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Vásquez Paredes PJ. From Forest to Intensive Care Unit: Managing Severe Complications of Bothrops bilineatus Envenomation. Wilderness Environ Med 2025:10806032251337667. [PMID: 40329703 DOI: 10.1177/10806032251337667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2025]
Abstract
Snakebites are a critical health issue in remote regions of the Amazon basin. I report a case of Bothrops bilineatus envenomation in a 29-y-old biologist conducting fieldwork in Parque Nacional del Manu, Peru. Following significant logistic delays-including an initial suboptimal antivenom dose and limited access to additional vials-the patient developed progressive edema, necrosis, coagulopathy, and signs of compartment syndrome. Management involved 2 partial doses of antivenom (1 at 1600 and the other at 2100), a subsequent transfer to a tertiary care center, antibiotics, analgesia, and eventually surgical intervention, including debridement and partial amputation. Although the patient received some treatment on the day of the bite, fragmented antivenom dosing and delayed transport likely contributed to worse local injury. This case highlights the importance of prompt, complete antivenom therapy, effective logistics, advanced diagnostic resources, and comprehensive rehabilitation in resource-limited settings.
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Melo PA, Nogueira-Souza PD, Romanelli MA, Strauch MA, Cesar MDO, Monteiro-Machado M, Patrão-Neto FC, Gonsalez SR, Siqueira NG, Schaeffer E, Costa PRR, da Silva AJM. Plant-Derived Lapachol Analogs as Selective Metalloprotease Inhibitors Against Bothrops Venom: A Review. Int J Mol Sci 2025; 26:3950. [PMID: 40362190 PMCID: PMC12071312 DOI: 10.3390/ijms26093950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2025] [Revised: 04/17/2025] [Accepted: 04/19/2025] [Indexed: 05/15/2025] Open
Abstract
Plant compounds that inhibit snake venom activities are relevant and can provide active molecules to counteract snake venom effects. Numerous studies on snake viperid venoms found that metalloproteinases play a significant role in the pathophysiology of hemorrhage that occurs on envenomation. Preclinical studies using vitro and in vivo protocols investigated natural compounds and viperid snake venoms, evaluating the enzymatic, procoagulant, hemorrhagic, edematogenic, myotoxic, and lethal activities. Many studies focused on Bothrops venoms and ascribed that angiorrhexis and hemorrhage resulted from the metalloproteinase action on collagen in the basal lamina. This effect resulted in a combined action with phospholipase A2 and hyaluronidase, inducing hemorrhage, edema, and necrosis. Due to the lack of efficient antivenoms in remote areas, traditional native plant treatments remain common, especially in the Amazon. Our group studied plant extracts, isolated compounds, and lapachol synthetic derivative analogs with selective inhibition for Bothrops venom proteolytic and hemorrhagic activity and devoid of phospholipase activity. We highlight those new synthetic naphthoquinones which inhibit snake venom metalloproteinases and that are devoid of other venom enzyme inhibition. This review shows the potential use of snake venom effects, mainly Bothrops venom metalloproteinase activity, as a tool to identify and develop new active molecules against hemorrhagic effects.
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Affiliation(s)
- Paulo A. Melo
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (P.D.N.-S.); (M.A.R.); (M.d.O.C.); (M.M.-M.); (F.C.P.-N.)
| | - Pâmella Dourila Nogueira-Souza
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (P.D.N.-S.); (M.A.R.); (M.d.O.C.); (M.M.-M.); (F.C.P.-N.)
| | - Mayara Amorim Romanelli
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (P.D.N.-S.); (M.A.R.); (M.d.O.C.); (M.M.-M.); (F.C.P.-N.)
| | - Marcelo A. Strauch
- Departamento de Ciências Fisiológicas, Instituto de Ciências Biológicas e da Saúde, Universidade Federal Rural do Rio de Janeiro, Seropédica 23890-000, Brazil;
| | - Marcelo de Oliveira Cesar
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (P.D.N.-S.); (M.A.R.); (M.d.O.C.); (M.M.-M.); (F.C.P.-N.)
