Fernando Chaves

Neutrophils do not contribute to local tissue damage, but play a key role in skeletal muscle regeneration, in mice injected with Bothrops asper snake venom.

Local tissue damage induced by crotaline snake venoms includes edema, myonecrosis, hemorrhage, and an inflammatory response associated with a prominent cellular infiltrate. The role of neutrophils in the local tissue damage induced by Bothrops asper snake venom and by myotoxin I, a phospholipase A2 isolated from this venom, was investigated. Male Swiss mice were pretreated with either an antimouse granulocyte rat monoclonal immunoglobulin G (IgG) antibody or with isotype‐matched control antibody. No significant differences in these local effects were observed between mice pretreated with antigranulocyte antibodies and those receiving control IgG. Moreover, myotoxicity induced by B. asper myotoxin I was similar in neutrophil‐depleted and control mice. The role of neutrophils in the process of skeletal muscle regeneration was also assessed. Muscle regeneration was assessed by quantifying the muscle levels of creatine kinase and by morphometric histological analysis of the area comprised by regenerating cells in damaged regions of skeletal muscle. Mice depleted of neutrophils and then injected with B. asper venom showed a more deficient regenerative response than mice pretreated with control IgG. Moreover, a drastic difference in the regenerative response was observed in mice injected with myotoxin I, because animals pretreated with control IgG showed a successful regeneration, whereas those depleted of neutrophils had abundant areas of necrotic tissue that had not been removed 7 days after injection, associated with reduced contents of creatine kinase. It is concluded that (1) neutrophils do not play a significant role in the acute local pathological alterations induced by the venom of B. asper, and (2) neutrophils play a prominent role in the process of skeletal muscle regeneration after injection of B. asper venom and myotoxin I, probably related to the phagocytosis of necrotic material and the recruitment of other inflammatory cells, two events directly associated with a successful muscle regenerative response. Muscle Nerve 28: 449–459, 2003

Inflammation induced by Bothrops asper venom.

Inflammation is a major characteristic of envenomation by snakes from viperine and crotaline species. Bothrops asper snake venom elicits, among other alterations, a pronounced inflammatory response at the site of injection both in humans and experimental animals. This review describes the current status of our understanding of the inflammatory reaction, including pain, triggered by Bothrops asper venom. The experimental studies on the action of this venom as well as the complex network of chemical mediators involved are summarized. Moreover, aspects of the molecular mechanisms orchestrating this important response to envenomation by Bothrops asper are presented. Considering that isolated toxins are relevant tools for understanding the actions of the whole venom, studies dealing with the mechanisms of inflammatory and nociceptive properties of phospholipases A(2), a metalloproteinase and serine-proteases isolated from Bothrops asper venom are also described.

Trends in Snakebite Envenomation Therapy: Scientific, Technological and Public Health Considerations

The therapy of snakebite envenomation has been based on the parenteral administration of animal-derived antivenoms. Despite the success of this treatment at reducing the impact of snakebite mortality and morbidity, mostly due to their capacity to neutralize systemically-acting toxins, antivenoms are of relatively low efficacy in the prevention of venom-induced local tissue damage, which often leads to permanent disability. The issue of safety also remains a concern, particularly for some antivenoms which induce a relatively high incidence of adverse reactions. Consequently, there is a need to improve the therapy of snakebite envenomations on the following lines: (a) the technologies to produce antivenoms require improvements aimed at obtaining more refined preparations of higher efficacy and safety, while being affordable for the public health systems of developing countries. (b) The growing knowledge on the biochemistry and toxicology of snake venoms should pave the way for the identification of natural and synthetic inhibitors of venom toxins, particularly of those involved in local tissue pathology. Such inhibitors might become a highly effective therapeutic tool for the abrogation of venom-induced local tissue damage. (c) A better knowledge of the inflammatory events secondary to venom actions may open the possibility of modulating such response, in order to prevent further tissue damage and to promote successful tissue repair and regeneration. A global partnership, involving many participants and combining scientific, technological and public health actions, is required to achieve a leap forward in the treatment of snakebite envenomations world-wide.

