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Cavalcante TTA, de Souza MBS, Neves JCF, Ibiapina HNS, Barbosa FBA, Bentes KO, Alves EC, Marques HO, Colombini M, Sampaio SV, Pucca MB, da Silva IM, Ferreira LCDL, Sampaio VDS, Moura-da-Silva AM, Costa AG, Monteiro WM, Sachett JAG, Sartim MA. Inflammatory Profile Associated with Secondary Infection from Bothrops atrox Snakebites in the Brazilian Amazon. Toxins (Basel) 2023; 15:524. [PMID: 37755950 PMCID: PMC10537699 DOI: 10.3390/toxins15090524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
Bothrops snakebite envenomation (SBE) is consider an important health problem in Brazil, where Bothrops atrox is mainly responsible in the Brazilian Amazon. Local effects represent a relevant clinical issue, in which inflammatory signs and symptoms in the bite site represent a potential risk for short and long-term disabilities. Among local complications, secondary infections (SIs) are a common clinical finding during Bothrops atrox SBE and are described by the appearance of signs such as abscess, cellulitis or necrotizing fasciitis in the affected site. However, the influence of SI in the local events is still poorly understood. Therefore, the present study describes for the first time the impact of SBE wound infection on local manifestations and inflammatory response from patients of Bothrops atrox SBE in the Brazilian Amazon. This was an observational study carried out at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus (Brazil), involving victims of Bothrops SBE. Clinical and laboratorial data were collected along with blood samples for the quantification of circulating cytokines and chemokines before antivenom administrations (T0) and 24 h (T1), 48 h (T2), 72 h (T3) and 7 days after (T4). From the 94 patients included in this study, 42 presented SI (44.7%) and 52 were without SI (NSI, 55.3%). Patients classified as moderate envenoming presented an increased risk of developing SI (OR = 2.69; CI 95% = 1.08-6.66, p = 0.033), while patients with bites in hands showed a lower risk (OR = 0.20; CI 95% = 0.04-0.96, p = 0.045). During follow-up, SI patients presented a worsening of local temperature along with a sustained profile of edema and pain, while NSI patients showed a tendency to restore and were highlighted in patients where SI was diagnosed at T2. As for laboratorial parameters, leukocytes, erythrocyte sedimentation ratio, fibrinogen and C-reactive protein were found increased in patients with SI and more frequently in patients diagnosed with SI at T3. Higher levels of circulating IL-2, IL-10, IL-6, TNF, INF-γ and CXCL-10 were observed in SI patients along with marked correlations between these mediators and IL-4 and IL-17, showing a plurality in the profile with a mix of Th1/Th2/Th17 response. The present study reports for the first time the synergistic effects of local infection and envenoming on the inflammatory response represented by local manifestations, which reflected on laboratorial parameters and inflammatory mediators and thus help improve the clinical management of SI associated to Bothrops SBE.
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Affiliation(s)
- Távila Tatiane Amorim Cavalcante
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas-UFAM, Manaus 69080-900, Brazil
| | | | - Juliana Costa Ferreira Neves
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
| | | | | | - Karolaine Oliveira Bentes
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
| | - Eliane Campos Alves
- Instituto Federal de Educação, Ciência e Tecnologia do Amazonas-IFAM, Manaus 69025-010, Brazil
| | - Hedylamar Oliveira Marques
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas-HEMOAM, Manaus 69050-001, Brazil
| | - Monica Colombini
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, Brazil
| | - Suely Vilela Sampaio
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo-USP, Ribeirão Preto 14040-903, Brazil
| | - Manuela Berto Pucca
- Curso de Medicina, Universidade Federal de Roraima-UFRR, Boa Vista 69310-000, Brazil
- Departamento de Análises Clínicas, Faculdade de Ciências Farmacêuticas, Universidaed Estadual Paulista-UNESP, Araraquara 14800-903, Brazil
| | - Iran Mendonça da Silva
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado–FMT-HVD, Manaus 69040-000, Brazil
| | - Luiz Carlos de Lima Ferreira
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado–FMT-HVD, Manaus 69040-000, Brazil
| | - Vanderson de Souza Sampaio
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado–FMT-HVD, Manaus 69040-000, Brazil
| | | | - Allyson Guimarães Costa
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas-UFAM, Manaus 69080-900, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas-HEMOAM, Manaus 69050-001, Brazil
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado–FMT-HVD, Manaus 69040-000, Brazil
| | - Wuelton Marcelo Monteiro
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado–FMT-HVD, Manaus 69040-000, Brazil
| | - Jacqueline Almeida Gonçalves Sachett
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado–FMT-HVD, Manaus 69040-000, Brazil
| | - Marco Aurélio Sartim
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas-UFAM, Manaus 69080-900, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas-UEA, Manaus 69040-000, Brazil (J.A.G.S.)