- Instituto Vital Brazil, Niterói 24230-410, Brazil
| | - Marcos Monteiro-Machado
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (P.D.N.-S.); (M.A.R.); (M.d.O.C.); (M.M.-M.); (F.C.P.-N.)
| | - Fernando Chagas Patrão-Neto
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (P.D.N.-S.); (M.A.R.); (M.d.O.C.); (M.M.-M.); (F.C.P.-N.)
| | - Sabrina R. Gonsalez
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Campus Macaé, Rio de Janeiro 21941-901, Brazil;
| | - Nilton Ghiotti Siqueira
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Rio Branco 69920-900, Brazil;
| | - Edgar Schaeffer
- Instituto de Pesquisas de Produtos Naturais Walter Mors, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (E.S.); (P.R.R.C.); (A.J.M.d.S.)
| | - Paulo R. R. Costa
- Instituto de Pesquisas de Produtos Naturais Walter Mors, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (E.S.); (P.R.R.C.); (A.J.M.d.S.)
| | - Alcides J. M. da Silva
- Instituto de Pesquisas de Produtos Naturais Walter Mors, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil; (E.S.); (P.R.R.C.); (A.J.M.d.S.)
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Werner RM, Soffa AN. Considerations for the development of a field-based medical device for the administration of adjunctive therapies for snakebite envenoming. Toxicon X 2023; 20:100169. [PMID: 37661997 PMCID: PMC10474190 DOI: 10.1016/j.toxcx.2023.100169] [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: 05/31/2023] [Revised: 07/27/2023] [Accepted: 08/12/2023] [Indexed: 09/05/2023] Open
Abstract
The timely administration of antivenom is the most effective method currently available to reduce the burden of snakebite envenoming (SBE), a neglected tropical disease that most often affects rural agricultural global populations. There is increasing interest in the development of adjunctive small molecule and biologic therapeutics that target the most problematic venom components to bridge the time-gap between initial SBE and the administration antivenom. Unique combinations of these therapeutics could provide relief from the toxic effects of regional groupings of medically relevant snake species. The application a PRISMA/PICO literature search methodology demonstrated an increasing interest in the rapid administration of therapies to improve patient symptoms and outcomes after SBE. Advice from expert interviews and considerations regarding the potential routes of therapy administration, anatomical bite location, and species-specific venom delivery have provided a framework to identify ideal metrics and potential hurdles for the development of a field-based medical device that could be used immediately after SBE to deliver adjunctive therapies. The use of subcutaneous (SC) or intramuscular (IM) injection were identified as potential routes of administration of both small molecule and biologic therapies. The development of a field-based medical device for the delivery of adjunctive SBE therapies presents unique challenges that will require a collaborative and transdisciplinary approach to be successful.
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Cavalcante JS, de Almeida DEG, Santos-Filho NA, Sartim MA, de Almeida Baldo A, Brasileiro L, Albuquerque PL, Oliveira SS, Sachett JAG, Monteiro WM, Ferreira RS. Crosstalk of Inflammation and Coagulation in Bothrops Snakebite Envenoming: Endogenous Signaling Pathways and Pathophysiology. Int J Mol Sci 2023; 24:11508. [PMID: 37511277 PMCID: PMC10380640 DOI: 10.3390/ijms241411508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 07/30/2023] Open
Abstract
Snakebite envenoming represents a major health problem in tropical and subtropical countries. Considering the elevated number of accidents and high morbidity and mortality rates, the World Health Organization reclassified this disease to category A of neglected diseases. In Latin America, Bothrops genus snakes are mainly responsible for snakebites in humans, whose pathophysiology is characterized by local and systemic inflammatory and degradative processes, triggering prothrombotic and hemorrhagic events, which lead to various complications, organ damage, tissue loss, amputations, and death. The activation of the multicellular blood system, hemostatic alterations, and activation of the inflammatory response are all well-documented in Bothrops envenomings. However, the interface between inflammation and coagulation is still a neglected issue in the toxinology field. Thromboinflammatory pathways can play a significant role in some of the major complications of snakebite envenoming, such as stroke, venous thromboembolism, and acute kidney injury. In addition to exacerbating inflammation and cell interactions that trigger vaso-occlusion, ischemia-reperfusion processes, and, eventually, organic damage and necrosis. In this review, we discuss the role of inflammatory pathways in modulating coagulation and inducing platelet and leukocyte activation, as well as the inflammatory production mediators and induction of innate immune responses, among other mechanisms that are altered by Bothrops venoms.