Neutralizacion de los efectos locales del veneno de Bothrops asper por un antiveneno polivalente

Abstract Neutralization of lethality, myonecrosis, hemorrhage and edema induced by Bothrops asper venom in mice was studied using the polyvalent antivenom produced in the Instituto Clodomiro Picado. The neutralizing effect ( ed 50 ) on each of these toxic activities varied; the neutralization of lethal and hemorrhagic effects being more effective than the neutralization of myonecrosis and edema. With independent inoculation of venom and antivenom, antivenom was not effective in neutralizing edema-forming activity. The myonecrotic effect was only partially neutralized when serum was given i.v. immediately after envenomation; however, antivenin effectively neutralized the hemorrhagic activity. The ineffectiveness of antivenom in neutralizing edema and myonecrosis could be partially explained by the rapid development of these effects. Hence, the time interval between envenomation and antivenom administration and the route of serum administration both play an important role in the neutralization of local effects.

Experimental pathology of local tissue damage induced by Bothrops asper snake venom

Envenomations by Bothrops asper are often associated with complex and severe local pathological manifestations, including edema, blistering, dermonecrosis, myonecrosis and hemorrhage. The pathogenesis of these alterations has been investigated at the experimental level. These effects are mostly the consequence of the direct action of zinc-dependent metalloproteinases (SVMPs) and myotoxic phospholipases A(2) (PLA(2)s). SVMPs induce hemorrhage, blistering, dermonecrosis and general extracellular matrix degradation, whereas PLA(2)s induce myonecrosis and also affect lymphatic vessels. In addition, the prominent vascular alterations leading to hemorrhage and edema may contribute to ischemia and further tissue necrosis. The mechanisms of action of SVMPs and PLA(2)s are discussed in detail in this review. Venom-induced tissue damage plays also a role in promoting bacterial infection. A prominent inflammatory reaction develops as a consequence of these local pathological alterations, with the synthesis and release of abundant mediators, resulting in edema and pain. However, whether inflammatory cells and mediators contribute to further tissue damage is not clear at present. Muscle tissue regeneration after venom-induced pathological effects is often impaired, thus resulting in permanent tissue loss and dysfunction. SVMP-induced microvessel damage is likely to be responsible of this poor regenerative outcome. Antivenoms are only partially effective in the neutralization of B. asper-induced local effects, and the search for novel toxin inhibitors represents a potential avenue for improving the treatment of this serious aspect of snakebite envenomation.

Pharmacological study of edema induced by venom of the snake Bothrops asper (terciopelo) in mice

The effect of several drugs on the edema-forming activity of Bothrops asper venom was studied plethysmographically using the mouse foot pad assay. Bothrops asper venom induced a dose-dependent edema which developed rapidly and peaked 1 hr after envenomation. Incubation of venom with EDTA before injection resulted in a significant reduction of edema. In addition, pretreatment with prazosin, indomethacin, dexamethasone, yohimbine and mepacrine resulted in a significant reduction in edema-forming activity. However, no inhibitory effect was observed when mice were pretreated with verapamil, nordihydroguaiaretic acid, pyrilamine, cimetidine and propranolol. When drugs were administered after venom injection, only prazosin and indomethacin were effective in reducing edema. These results suggest that B. asper venom-induced edema in the mouse foot pad model is mediated, at least partially, by metalloproteinases, phospholipase A2, eicosanoid products and activation of alpha 1 and alpha 2 adrenergic receptors.

Pharmacological activities of a toxic phospholipase A isolated from the venom of the snake Bothrops asper

A toxic phospholipase A was isolated from the venom of Bothrops asper. It induced skeletal muscle damage, anticoagulant effects and edema in the foot pad. The toxin had an intravenous LD50 of 95 micrograms/16-18 g mouse body wt and an intraventricular LD50 of 0.42 micrograms/16-18 g mouse body wt. Upon intramuscular and intravenous injections, the toxin induced a prominent increase in serum creatine kinase (CK) levels; only the CK-MM isozyme increased markedly. The toxin induced CK and creatine release from skeletal muscle incubated in vitro. The rate of efflux of creatine was higher than that of CK, although both markers were partially released as early as 15 min after incubation. The toxin also induced elevation of serum levels of lactic dehydrogenase isozymes. However, histological examination of skeletal muscle, kidneys, heart and lungs revealed cell damage only in skeletal muscle. The toxin was not cytotoxic to erythrocytes, lymphocytes or macrophages. In addition, it did not induce a mitogenic response on lymphocytes. In the absence of albumin in the medium, there was no significant difference between myotoxic activities in Ca2+-free and Ca2+-containing bathing solutions. However, when albumin was added, there was a significantly higher myotoxic effect in the presence of Ca2+. Thus, although phospholipolytic activity of the toxin plays a role in muscle damage when albumin is present, the toxin induces muscle damage even when phospholipase A activity is inhibited.

