the Crotalus durissus terrificus snake venom that displays, at non-toxic dose, antinociceptive, anti-inflammatory and immunomodulatory effects, in the pain and in symptoms progression of EAE. The pain threshold of female C57BL/6 mice decreased at the 4th day after immunization, while the first sign of disease appeared around the 11st-12nd days, coinciding with the onset of motor abnormalities. CTX (40 µg/kg, s.c.) administered in a single dose on the 5th day after immunization, induced a long-lasting analgesic effect (5 days), without interfering with the clinical signs of the disease. On the other hand, when crotoxin was administered for 5 consecutive days, from 5th-9th day after immunization, it induced analgesia and also reduced EAE progression. The antinociceptive effect of crotoxin was blocked by Boc-2 (0.5 mg/kg, i.p.), a selective antagonist of formyl peptide receptors, by NDGA (30 μg/kg, i.p.), a lipoxygenase inhibitor and by atropine sulfate (10 mg/kg, i.p.), an antagonist of muscarinic receptors, administered 30 min before CTX. CTX was also effective in decreasing EAE clinical signs even when administered after its onset. Regarding the interactions between neurons and immunocompetent cells, CTX, in vitro, was able to reduce T cell proliferation, decreasing Th1 and Th17 and increasing Treg cell differentiation. Furthermore, in EAE model, the treatment with 5 consecutive doses of CTX inhibited IFN-γ-producing T cells, GM-CSF-producing T cells, reduced the frequency of activated microglia/macrophages within the CNS and decreased the number of migrating cell to spinal cord and cerebellum at the peak of the disease. These results suggest that CTX is a potential treatment not only for pain alteration but also for clinical progression induced by the disease as well as an useful tool for the development of new therapeutic approaches for the multiple sclerosis control.
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Affiliation(s)
- N B Teixeira
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - M B Sant'Anna
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - A C Giardini
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - L P Araujo
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, Sao Paulo, Brazil
| | - L A Fonseca
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - A S Basso
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, Sao Paulo, Brazil
| | - Y Cury
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - G Picolo
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil.
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Sant’Anna MB, Lopes FSR, Kimura LF, Giardini AC, Sant’Anna OA, Picolo G. Crotoxin Conjugated to SBA-15 Nanostructured Mesoporous Silica Induces Long-Last Analgesic Effect in the Neuropathic Pain Model in Mice. Toxins (Basel) 2019; 11:E679. [PMID: 31757011 PMCID: PMC6949982 DOI: 10.3390/toxins11120679] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/13/2019] [Accepted: 11/18/2019] [Indexed: 12/29/2022] Open
Abstract
Neuropathic pain is a disease caused by structural and functional plasticity in central and peripheral sensory pathways that produce alterations in nociceptive processing. Currently, pharmacological treatment for this condition remains a challenge. Crotoxin (CTX), the main neurotoxin of Crotalus durissus terrificus rattlesnake venom, has well described prolonged anti-inflammatory and antinociceptive activities. In spite of its potential benefits, the toxicity of CTX remains a limiting factor for its use. SBA-15 is an inert nanostructured mesoporous silica that, when used as a vehicle, may reduce toxicity and potentiate the activity of different compounds. Based on this, we propose to conjugate crotoxin with SBA-15 (CTX:SBA-15) in order to investigate if when adsorbed to silica, CTX would have its toxicity reduced and its analgesic effect enhanced in neuropathic pain induced by the partial sciatic nerve ligation (PSNL) model. SBA-15 enabled an increase of 35% of CTX dosage. Treatment with CTX:SBA-15 induced a long-lasting reduction of mechanical hypernociception, without modifying the previously known pathways involved in antinociception. Moreover, CTX:SBA-15 reduced IL-6 and increased IL-10 levels in the spinal cord. Surprisingly, the antinociceptive effect of CTX:SBA-15 was also observed after oral administration. These data indicate the potential use of the CTX:SBA-15 complex for neuropathic pain control and corroborates the protective potential of SBA-15.
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Affiliation(s)
- Morena Brazil Sant’Anna
- Special Laboratory of Pain and Signalling, Butantan Institute, São Paulo 05503-900, Brazil; (M.B.S.); (F.S.R.L.); (L.F.K.); (A.C.G.)
| | - Flavia Souza Ribeiro Lopes
- Special Laboratory of Pain and Signalling, Butantan Institute, São Paulo 05503-900, Brazil; (M.B.S.); (F.S.R.L.); (L.F.K.); (A.C.G.)
| | - Louise Faggionato Kimura
- Special Laboratory of Pain and Signalling, Butantan Institute, São Paulo 05503-900, Brazil; (M.B.S.); (F.S.R.L.); (L.F.K.); (A.C.G.)
| | - Aline Carolina Giardini
- Special Laboratory of Pain and Signalling, Butantan Institute, São Paulo 05503-900, Brazil; (M.B.S.); (F.S.R.L.); (L.F.K.); (A.C.G.)
| | | | - Gisele Picolo
- Special Laboratory of Pain and Signalling, Butantan Institute, São Paulo 05503-900, Brazil; (M.B.S.); (F.S.R.L.); (L.F.K.); (A.C.G.)