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Affiliation(s)
- Joeliton S Cavalcante
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu 18618-687, São Paulo, Brazil
| | - Denis Emanuel Garcia de Almeida
- Department of Bioprocess and Biotechnology, School of Agriculture, Agronomic Sciences School, São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu 18618-687, São Paulo, Brazil
| | - Norival A Santos-Filho
- Institute of Chemistry, São Paulo State University (UNESP-Univ Estadual Paulista), Araraquara 14800-900, São Paulo, Brazil
| | - Marco Aurélio Sartim
- Laboratory of Bioprospection, University Nilton Lins, Manaus 69058-030, Amazonas, Brazil
- Research & Development Department, Nilton Lins Foundation, Manaus 69058-030, Amazonas, Brazil
- Graduate Program in Tropical Medicine, Department of Research at Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas State University, Manaus 69850-000, Amazonas, Brazil
| | - Amanda de Almeida Baldo
- Institute of Biosciences, São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu 18618-687, São Paulo, Brazil
| | - Lisele Brasileiro
- Graduate Program in Tropical Medicine, Department of Research at Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas State University, Manaus 69850-000, Amazonas, Brazil
| | - Polianna L Albuquerque
- Toxicological Information and Assistance Center, Instituto Doutor Jose Frota Hospital, Fortaleza 60025-061, Ceará, Brazil
- Faculty of Medicine, University of Fortaleza, Fortaleza 60430-140, Ceará, Brazil
| | - Sâmella S Oliveira
- Research Management, Hospital Foundation of Hematology and Hemotherapy of Amazonas, Manaus 69050-001, Amazonas, Brazil
| | - Jacqueline Almeida Gonçalves Sachett
- Research & Development Department, Nilton Lins Foundation, Manaus 69058-030, Amazonas, Brazil
- Graduate Program in Tropical Medicine, Department of Research at Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas State University, Manaus 69850-000, Amazonas, Brazil
| | - Wuelton Marcelo Monteiro
- Research & Development Department, Nilton Lins Foundation, Manaus 69058-030, Amazonas, Brazil
- Graduate Program in Tropical Medicine, Department of Research at Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas State University, Manaus 69850-000, Amazonas, Brazil
| | - Rui Seabra Ferreira
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu 18618-687, São Paulo, Brazil
- Center for Translational Science and Development of Biopharmaceuticals FAPESP/CEVAP-UNESP, Botucatu 18610-307, São Paulo, Brazil
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu 18610-307, São Paulo, Brazil
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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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Vera-Palacios AL, Sacoto-Torres JD, Hernández-Altamirano JA, Moreno A, Peñuela-Mora MC, Salazar-Valenzuela D, Mogollón NGS, Almeida JR. A First Look at the Inhibitory Potential of Urospatha sagittifolia (Araceae) Ethanolic Extract for Bothrops atrox Snakebite Envenomation. Toxins (Basel) 2022; 14:496. [PMID: 35878234 PMCID: PMC9315696 DOI: 10.3390/toxins14070496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 12/03/2022] Open
Abstract
Bothrops atrox snakebites are a relevant problem in the Amazon basin. In this biodiverse region, the ethnomedicinal approach plays an important role as an alternative to antivenom therapy. Urospatha sagittifolia (Araceae) is a plant used for this purpose; however, its neutralizing properties have not been scientifically accessed. To fill this gap, we investigated the ability of U. sagittifolia to modulate the catalytic activity of Bothrops atrox venom, and their toxic consequences, such as local damage and lethality. The venom profile of B. atrox was assessed by chromatography and electrophoresis. Inhibition of the three main enzymatic and medically important toxins from the venom was evaluated using synthetic substrates and quantified by chromogenic activity assays. Additionally, the neutralization of lethality, hemorrhage and edema were investigated by in vivo assays. The possible interactions between venom proteins and plant molecules were visualized by polyacrylamide gel electrophoresis. Finally, the phytochemical constituents present in the ethanolic extract were determined by qualitative and quantitative analyses. The ethanolic extract reduced the activity of the three main enzymes of venom target, achieving ranges from 19% to 81% of inhibition. Our in vivo venom neuralizations assays showed a significant inhibition of edema (38.72%) and hemorrhage (42.90%). Additionally, lethality was remarkably counteracted. The highest extract ratio evaluated had a 75% survival rate. Our data support the biomedical value of U. sagittifolia as a source of natural enzyme inhibitors able to neutralize catalytically active B. atrox venom toxins and their toxic effects.