Pharmacological modulation of edema induced by Lys-49 and Asp-49 myotoxic phospholipases A2 isolated from the venom of the snake Bothrops asper (terciopelo)

The pharmacological modulation of edema-forming activity of Bothrops asper myotoxins II and III, Lys-49 and Asp-49 phospholipases A2, respectively, was studied plethysmographically in the mouse foot pad model. Myotoxin III had phospholipase A2 activity, whereas myotoxin II was devoid of enzymatic activity when tested on egg yolk phosphatidylcholine. Both toxins induced a dose-dependent edema of rapid onset. Chemical modification of myotoxin III with p-bromophenacyl bromide abrogated enzymatic activity and significantly reduced edemat-forming activity, although a residual effect remained. Pre-treatment of animals with diphenhydramine, dexamethasone, indomethacin and prazosin significantly reduced the effect of both myotoxins. It is concluded that (a) these myotoxins are important edema-forming components of B. asper venom, (b) enzymatic activity is not a strict requirement to exert this effect, although in the case of myotoxin III it contributes to its development, and (c) several inflammatory mediators participate in mouse foot pad edema induced by these myotoxins.

Efectos proteolitico, hemorragico y mionecrotico de los venenos de serpientes costarricenses de los generos Bothrops, Crotalus y Lachesis☆

Abstract We studied the proteolytic, hemorrhagic and myonecrotic activities of ten Costa Rican species of snakes from the family Viperidae. All of them showed these three activities but we did not observe any correlation between their relative magnitudes. The most myonecrotic venoms were Bothrops asper and B. schlegelii; the most hemorrhagic was B. picadoi and the strongest proteolytic activity using casein was in the venoms of B. godmani and B. lateralis. The lethality of these venoms correlated with the magnitude of tissue destruction observed microscopically. The histopathological analysis showed two kinds of necrosis: either a myolitic necrosis or a mixed necrosis, with both myolitic and coagulative areas. All the histological slides showed a strong hemorrhagic action, a polymorphonuclear leucocyte rich exudate and some vascular alterations such as angionecrosis and thrombosis.

Effects of neutrophil depletion in the local pathological alterations and muscle regeneration in mice injected with Bothrops jararaca snake venom

In order to study the role of neutrophils in the acute local pathological alterations induced by Bothrops jararaca snake venom, and in the process of skeletal muscle regeneration that follows, an experimental model was developed in mice pretreated with either an anti‐mouse granulocyte rat monoclonal immunoglobulin G, which induces a profound neutropenia, or an isotype‐matched control antibody. B. jararaca venom induced prominent haemorrhage and oedema, but only a moderate myonecrosis. No significant differences were observed in the extent of local haemorrhage, oedema and myonecrosis between neutropenic and control mice, suggesting that neutrophils do not play a determinant role in the acute pathological alterations induced by B. jararaca venom in this experimental model. Moreover, no differences were observed in skeletal muscle regeneration between these two experimental groups. In both the cases, limited areas of myonecrosis were associated with a drastic damage to the microvasculature and a scarce inflammatory infiltrate, with the consequent lack of removal of necrotic debris during the first week, resulting in a poor regenerative response at this time interval. Subsequently, a similar regenerative process occurred in both groups, and by 30 days, necrotic areas were substituted by groups of small regenerating muscle fibres. It is suggested that the drastic effect exerted by B. jararaca venom in the microvasculature precludes an effective access of inflammatory cells to necrotic areas, thereby compromising an effective removal of necrotic debris; this explains the poor regenerative response observed during the first week and the fact that there were no differences between neutropenic and control mice. As neutropenia in this model lasted only 7 days, the successful regenerative process observed at 30 days is associated with revascularization of necrotic regions and with a successful removal by phagocytes of necrotic debris in both groups.