- Pró-Reitoria de Pesquisa e Pós-Graduação, Universidade Nilton Lins, Manaus 69058-030, Brazil
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Senthilkumaran S, Patel K, Rajan E, Vijayakumar P, Miller SW, Rucavado A, Gilabadi S, Sonavane M, Richards NJ, Williams J, Williams HF, Trim SA, Thirumalaikolundusubramanian P, Gutiérrez JM, Vaiyapuri S. Peripheral Arterial Thrombosis following Russell's Viper Bites. TH Open 2023; 7:e168-e183. [PMID: 37333023 PMCID: PMC10276757 DOI: 10.1055/s-0043-1769625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/05/2023] [Indexed: 06/20/2023] Open
Abstract
Envenomings by Russell's viper ( Daboia russelii ), a species of high medical importance in India and other Asian countries, commonly result in hemorrhage, coagulopathies, necrosis, and acute kidney injury. Although bleeding complications are frequently reported following viper envenomings, thrombotic events occur rarely (reported only in coronary and carotid arteries) with serious consequences. For the first time, we report three serious cases of peripheral arterial thrombosis following Russell's viper bites and their diagnostic, clinical management, and mechanistic insights. These patients developed occlusive thrombi in their peripheral arteries and symptoms despite antivenom treatment. In addition to clinical features, computed tomography angiography was used to diagnose arterial thrombosis and ascertain its precise locations. They were treated using thrombectomy or amputation in one case that presented with gangrenous digits. Mechanistic insights into the pathology through investigations revealed the procoagulant actions of Russell's viper venom in standard clotting tests as well as in rotational thromboelastometry analysis. Notably, Russell's viper venom inhibited agonist-induced platelet activation. The procoagulant effects of Russell's viper venom were inhibited by a matrix metalloprotease inhibitor, marimastat, although a phospholipase A 2 inhibitor (varespladib) did not show any inhibitory effects. Russell's viper venom induced pulmonary thrombosis when injected intravenously in mice and thrombi in the microvasculature and affected skeletal muscle when administered locally. These data emphasize the significance of peripheral arterial thrombosis in snakebite victims and provide awareness, mechanisms, and robust strategies for clinicians to tackle this issue in patients.
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Affiliation(s)
| | - Ketan Patel
- School of Biological Sciences, University of Reading, Reading, United Kingdom
| | | | | | - Stephen W. Miller
- The Poison Control Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Alexandra Rucavado
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Soheil Gilabadi
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Medha Sonavane
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | | | - Jarred Williams
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | | | | | | | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
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de Oliveira AK, Pramoonjago P, Rucavado A, Moskaluk C, Silva DT, Escalante T, Gutiérrez JM, Fox JW. Mapping the Immune Cell Microenvironment with Spatial Profiling in Muscle Tissue Injected with the Venom of Daboia russelii. Toxins (Basel) 2023; 15:toxins15030208. [PMID: 36977099 PMCID: PMC10057198 DOI: 10.3390/toxins15030208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
Pathological and inflammatory events in muscle after the injection of snake venoms vary in different regions of the affected tissue and at different time intervals. In order to study such heterogeneity in the immune cell microenvironment, a murine model of muscle necrosis based on the injection of the venom of Daboia russelii was used. Histological and immunohistochemical methods were utilized to identify areas in muscle tissue with a different extent of muscle cell damage, based on the presence of hypercontracted muscle cells, a landmark of necrosis, and on the immunostaining for desmin. A gradient of inflammatory cells (neutrophils and macrophages) was observed from heavily necrotic areas to less damaged and non-necrotic areas. GeoMx® Digital Spatial Profiler (NanoString, Seattle, WA, USA) was used for assessing the presence of markers of various immune cells by comparing high-desmin (nondamaged) and low-desmin (damaged) regions of muscle. Markers of monocytes, macrophages, M2 macrophages, dendritic cells, neutrophils, leukocyte adhesion and migration markers, and hematopoietic precursor cells showed higher levels in low-desmin regions, especially in samples collected 24 hr after venom injection, whereas several markers of lymphocytes did not. Moreover, apoptosis (BAD) and extracellular matrix (fibronectin) markers were also increased in low-desmin regions. Our findings reveal a hitherto-unknown picture of immune cell microheterogeneity in venom-injected muscle which greatly depends on the extent of muscle cell damage and the time lapse after venom injection.