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Affiliation(s)
- Antonio L. Vera-Palacios
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 8 Via Muyuna, Tena 150101, Ecuador; (A.L.V.-P.); (J.D.S.-T.); (J.A.H.-A.); (N.G.S.M.)
| | - Juan D. Sacoto-Torres
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 8 Via Muyuna, Tena 150101, Ecuador; (A.L.V.-P.); (J.D.S.-T.); (J.A.H.-A.); (N.G.S.M.)
| | - Josselin A. Hernández-Altamirano
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 8 Via Muyuna, Tena 150101, Ecuador; (A.L.V.-P.); (J.D.S.-T.); (J.A.H.-A.); (N.G.S.M.)
| | - Andres Moreno
- Facultad de Ingeniería en Sistemas, Electrónica e Industrial, Universidad Técnica de Ambato, Ambato 180207, Ecuador;
| | - Maria C. Peñuela-Mora
- Grupo de Ecosistemas Tropicales y Cambio Global, Universidad Regional Amazónica Ikiam, Km 8 Via Muyuna, Tena 150101, Ecuador;
| | - David Salazar-Valenzuela
- Centro de Investigación de la Biodiversidad y Cambio Climático (BioCamb) e Ingeniería en Biodiversidad y Recursos Genéticos, Facultad de Ciencias de Medio Ambiente, Universidad Tecnológica Indoamérica, Quito 180103, Ecuador;
| | - Noroska G. S. Mogollón
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 8 Via Muyuna, Tena 150101, Ecuador; (A.L.V.-P.); (J.D.S.-T.); (J.A.H.-A.); (N.G.S.M.)
| | - José R. Almeida
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 8 Via Muyuna, Tena 150101, Ecuador; (A.L.V.-P.); (J.D.S.-T.); (J.A.H.-A.); (N.G.S.M.)
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Review of the Mechanisms of Snake Venom Induced Pain: It's All about Location, Location, Location. Int J Mol Sci 2022; 23:ijms23042128. [PMID: 35216244 PMCID: PMC8879488 DOI: 10.3390/ijms23042128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 02/06/2023] Open
Abstract
Pain—acute, chronic and debilitating—is the most feared neurotoxicity resulting from a survivable venomous snake bite. The purpose of this review is to present in a novel paradigm what we know about the molecular mechanisms responsible for pain after envenomation. Progressing from known pain modulating peptides and enzymes, to tissue level interactions with venom resulting in pain, to organ system level pain syndromes, to geographical level distribution of pain syndromes, the present work demonstrates that understanding the mechanisms responsible for pain is dependent on “location, location, location”. It is our hope that this work can serve to inspire the molecular and epidemiologic investigations needed to better understand the neurotoxic mechanisms responsible for these snake venom mediated diverse pain syndromes and ultimately lead to agent specific treatments beyond anti-venom alone.
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Nascimento LS, Nogueira-Souza PD, Rocha-Junior JRS, Monteiro-Machado M, Strauch MA, Prado SAL, Melo PA, Veiga-Junior VF. Phytochemical composition, antisnake venom and antibacterial activities of ethanolic extract of Aegiphila integrifolia (Jacq) Moldenke leaves. Toxicon 2021; 198:121-131. [PMID: 33984369 DOI: 10.1016/j.toxicon.2021.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/30/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
Snakebites are considered a major neglected tropical disease, resulting in around 100,000 deaths per year. The recommended treatment by the WHO is serotherapy, which has limited effectiveness against the toxins involved in local tissue damage. In some countries, patients use plants from folk medicines as antivenoms. Aegiphila species are common plants from the Brazilian Amazon and are used to treat snakebites. In this study, leaves from Aegiphila integrifolia (Jacq) Moldenke were collected from Roraima state, Brazil and its ethanolic extract was evaluated through in vitro and in vivo experiments to verify their antiophidic activity against Bothrops atrox crude venom. The isolated compounds from A. integrifolia were analyzed and the chemical structures were elucidated on the basis of infrared, ultraviolet, mass, 1H and 1³C NMR spectrometry data. Among the described compounds, lupeol (7), betulinic acid (1), β-sitosterol (6), stigmasterol (5), mannitol (4), and the flavonoids, pectolinarigenin (2) and hispidulin (3), were identified. The ethanolic extract and flavonoids (2 and 3) partially inhibited the proteolytic, phospholipase A2 and hyaluronidase activities of B. atrox venom, and the skin hemorrhage induced by this venom in mice. Antimicrobial activity against different bacteria was evaluated and the extract partially inhibited bacterial growth. Thus, taken together, A. integrifolia ethanolic extract has promising use as an antiophidic and antimicrobial.