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Global proteomic and functional analysis of Crotalus durissus collilineatus individual venom variation and its impact on envenoming. J Proteomics 2019; 191:153-165. [DOI: 10.1016/j.jprot.2018.02.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/29/2018] [Accepted: 02/10/2018] [Indexed: 11/17/2022]
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Hamad MK, He K, Abdulrazeq HF, Mustafa AM, Luceri R, Kamal N, Ali M, Nakhla J, Herzallah MM, Mammis A. Potential Uses of Isolated Toxin Peptides in Neuropathic Pain Relief: A Literature Review. World Neurosurg 2018; 113:333-347.e5. [DOI: 10.1016/j.wneu.2018.01.116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 01/31/2023]
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Secreted Phospholipases A₂ from Animal Venoms in Pain and Analgesia. Toxins (Basel) 2017; 9:toxins9120406. [PMID: 29311537 PMCID: PMC5744126 DOI: 10.3390/toxins9120406] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/13/2017] [Accepted: 12/16/2017] [Indexed: 12/20/2022] Open
Abstract
Animal venoms comprise a complex mixture of components that affect several biological systems. Based on the high selectivity for their molecular targets, these components are also a rich source of potential therapeutic agents. Among the main components of animal venoms are the secreted phospholipases A2 (sPLA2s). These PLA2 belong to distinct PLA2s groups. For example, snake venom sPLA2s from Elapidae and Viperidae families, the most important families when considering envenomation, belong, respectively, to the IA and IIA/IIB groups, whereas bee venom PLA2 belongs to group III of sPLA2s. It is well known that PLA2, due to its hydrolytic activity on phospholipids, takes part in many pathophysiological processes, including inflammation and pain. Therefore, secreted PLA2s obtained from animal venoms have been widely used as tools to (a) modulate inflammation and pain, uncovering molecular targets that are implicated in the control of inflammatory (including painful) and neurodegenerative diseases; (b) shed light on the pathophysiology of inflammation and pain observed in human envenomation by poisonous animals; and, (c) characterize molecular mechanisms involved in inflammatory diseases. The present review summarizes the knowledge on the nociceptive and antinociceptive actions of sPLA2s from animal venoms, particularly snake venoms.
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Alonso-Castro AJ. Use of medicinal fauna in Mexican traditional medicine. JOURNAL OF ETHNOPHARMACOLOGY 2014; 152:53-70. [PMID: 24440438 DOI: 10.1016/j.jep.2014.01.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 01/07/2014] [Accepted: 01/07/2014] [Indexed: 05/22/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Mexico has great biodiversity of fauna. The use of fauna with medicinal properties is a common practice since pre-Hispanic times. In the last decade, there has been an interest in ethnozoological studies in Mexico. Therefore, more studies are needed in order to gather information regarding the use of fauna with medicinal properties in México. Ethnozoological studies are necessary in order to discover new medications for human health. This review presents current information in terms of ethnozoological, conservation status, trade, toxicological and pharmacological effects of fauna used for medicinal purposes in Mexican traditional medicine (MTM), based on scientific literature. Future prospects for research with medicinal fauna are discussed. MATERIALS AND METHODS Bibliographic investigation was carried out by analyzing recognized books and peer-reviewed papers, consulting worldwide accepted scientific databases from the last five decades. Reports included in this review complied with the three criteria cited as follows: (i) used in Mexican traditional medicine for medicinal and/or magical-religious purposes, (ii) with experimental studies regarding the toxicological or medicinal effects and/or with studies exploring mechanisms of medicinal effects, and (iii) with information obtained from a clear source. RESULTS A total of 163 animal species, belonging to 79 families and 4 taxonomic categories, used for medicinal purposes are reported in this review. Medicinal fauna used in MTM come from birds (48), fishes (3), insects (22), mammals (49) and reptiles (41). The most versatile species which had the greatest number of medicinal properties were Mephitis macroura (21 uses), Crotalus atrox (17 uses), Dasypus novemcinctus (13 uses) and Didelphis virginiana (13 uses). However, 14 of the 161 species listed in this review are classified as endangered. Animal species are mainly used for the treatment of inflammatory, respiratory and gastrointestinal diseases. Furthermore, insects and reptiles are the animal groups with more pharmacological studies. Approximately, 11% and 5% of medicinal fauna have been tested in terms of their pharmacological and toxicological effects, respectively. CONCLUSION Despite the use of medicinal fauna in MTM, during centuries, there are a very limited number of scientific studies published on this topic. This review highlights the need to perform pharmacological, toxicological and chemical studies with medicinal fauna used in MTM.
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