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Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights

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 la...

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Autores principales: Gimenes, Sarah N. C., Sachett, Jacqueline A. G., Colombini, Mônica, Freitas-de-Sousa, Luciana A., Ibiapina, Hiochelson N. S., Costa, Allyson G., Santana, Monique F., Park, Jeong-Jin, Sherman, Nicholas E., Ferreira, Luiz C. L., Wen, Fan H., Monteiro, Wuelton M., Moura-da-Silva, Ana M., Fox, Jay W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618272/
https://www.ncbi.nlm.nih.gov/pubmed/34822585
http://dx.doi.org/10.3390/toxins13110800
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author Gimenes, Sarah N. C.
Sachett, Jacqueline A. G.
Colombini, Mônica
Freitas-de-Sousa, Luciana A.
Ibiapina, Hiochelson N. S.
Costa, Allyson G.
Santana, Monique F.
Park, Jeong-Jin
Sherman, Nicholas E.
Ferreira, Luiz C. L.
Wen, Fan H.
Monteiro, Wuelton M.
Moura-da-Silva, Ana M.
Fox, Jay W.
author_facet Gimenes, Sarah N. C.
Sachett, Jacqueline A. G.
Colombini, Mônica
Freitas-de-Sousa, Luciana A.
Ibiapina, Hiochelson N. S.
Costa, Allyson G.
Santana, Monique F.
Park, Jeong-Jin
Sherman, Nicholas E.
Ferreira, Luiz C. L.
Wen, Fan H.
Monteiro, Wuelton M.
Moura-da-Silva, Ana M.
Fox, Jay W.
author_sort Gimenes, Sarah N. C.
collection PubMed
description 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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spelling pubmed-86182722021-11-27 Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights Gimenes, Sarah N. C. Sachett, Jacqueline A. G. Colombini, Mônica Freitas-de-Sousa, Luciana A. Ibiapina, Hiochelson N. S. Costa, Allyson G. Santana, Monique F. Park, Jeong-Jin Sherman, Nicholas E. Ferreira, Luiz C. L. Wen, Fan H. Monteiro, Wuelton M. Moura-da-Silva, Ana M. Fox, Jay W. Toxins (Basel) Article 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. MDPI 2021-11-13 /pmc/articles/PMC8618272/ /pubmed/34822585 http://dx.doi.org/10.3390/toxins13110800 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gimenes, Sarah N. C.
Sachett, Jacqueline A. G.
Colombini, Mônica
Freitas-de-Sousa, Luciana A.
Ibiapina, Hiochelson N. S.
Costa, Allyson G.
Santana, Monique F.
Park, Jeong-Jin
Sherman, Nicholas E.
Ferreira, Luiz C. L.
Wen, Fan H.
Monteiro, Wuelton M.
Moura-da-Silva, Ana M.
Fox, Jay W.
Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_full Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_fullStr Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_full_unstemmed Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_short Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_sort observation of bothrops atrox snake envenoming blister formation from five patients: pathophysiological insights
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618272/
https://www.ncbi.nlm.nih.gov/pubmed/34822585
http://dx.doi.org/10.3390/toxins13110800
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