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Affiliation(s)
- Ana K. de Oliveira
- School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | | | - Alexandra Rucavado
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501, Costa Rica
| | | | - Dilza T. Silva
- School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Teresa Escalante
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501, Costa Rica
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501, Costa Rica
| | - Jay W. Fox
- School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
- Correspondence:
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Gonçalves-Machado L, Verçoza BRF, Nogueira FCS, Melani RD, Domont GB, Rodrigues SP, Rodrigues JCF, Zingali RB. Extracellular Vesicles from Bothrops jararaca Venom Are Diverse in Structure and Protein Composition and Interact with Mammalian Cells. Toxins (Basel) 2022; 14:toxins14110806. [PMID: 36422980 PMCID: PMC9698812 DOI: 10.3390/toxins14110806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Snake venoms are complex cocktails of non-toxic and toxic molecules that work synergistically for the envenoming outcome. Alongside the immediate consequences, chronic manifestations and long-term sequelae can occur. Recently, extracellular vesicles (EVs) were found in snake venom. EVs mediate cellular communication through long distances, delivering proteins and nucleic acids that modulate the recipient cell's function. However, the biological roles of snake venom EVs, including possible cross-organism communication, are still unknown. This knowledge may expand the understanding of envenoming mechanisms. In the present study, we isolated and characterized the EVs from Bothrops jararaca venom (Bj-EVs), giving insights into their biological roles. Fresh venom was submitted to differential centrifugation, resulting in two EV populations with typical morphology and size range. Several conserved EV markers and a subset of venom related EV markers, represented mainly by processing enzymes, were identified by proteomic analysis. The most abundant protein family observed in Bj-EVs was 5'-nucleotidase, known to be immunosuppressive and a low abundant and ubiquitous toxin in snake venoms. Additionally, we demonstrated that mammalian cells efficiently internalize Bj-EVs. The commercial antibothropic antivenom partially recognizes Bj-EVs and inhibits cellular EV uptake. Based on the proteomic results and the in vitro interaction assays using macrophages and muscle cells, we propose that Bj-EVs may be involved not only in venom production and processing but also in host immune modulation and long-term effects of envenoming.
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Affiliation(s)
- Larissa Gonçalves-Machado
- Laboratório de Hemostase e Venenos, Instituto de Bioquímica Médica Leopoldo de Meis (IBqM), Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem (Inbeb), Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
- Instituto Vital Brazil, Gerência de Desenvolvimento Tecnológico, Niterói 24230-410, Brazil
| | - Brunno Renato Farias Verçoza
- Núcleo Multidisciplinar de Pesquisa em Biologia (NUMPEX-Bio), Universidade Federal do Rio de Janeiro, Campus UFRJ Duque de Caxias, Duque de Caxias, Rio de Janeiro 25240-005, Brazil
| | - Fábio César Sousa Nogueira
- Laboratório de Química de Proteínas, Unidade Proteômica, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-909, Brazil
- Laboratório de Proteômica (LabProt)—LADETEC, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-598, Brazil
| | - Rafael Donadélli Melani
- Laboratório de Química de Proteínas, Unidade Proteômica, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-909, Brazil
| | - Gilberto Barbosa Domont
- Laboratório de Química de Proteínas, Unidade Proteômica, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-909, Brazil
| | - Silas Pessini Rodrigues
- Núcleo Multidisciplinar de Pesquisa em Biologia (NUMPEX-Bio), Universidade Federal do Rio de Janeiro, Campus UFRJ Duque de Caxias, Duque de Caxias, Rio de Janeiro 25240-005, Brazil
| | - Juliany Cola Fernandes Rodrigues
- Núcleo Multidisciplinar de Pesquisa em Biologia (NUMPEX-Bio), Universidade Federal do Rio de Janeiro, Campus UFRJ Duque de Caxias, Duque de Caxias, Rio de Janeiro 25240-005, Brazil
| | - Russolina Benedeta Zingali
- Laboratório de Hemostase e Venenos, Instituto de Bioquímica Médica Leopoldo de Meis (IBqM), Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem (Inbeb), Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
- Correspondence: ; Tel.: +55-2139386782
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Wase N, Gutiérrez JM, Rucavado A, Fox JW. Longitudinal Metabolomics and Lipidomics Analyses Reveal Alterations Associated with Envenoming by Bothrops asper and Daboia russelii in an Experimental Murine Model. Toxins (Basel) 2022; 14:657. [PMID: 36287926 PMCID: PMC9610966 DOI: 10.3390/toxins14100657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 12/26/2023] Open
Abstract