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Affiliation(s)
- Leandro S Nascimento
- Chemical Engineering Section, Military Institute of Engineering, Rio de Janeiro, RJ, Brazil
| | - Pâmella D Nogueira-Souza
- Federal University of Rio de Janeiro, Pharmacology and Medicinal Chemistry Program, Rio de Janeiro, RJ, Brazil
| | - José R S Rocha-Junior
- Federal University of Rio de Janeiro, Pharmacology and Medicinal Chemistry Program, Rio de Janeiro, RJ, Brazil
| | - Marcos Monteiro-Machado
- Federal University of Rio de Janeiro, Pharmacology and Medicinal Chemistry Program, Rio de Janeiro, RJ, Brazil
| | | | - Simone A L Prado
- Federal University of Roraima, Department of Chemistry, Boa Vista, RR, Brazil
| | - Paulo A Melo
- Federal University of Rio de Janeiro, Pharmacology and Medicinal Chemistry Program, Rio de Janeiro, RJ, Brazil
| | - Valdir F Veiga-Junior
- Chemical Engineering Section, Military Institute of Engineering, Rio de Janeiro, RJ, Brazil.
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9
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Pucca MB, Knudsen C, S. Oliveira I, Rimbault C, A. Cerni F, Wen FH, Sachett J, Sartim MA, Laustsen AH, Monteiro WM. Current Knowledge on Snake Dry Bites. Toxins (Basel) 2020; 12:E668. [PMID: 33105644 PMCID: PMC7690386 DOI: 10.3390/toxins12110668] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022] Open
Abstract
Snake 'dry bites' are characterized by the absence of venom being injected into the victim during a snakebite incident. The dry bite mechanism and diagnosis are quite complex, and the lack of envenoming symptoms in these cases may be misinterpreted as a miraculous treatment or as proof that the bite from the perpetrating snake species is rather harmless. The circumstances of dry bites and their clinical diagnosis are not well-explored in the literature, which may lead to ambiguity amongst treating personnel about whether antivenom is indicated or not. Here, the epidemiology and recorded history of dry bites are reviewed, and the clinical knowledge on the dry bite phenomenon is presented and discussed. Finally, this review proposes a diagnostic and therapeutic protocol to assist medical care after snake dry bites, aiming to improve patient outcomes.
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Affiliation(s)
- Manuela B. Pucca
- Medical School, Federal University of Roraima, Boa Vista 69310-000, Roraima, Brazil;
| | - Cecilie Knudsen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark; (C.K.); (C.R.); (A.H.L.)
- Bioporto Diagnostics A/S, DK-2900 Hellerup, Denmark
| | - Isadora S. Oliveira
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil; (I.S.O.); (F.A.C.)
| | - Charlotte Rimbault
- Department of Biotechnology and Biomedicine, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark; (C.K.); (C.R.); (A.H.L.)
| | - Felipe A. Cerni
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil; (I.S.O.); (F.A.C.)
| | - Fan Hui Wen
- Butantan Institute, São Paulo 05503-900, Brazil;
| | - Jacqueline Sachett
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus 69065-001, Amazonas, Brazil;
- Department of Teaching and Research, Alfredo da Matta Foundation, Manaus 69065-130, Amazonas, Brazil
| | - Marco A. Sartim
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus 69040-000, Amazonas, Brazil;
- Institute of Biological Sciences, Amazonas Federal University, Manaus 69067-005, Amazonas, Brazil
| | - Andreas H. Laustsen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark; (C.K.); (C.R.); (A.H.L.)
| | - Wuelton M. Monteiro
- Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus 69065-001, Amazonas, Brazil;
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus 69040-000, Amazonas, Brazil;
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