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Ralph R, Garg D, Balachandran A, Ganesh SR, Lamb T. A case report of Ovophis monitcola (Mountain pit-viper) envenoming in northeastern India resulting in prolonged coagulopathy. Toxicon 2023; 229:107147. [PMID: 37127123 DOI: 10.1016/j.toxicon.2023.107147] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/03/2023]
Abstract
India is home to a diverse spectrum of medically-significant snakes accounting for the world's largest burden of envenoming, morbidity and mortality. Indian polyspecific antivenom is derived from the venom of four snake species (Daboia russelii, Echis carinatus, Naja naja and Bungarus caeruleus), considered to be responsible for the majority of snakebite morbidity and mortality. The treatment of venomous bites from other less-commonly encountered venomous snake species can be challenging. In this report, we describe the case of a 32-year-old male who presented with features of local cytotoxicity and coagulopathy following a bite from Ovophis monitcola (mountain pit-viper) in Nagaland, northeast India. Local and systemic envenoming, confirmed by bedside and laboratory based clotting assays, failed to respond to polyspecific antivenom and venom-induced consumption coagulopathy persisted for 28 days. Remote consultation with a national Poison Control Centre helped establish the responsible snake species and guide appropriate medical management.
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Affiliation(s)
- Ravikar Ralph
- Poison Control Center, Department of Medicine, Christian Medical College (CMC), Vellore, Tamil Nadu, 632004, India.
| | - Deepak Garg
- Medicine, Military Hospital, Dimapur, Nagaland, India; Medicine, Military Hospital, Jodhpur, Rajasthan, India
| | - Amith Balachandran
- Poison Control Center, Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - S R Ganesh
- Chennai Snake Park, Guindy, Chennai, Tamil Nadu, 600022, India
| | - Thomas Lamb
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Laos; Nuffield Department of Clinical Medicine, University of Oxford, India
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Tsai TS, Tsai IH. Full sequencing and comparison of five venom metalloproteases of Trimeresurus gracilis: The PI-enzyme is most similar to okinalysin but the PIII-enzyme is most similar to Crotalus venom enzymes. Toxicon 2023; 225:107053. [PMID: 36758773 DOI: 10.1016/j.toxicon.2023.107053] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
The cDNAs encoding the Zn+2-metalloproteases (SVMPs) of Trimeresurus gracilis (abbreviated as Tgc), a pitviper endemic to Taiwan, were cloned from venom glands and sequenced. The amino-acid sequences of five novel SVMPs, including one P-III, three P-II and one P-I class enzymes, were thus deduced and subjected to BLAST-analyses. The P-III enzyme (designated as Tgc-PIII) is structurally most similar to the PIII-SVMPs of New World pitvipers but not similar to the PIII-SVMP of Ovophis okinavensis. Sequence-similarity analysis of 22 homologous PIII-SVMPs reveal three major structural subtypes of the pitviper PIII-SVMPs, which possibly have different substrate specificities. In addition, Tgc-PIII and the PI-class SVMP (named Tgc-MP) were isolated from the venom and verified by mass spectrometry. All the three deduced sequences of PII-SVMPs (Tgc-PIIs) contain an abnormal Zn+2-binding-site in their catalytic-domain, and an identical "long-disintegrin" domain. The predicted 85-residues disintegrin, gracilisin, bears high similarities to some long-disintegrins of the New-World pitvipers and salmosin3. By BLAST search and comparison, Tgc-MP is 96% similar to okinalysin, the hemorrhagic PI-SVMP of O. okinavensis, rather than any other PI-SVMPs in the databanks. Our results confirm the fast evolution of Tgc-SVMPs as well as their structural similarities to different SVMP-classes of the New-World pitvipers and of O. okinavensis, respectively. The implications of our findings are discussed along with our previous sequence comparisons of venom phospholipases A2 and ten venom serine proteases of Tgc.