Longitudinal metabolomics and lipidomics analyses were carried out on the blood plasma of mice injected intramuscularly with venoms of the viperid species Bothrops asper or Daboia russelii. Blood samples were collected 1, 3, 6, and 24 h after venom injection, and a control group of non-envenomed mice was included. Significant perturbations in metabolomics and lipidomics were observed at 1, 3, and 6 h, while values returned close to those of control mice by 24 h, hence reflecting a transient pattern of metabolic disturbance. Both venoms induced significant changes in amino acids, as well as in several purines and pyrimidines, and in some metabolites of the tricarboxylic acid cycle. KEGG analysis of metabolic pathways that showed those with the greatest change included aminoacyl tRNA synthesis and amino acid biosynthesis and metabolism pathways. With regard to lipid metabolism, there was an increase in triglycerides and some acyl carnitines and a concomitant drop in the levels of some phospholipids. In addition, envenomed mice had higher levels of cortisol, heme, and some oxidative stress markers. The overall pattern of metabolic changes in envenomed mice bears similarities with the patterns described in several traumatic injuries, thus underscoring a metabolic response/adaptation to the injurious action of the venoms.
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Affiliation(s)
- Nishikant Wase
- School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501, Costa Rica
| | - Alexandra Rucavado
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501, Costa Rica
| | - Jay W. Fox
- School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
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Gimenes SNC, Sachett JAG, Colombini M, Freitas-de-Sousa LA, Ibiapina HNS, Costa AG, Santana MF, Park JJ, Sherman NE, Ferreira LCL, Wen FH, Monteiro WM, Moura-da-Silva AM, Fox JW. Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights. Toxins (Basel) 2021; 13:toxins13110800. [PMID: 34822585 PMCID: PMC8618272 DOI: 10.3390/toxins13110800] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
In the Brazilian Amazon, Bothrops atrox snakebites are frequent, and patients develop tissue damage with blisters sometimes observed in the proximity of the wound. Antivenoms do not seem to impact blister formation, raising questions regarding the mechanisms underlying blister formation. Here, we launched a clinical and laboratory-based study including five patients who followed and were treated by the standard clinical protocols. Blister fluids were collected for proteomic analyses and molecular assessment of the presence of venom and antivenom. Although this was a small patient sample, there appeared to be a correlation between the time of blister appearance (shorter) and the amount of venom present in the serum (higher). Of particular interest was the biochemical identification of both venom and antivenom in all blister fluids. From the proteomic analysis of the blister fluids, all were observed to be a rich source of damage-associated molecular patterns (DAMPs), immunomodulators, and matrix metalloproteinase-9 (MMP-9), suggesting that the mechanisms by which blisters are formed includes the toxins very early in envenomation and continue even after antivenom treatment, due to the pro-inflammatory molecules generated by the toxins in the first moments after envenomings, indicating the need for local treatments with anti-inflammatory drugs plus toxin inhibitors to prevent the severity of the wounds.
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Affiliation(s)
- Sarah N. C. Gimenes
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
| | - Jacqueline A. G. Sachett
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Dermatologia Alfredo da Matta, Manaus 69065-130, AM, Brazil
| | - Mônica Colombini
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
| | - Luciana A. Freitas-de-Sousa
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
| | - Hiochelson N. S. Ibiapina
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
| | - Allyson G. Costa
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Hematologia e Hemoterapia do Amazonas, Manaus 69040-010, AM, Brazil
| | - Monique F. Santana
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
- Departamento de Ensino e Pesquisa, Fundação de Hematologia e Hemoterapia do Amazonas, Manaus 69040-010, AM, Brazil
| | - Jeong-Jin Park
- School of Medicine, University of Virginia, Charlottesville, VA 22903, USA; (J.-J.P.); (N.E.S.)
| | - Nicholas E. Sherman
- School of Medicine, University of Virginia, Charlottesville, VA 22903, USA; (J.-J.P.); (N.E.S.)
| | - Luiz C. L. Ferreira
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
| | - Fan H. Wen
- Núcleo de Produção de Soros, Instituto Butantan, São Paulo 05503-900, SP, Brazil;
| | - Wuelton M. Monteiro
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
| | - Ana M. Moura-da-Silva
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
- Correspondence: (A.M.M.-d.-S.); (J.W.F.)
| | - Jay W. Fox
- School of Medicine, University of Virginia, Charlottesville, VA 22903, USA; (J.-J.P.); (N.E.S.)
- Correspondence: (A.M.M.-d.-S.); (J.W.F.)
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de Oliveira NA, Cardoso SC, Barbosa DA, da Fonseca CD. Acute kidney injury caused by venomous animals: inflammatory mechanisms. J Venom Anim Toxins Incl Trop Dis 2021; 27:20200189. [PMID: 34512738 PMCID: PMC8394371 DOI: 10.1590/1678-9199-jvatitd-2020-0189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/15/2021] [Indexed: 01/06/2023] Open
Abstract
Either bites or stings of venomous animals comprise relevant public health problems in tropical countries. Acute kidney injury (AKI) induced by animal toxins is related to worse prognostic and outcomes. Being one the most important pathways to induce AKI following envenoming due to animal toxins, inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. However, direct nephrotoxicity (i.e. apoptotic and necrotic mechanisms of toxins), pigmenturia (i.e. rhabdomyolysis and hemolysis), anaphylactic reactions, and coagulopathies could contribute to the renal injury. All these mechanisms are closely integrated, but inflammation is a distinct process. Hence, it is important to improve our understanding on inflammation mechanisms of these syndromes to provide a promising outlook to reduce morbidity and mortality. This literature review highlights the main scientific evidence of acute kidney injury induced by bites or stings from venomous animals and their inflammatory mechanisms. It included observational, cross-sectional, case-control and cohort human studies available up to December 2019. Descriptors were used according to Medical Subject Headings (MeSH), namely: “Acute kidney injury” or “Venom” and “Inflammation” on Medline/Pubmed and Google Scholar; “Kidney disease” or “Acute kidney injury” on Lilacs and SciELO. The present review evidenced that, among the described forms of renal inflammation, it can occur either directly or indirectly on renal cells by means of intravascular, systemic and endothelial hemolysis, activation of inflammatory pathway, as well as direct action of venom cytotoxic components on kidney structures.
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Affiliation(s)
- Naila Albertina de Oliveira
- Department of Nursing, Institute of Health Sciences, Paulista University (Unip), Jundiaí, SP, Brazil.,Graduate Program in Nursing, School of Nursing, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil
| | | | - Dulce Aparecida Barbosa
- Department of Clinical and Surgical Nursing, School of Nursing, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Cassiane Dezoti da Fonseca
- Department of Clinical and Surgical Nursing, School of Nursing, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil
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Soeiro PA, Romanelli MA, Cesar MO, Nogueira-Souza PD, Monteiro-Machado M, Oliveira SSC, Santos ALS, Melo PA, Lara LS. Doxycycline treatment reestablishes renal function of Wistar rats in experimental envenomation with Bothrops jararacussu venom. Toxicon 2021; 199:20-30. [PMID: 34058237 DOI: 10.1016/j.toxicon.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/12/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
Acute kidney injury is one of the main complications of ophidian accidents and the leading cause of death in patients who survive the initial damage effects of venom. The hypothesis proposed in this investigation is that the pharmacological repositioning of doxycycline (doxy) attenuates renal injury provoked by Bothrops jararacussu (Bj) venom. Male Wistar rats were subjected or not (control) to experimental envenomation with Bj venom (3.5 mg/kg, im). Doxy (3 mg/kg, ip) was administered 2 h after envenoming. Envenomation with Bj venom promoted tissue damage in the renal cortex (moderate degree, score 3) in 24 h associated with decreased glomerular and tubular function, which promoted proteinuria and polyuria. Doxy treatment prevented the increase in urinary volume in 3 times, the increase in plasma creatinine in 33%, the increase in blood urea-nitrogen accumulation in 65%, the increase in urinary Na+ excretion in 2 times, marked proteinuria and kidney cortex injury induced by Bj envenomation. Bj venom promoted increase in protein content (66%) and reduction of 45% (Na++K+)-ATPase activity in the renal cortex. The enzyme was detected mainly in the luminal membrane. Doxy treatment was effective in preventing the mentioned alterations, maintaining (Na++K+)-ATPase in the basolateral membranes.
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