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Affiliation(s)
- Tein-Shun Tsai
- Department of Biological Science and Technology, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Inn-Ho Tsai
- Institute of Biological Chemistry, Academia Sinica, Taipei, Taiwan; Institute of Biochemical Sciences, National Taiwan University, Taipei, Taiwan.
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Luo Y, Mao YC, Liu PY, Chiang LC, Lai CS, Lin WL, Huang CC. Case Report: Management of an Uncommon Crotaline Snakebite (Ovophis makazayazaya). Am J Trop Med Hyg 2022; 107:tpmd220255. [PMID: 35914686 PMCID: PMC9490670 DOI: 10.4269/ajtmh.22-0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/22/2022] [Indexed: 11/07/2022] Open
Abstract
Ovophis makazayazaya bite is an uncommon cause of snakebite that humans may sustain as a result of the continuous overexploitation of forest habitats and excessive development in Taiwan. Although the Taiwanese government has produced four antivenoms against medically important snakebite accidents, O. makazayazaya is not among the snakes for which an antivenom has been produced. A case of O. makazayazaya snakebite on a patient's right foot, which later swelled into the hip, is reported. In vitro studies have reported that monovalent antivenoms for Gloydius brevicaudus and Trimeresurus albolabris, and polyvalent antivenom for Calloselasma rhodostoma, Daboia siamensis, and T. albolabris show reactivity toward Ovophis venoms. However, these antivenoms are unavailable in Taiwan. Thus, bivalent antivenom for Trimeresurus stejnegeri stejnegeri and Protobothrops mucrosquamatus was used, assuming similar immunoreactivity and a possible para-specific effect of green pit viper antivenom against this Ovophis venom. A favorable outcome was observed, without significant extension in prothrombin time and activated partial thromboplastin time. In addition, no systemic bleeding occurred. Nonetheless, further venom and antivenom evaluations should ascertain the efficacy of this para-specific antivenoms against this crotaline snakebite.
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Affiliation(s)
- Yi Luo
- Liuzhou Integrated Chinese and Western Medicine Snake Injury Treatment Center, Liuzhou Traditional Chinese Medicine Hospital, Liuzhou, Guangxi, China
| | - Yan-Chiao Mao
- Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Po-Yu Liu
- College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Division of Infection, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Liao-Chun Chiang
- Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- College of Medicine, National Chung Hsing University, Taichung, Taiwan
- National Tsing Hua University, College of Life Sciences, Hsinchu, Taiwan
| | - Chih-Sheng Lai
- College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wen-Loung Lin
- Taichung Wildlife Conservation Group, Taichung, Taiwan
| | - Chia-Chun Huang
- Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- College of Medicine, National Chung Hsing University, Taichung, Taiwan
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Sahyoun C, Rima M, Mattei C, Sabatier J, Fajloun Z, Legros C. Separation and Analytical Techniques Used in Snake Venomics: A Review Article. Processes (Basel) 2022; 10:1380. [DOI: 10.3390/pr10071380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The deleterious consequences of snake envenomation are due to the extreme protein complexity of snake venoms. Therefore, the identification of their components is crucial for understanding the clinical manifestations of envenomation pathophysiology and for the development of effective antivenoms. In addition, snake venoms are considered as libraries of bioactive molecules that can be used to develop innovative drugs. Numerous separation and analytical techniques are combined to study snake venom composition including chromatographic techniques such as size exclusion and RP-HPLC and electrophoretic techniques. Herein, we present in detail these existing techniques and their applications in snake venom research. In the first part, we discuss the different possible technical combinations that could be used to isolate and purify SV proteins using what is known as bioassay-guided fractionation. In the second part, we describe four different proteomic strategies that could be applied for venomics studies to evaluate whole venom composition, including the mostly used technique: RP-HPLC. Eventually, we show that to date, there is no standard technique used for the separation of all snake venoms. Thus, different combinations might be developed, taking into consideration the main objective of the study, the available resources, and the properties of the target molecules to be isolated.
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